What is NAD+?
NAD+ is a key coenzyme of energy metabolism in the mitochondria and is needed for cellular repair and signalling. Because levels fall with age, NAD+ is marketed as an anti-ageing agent – directly by infusion/injection or via precursors such as nicotinamide riboside (NR) or NMN.
How well studied is NAD+?
Precursors such as NR reliably raise blood NAD+ levels and were well tolerated in small, mostly short studies; a clear clinical benefit for healthy people has not been shown. For NAD+ infusions there are only very small, mostly uncontrolled studies.
What side effects and risks does NAD+ have?
In one small analysis, all people receiving infusions reported abdominal cramps, nausea, vomiting, racing heart and chest pressure during administration. Infusions outside medical settings carry infection and circulatory risks. Long-term effects of permanently raised NAD+ are unknown.
Is NAD+ approved in Germany?
In short: no. NAD+ is not approved as a medicine in Germany/the EU; precursors are sold as food supplements. In the US, NAD is only “under evaluation” for pharmacy compounding (FDA 503A, category 1). “NAD infusions” offered by wellness clinics are in-house preparations without regulatory review.
Sources
- Berven et al. 2023: NR-SAFE – randomized safety trial of high-dose nicotinamide riboside (Nature Communications)
- Frontiers in Aging 2026: Intravenous infusion of NAD+ vs. NR – retrospective analysis
- FDA: Bulk drug substances nominated for use in compounding (503A), 2026
Note: We deliberately do not list any doses here. For approved medicines, your doctor sets the dose; for unapproved substances there is no reliable information.