NAD+
Also known as Nicotinamide Adenine Dinucleotide
A coenzyme (not a peptide) central to metabolism, marketed for longevity with limited human outcome data.
Medically reviewed by Dr. Jonathan Snipes, MD
Reviewed for clinical accuracy · Last reviewed July 22, 2026 · Review policy
Quick answer
NAD+ is a coenzyme (not a peptide) essential to energy metabolism and cellular repair, and levels decline with age. It is marketed via IV, injection, and precursors for longevity and energy, but human outcome evidence for most anti-aging claims is limited. It is sold as a supplement or compounded, not as an FDA-approved drug.
- Type
- Coenzyme (dinucleotide), not a peptide
- FDA status
- Supplement / compounded; not an approved drug
- Route
- IV, subcutaneous, nasal, oral precursors
- Evidence grade
- C (Emerging Human Data)
- Banned in sport
- No
Key takeaways
- →NAD+ is a coenzyme central to energy production and DNA repair, and it is not a peptide.
- →Its levels fall with age, which is the basis of interest in restoring it for longevity and energy.
- →Human evidence for most anti-aging and performance claims is limited; much is preclinical or mechanistic.
- →It is sold as IV therapy, injections, and oral precursors (NR, NMN), not as an FDA-approved drug.
NAD+ appears frequently alongside peptides in longevity marketing, so it is worth including here with one clarification: it is not a peptide. It is a coenzyme, a small molecule essential to how cells produce energy and repair DNA. The interest is real biology, NAD+ declines with age, but the leap from that fact to the marketed benefits of IV drips and injections outpaces the human evidence.
How NAD+ works
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in energy metabolism, mitochondrial function, and the activity of repair enzymes like sirtuins and PARPs. Restoring NAD+ (directly or via precursors such as NR and NMN) is proposed to support cellular health. Much of the supporting work is preclinical or mechanistic; robust human outcome trials for anti-aging endpoints are limited.
What the evidence shows, by use
Each use is graded on the same A-E scale, based on human-trial quality rather than popularity.
Energy, longevity, general wellness
CEmerging Human DataStrong mechanistic rationale and some early human studies of precursors, but limited controlled evidence for the marketed anti-aging outcomes.
Specific clinical conditions
CEmerging Human DataStudied in select conditions with mixed results; not an approved treatment.
Dosing
NAD+ is delivered as IV infusions, subcutaneous injections, nasal sprays, and oral precursors, with no standardized medical dosing. IV NAD+ in particular can cause uncomfortable infusion reactions if given too fast. Any injectable or IV use should be under clinical supervision.
Side effects
- •Flushing, warmth, or nausea (IV, infusion-rate related) · Common
- •Chest or abdominal tightness during IV · Less common
- •Injection-site reactions · Reported
- •Headache · Reported
Legal & regulatory status
NAD+ and its precursors are sold as supplements or compounded IV/injectable therapies. NAD+ itself is not an FDA-approved drug.
Is NAD+legal? Full regulatory status →Where to get it: TeleRanked independently ranks the telehealth providers that offer clinician-prescribed peptides. See our Longevity & Anti-Aging rankings. We rank providers, we do not sell compounds, and rankings are never for sale.
Frequently asked questions
Is NAD+ a peptide?+
No. NAD+ is a coenzyme (a dinucleotide), not a peptide. It is grouped with peptides mainly in longevity marketing.
Does NAD+ therapy work for anti-aging?+
The underlying biology is real and NAD+ declines with age, but controlled human evidence for the marketed anti-aging and energy benefits is limited.
Why does IV NAD+ feel uncomfortable?+
Infusion reactions (flushing, nausea, chest tightness) are related to how fast NAD+ is given and typically ease when the infusion is slowed.
How we grade evidence
Grade C: Emerging Human Data. Early or small human studies exist; results are preliminary and not yet confirmed at scale. Our A-E scale reflects the strength of human evidence, not how popular a compound is.
Sources
- 1.Compounding and the FDA: Questions and Answers · U.S. Food & Drug Administration