NAD+ injections: what the evidence does and does not show
NAD+ is essential to every cell, and the animal research is genuinely interesting. The human evidence for injections is early, and it should be described that way.
At a glance
NAD+ (nicotinamide adenine dinucleotide) is a molecule every cell uses to turn food into energy and to run enzymes involved in repair and signaling. Levels fall with age in many tissues1, and raising NAD+ improved several measures of health in animal studies.2 Human evidence for NAD+ given by injection or nasal spray is still emerging: small studies describe what happens to it in the body, not that it slows aging or reliably improves energy. Injectable and nasal NAD+ are compounded by licensed U.S. pharmacies and are not FDA-approved.
In this guide7 sections
What NAD+ is
NAD+ is a coenzyme: a helper molecule that enzymes need to work. It carries electrons in the reactions that turn food into usable energy, and it is consumed by enzymes such as sirtuins and PARPs that help regulate DNA repair, inflammation, and the body’s daily rhythms.
The body makes NAD+ from building blocks in food, including forms of vitamin B3, and recycles it constantly. Levels decline with age in several tissues, and that decline has been linked in research to many age-related changes.1
Why it became a longevity topic
In older or diseased animals, restoring NAD+ levels has improved measures of metabolism, muscle function, and resilience, and in some studies extended lifespan.2 Those results prompted a search for safe ways to raise NAD+ in people.
Animal results do not automatically carry over to humans. Doses, routes, and biology differ, and most of the strongest findings come from mice. That is why the human evidence below is labeled emerging.
Injection, nasal spray, and oral precursors
NAD+ can be given directly, by injection under the skin, into a muscle, or by IV infusion, or as a nasal spray. Supplements such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are precursors the body converts into NAD+.
In a small pilot study of a six-hour IV infusion, NAD+ was rapidly and completely removed from the blood for at least the first two hours before levels rose, which shows how quickly the body processes it.3 Published human data on nasal NAD+ are very limited.
| Form | How it is taken | Evidence so far |
|---|---|---|
| NAD+ injection | Under the skin or into a muscle, on a schedule your clinician sets | Emerging: small human studies on how the body handles it; benefits not established |
| NAD+ nasal spray | Sprayed into the nose | Very limited published human data |
| NR or NMN supplements | Capsules by mouth | Shown to raise blood NAD+ in people; clinical benefits not consistently shown |
What the evidence does and does not show
Being clear about the limits is part of responsible care. NAD+ therapy should be presented as a reasonable option to discuss, not as a proven treatment for aging.
- Shown: NAD+ is essential to energy metabolism and cell maintenance
- Shown: NAD+ levels decline with age in several tissues
- Shown in animals: raising NAD+ improved several health measures
- Not yet shown: that NAD+ injections slow aging in people
- Not yet shown: reliable improvements in energy, focus, or recovery from injections
- Not yet known: the long-term safety of repeated injections
Safety and what to ask
People who use NAD+ injections report effects such as injection-site soreness, flushing, nausea, and lightheadedness, but systematic safety data are limited. Tell your clinician about every medicine and supplement you take, and about pregnancy, breastfeeding, or any history of cancer.
Injectable and nasal NAD+ are compounded by licensed U.S. pharmacies and are not FDA-approved.4 At Everdawn, NAD+ injection is $159 a month and NAD+ nasal spray is $149 a month, each including the clinician visit, and a licensed clinician decides whether treatment is appropriate. Learn more about Everdawn longevity care and the longevity and peptides program.
Common questions
Is NAD+ FDA-approved?
No. NAD+ injections and nasal sprays are compounded by licensed pharmacies and are not FDA-approved. NR and NMN are sold as dietary supplements, which FDA does not approve.
Is an NAD+ injection better than a nasal spray?
There is not enough human research to say. Injections have a little more published data on how the body processes NAD+, but neither form has proven long-term benefits.
Will NAD+ make me younger?
No treatment has been shown to do that. NAD+ is an area of active research, and current human evidence does not show that NAD+ injections slow or undo aging.
Can I use NAD+ with other medicines or supplements?
Ask your clinician first. Bring a full list of medicines and supplements, including any B3 or NR products, so overlap and interactions can be checked.
References
- Source 1: Covarrubias AJ et al. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol, 2021 (opens in a new tab)
- Source 2: Rajman L et al. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metab, 2018 (opens in a new tab)
- Source 3: Grant R et al. Changes in the human plasma and urine NAD+ metabolome during a 6 hour IV infusion of NAD+. Front Aging Neurosci, 2019 (opens in a new tab)
- Source 4: FDA: Compounding and the FDA, questions and answers (opens in a new tab)
A number in the text links to the source for that statement.
This guide provides general educational information and is not medical advice, diagnosis, or treatment. Treatment decisions require an appropriately licensed clinician who understands your history and circumstances.
Images are illustrations, not Everdawn members or clinicians.