NAD+

Nicotinamide Adenine Dinucleotide, a coenzyme found in every cell rather than a peptide. The human evidence is short trials of the oral precursors NR and NMN plus one small intravenous infusion pilot, and no approved label sets a dose for NAD+ itself.

Last updated: September 2026

What is NAD+?

NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme found in every living cell. It is essential for over 500 enzymatic reactions including the production of ATP (cellular energy), DNA repair, and the activation of sirtuins, a family of proteins that regulate aging, metabolism, and stress resistance. Browse the full peptide library for related longevity compounds.

Tissue NAD+ is widely described as falling with age, and that decline is the premise behind the whole supplement category. The specific figure that circulates, a 50 percent drop between the ages of 40 and 60, has been removed from this page: it is repeated far more often than it is sourced, measurements differ sharply by tissue and by assay, and no single study establishes it as a general rule. Whether raising NAD+ back up changes anything that matters in humans is still an open question rather than a settled one. Exercise, sleep and sunlight also move NAD+ without a purchase, covered in our guide on how to increase NAD+ naturally.

Injectable or IV NAD+ enters the circulation directly, and whether that produces a better outcome than oral precursors has not been shown in a head-to-head trial; the one infusion pilot on this page found NAD+ was cleared from plasma rapidly (PMID 31572171), where NMN and NR are precursors rather than NAD+ itself. It is offered in clinics for addiction recovery, neurological recovery and general anti-aging use, none of which rests on a controlled trial of the infusion. It is often discussed alongside Epitalon (community practice, no trial), a pairing nobody has tested.

How It Works

Sirtuin Activation: NAD+ is the essential cofactor for sirtuin proteins (SIRT1 to 7), which regulate gene expression, DNA repair, inflammation, and metabolic function. Higher NAD+ levels = more active sirtuins = better cellular maintenance.

PARP Activation: NAD+ fuels PARP enzymes (Poly ADP-Ribose Polymerases) which are critical for DNA repair. DNA damage accumulates with age; robust PARP activity keeps the genome stable.

ATP Production: NAD+ is the electron carrier in the mitochondrial electron transport chain, the final step in cellular energy production. More NAD+ = more efficient ATP production = more energy.

CD38 Regulation: CD38 is an NADase enzyme that increases with aging and consumes NAD+. The idea of inhibiting CD38 while supplementing NAD+ follows from that mechanism, but no human trial has tested the combination, so whether it amplifies anything in people is unknown.

Benefits

Increased cellular energy and reduced fatigue (community claim, no trial on this page)
Enhanced DNA repair capacity (mechanism review: NAD+ is a cosubstrate for PARP enzymes, PMID 26785480; no trial on this page measured DNA repair)
Sirtuin activation: downstream anti-aging effects (mechanism review, PMID 26785480; no human trial has measured an anti-aging outcome)
Improved cognitive function and mental clarity (community claim, no trial on this page)
Metabolic improvements: muscle insulin sensitivity (human trial of oral NMN in prediabetic postmenopausal women, PMID 33888596); mitochondrial function is a mechanism argument, not measured in that trial
Faster recovery from exercise and injury (community claim, no trial on this page)
Neuroprotection and addiction recovery support (community claim, no trial on this page)
Potential lifespan extension (animal models) (animal data reviewed in PMID 29514064; the 12 month mouse NMN study measured age-associated physiological decline, not lifespan, PMID 28068222)

Dosing Described in Research and Labels

Phase	Dose	Frequency	Duration
Oral precursors (NMN/NR)	Sold as a supplement; no established dose	Oral	Not established
Injectable or IV (clinic)	No established dose	Subcutaneous or intravenous	Not established
Human pilot: intravenous NAD+ infusion	3 micromol per minute (trial dose, not a recommendation)	Continuous intravenous infusion	6 hours, a single infusion, plasma and urine NAD+ metabolites only (PMID 31572171)
Human trial: nicotinamide riboside, single dose	100mg, 300mg and 1,000mg single oral doses (trial dose, not a recommendation)	Oral, one dose per arm	The first clinical trial of NR pharmacokinetics in humans, blood NAD+ metabolome only (PMID 27721479)
Human trial: nicotinamide riboside, 6 weeks	Dose not stated in the abstract (trial dose, not a recommendation)	Oral	Two 6 week periods, randomised double-blind placebo-controlled crossover in healthy middle-aged and older adults (PMID 29599478)
Human trial: NMN, 12 weeks	250mg per day (trial dose, not a recommendation)	Oral	12 weeks, n=30 healthy adults, 15 on NMN and 15 on placebo (PMID 35479740)
Human trial: NMN, dose ranging	300mg, 600mg or 900mg daily (trial dose, not a recommendation)	Oral, once daily	60 days, n=80 healthy middle-aged adults randomised against placebo (PMID 36482258)
Human trial: NMN in prediabetic women	Dose not stated in the abstract (trial dose, not a recommendation)	Oral	10 weeks, randomised placebo-controlled double-blind, postmenopausal women with prediabetes who were overweight or obese (PMID 33888596)

These figures summarise what published research and approved labels describe. They are educational, not a recommendation or a personal protocol. Any dose, schedule, or decision to use a compound belongs with a licensed prescriber.

Side Effects

Common

⚠Flushing, reported more often with faster infusion rates (clinic and community reports, no trial)
⚠Nausea during IV administration (clinic and community reports, no trial)
⚠Muscle cramping or chest tightness during IV, reported with faster rates (clinic and community reports, no trial)
⚠Headache (clinic and community reports, no trial)
⚠Fatigue in the first 1 to 2 days (clinic and community reports, no trial)

Rare

•Anxiety or restlessness at high IV doses (clinic and community reports, no trial)
•Hypotension with rapid IV infusion (clinic and community reports, no trial)

Who Should NOT Use NAD+

✕Active cancer (consult oncologist: sirtuins can theoretically help or hinder depending on cancer type)
✕Pregnancy or breastfeeding
✕History of severe cardiovascular disease (for high-dose IV)

What to Expect

Day 1 to 3

IV or injectable NAD+ often produces immediate energy and mood effects. Flushing and nausea possible during infusion (community practice, no trial).

Week 1 to 2

Sustained energy improvement. Cognitive clarity often notable. Sleep quality may improve (community practice, no trial).

Month 1 to 3

Metabolic improvements. Better exercise recovery. Oral users see more gradual benefits over this timeframe (community practice, no trial).

Month 3+

Quarterly IV courses with daily oral NMN in between is the commonly reported pattern (community practice, no trial). No trial has tested that schedule, or measured what long-term use of either route does.

Notes from Ho Chi Minh City

NAD+ is one of the few longevity protocols where HCMC IV-drip clinics are a genuine retail route rather than only a research-grade option: the Maple Healthcare clinic in District 2 and the IV Doctors operation in An Phu run NAD+ drips, with users describing the cleanest cognitive lift in the category over the following day or two. The clinically important detail is that the infusion is run slowly on purpose; pushing it fast is what produces the chest tightness and nausea people are not warned about. Home subcutaneous protocols and oral NMN from Thao Dien supplement retailers are the routes people use outside a clinic (community practice, no trial), but infusion rate, dose, and route are exactly what a clinician supervises, not something to improvise.

Sourcing in Vietnam

NAD+ IV drips are available at HCMC wellness clinics including Maple Healthcare (District 2), IV Doctors (An Phu), and several District 1 longevity clinics. Injectable NAD+ for home protocols is sourced through cold-chain importers, and oral NMN supplements are widely available at HCMC supplement retailers and on Lazada/Shopee. None of that is a regulated pharmaceutical route: NAD+ is not stocked at Long Châu or Pharmacity as a registered product, and no approved label sets an established dose for it by any route. See the supplier list and COA guide before purchasing injectable forms.

FAQ

Q: Is injectable NAD+ better than NMN or NR?

A: No head to head trial has compared the routes, so nobody has shown that one produces better outcomes than another. Factually, NAD+ given by injection or infusion enters the circulation directly while NMN and NR are oral precursors that cells convert. The human evidence on the oral precursors is short and limited: a randomised placebo-controlled crossover trial found that 6 weeks of nicotinamide riboside was well tolerated and raised NAD+ in healthy middle-aged and older adults, with blood pressure and arterial stiffness flagged only as questions for future trials (human trial, not a recommendation, PMID 29599478). Assigning each route a job, one for effect and one for maintenance, is protocol design, and that is a clinical decision rather than something a guide should be making.

Q: Can I stack NAD+ with longevity peptides and other compounds?

A: No trial has tested NAD+ alongside Epitalon or MOTS-c, in any combination, so there is no evidence describing what that grouping does in people and no interaction data to report. Absence of interaction data is not evidence that a combination is safe. Each mechanism can be described on its own, and the individual evidence bases are thin and mostly short term, but describing three mechanisms is not the same as testing them together. Whether any of them belongs in use, alone or alongside anything else, is a clinical decision. Source from the community-verified supplier list. For how NAD+ therapy is offered in HCMC and Hanoi, see the NAD+ therapy guide for Vietnam.

Where to Get NAD+ in Vietnam

See our community-verified supplier list with COA verification and cold-chain shipping to Vietnam. Our supply partner Peptara Labs sells research-grade NAD+ in 1000 mg vials.

View Supply Index NAD+ 1000 mg at Peptara Labs

Related Peptides

MOTS-c Epitalon SS-31 GHK-Cu

Research & Sources

NAD+ in aging, metabolism, and neurodegeneration · Verdin E · Science (2015) (PMID: 26785480)
Foundational review of NAD+ decline with age and the rationale for supplementation as a longevity intervention.
Therapeutic potential of NAD-boosting molecules: the in vivo evidence · Rajman L, Chwalek K, Sinclair DA · Cell Metabolism (2018) (PMID: 29514064)
Comprehensive review of NMN and NR pharmacokinetics and the rationale for IV NAD+ over oral precursors.
Long-Term Administration of Nicotinamide Mononucleotide Mitigates Age-Associated Physiological Decline in Mice · Mills KF, Yoshida S, Stein LR, et al. · Cell Metabolism (2016) (PMID: 28068222)
Animal data demonstrating NMN supplementation preserves NAD+ levels and metabolic function with age.
Effect of nicotinamide mononucleotide on insulin sensitivity in prediabetic women · Yoshino M, Yoshino J, Kayser BD, et al. · Science (2021) (PMID: 33888596)
Human randomized trial showing measurable metabolic benefits from oral NMN in prediabetic postmenopausal women. 10 weeks, placebo-controlled, and the abstract states no milligram amount.
A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD · Grant R, Berg J, Mestayer R, et al. · Frontiers in Aging Neuroscience (2019) (PMID: 31572171)
The only human study of infused NAD+ itself on this page. Pilot design, a single 6 hour infusion at 3 micromol per minute, plasma and urine metabolites only, no clinical outcome and no control group. The abstract does not state how many people were infused.
Nicotinamide riboside is uniquely and orally bioavailable in mice and humans · Trammell SA, Schmidt MS, Weidemann BJ, et al. · Nature Communications (2016) (PMID: 27721479)
First clinical trial of NR pharmacokinetics in humans: single oral doses of 100, 300 and 1,000 mg. Blood NAD+ metabolome only, no clinical outcome, and the study was sponsored by the NR supplier.
Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults · Martens CR, Denman BA, Mazzo MR, et al. · Nature Communications (2018) (PMID: 29599478)
Randomised double-blind placebo-controlled crossover, two 6 week periods, healthy middle-aged and older adults. The abstract states no milligram amount and flags blood pressure and arterial stiffness as questions for future trials rather than findings.
Oral Administration of Nicotinamide Mononucleotide Is Safe and Efficiently Increases Blood Nicotinamide Adenine Dinucleotide Levels in Healthy Subjects · Okabe K, Yaku K, Uchida Y, et al. · Frontiers in Nutrition (2022) (PMID: 35479740)
Small randomised placebo-controlled trial, n=30 healthy adults at 250 mg per day for 12 weeks. Blood NAD+ and safety endpoints only. Four authors were employees of the company that supplied the NMN and the placebo.
The efficacy and safety of beta-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial · Yi L, Maier AB, Tao R, et al. · GeroScience (2023) (PMID: 36482258)
The largest human dose-ranging trial on this page: n=80, 60 days, once daily oral placebo or 300, 600 or 900 mg NMN. Blood NAD+, six-minute walk distance and questionnaire endpoints. Three authors work for the sponsor companies.

Important Disclaimer

Educational content only. Not medical advice. Peptides discussed on this page are not approved by Vietnam’s Ministry of Health (Bộ Y Tế) or the Drug Administration of Vietnam (DAV) for the indications described. Research peptides are not stocked at Long Châu, Pharmacity, or any retail pharmacy in Vietnam. Consult a licensed physician before any use.