NAD+ Infusions: Lack of Medical Evidence and Safety Concerns
NAD+ infusions are not recommended for any medical condition due to lack of clinical evidence supporting their safety and efficacy. 1, 2, 3
What is NAD+?
- NAD+ (Nicotinamide adenine dinucleotide) is a coenzyme required by more than 400 enzymes to catalyze reactions in the body, helping convert nutrients into energy, create cholesterol and fats, repair DNA, and exert antioxidant effects 1, 2
- NAD+ plays central roles in mitochondrial energy metabolism, DNA repair, gene expression, and stress responses 3
Current Evidence and Guidelines
- No established clinical guidelines recommend the use of NAD+ infusions for any medical condition 1, 3
- The American Academy of Physical Medicine and Rehabilitation does not recommend NAD+ infusions due to lack of clinical evidence 1
- Injectable NAD+ products are not FDA-approved for clinical use in the United States 3
Safety Concerns with Injectable NAD+
- Injectable administration bypasses normal protective barriers and introduces significant risks including infection from improper sterile technique 3
- Potential for adverse reactions including hypersensitivity 3
- Unknown pharmacokinetics when administered parenterally 3
- No standardized dosing protocols exist for injectable NAD+ administration 3
Reported Side Effects
- Common side effects associated with high-dose niacin (a precursor to NAD+) include:
- Studies on oral NAD+ precursors report side effects including muscle pain, nervous disorders, fatigue, sleep disturbance, and headaches 5
Recommended Dietary Intake of Niacin (NAD+ Precursor)
- For enteral nutrition: 18-40 mg per day of niacin in 1500 kcal 4
- For parenteral nutrition: at least 40 mg of niacin per day 4
- American College of Nutrition recommends daily intake of niacin: adult males 16 mg/day, adult females 14 mg/day 2
Upper Intake Limits
- Upper limit for free nicotinic acid: 10 mg/day (based on flushing effects) 2
- Upper limit for nicotinamide: approximately 900 mg/day for adults 4, 2
Emerging Research
- Some preliminary research suggests potential benefits of NAD+ supplementation for:
- However, these studies are limited, often conducted in animal models, and lack robust clinical evidence in humans 7, 9
Alternative Approaches to Support NAD+ Levels
- Dietary sources of niacin include meat, poultry, fish, nuts, legumes, and fortified foods 1, 2
- The oral/enteral route should be used whenever the gastrointestinal tract is functional 4
Conclusion
While NAD+ plays important roles in cellular metabolism and some preliminary research shows potential benefits of supplementation, there is insufficient evidence to support the use of NAD+ infusions in clinical practice. The lack of FDA approval, standardized protocols, and safety concerns make NAD+ infusions inadvisable until more robust clinical evidence becomes available.