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Longevity

NAD+

A central coenzyme of energy metabolism whose levels fall with age, at the heart of longevity research.

2 min read 10 sources

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Phase 1 · not approvedLab tested in the shop

No time to read it all? The video sums up the whole entry in about a minute, from how it works to the studies and storage.

Summary

At a glance

Sources checked on 26 Oct 2026

NAD+ measured in the skin
49 people

from newborns to 77 years, NAD+ fell with age3

No rise in plasma
2 hours

for that long NAD+ given as an infusion vanished from the blood at once, pilot study with a 6-hour infusion5

Pump function after 1 month
45.4 %

against 42.4% on placebo, 180 people with heart failure, NAD+ as an infusion for 7 days6

Outcome studies with NAD+ into a vein or muscle for ageing
0 studies

in a systematic review of 33 human studies up to October 20258

  • NAD+ is a coenzyme in every cell. It carries electrons in energy production and is consumed by enzymes such as the sirtuins, PARP and CD38.2
  • In skin and blood plasma the NAD+ level falls with age. In old or diseased animals restoring NAD+ improved health and lifespan in studies.341
  • There is no study with NAD+ injected under the skin. As an infusion NAD+ vanished from the plasma at once for the first 2 hours.85
  • In a randomised trial with 180 people with heart failure pump function after 7 days of NAD+ infusion and 1 month was 45.4 against 42.4 percent on placebo.6
  • A review found no outcome study with NAD+ into a vein or muscle for ageing. The registry lists one phase 1 trial and there is no approval. Everything here is the state of research, not a recommendation.8910
Profile

Updated May 2026

Class
Coenzyme

energy metabolism

Use
Subcutaneous, slow

in mg

Half-life
short
Status
Much animal research

growing human data

Sizes
100 to 1,000 mg

4 sizes in the shop

Contents 15 sections
  1. At a glance
  2. What is NAD+?
  3. How it works
  4. What you need
  5. Reconstitution
  6. Dosing
  7. Injection
  8. What the research shows
  9. Research status
  10. Side effects
  11. Storage
  12. Related compounds
  13. FAQ
  14. Glossary
  15. Sources

What is NAD+?

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in energy metabolism in every cell. It powers the mitochondria and fuels repair enzymes like the sirtuins and PARPs. NAD+ levels fall with age, which makes it a central topic in longevity research.

Comparison

NAD+ in different forms

NAD+ and related products, as described in the TPD lexicon. Tap a card to open its entry.

Powder for injection under the skin NAD+ NAD+
Ready solution for injection NAD+ Inject NAD+ Powder for infusion NAD+ IV NAD+ Blend with MOTS-c and 5-amino-1MQ NAD+ + MOTS-C + 5-Amino-1MQ Blend NAD+ Tablets with an NAD+ building block 5-Amino + NAD+ (Oral) NAD+

How it works

NAD+ is a co-substrate for enzymes that govern DNA repair, the stress response and mitochondrial function. More available NAD+ is meant to support these processes. In preclinical models, restoring physiological NAD+ levels was associated with better mitochondrial function and less oxidative stress.

Where it acts

Where NAD+ plays a role in studies

Tap a point or a card. Grey = observed, in humans only with infusions.

  1. Skin

    NAD+ falls with age, in men PARP activity rises at the same time3

    Observed in trials
  2. Blood plasma

    Plasma NAD+ falls with age, breakdown products rise4

    Observed in trials
  3. Heart

    Pump function after 1 month higher than on placebo (heart failure, infusion)6

    Observed in trials
  4. Kidney and urine

    More NAD+ and methylnicotinamide in urine after an infusion5

    Observed in trials

Known targets2

Compound CHEMBL1234613: three described targets, type of action on each card.

Sirtuin 1
Gene
SIRT1
UniProt
Q96EB6
ChEMBL
CHEMBL4506
Action
Needs NAD+ as a cosubstrate and consumes it
PARP1 (DNA repair)
Gene
PARP1
UniProt
P09874
ChEMBL
CHEMBL3105
Action
Consumes NAD+ when repairing DNA breaks
CD38
Gene
CD38
UniProt
P28907
ChEMBL
CHEMBL4660
Action
Breaks down NAD+
Glass cell with a glowing golden DNA strand on which small glass enzymes are working, next to it a glass mitochondrion into which blue and white molecules flow
NAD+ serves repair enzymes and energy production. Symbolic image.

What you need

Supplies

2 things, numbered as in the picture

Tick off what you already have. Vial and BAC water are our real shop photos at the same size.

Vial with a black TPD label reading “NAD+” and a vial of bacteriostatic water at the same size, next to them two insulin syringes with blue caps, two alcohol swabs and a sharps container with a blue lid

  1. NAD+ vial

    The NAD+ vial (lyophilized powder).

    In the shop

  2. Water and supplies

    Bacteriostatic water, U-100 insulin syringes, alcohol swabs.

    In the shop

Reconstitution

Use the peptide calculator. A 500mg vial with 3ml water gives roughly 167mg per ml. Just add the water to the vial and let it dissolve.

Step by step

Dissolving the powder

Four steps, the same for every vial size.

  1. 1Wipe the cap

    Clean the rubber stopper with an alcohol swab.

  2. 2Add BAC water

    Just add it, it does not matter if it hits the powder directly.

  3. 3Swirl or shake

    Until everything has dissolved, both are fine.

  4. 4Draw up

    With the U-100 insulin syringe.

Less water higher concentration fewer units on the syringe Example: 500 mg + 3 ml = 166.67 mg/ml

Dosing

Dosing

Dosing, titration and syringe

Loading the dosing information …

  • Getting started and stepping up, drawn as a staircase
  • Units on the U-100 syringe for every step
  • How long one vial lasts

Injection

The injection is subcutaneous, into the fat layer under the skin. Common spots are the abdomen (keep about two finger-widths clear of the navel), the front and the inner side of the thigh, or the back of the upper arm.

The short version:

Injection

Where and at what angle

Pick a spot or switch the angle. Subcutaneous means: into the fat layer, not the muscle.

Rotate the spot each time, never the same one twice in a row.

90°More fat under the skin

Rule of thumb: where there is more fat under the skin, insert straight at 90 degrees. In lean people with little fat, 45 degrees, so the needle stays in the fat layer. Simplified diagram.

  1. Clean the spot with an alcohol swab and let it dry

  2. Pinch up a small fold of skin

  3. Insert the needle: at 90 degrees where there is more fat under the skin, at 45 degrees in lean people with little fat

  4. Inject slowly, wait a moment, then withdraw

  5. Put the needle straight into the sharps container

Rotate the site each time so the tissue does not get irritated. Never the same spot twice in a row.

With NAD+ inject especially slowly, because too-fast dosing is unpleasant (flush, tightness).

What the research shows

A widely cited review (Rajman, 2018) summarizes the in vivo evidence for NAD-boosting molecules: broad effects on metabolism and aging in animal models, growing but still limited data in humans. A large part of the enthusiasm comes from animal studies, which should be honestly noted.

Study results

What the trials measured

Interactive: switch tabs, tap points, show or hide arms. Arms are named relative to each other, no dosing advice.

NAD+ in heart failure after infarctions6

180 adults, 7 days of NAD+ or placebo as an infusion on top of standard care

Pump function (LVEF)6 after 1 month
Placebo 42.4%
NAD+ as an infusion 45.4%
Better exercise capacity (NYHA)6 after 1 month, not significant
Placebo 57.3%
NAD+ as an infusion 73.0%
Major cardiovascular events6 over 6 months, not significant
Placebo 24.7%
NAD+ as an infusion 14.6%

Abstract values 45.44 and 42.44 percent, rounded in the chart. Only pump function differed significantly. NAD+ was given into a vein here, not under the skin. One hospital in China, registered in the Chinese trial registry.

How long an infusion took7

Mean minutes, review of client records of one clinic, four days each

Infusion time7
NAD+ as an infusion 97 min
Nicotinamide riboside as an infusion (comparison) 37 min

On NAD+ participants reported moderate to severe gastrointestinal symptoms, a faster pulse and chest pressure, so the infusion ran slower. All symptoms ended with the infusion. Retrospective review, the authors worked for the provider.

Warmly glowing glass mitochondrion on the middle shelf of a cold room between stacks of petri dishes
Much research in animals and with precursors, no study with NAD+ under the skin. Symbolic image.

Research status

Where the research stands

Registered trials with NAD+ as an injection or infusion, none of them under the skin. Precursors such as nicotinamide riboside and NMN as well as NAD+ taken orally, as a patch or a nasal spray are not included. As of 26 Oct 2026. 9

  1. Preclinical Animal models of NAD+ in ageing
  2. Phase 1 1 trial, 0 completed
  3. Phase 2 no registered trial
  4. Phase 3 no registered trial
  5. Approval not yet
Not approved: ChEMBL lists NAD+ (nadide) with phase 2 as the highest phase, without an approval year.9
Show all 1 trial on a timelineHide timeline 0 completed 1 running 0 with results
Without phase

Bar: start to primary endpoint (planned for running trials). Green = completed, blue = progress until 26 Oct 2026. Phase 1: 1 trial on safety and pharmacokinetics, not shown as bars.

Side effects

  • Flush, pressure or tightness during dosing, especially when injecting too fast.
  • Nausea, local reactions at the injection site.

Tolerability

Events in the heart failure trial

Out of 100 participants per group, how many had the event over 6 months.

1 of 100 Placebo
2 of 100 NAD+ as an infusion
Event PlaceboNAD+ as an infusion
Heart attack6 1%2%
Cardiac death6 1%1%
Stroke6 0%1%
Dizziness during infusion6 0%1%

Values from the full text (table 3 and safety section), none of the differences was significant. Liver and kidney values did not change. There are no data on injection under the skin. In a clinic review NAD+ infusions led to gastrointestinal symptoms, a faster pulse and chest pressure.67

Storage

Before mixing the powder is robust, normal room temperature (around 20 to 25 degrees) is fine, ideally kept in the dark. After mixing, keep in the fridge (2 to 8 degrees), do not freeze. It stays good there for at least 4 to 6 months with barely any loss of potency, in practice considerably longer. Swirl or shake to mix, both are fine.

Shelf life

How long it keeps

Undissolved (powder) Room temperature, around 20 to 25 degrees, dark

Robust, no fridge needed.

Dissolved (mixed) Fridge, 2 to 8 degrees, do not freeze

At least 4 to 6 months with barely any loss of potency.

  • Keep it dark
  • Dissolved: 2 to 8 degrees
  • Note the mixing date on the vial
Nine vials with white powder and blue caps in the door shelf of a bright fridge
Powder dark at room temperature, once dissolved into the fridge (2 to 8 degrees), stable there for at least 4 to 6 months. Symbolic image.

Related

Related compounds

Same targets, blends with NAD+ or a different path: all in the TPD lexicon.

NAD+
NAD+ Inject The same compound as a ready solution NAD+ IV The same compound for infusion NAD+ + MOTS-C + 5-Amino-1MQ Blend Contains NAD+ plus MOTS-c and 5-amino-1MQ 5-Amino + NAD+ (Oral) Tablets for NAD+ metabolism 5-Amino-1MQ Different route in NAD+ metabolism (NNMT inhibitor) MOTS-c Different approach at the mitochondria

FAQ

Common questions about NAD+

Short answers, each backed by the sources below.

What is NAD+ and what does it do in the cell?

NAD+ is a coenzyme for redox reactions and therefore central to energy production. It is also fuel for enzymes such as the sirtuins, CD38 and PARP that take part in DNA repair, gene regulation and immune function. According to a review NAD+ levels fall with age in rodent and human tissues.2

Does NAD+ really fall with age in humans?

In studies, yes. In skin samples from 49 people between newborns and 77 years NAD+ fell with age. In men activity of the repair enzyme PARP rose at the same time. In the blood plasma of healthy adults NAD+ and related compounds fell with age while breakdown products rose.34

Are there studies with NAD+ injected under the skin?

No, no such human study was found. NAD+ has been studied as an infusion: in a pilot study plasma NAD+ did not rise at all in the first 2 hours, it was removed from the blood at once. A systematic review found no outcome study with NAD+ into a vein or muscle for ageing.58

What do controlled trials with NAD+ show?

The largest tested 180 adults with heart failure after infarctions: 7 days of NAD+ or placebo as an infusion on top of standard care. After 1 month pump function was 45.4 against 42.4 percent. Hospital admissions and major events were less frequent but not significantly. This is not a study on ageing.6

Which symptoms were seen?

In a clinic review NAD+ infusions led to moderate to severe gastrointestinal symptoms, a faster pulse and chest pressure. The infusion therefore took 97 minutes on average and all symptoms ended with it. In the heart failure trial there was one case of dizziness on NAD+. There are no figures for injection under the skin.76

What do animal studies and studies with precursors show?

In old or diseased animals restoring NAD+ improved health and lifespan in many studies. In humans the precursors NR and NMN reliably raised blood NAD+ levels, effects on health outcomes were inconsistent. Precursors taken by mouth are not the same as injected NAD+.18

Glossary

Terms explained briefly

Dotted words in the text open these explanations directly.

CD38
Enzyme on immune and other cells that breaks down NAD+.
Coenzyme
Helper molecule that assists enzymes and is changed or consumed in the process.
Infusion
Slow delivery of a fluid directly into a vein, usually by drip.
Lyophilisate
Freeze-dried powder. Without water a compound keeps much longer.
Mitochondria
Power plants of the cell. Their respiratory chain produces most of the energy carrier ATP.
NMN and NR
Nicotinamide mononucleotide and nicotinamide riboside, precursors from which the body makes NAD+.
Oxidative stress
An excess of reactive oxygen compounds that can damage fats, proteins and DNA in the cell.
PARP
Enzymes that detect DNA breaks and consume NAD+ for the repair.
Placebo
Dummy preparation without active substance. Comparing against it shows what is due to the substance itself.
Sirtuins
Family of seven enzymes (SIRT1 to 7) that consume NAD+ and control genes and metabolism.
Subcutaneous
Into the fat layer just under the skin.

Evidence

Sources

Show all 10 sourcesHide sources 8 Studies1 Trial registry1 Database checked 26 Oct 2026

Studies

  1. Review: NAD-boosting molecules in animal studies

    Rajman, Chwalek und Sinclair, Cell Metabolism, 2018

    DOI 10.1016/j.cmet.2018.02.011 PMID 29514064
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  2. Review: NAD+ metabolism and ageing

    Covarrubias et al., Nature Reviews Molecular Cell Biology, 2021

    DOI 10.1038/s41580-020-00313-x PMID 33353981
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  3. NAD+ and PARP in human skin by age

    Massudi et al., PLoS One, 2012

    DOI 10.1371/journal.pone.0042357 PMID 22848760
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  4. NAD+ in blood plasma by age

    Clement et al., Rejuvenation Research, 2019

    DOI 10.1089/rej.2018.2077 PMID 30124109
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  5. Pilot study: NAD+ as a 6-hour infusion

    Grant et al., Frontiers in Aging Neuroscience, 2019

    DOI 10.3389/fnagi.2019.00257 PMID 31572171
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  6. NAD+ infusion in heart failure, randomised against placebo

    Yu et al., American Journal of Cardiovascular Drugs, 2026

    DOI 10.1007/s40256-025-00764-7 PMID 40954388
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed, PMC (Volltext)
  7. Tolerability of NAD+ and NR infusions in a clinic

    Reyna et al., Frontiers in Aging, 2026

    DOI 10.3389/fragi.2026.1652582 PMID 41704678
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  8. Systematic review: NAD+ for anti-ageing

    Gallagher und Emmanuel, Ageing Research Reviews, 2026

    DOI 10.1016/j.arr.2026.103057 PMID 41655607
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed

Trial registry

  1. Search on ClinicalTrials.gov

    ClinicalTrials.gov, U.S. National Library of Medicine

    Checked 26 Oct 2026 via ClinicalTrials.gov API v2

Database

  1. NAD+ (nadide) in ChEMBL

    ChEMBL, EMBL-EBI (CHEMBL1234613)

    Checked 26 Oct 2026 via ChEMBL

In the shop

NAD+ in the catalog

Sizes, prices and shipping times are on the product page.

To the product