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Peptides / NAD+

Can be compoundedCoenzyme (not strictly a peptide)Not FDA approved

NAD+

NAD+ (nicotinamide adenine dinucleotide) is a molecule every cell uses to turn food into energy and to repair DNA. Strictly speaking it is a coenzyme, not a peptide, but it is sold through the same clinics. Levels fall with age, which is why it is offered as an anti-aging drip or injection.

Used for
Energy, anti-aging, addiction recovery
FDA status
Category 1
Strongest evidence
Small human studies
Legal to compound in the US
Yes, with a prescription

Effects studied or claimed

What it is promoted for, and where each effect has actually been seen

  • More energy and less fatigueClaimed
  • Slower ageingClaimed, based on animal work
  • Easier withdrawal from alcohol and drugsClaimed, very old uncontrolled reports
  • Higher NAD+ levels in the bloodShown with oral precursors

How it is thought to work

NAD+ shuttles electrons in the cell's energy factories and fuels enzymes, including sirtuins, linked to DNA repair and ageing. Raising NAD+ extends healthy lifespan in some animal studies.

What the evidence shows

In animals and the lab

Studies in mice and worms link higher NAD+ to better metabolism and longer healthy lifespan.

In people

Oral precursors such as nicotinamide riboside (NR) and NMN raise NAD+ levels in small human trials, but clear health benefits have not been shown. Intravenous NAD+ itself has almost no controlled human trials.

Safety and unknowns

Drips given too fast commonly cause flushing, nausea, chest tightness and cramps. Long-term effects of repeated high-dose infusions are unknown, and the treatments are expensive.

Regulatory status

Not under active review. NAD sits in the FDA's Category 1, which means pharmacies may compound it while the FDA evaluates it.

Compounded products are not FDA approved: the FDA does not check them for safety, effectiveness or quality before they are sold. Use only a licensed pharmacy with a prescription.

Sources

Analysis

Raising NAD+ is easy; proving it helps is not

Peptide Evidence IndexBiology 8/10In people 4/10Index 5.0, rank 3 of 15See the full index

NAD+ is a coenzyme every cell needs to turn food into energy and repair DNA. Levels fall with age in animals, and in mice, restoring them improves several markers of ageing. That research, led by scientists such as David Sinclair and Shin-ichiro Imai, turned NAD+ into one of the most popular longevity products, sold as IV drips and as the oral precursors NR and NMN.

Human trials have mainly tested the oral precursors. In healthy older adults, six weeks of nicotinamide riboside raised NAD+ levels in blood cells and was well tolerated, with a possible fall in blood pressure in those whose pressure was raised (Martens and colleagues, 2018). In 25 postmenopausal women with prediabetes, ten weeks of NMN improved how well muscle responded to insulin, although blood sugar itself did not change (Yoshino and colleagues, 2021). IV NAD+ infusions, often promoted for energy and addiction recovery, have very little controlled evidence and commonly cause flushing, chest tightness and nausea if run quickly.

Our view. oral precursors reliably raise NAD+ and look safe in short trials, and a few small studies show metabolic signals. Clear benefits on ageing in people have not been shown, and the expensive IV route has the weakest evidence of all.

Studies and reports cited

  1. Martens CR et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun, 2018
  2. Yoshino M et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science, 2021

Summary of published research for general information. It is not medical advice and not a recommendation to use this substance.

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General information, not medical advice. Do not buy or inject unregulated peptides.