NAD+: Potential Benefits, Known Risks, and More

Note: The U.S. Food and Drug Administration (FDA) does not approve supplements for safety or effectiveness. Talk to a healthcare professional about whether a supplement is the right fit for your individual health, and about any potential drug interactions or safety concerns.

Scientists are studying whether increased NAD+ levels improve health markers and prevent age-related health conditions. “The idea is that if you can restore NAD+, it will improve health and function across a lot of different domains,” Dr. Craighead says.

While the role of naturally occurring NAD+ for health and longevity is well-established, whether NAD+ supplements can provide additional benefit (or make up for natural decreases in NAD+) is less conclusive. Here’s what you need to know about NAD+ supplements and whether they may be supportive of your health goals.

NAD+ has gotten a lot of hype for its potential to lower inflammation, improve cognitive function, lower the risk of type 2 diabetes and blood pressure issues, and repair the skin.

“There's a lot of interest and promise in boosting NAD+ because of the research that's been done in animal models, but the human research hasn't been as exciting,” Craighead says. “A lot of the studies done with people have been small and for a short duration, and we're still waiting for bigger studies to come out and provide definitive proof.”

Here are some of the potential health benefits of NAD+ according to research on oral NAD+ precursor supplementation so far.

May Reduce Inflammation

“Reductions in inflammation is the most consistent benefit we see across studies of NR,” Craighead says. But whether the reduction in inflammation linked to NAD+ is also associated with lower chronic disease risk or prognosis hasn’t been proven, Craighead says. “What it does in the long run, we don't yet know.”

May Improve Cognitive Function for Certain Populations

Researchers suspect the anti-inflammatory effects of NAD+ may offer perks for brain health — in particular, for inflammatory neurodegenerative diseases like Parkinson’s, Alzheimer’s, and amyotrophic lateral sclerosis (ALS). And they’ve started to investigate if there is indeed a link.

The researchers believe NR may help prevent Parkinson’s disease from worsening, but more research is needed. “There are some promising signs of benefit, but the benefits are pretty small and only tested in a handful of people,” Craighead says.

May Lower Diabetes Risk

NAD+ may lower the risk of type 2 diabetes by improving insulin sensitivity (how well your body responds to insulin, a hormone that regulates blood sugar).

Craighead says the research is promising but calls for more studies with larger sample sizes.

May Improve Heart Health

Craighead notes that a caveat of this review is that it involved studies using niacin, which is a precursor to NAD+, but isn’t commonly used, owing to its adverse side effects.

Here’s what to know about the safety of taking NAD+ supplements. Note that the U.S. Food and Drug Administration (FDA) does not regulate supplements as rigorously as it does medications, so it’s important to use them with caution.

Risks

In addition, because NAD+ boosts cellular activity, there’s concern that it may encourage abnormal cells, like cancer cells, to survive. “As a precaution, we do not give NAD+ to patients with cancer,” says Amanda Kahn, MD, a board-certified internist in private practice in New York City who specializes in longevity medicine.

She also advises avoiding NAD+ if you’re pregnant or breastfeeding, citing a lack of safety data in these populations.

Side Effects

• Liver damage
• Headache
• Skin flushing
• Dizziness

NAD+ is sometimes provided by a healthcare professional as an injection or infusion. If you receive NAD+ as an injection, you may experience redness, itching, or tenderness at the injection site. “But this dissipates quickly and is not harmful,” Dr. Kahn says.

NAD+ supplements are available in the following forms:

• Capsules
• Powders
• Injections
• Intravenous (IV) infusions
• Nasal sprays

As NAD+ isn’t well absorbed by the body, Kahn recommends oral supplements made of a precursor, such as NR or NMN, or an injection of NAD+.

Injections and IV infusions deliver NAD+ to the bloodstream quickly and are absorbed better by the body since they bypass the gut, Craighead says. But he says a pill form of a precursor should be just as efficient (and probably more convenient).

You may also encounter an NAD+ nasal spray, which may be preferred by needle-averse patients, Kahn says. “However, these patients may not receive the full benefits,” she says, as nasal sprays don’t fully reach the bloodstream the way injections do.

• Beef liver (3 ounces): 14.9 mg
• Chicken breast (3 oz): 10.3 mg
• Marinara sauce (1 cup): 10.3 mg
• Turkey breast (3 oz): 10 mg
• Sockeye salmon (3 oz): 8.6 mg
• Canned tuna (3 oz): 8.6 mg
• Peanuts (1 oz): 4.2 mg
• Russet potato (1 medium): 2.3 mg

But relying on diet isn’t the most effective way to increase your body’s NAD+ supply, Craighead says. Kahn agrees: “Dietary niacin, while important, is likely not consumed in large enough quantities to impact NAD+ levels.”

Here’s what to keep in mind when shopping for and storing an NAD+ supplement.

Selection

When choosing a supplement, look for one with third-party approval, Craighead says. This means the product has undergone testing for quality and purity. Check the label for approval from an organization such as U.S. Pharmacopeia, NSF International or ConsumerLab.

And remember: Because NAD+ isn’t absorbed well by the body, it’s best to look for a precursor, Craighead says. You’re more likely to find NR, as NMN was banned by the FDA in 2022 to explore its use as a pharmaceutical medication versus a supplement, Craighead says.

Storage

NAD+ and precursor supplements can be stored at room temperature, but NAD+ injections should be refrigerated, Kahn says. When in doubt, check the supplement label for storage instructions.

There’s no standard dose of NAD+ at this time because new research is still emerging. So far, research has focused on 1,000 mg of NR per day and 250 mg of NMN per day, Craighead says.

For reference, Kahn prescribes 200 to 400 mg of NAD+ in injections directly under the skin in one or two doses per week. Yet, protocols for injection and IV infusion of NAD+ are still experimental and need further validation from research.

• NAD+ is an essential coenzyme that plays a role in energy production, DNA repair, and communication between cells. Levels naturally decline with age, which may increase the risk of chronic health conditions.
• Precursor supplements that boost NAD+ levels may lower inflammation, improve brain and heart health, and lower diabetes risk. Yet, the research is limited overall at this time and larger clinical trials are needed.
• NAD+ supplements are generally safe when taken in amounts recommended by a physician. But you should avoid NAD+ supplements if you have cancer or are pregnant or breastfeeding.
• Consult your healthcare provider before taking NAD+ supplements, especially if you’re managing a chronic condition or using medications.