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What it is
A coenzyme present in every cell, essential to redox reactions and to enzymes including sirtuins and PARPs. It is not a peptide and does not belong to the same class as anything else in this library — it is here because it is sold alongside them.
How it is proposed to work
Tissue NAD+ declines with age, and restoring it is proposed to support mitochondrial function and DNA repair. The gap in the reasoning is between raising a measurable pool and producing an outcome. NAD+ itself is a large charged molecule with poor cellular uptake, which is why precursors are used orally — and why the rationale for infusing NAD+ directly is weaker than it appears.
Approved medical uses
None. NAD+ has no approved human medical indication in the jurisdictions we track. Any use is outside an approved label.
Human research
Each entry states what the study found and, separately, what it cannot show.
- Systematic review2026
Systematic review of NAD+ intervention studies (oral precursors and parenteral NAD+)
Finding. A PRISMA-guided review of human and rodent intervention studies from January 2010 to October 2025, covering 113 eligible studies: 33 human intervention studies, 28 of them randomised, and 80 rodent studies. In humans, oral nicotinamide riboside and NMN consistently demonstrated biochemical target engagement in circulating or cellular NAD-related metabolites and were generally well tolerated over weeks to months, but effects on functional, metabolic, vascular and other healthspan-relevant outcomes were heterogeneous and often null or endpoint-specific. No eligible outcomes trial evaluated intravenous or intramuscular NAD+ itself for anti-ageing or wellness indications.
Limitation. Raising a biomarker is not an outcome, and the trials that measured things people would notice have mostly not found them. Most of the pooled evidence is rodent — 80 of the 113 studies — and the review's own conclusion is that clinical effectiveness for anti-ageing or wellness outcomes remains inconclusive, with larger randomised trials using prespecified clinically meaningful endpoints still needed. Being a synthesis, it inherits the heterogeneity of the trials beneath it and adds no new data. No eligible outcomes trial evaluated intravenous or intramuscular NAD+ itself for anti-ageing or wellness indications, which is the route sold in clinics; one nonrandomised intravenous NMN study met inclusion criteria and contributed mainly short-term safety and biomarker information. The first author declares ownership of a management services organisation providing administrative services to an aesthetics clinic, which the declaration states offers neither NAD+ infusions nor NAD+ supplementation.
Preclinical research
Animal and laboratory work. Useful for generating hypotheses; it cannot establish that something works in people.
No preclinical studies catalogued.
Potential safety concerns
- CautionPreliminary
Intravenous NAD+ commonly produces chest tightness, nausea and flushing when infused quickly, which is why clinic protocols run long infusions. There is no controlled evidence establishing benefit to weigh that against.
- SeriousPromising
Compounded NAD+ products have been associated with emergency presentations including hypotension and severe shivering, and have drawn FDA enforcement. The signal here is about the compounding channel rather than the molecule.
- CautionEstablished
Regulatory status differs sharply by country and has changed recently in both directions. Anyone relying on a status claim more than a few months old is likely relying on something no longer true.
Known interactions and contraindication considerations
- Not well characterised. Relevant to consider in active malignancy given roles in DNA repair and cellular energetics.
This list is not exhaustive and is not a substitute for a clinician reviewing your full medication history.
Regulatory status
Status is shown per jurisdiction and is accurate only as of the date stated. Where a compound is approved, the approval is bound to a specific formulation, manufacturer and indication — shown in the detail column.
| Jurisdiction | Standing | Detail |
|---|---|---|
United States FDA | Listed as of 6 Aug 2026 | NMN may lawfully be marketed as a dietary supplement following FDA's 2025 reversal, but remains a New Dietary Ingredient requiring a compliant NDI notification — self-affirmed GRAS does not substitute. Injectable and IV NAD+ is a different matter: it is an unapproved drug, and compounded NAD+ products have drawn FDA enforcement. |
European Union EMA | Not approved as of 6 Aug 2026 | NMN is not authorised as a novel food. EFSA issued a positive safety opinion in 2026 but Commission authorisation remains pending. |
India CDSCO | Not approved as of 6 Aug 2026 | NMN is not an approved supplement ingredient. FSSAI moved against it in July 2026, with e-commerce delisting ordered and company applications rejected. This is the inverse of the current US position and is the one that binds readers here. |
How it is being used
What the grey community actually runs, the reasoning they give, and our read on whether it follows from known biology. This is observation, not evidence, and not a recommendation.
No community use documented for this compound yet. Absence here means our editorial team has not reviewed and verified a pattern — not that none exists.
Active clinical trials
No registered trials currently tracked for NAD+.
What remains unknown
The questions that would change our assessment if they were answered.
- Does raising NAD+ produce any outcome a person notices, as opposed to a measurable change?
- Is there any rationale for infusing NAD+ directly rather than using a precursor?
- Which tissues actually see a change after oral precursor dosing?
References
Editorial change history
When we change a grade or a regulatory note, we log it here rather than editing quietly.
Dossier created. Fact-check correction applied: FDA's exclusion of NMN from the dietary supplement definition was REVERSED in late 2025. Publishing the old position as current would have been a false statement of US law. The India and EU positions were added — both are the inverse of the US one, and are the ones that bind our readership.
Spotted something wrong? Tell us — we publish corrections.