NAD+ (Nicotinamide Adenine Dinucleotide)
Coenzyme essential for cellular energy production and DNA repair (NOT a peptide — it's a nucleotide). Available as IV infusion, intranasal, and oral precursors (NR, NMN). Heavily discussed in longevity communities. Direct NAD+ supplementation has weak human RCT support; precursors have somewhat better data.
Educational only — not medical advice. SmartPeptide does not prescribe, diagnose, or treat. Always consult a licensed healthcare provider before using any peptide, supplement, medication, or protocol.
What the research shows
NAD+ precursors (NR, NMN) raise blood and tissue NAD+ levels in humans. Effects on aging biomarkers, sleep, and cognitive measures are modest at best in published RCTs. Direct IV NAD+ has very limited rigorous human-trial support outside addiction medicine.
What's still experimental
Virtually every consumer-marketed claim about NAD+ extending healthspan, reversing aging, or treating long COVID is extrapolated from animal/in-vitro work, not from confirmatory human RCTs.
Anecdotal / community reports
Subjective energy, cognitive clarity, and 'recovery' reports are very common. These are heavily confounded by placebo (especially with high-cost IV infusions) and concurrent lifestyle changes.
Anecdotal reports are NOT scientific evidence. They reflect personal experience and may not generalize.
FDA approval status
Source: openFDA + DailyMed (NIH/NLM)Doses studied in research
No established dose rangeWhat published trials tested or FDA-approved labels specify. Reporting research facts — not a SmartPeptide recommendation.
This is the honest answer for peptides like BPC-157, IGF-1 LR3, MOTS-c, Epitalon and similar research compounds — robust human dose- ranging studies have not been published. Always work with a licensed clinician familiar with experimental peptides if you are considering any use.
FDA enforcement & recalls
Live · openFDA Drug Enforcement API- Class IIOngoing· Voluntary: Firm initiatedFDA record
NAD+ (Nicotinamide adenine dinucleotide), a) 50 mg/mL, b) 100 mg/mL, 10 mL multi-dose vials, all strengths and presentations, GenoGenix, LLC, 2840 NW 2nd Ave Ste 204 Boca Raton, FL 33431-6692. Also la…
Reason: Lack of Assurance of Sterility
Jul 30, 2025·GenoGenix LLC - Class IOngoing· Voluntary: Firm initiatedFDA record
NAD+ (Nicotinamide adenine dinucleotide) for Injection, a) 100 mg/mL b) 200 mg/mL, 10 mL multi-dose amber vials, GenoGenix, LLC, 2840 NW 2nd Ave Ste 204 Boca Raton, FL 33431-6692.
Reason: Microbial Contamination of Sterile Products: elevated endotoxin levels
Jul 30, 2025·GenoGenix LLC - Class IICompleted· Voluntary: Firm initiatedFDA record
NAD+ Nicotinamide Adenine Dinucleotide, Lyophilized powder for reconstitution, Multi-Dose 500 mg per vial, Rx Only, Olympia Pharmaceuticals, 6700 Conroy Rd., Ste. 155 Orlando, FL 32835. NDC 73198-008…
Reason: Lack of assurance of sterility.
May 9, 2022·Olympia Compounding Pharmacy dba Olympia Pharmacy - Class IITerminated· Voluntary: Firm initiatedFDA record
NAD+ Nicotinamide Adenine Dinucleotide Lyophilized powder for reconstitution, Multi-Dose 500 mg Per Vial, Rx Only, Olympia Pharmaceuticals 6700 Conroy Rd., Ste. 155, Orlando, FL 32835. NDC 73198-0083…
Reason: CGMP Deviations: prior to October 1, 2021, environmental and personnel monitoring Out of Action Limit (OOAL) excursions were not being properly investigated
Apr 4, 2022·Olympia Compounding Pharmacy dba Olympia Pharmacy - Class IITerminated· Voluntary: Firm initiatedFDA record
NAD+ Nicotinamide Adenine Dinucleotide Lyophilized powder for reconstitution, Multi-Dose 500 mg Per Vial, Rx Only, Olympia Pharmaceuticals 6700 Conroy Rd., Ste. 155, Orlando, FL 32835. NDC 73198-0083…
Reason: Failed Reconstitution time
Apr 4, 2022·Olympia Compounding Pharmacy dba Olympia Pharmacy
Mechanism & targets
ChEMBL · UniProt · Open TargetsMolecule (ChEMBL)
View on ChEMBLProtein targets (UniProt)
- Mitochondrial nicotinamide adenine dinucleotide transporter 1P40556gene: YIA6Saccharomyces cerevisiae (strain ATCC 204508 / S288c)· 373 aaReviewed
Mitochondrial inner membrane carrier protein that mediates the import of NAD(+) into mitochondria (PubMed:16291748, PubMed:32906142, PubMed:33087354). Can transport NAD(+) by unidirectional transport or by exchange with intramitochondrially generated dAMP and dGMP (PubMed:16291748). Also able to transport NAD(+) by exchange with AMP, GMP or deamido-NAD (+) in vitro (PubMed:16291748)
- Conidial surface nicotinamide adenine dinucleotide glycohydrolaseQ7S936Neurospora crassa (strain ATCC 24698 / 74-OR23-1A / CBS 708.71 / DSM 1257 / FGSC 987)· 243 aaReviewed
Conidial surface nicotinamide adenine dinucleotide glycohydrolase that cleave NAD(+) and NADP(+) but not their reduced counterparts, NADH and NADPH (PubMed:33712585, PubMed:6260480). Lacks both ADP-ribosyl cyclase and base exchange activity and does not mediate synthesis of calcium messengers cADPR or NAADP (PubMed:33712585). Its function is correlated with aerial hyphae formation and conidiogenesis, but its physiological role is still obscure (PubMed:131723, PubMed:165174). Is able to ADP-ribos…
- NH(3)-dependent NAD(+) synthetaseP18843gene: nadEEscherichia coli (strain K12)· 275 aaReviewed
Catalyzes the ATP-dependent amidation of deamido-NAD to form NAD. Uses ammonia as a nitrogen source
Live research
PubMed · ClinicalTrials.gov · Europe PMC · OpenAlexClinical trials (ClinicalTrials.gov)
- Study of the Fetal and Maternal Microbiota in Preganant Women With Fetal Defect GrowthTERMINATEDNCT04047966 · N/A · n=42 · 2018-03-02
- Effect of Metformin on Vascular and Mitochondrial Function in Type 1 DiabetesCOMPLETEDNCT01813929 · PHASE4 · n=23 · 2011-06
- Nicotinamide Riboside in Ulcerative ColitisRECRUITINGNCT05561738 · NA · n=40 · 2024-02-28
- N-DOSE: A Dose Optimization Trial of Nicotinamide Riboside in Parkinson's DiseaseCOMPLETEDNCT05589766 · PHASE2 · n=81 · 2023-01-23
- Atherosclerotic Plaque Characteristics Associated With a Progression Rate of the Plaque in Carotids and a Risk of StrokeUNKNOWNNCT02360137 · N/A · n=1863 · 2015-04-01
Europe PMC — 4,833 additional records
Includes EU/UK studies and PubMed Central full-text articles. Often surfaces research weeks before PubMed indexes it.
- NAD<sup>+</sup> precursor supplementation reverses CD36-mediated lipid accumulation and ferroptosis to restore antitumor function of NK cells in DLBCLShi L, Huang X, Han X, et al. · 2026Open access
- Mechanisms and therapeutic potential of mitochondrial-targeted therapies in bone repairXu N, Ma W, Liu G, et al. · 2026Open access· cited 2×
- A sustained NAD<sup>+</sup> supplementation-biosynthesis nanoplatform for metabolic restoration in aged bone regenerationXie F, He Z, Xu S, et al. · 2026Open access
- Mitochondrial Metabolic Biomarkers in Periodontitis: Discovery and Clinical ValidationWu J, Wu J, Hong Y, et al. · 2026Open access
Research volume (OpenAlex topic graph)
Human clinical evidence
Semantic Scholar · AI TLDRs · influence-rankedHuman-study summaries for “NAD+ supplementation OR NMN OR nicotinamide riboside” are available on Semantic Scholar but the shared free-tier API quota is exhausted right now. Try refreshing in a few minutes, or check the PubMed and Europe PMC panels above for the same literature.
Research funding & verification
NIH RePORTER · CrossRef DOI registryNIH-funded research
U.S. National Institutes of Health- 1R01HL165792-01$733KUnderstanding the roles of cardiac NAD pools and therapeutic effects of precursor supplements in heart failureJoseph A. Baur · UNIVERSITY OF PENNSYLVANIA · FY2022
- 5R01HL165792-02$661KUnderstanding the roles of cardiac NAD pools and therapeutic effects of precursor supplements in heart failureJoseph A. Baur · UNIVERSITY OF PENNSYLVANIA · FY2023
- 5R01HL165792-03$644KUnderstanding the roles of cardiac NAD pools and therapeutic effects of precursor supplements in heart failureJoseph A. Baur · UNIVERSITY OF PENNSYLVANIA · FY2024
- 5R01HL165792-04$635KUnderstanding the roles of cardiac NAD pools and therapeutic effects of precursor supplements in heart failureJoseph A. Baur · UNIVERSITY OF PENNSYLVANIA · FY2025
Publication landscape
CrossRef · DOI registry- National Natural Science Foundation of China2,901 works
- National Institutes of Health997 works
- National Key Research and Development Program of China741 works
- Conselho Nacional de Desenvolvimento Científico e Tecnológico517 works
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior481 works
- National Research Foundation of Korea295 works
Funder diversity is a credibility signal. Research concentrated in a single drug company's funding warrants more scrutiny than research funded across NIH, charities, and academic grants.
Preprints — cutting edge
bioRxiv · medRxiv · via Europe PMCPreprints have NOT been peer-reviewed. They are early research shared by authors before formal validation. Treat findings as preliminary.
- PreprintThe divergent effects of nicotinamide riboside and high-intensity exercise training on skeletal muscle epigenetic agingHeikkinen A, Uusitalo-Kylmälä L, Blom I, et al. · 2026-01-21
- PreprintPreliminary Safety Analysis of Two Pilot Clinical Trials Involving Injections of Niagen®, Nicotinamide Riboside ChlorideNkrumah-Elie Y, Kwon J, Simpson S, et al. · 2026-04-30
- PreprintSIRT5-dependent regulation of ASL controls arginine metabolism and T cell functionHan K, Klein RJ, Wu K, et al. · 2026-06-29
- PreprintNicotinamide Riboside Enhances Mitochondrial Bioenergetics and Dopaminergic Signaling Independent of Neuron Survival in a Double-Hit Parkinson’s ModelSaha S, Meng C, Dong J, et al. · 2026-06-19
- PreprintNuclear DNA Damage is a Primary Driver of Mitochondrial Dysfunction in <i>C9ORF72</i> ALS/FTDZilocchi M, Salvatori I, Lombardi S, et al. · 2026-05-21
- Preprint3D human skeletal muscle organoids reveal distinct effects of high-dose dihydronicotinamide riboside on muscle developmentVenkateshvaran A, Pundlik SS, Suresh Y, et al. · 2025-12-03
Known risks
IV NAD+ administration can cause significant flushing, chest pressure, nausea — particularly at fast infusion rates. Quality and dosing of compounded NAD+ vary widely. Long-term high-dose safety data is sparse. Theoretical concern about cancer cell metabolism support.
Reported side effects
IV: flushing, nausea, chest discomfort, fatigue post-infusion. Oral precursors (NR, NMN): generally well-tolerated; mild GI upset.
FDA adverse event reports (FAERS)
Updated quarterly by FDA- US2
Most-reported reactions
- Blood Urine Present1
- Diarrhoea Haemorrhagic1
- Erectile Dysfunction1
- Loss Of Libido1
- Nausea1
Counts from FDA Adverse Event Reporting System (FAERS). Voluntary reports — they show what was reported, not whether the drug caused the event. Many reports lack confirmation. FAERS docs
What requires medical supervision
IV infusions require trained clinicians and proper monitoring. Oral precursors (NR, NMN) are sold OTC; quality varies. Discuss with a clinician if you have any cancer history or active malignancy.
Questions for your clinician
- What's the evidence for my specific goal vs. just elevating NAD+ levels?
- Are oral precursors a more rational starting point than IV?
- What's the cancer-history discussion for me?