NAD+
What We've Seen in Practice, and What the Research Says
We should say one thing at the top, because it is both true and useful: NAD+ is not a peptide. It is a coenzyme, a small helper molecule that every cell in your body uses to make energy. We include it in this directory because it belongs to the same world of cellular energy and healthy aging that these peptides live in, and because it is, honestly, one of the most important tools in our own practice.
NAD+ carries the electrons that let your cells turn food and oxygen into usable energy, and it is also the fuel for the enzymes that repair your DNA and for the "longevity" enzymes called sirtuins. Your own level of it falls as you age, and that decline lines up with the gradual loss of energy and resilience that comes with getting older. The idea behind NAD+ therapy is simple: put back what time takes away.
Below we separate what we have seen in our own practice, where NAD has been a mainstay for years, from what the published research has and has not established.
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What we've seen in practice
Of everything on this page, NAD is the one we know best. It is the number one IV we do, and Dr. Koniver describes it plainly as the best we have for a wide range of goals. It is a workhorse, not a specialty item, and when we teach other providers how to build an IV practice, NAD is the foundation we tell them to master first, before the more nuanced peptide IVs.
That comes from long experience. Dr. Koniver was an early adopter of NAD IV therapy in the United States and has overseen a very large volume of NAD treatments over the years, which is a big part of why we have a clear sense of how people respond to it. NAD is also the one people tend to actually feel, usually as a lift in energy, which is not true of every molecule in this family.
We use it in two main ways. The first is intravenously, given slowly, which is both how it is tolerated best and how it delivers that energy effect. The second is as at-home injections for people who want to maintain the benefit between visits. NAD is also the anchor of the mitochondrial work we do: we have dripped MOTS-c in after an NAD infusion, we pair it with humanin, and we offer combinations of NAD with humanin and with SS-31. In our hands, mixing NAD with these mitochondrial molecules has worked well together.
None of that replaces the honest research picture below. But NAD is the part of this directory where our own experience is deepest, and we wanted to say that plainly.
NAD+ at a glance
A coenzyme (not a peptide): a small molecule every cell uses to make energy, repair DNA, and run its longevity enzymes [1]
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Healthy aging and energy, metabolic health, and cellular repair; the body's own level falls with age [1, 3]
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The biology is bedrock; human trials mostly use oral precursors (which reliably raise NAD+ and are well tolerated); trials of IV NAD+ itself are still limited [1, 2, 3]
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Intravenously (given slowly) and by injection; poor oral absorption in its direct form
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Nicotinamide adenine dinucleotide, formula C21H27N7O14P2, about 663.4 g/mol; exists as NAD+ (oxidized) and NADH (reduced) [4]
A widely available coenzyme: a dietary-supplement ingredient, with injectable and IV forms via compounding pharmacies; not a restricted research peptide, and not prohibited in sport
Our number-one IV and a cornerstone of our longevity work, given by IV and at-home injection, and the anchor of our mitochondrial stacks. See what we've seen in practice above
Two nucleotides joined by phosphates - a coenzyme, not a chain of amino acids.
What NAD+ is
For most of the last century, NAD+ was known mainly as a piece of basic biochemistry: the molecule that shuttles electrons through the reactions that produce cellular energy. What changed is the discovery of two other jobs it does. NAD+ is consumed by the repair crews that fix damaged DNA, and it is the required partner for a family of enzymes called sirtuins that help regulate how cells age. That put a single, measurable molecule at the intersection of energy, repair, and longevity, which is why it draws so much attention.
The other half of the story is decline. The amount of NAD+ in our tissues drops as we get older, and lower NAD+ tracks with the slowdown in energy and repair that we associate with aging. That decline is what NAD+ therapy is trying to address, by supplying either NAD+ directly or the building blocks the body uses to make it.
It carries the energy
DNA repair
Sirtuins
All three jobs draw on the same NAD+ pool, and that pool falls with age.
How it works
NAD+ is a central electron carrier in the reactions that turn nutrients into ATP. Without enough of it, the energy machinery runs less efficiently. [1]
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NAD+ is the raw material for PARP enzymes, which detect and patch DNA damage. Every repair uses up NAD+, linking genome upkeep to NAD+ supply. [1]
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NAD+ is required for sirtuins, which adjust gene activity, stress resistance, and metabolism in ways tied to healthier aging. Low NAD+ means less sirtuin activity. [1]
Strong biology, achievable to raise, and an honest work-in-progress on clinical outcomes [1,3].
What the research shows
The foundation here is not really in question. Decades of biochemistry establish NAD+ as essential to energy production, DNA repair, and sirtuin function, and a large body of work documents that tissue NAD+ declines with age. That is the strongest part of the story, and it is why the molecule is taken seriously. [1]
The human treatment research is younger and more mixed, and we want to represent it honestly. Most of the controlled human trials have used oral NAD+ precursors, particularly nicotinamide riboside, rather than NAD+ itself. A well-run randomized trial showed that nicotinamide riboside safely and reliably raised blood NAD+ in healthy middle-aged and older adults, and that raising it was well tolerated [2]. What those trials have been less able to show so far is large, consistent improvement in hard clinical outcomes, and a recent review of the field summarizes exactly that [3]. Controlled trials of intravenous NAD+ specifically are still limited.
Core biology and age-related decline
Extensive laboratory and human data
NAD+ is essential to energy, DNA repair, and sirtuins, and falls with age
Well established [1]
Raising NAD+ in people
Randomized trial of an oral precursor
Nicotinamide riboside safely raised NAD+ and was well tolerated
Established for precursors [2]
Clinical outcomes
Human trials, varied and often small
Some signals, inconsistent effects on hard endpoints
Early and mixed [3]
Intravenous NAD+ specifically
Limited controlled data
Widely used clinically; formal IV trials are still few
Emerging
The evidence, area by area
Green marks our own clinical observation, which is experience, not a trial.
NAD+ has a reassuring tolerability record across the oral and injectable routes, which is part of why it is so widely used. The effects people do notice are usually mild and tied to how it is given: a transient flushing or "rushing" feeling during an IV, which is exactly why we infuse it slowly, and occasional mild reactions at an injection site. It is not a molecule with a long list of common side effects.
The cautions are sensible rather than alarming. Because NAD+ supports cellular energy broadly, there is a theoretical concern that it could feed existing cancer cells, so we are careful in anyone with active malignancy. We avoid it in pregnancy and breastfeeding for lack of data, we monitor higher-dose protocols, and we assess anyone with significant cardiovascular instability before starting. As with all IV therapy, it belongs in a supervised setting with appropriate screening.
Regulatory status
Regulatory information current as of 12 August 2026. This is a summary, not legal or medical advice, and status can change.
As a medicine,
worldwide
A coenzyme, not a patented drug; not approved as a pharmaceutical for a specific disease.
United States
AVAILABLE
A dietary-supplement ingredient (generally recognized as safe for supplementation); injectable and IV forms via compounding pharmacies. Not part of the 2023 or 2026 compounding restrictions; broadly available.
Sport (WADA)
NOT PROHIBITED
NAD+ is not on the World Anti-Doping Agency Prohibited List. It is not a prohibited substance.
Everywhere else
Availability of any compounded or supplement product depends on the pharmacy and provider, and quality varies by source.
Regulatory information current as of 12 August 2026. Verify status at publication.
NAD+, answered plainly
No. NAD+ is a coenzyme, a small molecule your cells use to make energy, repair DNA, and run their longevity enzymes. We include it in this directory because it is central to the same cellular-energy and healthy-aging work as these peptides, and because it is a cornerstone of our IV therapy [1].
It is used to support energy and healthy aging, on the rationale that the body's own NAD+ falls with age. In our practice it is our main IV and the anchor of our mitochondrial work. The biology behind it is strong; the size of the clinical benefit is still being studied [1,3].
Yes. A randomized human trial showed that an oral precursor, nicotinamide riboside, reliably raised blood NAD+ and was well tolerated. Raising NAD+ is achievable; the open question is how much downstream benefit that produces [2].
It has a good tolerability record. The main IV effect is a transient flushing if it is infused too quickly, which is why we give it slowly. We are cautious in active cancer, and avoid it in pregnancy and breastfeeding [2].
Yes. NAD+ is not on the WADA Prohibited List.
Related in this directory
References
- Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22(2):119-141. PMID 33353981.
- Martens CR, Denman BA, Mazzo MR, Armstrong ML, Reisdorph N, McQueen MB, Chonchol M, Seals DR. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9(1):1286. PMID 29599478.
- Freeberg KA, Udovich CC, Martens CR, Seals DR, Craighead DH. Dietary Supplementation With NAD+-Boosting Compounds in Humans: Current Knowledge and Future Directions. J Gerontol A Biol Sci Med Sci. 2023;78(12):2435-2448. PMID 37068054.
- PubChem, National Library of Medicine. Nicotinamide adenine dinucleotide (NAD+), CID 5892: C21H27N7O14P2, 663.43 g/mol.
This page is for informational and educational purposes and does not constitute medical advice, diagnosis, or treatment. NAD+ is a coenzyme available as a dietary-supplement ingredient and as compounded injectable and intravenous preparations; it is not approved by the FDA as a drug for any specific disease. Statements describing how Dr. Koniver and the Koniver Wellness team use NAD+ reflect clinical experience and judgment, which is not the same as controlled clinical evidence. Nothing here is a substitute for consultation with a qualified healthcare provider. IV and injection therapy at Koniver Wellness is provided under physician supervision after appropriate screening.
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