NAD+ is a coenzyme found in every cell, and interest in boosting it has surged. A grounded look at its biology, the human studies that exist, and the gap between laboratory findings and marketing claims.
NAD+ has gone from a biochemistry lecture topic to a wellness buzzword in a remarkably short time. It shows up in supplements, IV drips, injections and nasal sprays, often with claims about energy and healthy aging. Some of those claims trace back to genuine science. Others run far ahead of it. This article explains what NAD+ does, what human research has and has not shown, and how to think about the products available, including compounded ones. It is educational and not a recommendation for any treatment.
NAD+ stands for nicotinamide adenine dinucleotide. It is a coenzyme, a molecule that enzymes need in order to work, present in every living cell. A 2021 review in Nature Reviews Molecular Cell Biology by Covarrubias and colleagues summarizes its two broad roles.
First, NAD+ is central to energy metabolism. It shuttles electrons during the breakdown of glucose and fat, cycling between NAD+ and NADH, and this is how cells extract usable energy from food.
Second, NAD+ is consumed by enzyme families that regulate cellular maintenance, including sirtuins (gene regulation and stress responses), PARPs (DNA repair) and CD38 (immune signaling). Because these enzymes use NAD+ up, the cell must constantly make more from dietary precursors, mainly forms of vitamin B3 and the amino acid tryptophan.
NAD+ levels decline in many tissues with age, driven by increased consumption and reduced synthesis. In animal studies, restoring NAD+ through precursor supplementation has improved markers of metabolic health and mitochondrial function. This is the legitimate foundation for the interest. It is also where caution begins, because mouse results do not reliably translate to people.
Human research has focused mainly on oral precursors, nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). A 2023 review by Freeberg and colleagues found that several randomized trials show these are well tolerated over weeks to months and raise NAD+ or related metabolites in blood. In a 2018 trial, Martens and colleagues found a roughly 60 percent increase in NAD+ in blood cells after six weeks of NR. A 2022 trial by Okabe and colleagues found that 12 weeks of oral NMN raised whole-blood NAD+ with no safety signals.
Whether raising blood NAD+ changes anything that matters is less clear. Some trials reported modest improvements in measures such as walking speed or muscle insulin sensitivity, but many found no change in blood pressure, body composition, lipids, glucose tolerance, cognition, sleep or fatigue. In short: oral precursors raise a blood marker; a health benefit in people has not been established.
Many clinic products are NAD+ itself, delivered by injection or nasal spray. The evidence for these routes is thinner than for oral precursors. There are no large randomized controlled trials showing that injected or intranasal NAD+ improves energy, cognition or any clinical outcome in healthy adults.
NAD+ injections and nasal sprays are compounded medications. They are not FDA-approved, and the FDA does not review compounded drugs for safety, effectiveness or quality before they are sold. The NAD+ products available through Oh My Body Studio are compounded and not FDA-approved.
Trials have mostly excluded people with significant medical conditions, pregnancy and breastfeeding. Anyone with cancer or a cancer history should discuss NAD+ with their oncology team. People with liver or kidney disease, and anyone taking multiple medications, should have a licensed provider review potential interactions.
If you are curious about NAD+, a licensed provider can discuss the current evidence honestly, review your medications and history, and help you decide whether a compounded product makes sense for you. This article is educational, makes no claims about results, and does not determine eligibility for any treatment.
This article is educational and does not diagnose conditions, establish eligibility for any medication, or replace care from a licensed provider. Compounded medications are not FDA-approved.
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