NAD+

Overview

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in all living cells, not a peptide. It is classified here alongside peptides for user convenience in the anti-aging / metabolic category. NAD+ plays a central role in cellular energy metabolism and redox reactions and is studied for its involvement in mitochondrial function, DNA-damage signaling via sirtuins and PARPs, and age-associated metabolic decline. IV NAD+ is not FDA-approved for any clinical indication; it is administered off-label through compounding pharmacies and functional-medicine clinics with limited rigorous outcome data.

Mechanism of Action

NAD+ functions as a primary electron carrier in glycolysis, the TCA cycle, and oxidative phosphorylation. Beyond its redox role, NAD+ serves as a consumable substrate for sirtuin deacetylases (SIRT1-7), poly(ADP-ribose) polymerases (PARPs), and CD38/CD157 ectoenzymes. Sirtuin activation is linked to mitochondrial biogenesis, autophagy, and stress-response gene expression, and PARP activity is central to DNA-damage repair. Oral bioavailability of intact NAD+ is poor, which is why clinics market IV infusion; the best human data for raising tissue NAD+ involve oral precursors NR (nicotinamide riboside) and NMN (nicotinamide mononucleotide) rather than NAD+ itself.

Research Summary

The strongest human evidence for raising circulating NAD+ comes from oral-precursor trials. A randomized, double-blind, placebo-controlled study of nicotinamide riboside combined with pterostilbene (NRPT) showed sustained dose-dependent increases in whole-blood NAD+ over 8 weeks in healthy adults (Dellinger et al., npj Aging and Mechanisms of Disease, 2017). A Yoshino/Baur/Imai review summarizes the biology and emerging therapeutic potential of NR and NMN, including preclinical healthspan data in aged mice (Cell Metabolism, 2018). Direct IV NAD+ has only small pilot pharmacokinetic data: Grant et al. infused 750 mg over 6 hours in 8 healthy men and documented altered plasma and urine NAD+ metabolome without clinical-outcome endpoints (Frontiers in Aging Neuroscience, 2019). No adequately powered RCTs support IV or SubQ NAD+ for anti-aging, cognition, addiction, or Parkinson's disease; clinic marketing claims outrun the published outcome evidence.

Vendors selling NAD+

Scored vendors carrying NAD+, ranked by trust grade. Grades are computed from indexed Certificates of Analysis. Full $/mg pricing is on the comparison page.

Prescribers who offer NAD+

344 prescribers in our directory work with NAD+, each confirmed from their own website. Peptides like NAD+ require a prescription from a licensed provider.

Reported Side Effects

• Flushing and warmth during IV infusion (rate-dependent)
• Chest tightness or pressure with fast infusion
• Nausea and abdominal cramping
• Anxiety or restlessness during infusion
• Headache and post-infusion fatigue
• Theoretical acute methyl-group depletion with very high-dose repeated IV

Research Guides

• Cheapest verified NAD+: live prices, vendors & COA data

Compare NAD+ with Others

Research References

• Repeat dose NRPT (nicotinamide riboside and pterostilbene) increases NAD+ levels in humans safely and sustainably: a randomized, double-blind, placebo-controlled study (2017)
• NAD+ Intermediates: The Biology and Therapeutic Potential of NMN and NR (2018)
• A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+ (2019)

Frequently asked questions

Has NAD+ been independently lab-tested?

Disclosed Labs has collected 154 Certificates of Analysis (COA) for NAD+ from 15 independent testing labs. 43 vendors have submitted material for testing. Products average 99.4% tested purity across the corpus. Full testing data is available at https://www.disclosedlabs.com/peptides/nad-plus/testing.

What is the average purity of NAD+ on the market?

Based on 154 COAs analyzed by Disclosed Labs, NAD+ products average 99.4% (±1.2%) tested purity. Individual vendor results vary; see per-vendor COA data at https://www.disclosedlabs.com/peptides/nad-plus/coas.

Which labs have tested NAD+?

Independent labs that have tested NAD+ include: ILS Labs (Grade B). Full lab credibility grades and profiles are at https://www.disclosedlabs.com/labs.

Where can researchers source NAD+?

8 vendors with Disclosed Labs trust grades currently list NAD+, including Glacier Aminos, Ion Peptide, Crush Research. Compare live prices and lab-verified COAs at https://www.disclosedlabs.com/prices/nad-plus.

Which prescribers offer NAD+ with a prescription?

344 prescribers in the Disclosed Labs directory work with NAD+, each confirmed from their own website. NAD+ requires a prescription from a licensed provider. Browse them at https://www.disclosedlabs.com/prescribers?peptide=NAD%2B.

How does NAD+ work?

NAD+ functions as a primary electron carrier in glycolysis, the TCA cycle, and oxidative phosphorylation. Beyond its redox role, NAD+ serves as a consumable substrate for sirtuin deacetylases (SIRT1-7), poly(ADP-ribose) polymerases (PARPs), and CD38/CD157 ectoenzymes. Sirtuin activation is linked to mitochondrial biogenesis, autophagy, and stress-response gene expression, and PARP activity is central to DNA-damage repair. Oral bioavailability of intact NAD+ is poor, which is why clinics market IV infusion; the best human data for raising tissue NAD+ involve oral precursors NR (nicotinamide riboside) and NMN (nicotinamide mononucleotide) rather than NAD+ itself.

What does the research say about NAD+?

The strongest human evidence for raising circulating NAD+ comes from oral-precursor trials. A randomized, double-blind, placebo-controlled study of nicotinamide riboside combined with pterostilbene (NRPT) showed sustained dose-dependent increases in whole-blood NAD+ over 8 weeks in healthy adults (Dellinger et al., npj Aging and Mechanisms of Disease, 2017). A Yoshino/Baur/Imai review summarizes the biology and emerging therapeutic potential of NR and NMN, including preclinical healthspan data in aged mice (Cell Metabolism, 2018). Direct IV NAD+ has only small pilot pharmacokinetic data: Grant et al. infused 750 mg over 6 hours in 8 healthy men and documented altered plasma and urine NAD+ metabolome without clinical-outcome endpoints (Frontiers in Aging Neuroscience, 2019). No adequately powered RCTs support IV or SubQ NAD+ for anti-aging, cognition, addiction, or Parkinson's disease; clinic marketing claims outrun the published outcome evidence.