NAD+

Areas of active research — not promised effects

Each tag links to other compounds with research into that goal. Research use only: these are areas of study, not human-use claims.

Related by research scope · open each to compare

NAD+ as a bulk compound (CAS 53-84-9) is not an FDA-approved drug and is not specifically regulated as a dietary supplement. Its main oral precursors have distinct statuses: NMN was confirmed lawful as a dietary supplement ingredient by FDA in September 2025 (reversing its 2022 exclusion), with New Dietary Ingredient Notification requirements. NR has GRAS and NDI precedent. Direct IV administration of NAD+ is not FDA-approved; it is offered in compounding/wellness settings without regulatory clearance.

Confirmed high-severity market-integrity event (enforcement / recall / counterfeit)

Transparent blend · bci-1.0 · never paid-placement

Primary name

NAD+

Origin

NAD+ (nicotinamide adenine dinucleotide) is an endogenous dinucleotide found in every living cell. It is biosynthesized de novo from tryptophan and via salvage pathways from nicotinamide (niacin), nicotinamide riboside (NR), or nicotinamide mononucleotide (NMN). As a research compound it is produced synthetically; CAS 53-84-9, formula C21H27N7O14P2 (MW 663.4 g/mol), PubChem CID 5892.

Registry IDs

PubChem CID

5892

CAS

53-84-9

InChIKey

BAWFJGJZGIEFAR-NNYOXOHSSA-N

DrugBank

DB14128

ChEMBL

CHEMBL1234613

Molecular formula

C21H27N7O14P2

Molar mass

663.4 g/mol

Monoisotopic

663.10912256 Da

InChIKey

BAWFJGJZGIEFAR-NNYOXOHSSA-N

Appearance

White to off-white lyophilized powder

Solubility

Freely soluble in water; aqueous solutions are acidic (pKa ~1 for phosphate grou…

Sequence not available in current seed.

Stability: NAD+ is susceptible to hydrolysis at neutral-to-alkaline pH and degrades under elevated temperature, light, and oxidizing conditions; the reduced form NADH is m

Vial sizes

500 mg · 100 mg

Purity grades

≥95% / ≥98%

Salt forms

Free base (primary)

• GHS hazard class on file
• PPE & spill response
• Disposal guidance
• Not-for-human-consumption posture

How much research exists, and of what maturity — never a verdict on whether it works.

Mechanism of action

• NAD+ functions as an essential redox cofactor, cycling between its oxidized (NAD+) and reduced (NADH) forms to drive mitochondrial oxidative phosphorylation and glycolysis
• Beyond its redox role, NAD+ is the obligate substrate for three major enzyme classes: sirtuins (SIRT1–7), which use NAD+ for NAD+-dependent protein deacylation to regulate gene expression, mitochondrial biogenesis, and stress responses; poly(ADP-ribose) polymerases (PARPs), which consume NAD+ during DNA damage repair; and the ectoenzyme CD38/CD157, which hydrolyzes NAD+ to modulate calcium signaling
• Intracellular NAD+ levels decline progressively with age, partly due to chronic PARP and CD38 activation outpacing biosynthesis via NAMPT (the rate-limiting salvage enzyme), leading to reduced sirtuin activity and impaired mitochondrial function
• Research has focused on whether restoring NAD+ levels through precursor supplementation or direct administration can reverse aspects of this age-associated decline

Pharmacokinetics (ADME)

Half-life

Rapid plasma clearance; no detectable rise in plasma NAD+ or metabolites observed during the first ~2 hours of IV infusion at 3 µmol/min (pilot PK study, PMC6751327)

Clearance

Rapidly cleared from plasma by ectonucleotidases (NAD+ glycohydrolase, pyrophosphatase activity); urinary excretion of methylnicotinamide and NAD+ observed at 6 hours post-infusion

PK–PD note: Orally administered NAD+ is poorly absorbed intact; precursors NMN and NR cross intestinal epithelium more efficiently and are converted intracellularly. IV NAD+ metabolite profiles in humans suggest …

Reading the evidence

• Evidence quality and gaps vary by application — see the cited grades above.
• Indexed-article counts span all evidence tiers, not only completed human trials.
• No first-party human-dosing, efficacy, or benefit claims are made here.

Key reviews & evidence-gap sources

• Gallagher & Emmanuel 2026 — NAD+ supplementation for anti-aging and wellness: a PRISMA-guided systematic review (Ageing Research Reviews 116:103057) — 113 eligible studies, Jan 2010–Oct 2025: 33 human (28 randomized + 5 nonrandomized) + 80 rodent. The anchor for completedHumanRcts=28. Conclusion: rodent data broadly support NAD+ augmentation; human trials reliably raise NAD+ metabolites (target engagement) but clinical/functional outcomes are heterogeneous; controlled outcome evidence for parenteral NAD+ infusions specifically is limited. [Verified: PMID 41655607 / DOI 10.1016/j.arr.2026.103057.]
• Vinten et al. 2025 — NAD+ precursor supplementation in human ageing: clinical evidence and challenges (Nature Metabolism 7:1974–1990) — Human trials of NAD+ precursors show limited efficacy despite preclinical promise; an age-related NAD+ decline is only consistently demonstrated in a limited number of human studies — a caution against overstating translation.
• Prokopidis et al. 2025 — NMN and NR on skeletal muscle mass/function: systematic review + meta-analysis (J Cachexia Sarcopenia Muscle; PMID 40275690) — 10 completed RCTs (6 NMN + 4 NR), adults mean age >60. Concludes current evidence does NOT support NMN/NR for preserving muscle mass or function. [Verified — precursor evidence, not intact NAD+.]
• Chen et al. 2024 — NMN on glucose/lipid metabolism: systematic review + meta-analysis (Current Diabetes Reports; PMID 39531138) — 8 completed RCTs, 342 mostly non-diabetic adults, 250–2000 mg/day. No significant benefit vs placebo on fasting glucose, insulin, HbA1c, HOMA-IR, or lipids. [Verified — NMN precursor, null-efficacy finding.]
• Covarrubias, Perrone, Grozio & Verdin 2020 — NAD+ metabolism and its roles in cellular processes during ageing (Nat Rev Mol Cell Biol 22:119–141) — Mechanistic anchor: NAD+ as redox cofactor + substrate for sirtuins, CD38, PARPs; documents age-related tissue NAD+ decline across species.
• Rajman, Chwalek & Sinclair 2018 — Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence (Cell Metab 27:529–547) — Foundational review of preclinical (largely rodent) in-vivo efficacy for NAD-boosting molecules, predating most human RCTs.

5 registered trials — 1 currently recruiting.

NA
NCT04907110
NR Supplementation and Exercise

COMPLETED

Phase 2
NCT05169554
Beta-Lactam Containing Regimen for the Shortening of Buruli Ulcer Disease Therapy

RECRUITING

NA
NCT05229705
Exercise in Older Adults at Risk for Type 2 Diabetes

COMPLETED

Phase 2
NCT00183222
Effectiveness of Naltrexone and/or Ondansetron to Reduce Craving for Alcohol and Drinking

COMPLETED

Phase 2
NCT04870866
NAD Supplementation to Prevent Progressive Neurological Disease in Ataxia Telangiectasia

ACTIVE_NOT_RECRUITING

Summary (literature)

In research and clinical settings, intravenous NAD+ infusion is generally reported to be well tolerated at standard rates; rate-dependent adverse effects commonly reported include flushing, nausea, headache, chest tightness, dizziness, and palpitations, which typically resolve on…

WADA status

Not specifically listed as a prohibited substance by name on the 2026 WADA Prohibited List. However, athletes should note that WADA prohibits IV infusions/injec…

Dominant research route: For the intact NAD+ molecule, only two human-relevant routes are formally registered: IV infusion (one completed PK pilot + one retrospective tolerability comparison) and SC/IM injection (a single Phase 1 trial, still recruiting, no results yet). The dominant human-research route for this compound FAMILY is oral administration of the precursors NMN and NR (multiple RCTs and PK trials) — NOT intact NAD+, which has no dedicated oral human study. In rodent mechanistic/aging research, intraperitoneal dosing of the precursor NMN is the dominant preclinical route.

The only route with a dedicated human PK study of the intact molecule: a 6-hour, 3 µmol/min (~750 mg total) NAD+ infusion pilot in 8 healthy males (Grant et al., Front Aging Neurosci 2019; PMID 31572171). A separate retrospective real-world tolerability review (n=14; 6 NAD+, 8 NR) compared IV NAD+ against IV NR at a commercial wellness clinic.

Bioavailability: 100% bioavailable by definition, but plasma NAD+ showed NO measurable rise for roughly the first 2 hours of continuous infusion (rapidly cleared, consistent with NAD+ glycohydrolase/pyrophosphatase activity). By 6 hours plasma NAD+ was +398% vs baseline (p<0.0001), alongside +409% nicotinamide and +350% methylnicotinamide; urinary NAD+ excretion +538% at 6 hours (p<0.001). [All four PK figures verified against PMID 31572171 / DOI 10.3389/fnagi.2019.00257.]

The retrospective tolerability review found IV NAD+ (500 mg lyophilized in 500 mL saline) caused moderate-to-severe abdominal cramping, diarrhea, nausea, vomiting, elevated heart rate, throat pain, congestion, and chest pressure during infusion in all 6 recipients (resolving on completion) — markedly worse-tolerated than IV NR (minor tingling/cramping in 5 of 8). A real-world commercial-clinic case series, not a controlled efficacy trial; no human dosing protocol implied.

Intact NAD+ has NO dedicated human oral PK study. All oral human data belong to the aliased precursors: NR in a dose-dependent 100/300/1000 mg trial (Trammell et al. 2016) and an 8-subject escalation to 1000 mg BID; NMN in a randomized, double-blind, placebo-controlled 12-week trial (250 mg/day as 125 mg BID, n=30, 15/15; Okabe et al. 2022, verified PMID 35479740) and open-label safety trials up to 1250 mg/day; sublingual vs oral NMN compared in a 14-subject crossover.

Bioavailability: Intact NAD+'s oral bioavailability has never been quantified in any species; reviews describe it as hydrolyzed by intestinal nucleotidases/phosphatases before absorption. NR: elimination half-life ~2.7 h, Tmax ~3 h, highly variable peak response, mean blood NAD+ roughly doubled. NMN: 250 mg/day for 12 weeks significantly raised blood NAD+ (peak ~week 4, sustained to week 12) with no serious adverse events; sublingual NMN produced a faster early rise in catabolites 2PY/4PY than oral (a possible first-pass-avoidance signal, not a quantified %).

This entry's oral human evidence belongs to the aliased PRECURSOR forms (NMN, NR), not intact NAD+, which is not established as orally bioavailable in any species. No human dosing protocol implied — figures are published trial doses, not recommendations.

No completed human PK or efficacy study exists for direct NAD+ by this route. The only registered human trial covering it is a Phase 1 safety pilot of injectable nicotinamide riboside (SC + IM arms, n=40, ClinicalTrials.gov NCT07251608).

Bioavailability: No published SC PK data for NAD+ or its precursors. The registered SC/IM NR trial is designed to measure blood NAD+ change and injection-site tolerability but was last verified as Recruiting (status verified Nov 2025; estimated primary completion 2026-02-15 has since passed without a registry update).

Marketed by IV-therapy/wellness/compounding clinics as an at-home maintenance route (self-administered injection kits) between in-clinic IV visits, per commercial provider materials — not derived from a completed peer-reviewed study. No human dosing protocol implied.

Same registered-but-unreported status as SC: the only trial covering IM is the ongoing Phase 1 injectable-NR pilot (NCT07251608, last verified Recruiting Nov 2025). No completed human IM PK study exists for NAD+ or its precursors.

Bioavailability: No published IM PK data. Commercial-clinic materials describe IM as intermediate in onset between SC and IV — a marketing framing, not a peer-reviewed PK finding.

Offered at wellness/IV-therapy clinics alongside SC and IV; PK/efficacy unestablished for this compound. No human dosing protocol implied.

A common systemic route in rodent mechanistic/aging research, almost always using the precursor NMN rather than intact NAD+ — e.g., a 500 mg/kg IP bolus raised liver, pancreas, and white-adipose NMN and NAD+ within 15 min in mice; repeated IP NMN also appears in aged-rodent cardiac-ischemia and muscle/vascular models.

Bioavailability: Used as a laboratory dosing route in mechanistic/efficacy studies rather than a dedicated PK characterization; not a human route.

A laboratory-animal administration route, cited only to describe how preclinical precursor (NMN) research was conducted. No human dosing implied.

No published human or animal study of intranasal NAD+ (or precursor) administration was found; marketed nasal-spray products exist, and even vendor-facing reviews acknowledge no human trials have been published on this route.

Bioavailability: No PK data exists. Vendor claims of peak plasma levels within 10–20 minutes and bioavailability '30% higher than oral' are marketing statements not traceable to a published study.

A commercially marketed route without a published clinical trial confirming absorption or a blood NAD+ change. No human dosing protocol implied.

No published RCT or peer-reviewed human study has evaluated NAD+ patches against placebo, and no study has measured blood NAD+ following patch application. Most marketed patches actually contain the precursors NR/NMN rather than intact NAD+.

Bioavailability: No dedicated PK/bioavailability study exists; intact NAD+'s size (~663 Da) and charge make passive transdermal penetration implausible without enhancers. Vendor-cited bioavailability ranges (e.g. '30–70%') are marketing claims without a traceable published source.

A commercially marketed route; independent reviewers explicitly describe the human evidence base as preliminary or absent. No human dosing protocol implied.

Animal & human figures are kept visibly separate so studied animal doses are never misread as human guidance.

Sorted A–Z by vendor — never by price

Weekly median $/mg from the live vendor crawl.

Researched storefront prices, bucketed

p25 $0.110 · median $0.180 · p75 $0.330 · 14 researched vendors

Legit, COA-backed band: $0.100–$0.250/mg.

Value rule: don't just buy the cheapest — a price under $3/mg is a red flag. Pair price with COA and independent-test grade.

Estimated cost of research (10 mg)

Vial (best researched price)

$1

Bacteriostatic water (generic estimate)

$6

Syringes / supplies (generic estimate)

$12

What each test proves — general guidance, plus this compound's researched purity data

Purity on the current market (researched)

US research-market vendors near-uniformly advertise ≥99% HPLC purity for lyophilized NAD+ (e.g. Nationwide Peptides, Peptide Systems, Biotech Peptides, Pure Health Peptides, Cosmic Peptides, Verified Peptides), but no independent cross-vendor purity aggregate (a Finnrick/Janoshik-style published dataset, as exists for BPC-157) was found for NAD+ in the research-vendor channel this pass — the ≥99% figures are vendor-reported claims, not an independently audited distribution. Separately, in the ADJACENT retail oral-supplement channel (capsules/softgels/liquids on marketplaces like Amazon — a different market from injectable research vials), a self-published market-surveillance report found substantial under-content; see underdosingNote for the full conflict-of-interest caveat.

Independent labs cited for this compound

Unlike many research peptides, NAD+ has a CONFIRMED US recall history rather than an empty one: GenoGenix, LLC voluntarily recalled injectable NAD+ product lines in 2025 for a sterility-assurance failure (Class II, #D-0065-2026) and, separately, for elevated endotoxin levels (Class I, #D-0094-2026, tied to reported adverse reactions requiring emergency care per the FDA Form 483). These are COMPOUNDING-PHARMACY recalls (GenoGenix supplies clinics, not a direct-to-consumer RUO research vendor), but they document a real, compound-specific injectable-quality failure mode for NAD+, not a hypothetical one.

Buyer red-flag checklist

• No batch-specific COA provided on request, or a COA showing only a summary purity number with no HPLC chromatogram.
• A COA verification key/QR/task-ID that doesn't resolve in the testing lab's public database, or resolves to a DIFFERENT product entirely.
• Vial lot number that doesn't match the lot printed on the COA.
• Visible discoloration (yellow, tan or pink) in reconstituted or stored product — NAD+ degrades via oxidation to nicotinamide + ADP-ribose; discolored product can still pass a purity-only identity COA while delivering reduced potency.
• Ingredient sourced as 'food grade' rather than pharmaceutical/USP grade for an injectable product — the documented failure mode behind the 2025 GenoGenix recalls (endotoxin contamination, sterility-assurance failure).
• No endotoxin (LAL) or sterility data for a product implied for injection.
• Price far below the market median for the mg size (consistent with underfilled/off-spec product).
• Human-dosing or benefit marketing on a 'research use only' site — the pattern that has drawn FDA warning letters and DOJ action against peptide sellers generally.

GMP vs research-grade: the chemistry (SPPS + HPLC + MS) is identical — the difference is the quality system.

Underdosing / mislabeling: No independent lab aggregate (Janoshik / MZ Biolabs / Finnrick) quantifying NAD+ underdosing prevalence in the research-vendor (injectable-vial) channel was found this pass, so no prevalence figure is asserted for that market — an honest gap, not a clean bill of health. The one quantitative signal is from a DIFFERENT market segment and a CONFLICTED source: Niagen Bioscience (formerly ChromaDex, maker of the competing Tru Niagen NR brand) published a self-published market-surveillance report (a white paper, NOT a peer-reviewed study) reporting that of 22 best-selling ORAL NAD+ consumer products on Amazon (tested May 2025), 55% (12 of 22) contained less than 1% of label claim ('little to no actual NAD+') and only 23% met label. Because Niagen Bioscience is a direct commercial competitor to the tested brands and the report covers a different (oral consumer) market — not the injectable research-vial market this platform's commerce section tracks — the finding is kept OUT of the numeric underdosingPrevalence field and reads as an interested-party claim, not an independent audit. A separately-circulating claim that a University of Mississippi NCNPR study found '26% of NAD+ supplements under 50% of labeled content' could NOT be traced to a primary/published source after multiple searches and is treated as UNVERIFIED (flagged for human review). NAD+ is also chemically labile in solution (oxidation to nicotinamide + ADP-ribose, visible as yellow/tan/pink discoloration) — a distinct storage-degradation risk separate from underdosing at manufacture.

• The general FDA mechanism applicable to a research-labeled NAD+ shipment is Import Alert 66-41 (detention-without-physical-examination of unapproved new drugs), which covers peptides/compounds marketed as research chemicals generically; no NAD+-specific import-alert listing or named detention case was found this pass. An RUO label is not an import exemption — CBP/FDA judge actual intended use.66-41 (unapproved new drugs)
• An RUO label is not an import exemption — CBP judges actual intended use.
• Lyophilized powder is ambient-stable in transit; temperature control needed for > 7-day transit.
• US-warehouse vendors dodge import scrutiny — they cost more but ship more reliably.

Every item dated & sourced

Neither NAD+ (nicotinamide adenine dinucleotide) nor NMN (nicotinamide mononucleotide) is named anywhere on the WADA 2026 Prohibited List (effective 1 Jan 2026) or the USADA list, and neither is expressly designated under the S0 'Non-Approved Substances' category (whose enumerated examples are BPC-157, 2,4-DNP, S-107/ARM210, reldesemtiv/tirasemtiv). CAVEAT: S0 is a catch-all covering 'any pharmacological substance … with no current approval by any governmental regulatory health authority for human therapeutic use', so anti-doping bodies (e.g. BSCG) caution that injectable/RUO NAD+ could still be captured by S0 despite not being named. Separately, WADA method M2.2 (a Specified Method under M2 'Chemical and Physical Manipulation') prohibits IV infusions/injections exceeding 100 mL per 12-hour period (except hospital treatment, surgery, or clinical diagnostics), which constrains typical IV NAD+ protocols (~500–1000 mL) for athletes absent a TUE.

No granted patents identified in current seed. Composition-of-matter coverage is limited given the peptide's synthetic origin.

• IACUC / IRB research context
• RUO buyer responsibilities & documentation
• Veterinary / alternative-use where lawful
• Jurisdiction-aware "who may lawfully obtain"

What people discuss

Reported concerns — discussion, not established effects

Reading caveats

• High-profile celebrity and influencer amplification (widely-covered reality-TV / wellness-podcast IV-therapy commentary) skews framing positive relative to the still-thin large-human-trial evidence base. Specific individuals are deliberately not named.
• Researchers explicitly flag a marketing-vs-science gap — Christopher Martens, director of the Delaware Center for Cognitive Aging Research, told NPR 'the cart may be well ahead of the horse' (attributed Layer-B scientific caution; NPR gives his title as 'director', not 'Dr.').
• Secondary SEO/marketing blogs ('is NAD+ worth it', vendor-comparison content) mediate most of this read — native Reddit/YouTube/X threads are hard to retrieve directly, so tone is partly inferred through paraphrase rather than raw posts.
• Cost-driven negativity — roughly $300–$2,000 per IV-CLINIC SESSION (a bundled clinical service, distinct from research-vial pricing) generates skepticism independent of any safety signal.
• Placebo / expectation confounding inherent to a heavily-marketed 'anti-aging/glow' narrative and concurrent supplement/protocol stacking.
• Survivorship / positivity bias — dramatic energy or anti-aging testimonials are over-shared vs silent null results.

Manually researched from reddit, youtube, x— theme weights are research estimates, not live counts; aggregated & de-identified. No individual posts, quotes, or usernames are ever shown.

Relative research / market volume — populated once the activity stream is wired

Inline tooltips for lyophilized, RUO, EU/mg, SPPS, 503A and more.

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Endogenous coenzyme central to cellular energy metabolism, redox signaling, and longevity-related enzyme activity; levels decline with age. Approximately 8,172 articles are indexed (literature last scanned 2026-05-29). US regulatory status: Research use only; precursors (NMN, NR) lawful as dietary supplements. Research use only.

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