Is it safe to combine 25mg intramuscular (IM) Nicotinamide adenine dinucleotide (NAD) with Tru Niagen (Nicotinamide riboside) supplements?

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From the Research

I would not recommend combining 25mg intramuscular (IM) NAD with Tru Niagen (nicotinamide riboside) supplements without medical supervision. Both substances ultimately increase NAD+ levels in your body through different mechanisms, and combining them could potentially lead to excessive NAD+ levels. Tru Niagen is converted to NAD+ in your cells, while IM NAD directly introduces NAD into your system. This combination hasn't been well-studied for safety or efficacy, and there's potential for unpredictable interactions or side effects.

The safety profile of IM NAD itself is not well-established through rigorous clinical trials, as noted in the provided evidence 1, 2, 3. If you're interested in NAD+ enhancement, it would be safer to choose one method rather than combining them. Additionally, IM injections carry risks including infection, pain, and tissue damage if not properly administered.

Some studies have shown that nicotinamide riboside (NR) can increase NAD+ levels in the body, as seen in a study published in 2017 1. Another study published in 2025 found that nicotinic acid riboside maintains NAD+ homeostasis and ameliorates aging-associated NAD+ decline 2. Furthermore, a 2025 study showed that nicotinamide riboside and nicotinamide mononucleotide facilitate NAD+ synthesis via enterohepatic circulation 3.

However, these studies do not provide sufficient evidence to support the safety and efficacy of combining IM NAD with Tru Niagen supplements. Before pursuing either treatment, especially in combination, consult with a healthcare provider who is knowledgeable about NAD+ therapies and can provide personalized guidance based on your specific health situation. They can help you weigh the potential benefits and risks and make an informed decision about the best course of treatment for your individual needs.

Some key points to consider when discussing this with your healthcare provider include:

  • The potential risks and benefits of combining IM NAD with Tru Niagen supplements
  • The safety profile of IM NAD and Tru Niagen supplements individually
  • The potential for unpredictable interactions or side effects when combining these substances
  • Alternative methods for increasing NAD+ levels, such as oral supplements or dietary changes
  • The importance of proper administration and monitoring when using IM injections.

By consulting with a healthcare provider and carefully considering the potential risks and benefits, you can make an informed decision about the best course of treatment for your individual needs.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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