Coenzyme

NAD+

Not FDA approved

5.0/10

BioHarmony verdict

Neutral

NAD+ (Direct) is the central redox coenzyme given by IV, injection, sublingual, or intranasal route, and it scores 5.0-5.5/10 because the human evidence is a single 6-hour IV pharmacokinetic study by Grant 2019 with no efficacy trials, while the oral precursors NMN and NR carry stronger data.

Read full report

What is NAD+?

NAD+ (Direct) is nicotinamide adenine dinucleotide, the central redox coenzyme of metabolism, given as the molecule itself by IV drip, injection under the skin, sublingual lozenge, or nasal spray, rather than as the swallowed precursors NMN or NR. It lands at 5.0-5.5/10, in the Neutral tier, and the reason is delivery, not biology. NAD+ runs the engine of energy metabolism and is consumed by sirtuins, PARPs, and the NADase CD38, and tissue NAD+ falls with age, per Massudi 2012. That decline is the entire reason people try to put NAD+ back.

From the BioHarmony report, reviewed 2026-09-08.

How it is thought to work

Redox carrier plus a consumed substrate for sirtuins, PARPs, and CD38

Safety watch-outs

Strong infusion reaction with chest tightness, severe nausea, or lightheadedness: slow or stop the drip immediately.
Signs of infusion-site infection, redness, swelling, or fever: seek care, since IV and SubQ sourcing and sterility are the main hazards.
Using research-chemical material with no certificate of analysis: stop, since purity and sterility are unverified.
Spending heavily on repeated infusions for an unproven benefit: reconsider, since the cheaper oral precursors carry stronger evidence.

Full risk profile in the BioHarmony report.

Dosing as published

No approved-label or study protocol is recorded for NAD+ yet.

More reported protocols

Members

Members can compare additional reported doses, schedules, and preparation notes.

Educator coverage (1)

Attributed viewpoints, separate from primary research.

Harnessing NAD+ for Optimal Health, Performance, and Longevity with Dr. Jin-Xiong SheJay Campbell · 2026-04-29

Trust & sourcing

US approvalNot FDA approved

CompoundingFDA states NAD+ is not eligible for 503B compounding when it is not on the 503B bulks or shortage lists

Last checked2026-07-13

Next review2026-10-11

FDA has warned that food-grade NAD+ is unsuitable for sterile compounding and has received adverse-event reports after injectable NAD+ products, including severe chills, shaking, vomiting, and fatigue. FDA also cited NAD+ as ineligible for 503B exemptions at an inspected outsourcing facility.

Primary sources

FDA reminds compounders to use ingredients suitable for sterile compoundingU.S. Food and Drug Administration · 2024-10-29
GenoGenix LLC warning letterU.S. Food and Drug Administration · 2026-01-20

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