Dinucleotide coenzyme; not a peptide

Nicotinamide adenine dinucleotide, oxidized form (NAD+)

aka NAD+ · NAD · oxidized nicotinamide adenine dinucleotide

Evidence grade
Grade C: Preliminary human data
for NAD+ infusions/injections for energy, cognition and anti-ageing
User score everyone · n = 30
US FDA Not approved checked 2026-11-13
WADA 2026 Not named no clearance either · checked 2026-11-13
EU No data · checked 2026-11-13

Goals: Cognition & mood · Longevity Compare with another peptide →

User reports

approximate — combined from two independent Reddit reads

Men 45–60

1 man aged 45–60

small sample · n = 1

Outcome unclear 1 of 1

Side effects none reported

Stopped 0 of 1 Used with other compounds 1 of 1

All men

3 men

small sample · n = 3

Outcome positive 2 of 3 · unclear 1 of 3

Benefits energy 1 of 3 · focus / cognition 1 of 3 · mood / anxiety 1 of 3 · recovery 1 of 3

Side effects none reported

Stopped 0 of 3 Used with other compounds 2 of 3

Everyone

30 people

  • Positive: 11 of 30 (37%)
  • Mixed: 6 of 30 (20%)
  • Negative: 8 of 30 (27%)
  • No effect: 1 of 30 (3%)
  • Unclear: 4 of 30 (13%)
Benefits reported of 30
Benefits reported (n = 30)
ItemReports
Energy9 of 30 (30%)
Focus / cognition2 of 30 (7%)
Mood / anxiety2 of 30 (7%)
Recovery1 of 30 (3%)
Side effects reported of 30
Side effects reported (n = 30)
ItemReports
Injection site5 of 30 (17%)
Other5 of 30 (17%)
Fatigue4 of 30 (13%)
Blood pressure2 of 30 (7%)
Flushing2 of 30 (7%)
Insomnia2 of 30 (7%)
Anxiety1 of 30 (3%)
GI upset1 of 30 (3%)
Why people stopped of 30
Why people stopped (n = 30)
ItemReports
Side effects1 of 30 (3%)

Stopped 1 of 30 (3%) Used with other compounds 3 of 30 (10%)

User reports are anecdata, not evidence: self-selected, unverified, often combined with other compounds.

In their words

  • “Energy levels have been extremely high”

  • “I genuinely thought I was gonna pass out and die.”

  • “I did NAD for two months and felt nothing except a rash on the site and weird body jitters for 20 mins.”

  • “Same here I just got done injecting and I feel ALIVE. My eyes feel more wide open and brain feels like it's working.”

  • “At just 20mg my body reacts so hard it literally drops me to my knees. I've heard of people even passing out from it.”

  • “I did a self-injection of only 25mg and I was super sleepy and fatigued.”

  • “NAD+ can cause a sudden blood pressure drop... The NAD+ reaction for me only last seconds and only when I take too much.”

Read summaries and method notes

Read 1. One qualifying 50-year-old male reported injectable NAD+ as part of an SS-31 and MOTS-c regimen, but did not establish a separate NAD+ outcome; his result was therefore coded unclear. A 31-year-old man separately described a marked increase in energy, recovery, and mental clarity following intramuscular injections. Across the 12 coded reports, energy was the most frequently mentioned benefit, while flushing, gastrointestinal discomfort, insomnia, injection-site reactions, and severe dizziness or near-fainting appeared in adverse reports. Some users described effects within hours or days, while another described a delayed improvement during a multi-treatment regimen. Injectable NAD+ was kept separate from oral NMN and NR; the sample is too small and confounded to establish either effectiveness or safety in men aged 45–60.

Read 2. No man aged 45–60; one man (31M, very positive, with tirzepatide). Twenty-five users from 14 threads: 9 positive, 5 mixed, 7 negative, 1 no effect, 3 unclear. Responders felt immediate "clean energy" and sharper focus at 25–100 mg 2–5 times a week. Side effects were frequent and dose-limiting: burning and lumps from unbuffered SubQ shots; above 40–60 mg, or accidental vein hits, sudden low blood pressure, vertigo, fainting, racing heart, nausea, soreness and lethargy. Users advise starting at 20–25 mg, morning dosing, buffered solutions, and aspirating.

Note 1. Includes only explicit or contextually clear injections/infusions, not oral precursors. One 50M user documented NAD+ use with SS-31 and MOTS-c but gave no separable NAD+ verdict. One older woman's delayed energy improvement also involved several treatments. Other includes dizziness, near-fainting, or jitters; blood pressure was not coded from symptoms alone. Doses expressed as syringe units were retained without conversion. Counts are a verified subset, not a full census.

Note 2. Oral NR/NMN reports and clinic-promotion comments were excluded. Only injectable/IV NAD+ self-reports were counted.

Each read counted people independently. Overlap between the two reads is estimated from shared threads and removed; counts are approximate. How we count.

Summary

Critical dinucleotide coenzyme—not a peptide—involved in cellular energy production, DNA repair, sirtuin activation and mitochondrial function. These physiological roles do not by themselves demonstrate benefits from administering NAD+. Age-related changes depend on tissue and measurement: recent whole-blood studies did not find a universal healthy-aging decline, so “levels decline significantly with age” is not a universal finding. One of the most well-researched molecules in aging biology.

Proposed mechanism

  • Fundamental to cellular energy production (>500 metabolic reactions)
  • Activates sirtuins (longevity proteins)
  • Supports normal mitochondrial function; this is distinct from proving clinical improvement after NAD+ administration
  • Supports DNA repair mechanisms

Safety

  • Infusion-related gastrointestinal symptoms, chest pressure and increased heart rate
  • FDA reports severe chills, shaking, vomiting and fatigue consistent with excessive endotoxin exposure
  • Long-term safety for wellness use not established
  • Safety and efficacy cannot be transferred between NAD+, NADH, NR, NMN or administration routes

From labels, regulators and trials. No signal in small studies ≠ safe.

Evidence C NAD+ infusions/injections for energy, cognition and anti-ageing

C stands. For the wellness use there is an 11-person pharmacokinetic pilot, a 14-person tolerability comparison and a 5-day oral biomarker trial - early human work with no clinical benefit shown. The two positive cardiac RCTs (ischaemic cardiomyopathy, post-heart-attack) are a different use at a different dose and neither lifts the wellness grade to B nor is relevant to it. Not D, because humans have been dosed and measured.

Human trials · 5

  1. PMID 315721712019Controlled pilot pharmacokinetic/metabolomic study 11 people

    Healthy men; eight NAD+ recipients and three saline controls

    Measured plasma and urine metabolism after one infusion; did not test longevity, cognition or functional efficacy. Source

  2. PMID 417046782026Retrospective nonrandomized tolerability comparison 14 people

    Six NAD+ and eight nicotinamide-riboside infusion recipients

    NAD+ caused more infusion symptoms; small short-term study cannot establish durable benefit or safety.

  3. PMID 409543882025Single-center placebo-controlled RCT; online 2025, journal issue 2026 180 people

    Ischemic cardiomyopathy with LVEF at most 45% and NYHA II-III

    One-month LVEF 45.44% versus 42.44% (p=0.024); six-month clinical-event difference not significant. Source

  4. PMID 429616392026Placebo-controlled RCT 120 people

    ST-elevation myocardial infarction after primary PCI

    Thirty-day LVEF 56.32% versus 53.37% (p=0.048); no significant six-month MACCE reduction. Source

  5. PMID 425308102026Phase 0/1b placebo-controlled RCT; 50 in primary analysis; retrospectively registered 60 people

    Healthy adults aged 45-75; specialized oral NAD+ formulation

    Five-day intracellular blood NAD biomarker increase; not evidence of extended lifespan or established wellness efficacy.

Bar length = trial size on a log scale.

Dose ranges

Reported ranges from labels and studies, with context. Not a recommendation.

  • clinical trial
    750 mg IV over six hours once, 2019 metabolism pilot Source on a non-primary host — not linked
  • clinical trial
    10 mg IV daily for seven days alongside standard treatment in cardiac-disease RCTs Source
  • user-reported
    500 mg IV on four consecutive days, documented retrospectively in medical records; not a recommended wellness regimen Source on a non-primary host — not linked

Editorial ratings EDITORIAL

Editors’ judgement, 0–5. Opinion, not data; separate from grade and user score.

  • Safety 4 out of 5
  • Sleep 3 out of 5
  • Recovery not rated —
  • Cognitive 4 out of 5

Sources

  1. pmc.ncbi.nlm.nih.gov/articles/PMC6751327/
  2. pubmed.ncbi.nlm.nih.gov/40954388/
  3. pubmed.ncbi.nlm.nih.gov/42961639/
  4. fda.gov/media/94155/download
  5. wada-ama.org/sites/default/files/2025-09/2026list_en_final_clean_september_2025.pdf
  6. fda.gov/drugs/human-drug-compounding/fda-reminds-compounders-use-ingredients-suitable-ster
  7. fda.gov/drugs/human-drug-compounding/bulk-drug-substances-used-compounding-under-section-5
  8. fda.gov/advisory-committees/advisory-committee-calendar/july-23-24-2026-meeting-pharmacy-c
  9. pmc.ncbi.nlm.nih.gov/articles/PMC12907335/
  10. pubmed.ncbi.nlm.nih.gov/42530810/
  11. pubmed.ncbi.nlm.nih.gov/42135539/
  12. pubmed.ncbi.nlm.nih.gov/42983021/

Reddit threads read · 17

4 further sources on commercial or non-primary hosts not listed.

Research checked 2026-11-13.