What are the key points in brief?
- A 2026 systematic review found no suitable outcome study on NAD+ given as an infusion or injection for anti-aging or wellness2.
- A pilot study examined metabolism during a six-hour infusion. It did not examine health effects3.
- In an analysis from a commercial facility, people reported gastrointestinal symptoms, a raised heart rate and chest pressure during NAD+ infusions1.
Which studies exist on NAD+ infusions?
The 2026 systematic review found no suitable outcome study that tested NAD+ itself as an infusion or injection for anti-aging or wellness. It counted a pilot study on the fate of infused NAD+ in the body, which had no suitable clinical endpoints, as background only2.
This pilot study measured plasma and urine during a six-hour NAD+ infusion. In the first two hours, the NAD+ level in plasma did not rise. In that time, NAD+ was cleared quickly and completely from the plasma3.
The authors of a 2026 study write that commercial facilities increasingly offer NAD+ infusions although safety and efficacy have been little studied1.
Which symptoms were reported during infusions?
A retrospective analysis of treatment records from a commercial facility compared infusions of NAD+ and of NR on four consecutive days1.
- During NAD+ infusions, people reported moderate to severe gastrointestinal symptoms, a raised heart rate and chest pressure1.
- The symptoms subsided after the infusion ended1.
- Because of the symptoms, NAD+ infusions lasted 97 minutes on average and NR infusions 37 minutes1.
This is a retrospective pilot study. The authors speak of preliminary results1.
Which questions can you ask before an infusion offer?
If you have been offered an NAD+ infusion, these questions can help:
- Which causes of my symptoms were checked medically beforehand?
- Which studies in humans support the hoped-for benefit?
- Which symptoms can occur during the infusion, and who is on site then?
- Who leads the treatment, and with what specialist qualification?
Common causes of persistent fatigue can be narrowed down with a conversation, an examination and simple lab values4. The five-step preparation helps with the appointment.
If you are pregnant or breastfeeding, take medication regularly or have or had cancer, the page Does NAD+ have side effects? has notes on this.
Which sources does this page rely on?
- Reyna K et al. (2026). Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. Frontiers in Aging. DOI: 10.3389/fragi.2026.1652582
The study compares how well NAD+ and NR infusions on four consecutive days are tolerated. It is a retrospective review of treatment records with 30 days of follow-up. NAD+ was more often linked to marked discomfort during the infusion and longer infusion times, and symptoms resolved once the infusion ended.
- Gallagher C, Emmanuel OO (2026). NAD⁺ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Research Reviews. DOI: 10.1016/j.arr.2026.103057
The review asks what studies on NAD+ products show for ageing and well-being. It systematically assesses 113 studies, 33 of them in humans. NR and NMN may raise NAD levels and appear well tolerated, while a clinical benefit remains open, and suitable trials of NAD+ infusions were lacking.
- Grant R et al. (2019). A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+. Frontiers in Aging Neuroscience. DOI: 10.3389/fnagi.2019.00257
The study followed what happens to NAD+ in plasma and urine during a six-hour infusion. It is a pilot study in humans. Plasma NAD+ did not rise during the first two hours, which may indicate rapid breakdown in the body.
- Maisel P, Baum E, Donner-Banzhoff N (2021). Fatigue as the Chief Complaint. Deutsches Ärzteblatt International. DOI: 10.3238/arztebl.m2021.0192
The paper summarises how family doctors may assess persistent fatigue. It is a review based on a literature search. Its authors suggest that history, physical examination and simple laboratory tests may usually be enough, with further tests mainly when other findings point that way.