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Study · Observational study · 2026

14 results

Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting.

Reyna K, Heinzen G, Patel N, Ritter M, Siojo A, Legere H, Pojednic R

Frontiers in aging2 Feb 2026Cited by 1 (Europe PMC)

PMID41704678 (opens in a new tab)PMCIDPMC12907335 (opens in a new tab)DOI10.3389/fragi.2026.1652582 (opens in a new tab)PepBankPUB-41704678
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Summary

BackgroundNicotinamide adenine dinucleotide (NAD+) is a cofactor for NAD+-dependent enzymes that regulate DNA repair, cellular metabolism, and immune function. Supplementation with NAD+ and its precursors is commonly used to prevent age-related disease and extend healthspan. Commercial clinical and wellness settings increasingly provide intravenous (IV) NAD+ and nicotinamide riboside (NR) despite limited evaluation of safety and effectiveness. These considerations are important, as NAD+ and its precursors differ in reported side effects, cellular uptake, and metabolism. This study sought to compare commercially administered NAD+ IV and NR IV in humans by evaluating infusion time, tolerability, safety markers, and metabolic outcomes.MethodsA retrospective review of electronic medical records was conducted in clients from a commercial setting. Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up. Primary outcomes included reported symptoms, total infusion time, blood pressure, resting heart rate, and biomarker assessments (ALT, AST, hsCRP, BUN/creatinine, and TSH). Exploratory analyses included metabolic biomarkers (HbA1c, fasting glucose, HDL-C, LDL-C, and triglycerides).ResultsTolerability differed between groups. Participants that received NAD+ IV reported moderate to severe gastrointestinal symptoms, increased heart rate, and chest pressure during infusions. Participants receiving NR IV experienced minor tongue, jaw, and arm tingling and mild cramping during infusion. All symptoms resolved upon infusion completion. Moderate to severe symptoms with NAD+ IV resulted in longer infusion times compared to NR IV, averaging 97 min versus 37 min, respectively. No significant changes were observed in ALT, AST, hsCRP, BUN/creatinine, or TSH. Alkaline phosphatase (ALP) decreased significantly in the NAD+ IV group only, with values remaining within normal reference ranges. The NR IV group demonstrated a significant reduction in HbA1c, whereas the NAD+ IV group showed a significant reduction in HDL-C. Neither group exhibited changes in fasting glucose or LDL-C over the 30-day period.ConclusionThis study directly compared commercially administered NAD+ IV and NR IV, providing preliminary real-world evidence of infusion tolerability and short-term safety. Exploratory metabolic outcomes were variable and warrant further investigation. Additional studies are needed to evaluate dosage and effectiveness beyond 30 days.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study14

14 results from studies that gave the peptide. 14 results from people.

  1. 01HumanObservational studySafety outcome

    In commercial clients, NAD+ infusions were associated with moderate to severe gastrointestinal symptoms.

    In plain wordsIn commercial clients, NAD+ infusions were linked to moderate to severe digestive symptoms.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    Not applicableGastrointestinal symptoms
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Gastrointestinal adverse events · Gastrointestinal
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    Participants that received NAD+ IV reported moderate to severe gastrointestinal symptoms, increased heart rate, and chest pressure during infusions.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  2. 02HumanObservational studySafety outcome

    In commercial clients, NAD+ infusions were associated with increased heart rate.

    In plain wordsIn commercial clients, NAD+ infusions were linked to increased heart rate.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    IncreaseHeart rate during infusion
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Adverse events · Cardiovascular
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    Participants that received NAD+ IV reported moderate to severe gastrointestinal symptoms, increased heart rate, and chest pressure during infusions.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  3. 03HumanObservational studySafety outcome

    In commercial clients, NAD+ infusions were associated with chest pressure.

    In plain wordsIn commercial clients, NAD+ infusions were linked to chest pressure.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    Not applicableChest pressure
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Adverse events · Cardiovascular
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    Participants that received NAD+ IV reported moderate to severe gastrointestinal symptoms, increased heart rate, and chest pressure during infusions.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  4. 04HumanObservational studySafety outcome

    In commercial clients, all infusion symptoms, including those with NAD+ IV, resolved on infusion completion.

    In plain wordsIn commercial clients, all symptoms during infusions, including NAD+ infusions, stopped when the infusion ended.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    Not applicableSymptom resolution
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Adverse events · Whole body
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    All symptoms resolved upon infusion completion.
    3 context sentences
    Summary · context
    Participants that received NAD+ IV reported moderate to severe gastrointestinal symptoms, increased heart rate, and chest pressure during infusions.
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  5. 05HumanObservational studySafety outcome

    In commercial clients, NAD+ infusion took longer than NR infusion because of moderate to severe symptoms.

    In plain wordsIn commercial clients, NAD+ infusion took longer than NR infusion because of symptoms.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    IncreaseInfusion time
    Study

    n: not reported in source

    Comparator
    NR IV
    Analysis
    Primary
    Outcome group
    Adverse events · Whole body
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Measurements

    infusion time
    97 min
    NAD+
    infusion time
    37 min
    NR

    Source sentences

    Summary
    Moderate to severe symptoms with NAD+ IV resulted in longer infusion times compared to NR IV, averaging 97 min versus 37 min, respectively.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  6. 06HumanObservational studySafety outcome

    In commercial clients receiving NAD+ infusions, ALT did not significantly change.

    In plain wordsIn commercial clients receiving NAD+ infusions, ALT did not significantly change.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    No significant changeALT
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Liver fat and liver function · Liver
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    No significant changes were observed in ALT, AST, hsCRP, BUN/creatinine, or TSH.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  7. 07HumanObservational studySafety outcome

    In commercial clients receiving NAD+ infusions, AST did not significantly change.

    In plain wordsIn commercial clients receiving NAD+ infusions, AST did not significantly change.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    No significant changeAST
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Liver fat and liver function · Liver
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    No significant changes were observed in ALT, AST, hsCRP, BUN/creatinine, or TSH.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  8. 08HumanObservational studySafety outcome

    In commercial clients receiving NAD+ infusions, hsCRP did not significantly change.

    In plain wordsIn commercial clients receiving NAD+ infusions, hsCRP did not significantly change.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    No significant changehsCRP
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Inflammation markers · Immune and inflammation
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    No significant changes were observed in ALT, AST, hsCRP, BUN/creatinine, or TSH.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  9. 09HumanObservational studySafety outcome

    In commercial clients receiving NAD+ infusions, BUN/creatinine did not significantly change.

    In plain wordsIn commercial clients receiving NAD+ infusions, BUN/creatinine did not significantly change.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    No significant changeBUN/creatinine
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Kidney function · Kidney and urinary
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    No significant changes were observed in ALT, AST, hsCRP, BUN/creatinine, or TSH.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  10. 10HumanObservational studySafety outcome

    In commercial clients receiving NAD+ infusions, TSH did not significantly change.

    In plain wordsIn commercial clients receiving NAD+ infusions, TSH did not significantly change.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    No significant changeTSH
    Study

    n: not reported in source

    Analysis
    Primary
    Outcome group
    Thyroid function · Endocrine and hormones
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    No significant changes were observed in ALT, AST, hsCRP, BUN/creatinine, or TSH.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  11. 11HumanObservational studyEfficacy outcome

    In commercial clients, NAD+ infusions were associated with significantly reduced HDL-C.

    In plain wordsIn commercial clients, NAD+ infusions were linked to reduced HDL-C.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    DecreaseHDL-C
    Study

    n: not reported in source

    Analysis
    Exploratory
    Outcome group
    Lipids · Metabolic and weight
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    The NR IV group demonstrated a significant reduction in HbA1c, whereas the NAD+ IV group showed a significant reduction in HDL-C.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  12. 12HumanObservational studyEfficacy outcome

    In commercial clients receiving NAD+ infusions, fasting glucose did not change over the follow-up period.

    In plain wordsIn commercial clients receiving NAD+ infusions, fasting glucose did not change.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    No significant changeFasting glucose
    Study

    n: not reported in source

    Analysis
    Exploratory
    Outcome group
    Glycemic control · Metabolic and weight
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    Neither group exhibited changes in fasting glucose or LDL-C over the 30-day period.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  13. 13HumanObservational studyEfficacy outcome

    In commercial clients receiving NAD+ infusions, LDL-C did not change over the follow-up period.

    In plain wordsIn commercial clients receiving NAD+ infusions, LDL-C did not change.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    No significant changeLDL-C
    Study

    n: not reported in source

    Analysis
    Exploratory
    Outcome group
    Lipids · Metabolic and weight
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    Neither group exhibited changes in fasting glucose or LDL-C over the 30-day period.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.
  14. 14HumanObservational studySafety outcome

    In commercial clients, ALP decreased with NAD+ infusions and remained within normal reference ranges.

    In plain wordsIn commercial clients, ALP decreased with NAD+ infusions and remained within normal reference ranges.

    Peptide
    NAD+ (nicotinamide adenine dinucleotide)
    Outcome
    DecreaseAlkaline phosphatase
    Study

    n: not reported in source

    Outcome group
    Liver fat and liver function · Liver
    Studied dose
    500 mg · intravenous · four consecutive daysAs given in this study (human).

    Source sentences

    Summary
    Alkaline phosphatase (ALP) decreased significantly in the NAD+ IV group only, with values remaining within normal reference ranges.
    2 context sentences
    Summary · context
    A retrospective review of electronic medical records was conducted in clients from a commercial setting.
    Summary · context
    Participants received four consecutive days of 500 mg NAD+ IV or NR IV, with 30 days follow-up.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 2Current

    14 Oct 2026, 05:02 UTC

    Study results updated

  2. Version 1

    14 Oct 2026, 01:46 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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