NAD+ sits at the center of how cells make energy. Because its levels tend to fall with age, raising it has become a popular idea. The question is what raising it actually does for people.
Key points
- NAD+ is not an FDA-approved drug.
- FDA lists NAD as under evaluation for pharmacy compounding.
- Oral precursors such as nicotinamide riboside are sold as dietary supplements, which FDA does not approve for effectiveness.
- Human studies show NAD+ levels can be raised; clear benefits are not yet established.
- Research on IV NAD+ is limited.
Where things stand (as of November 2026)
NAD+ is not an FDA-approved drug. On FDA's list of substances nominated for pharmacy compounding (updated May 14, 2026), NAD is in Category 1, "under evaluation," which means FDA has not yet decided whether to add it to the list of substances pharmacies may use.
Oral precursors such as nicotinamide riboside are sold as dietary supplements, which FDA does not approve for effectiveness.
Availability of NAD+ treatments depends on current federal rules; we review options at your visit.
What it does
NAD+ is a coenzyme in every cell, central to energy production and to enzymes involved in DNA repair. Levels tend to fall with age in many tissues.
What the evidence shows
A 2018 randomized trial in healthy middle-aged and older adults found the precursor nicotinamide riboside was well tolerated and raised NAD+ levels in blood.
Human studies so far show NAD+ levels can be raised; clear benefits for aging, energy or disease are not yet established. Research on IV NAD+ is limited.
Safety
Infusions can cause flushing, nausea, chest tightness or cramping if given quickly. Supplements are generally well tolerated in short studies. Talk with a physician first, especially with a cancer history or during pregnancy.
Common questions
Is NAD+ FDA-approved?
No. NAD+ is not an FDA-approved drug, and FDA lists NAD as under evaluation for pharmacy compounding.
What is the difference between NAD+ and NMN or nicotinamide riboside?
NAD+ is the coenzyme cells use. NMN and nicotinamide riboside are precursors the body can convert into NAD+. Precursors are sold as dietary supplements, which FDA does not approve for effectiveness.
Does NAD+ slow aging?
This is not established in humans. Studies show NAD+ levels can be raised, but clear benefits for aging, energy or disease have not been shown.
Is IV NAD+ better than supplements?
This has not been shown in good-quality studies. Research on IV NAD+ is limited, and infusions can cause flushing, nausea or chest tightness if given quickly.
Can Institute of Function offer NAD+?
Availability depends on current federal rules; we review options at your visit. A physician assessment comes first, and prescribing is never guaranteed.
What this means for patients
- NAD+ biology is well established; the benefit of raising it in people is not yet.
- Any decision starts with a physician review of your history and goals.
What this does not mean
- It does not mean NAD+ infusions or supplements slow aging.
- It does not mean IV NAD+ works better than oral precursors.
Sources
- FDA, Bulk Drug Substances Nominated for Use in Compounding Under Section 503A (updated May 14, 2026)
FDA's list showing NAD in Category 1, under evaluation.
- Martens CR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9:1286.
Randomized trial showing nicotinamide riboside raised blood NAD+ and was well tolerated.
- Covarrubias AJ, et al. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22:119-141.
Review of NAD+ biology, its decline with age and the open questions in human research.
Many peptide-based therapies remain investigational for musculoskeletal pain, recovery, and performance applications. Available evidence varies by compound, indication, and route of administration. Treatment decisions require physician evaluation, informed consent, and compliance with applicable law.
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