NAD+

NAD+ is short for nicotinamide adenine dinucleotide. It is a coenzyme, a helper molecule found in every living cell ^[21]. Cells use it to turn food into energy and to repair DNA ^[21]. It is not a peptide. NADH is its reduced form, and FDA lists the two apart ^[1].

It is sold in several forms. Clinics give it by drip into a vein or by shot ^{[5] [11]}. Pills and gels held under the tongue are sold too ^{[6] [19]}. A result for one form does not carry over to another ^[14].

Many studies use precursors instead, such as nicotinamide riboside (NR) or NMN. The body turns these into NAD+, but they are different compounds ^{[14] [15]}. A study of a precursor is not a study of NAD+ ^[14].

NAD+ is in Category 1: FDA's list of substances pharmacies may use while FDA decides whether to add them to the federal list ^{[1] [2]}. That is not approval, and FDA is still deciding ^{[1] [2]}. Checked 26 October 2026.

FDA's May 2026 list names NAD and NADH under Category 1 ^[1]. One salt form is in Category 3, which falls outside FDA's policy for Category 1 ^{[1] [2]}. For Category 1, FDA says it does not plan to act against a pharmacy that meets the policy's conditions ^[2]. That is a choice not to act, not approval of NAD+ as a drug ^[2]. NAD+ is also in Category 1 on FDA's list for outsourcing facilities, which make larger batches ^[3]. It is not in Category 2, FDA's list of substances that may present significant safety risks ^{[1] [4]}.

In 2020, FDA and the FTC warned a seller of NAD+ gels sold with COVID-19 claims. FDA called those gels unapproved new drugs ^[6]. Pills and gels are often called supplements ^{[19] [21]}. No FDA page we checked names NAD+ as a dietary supplement ingredient ^{[7] [8]}. So this page does not give it that status.

The evidence grade is limited-human: one randomized trial and a few small studies test NAD+ itself, and none test aging ^{[12] [14]}.

Heart failure: in a trial in China, 180 adults with heart failure got NAD+ or a dummy drip for a week ^[12]. At one month, heart pumping improved a little more with NAD+ ^[12]. Hospital stays and symptoms showed only trends, not clear results ^[12].

Drips in people: a 2019 pilot in people tracked NAD+ in the blood during a six-hour drip ^[10]. It measured levels, not health ^[10]. A 2026 review of clinic records found NAD+ drips caused more discomfort than drips of a precursor ^[11].

NADH: a 1999 crossover trial of 26 people with chronic fatigue syndrome tested NADH pills, the reduced form ^[13]. Eight improved on NADH and two on a dummy pill ^[13]. That is a small result for a related form ^[13].

Aging: a 2026 systematic review found no outcome trials of NAD+ drips or shots for aging or wellness ^[14]. Precursor pills raised NAD+ levels, but health results were mixed or null ^[14].

Animals: mouse studies often cited for NAD+ used nicotinamide riboside, a precursor ^{[16] [17]}. In mice, it slowed hearing loss with age and eased signs of an Alzheimer's model ^{[16] [17]}. Those are precursor results in mice, not NAD+ results in people ^{[16] [17]}.

The legal ways to get NAD+ are from a pharmacy that compounds it, or in a clinical trial ^{[1] [18]}.

A prescriber can order NAD+ made by a pharmacy, because it is in Category 1 ^{[1] [2]}. That is not FDA approval ^[2]. FDA has told compounders to use only ingredients fit for sterile drugs ^[5].

A trial in Alabama is recruiting healthy adults to compare NAD+ shots with a precursor ^[18]. Other trials plan to start in Canada and China ^{[19] [20]}. The trials block on this page lists open trials with their dates.

NAD+ drips and shots reach people through wellness clinics, med spas and drip bars ^{[11] [21]}. Some are made from food-grade NAD+ sold by repackagers ^[5].

FDA says food-grade ingredients are not fit for sterile drugs without proper processing ^[5]. FDA has reports of severe chills, shaking, vomiting and fatigue after NAD+ shots and drips ^[5]. FDA says these fit too much endotoxin, a toxin from bacteria ^[5].

Under section 503A, a licensed pharmacist or doctor compounds, using ingredients that meet FDA's conditions ^[2]. A law firm notes that FDA treats adding vitamins to a drip bag as compounding ^[9].

An online seller marketed NAD+ gels with disease claims. In 2020, FDA and the FTC warned that seller over COVID-19 claims ^[6].