NAD+: The anti-aging drip that might not work
NAD+ infusions are the latest anti-aging craze among celebrities and biohackers, but do they actually deliver on their promises? Bryan Hubbard investigates
It’s the anti-aging therapy that everyone’s talking about. NAD+ (nicotinamide adenine dinucleotide) infusions are being offered by wellness clinics everywhere, promising to reverse the clock on aging, boost energy, sharpen mental clarity and even help overcome addiction.
Celebrities and tech entrepreneurs swear by it. Social media influencers document their drip sessions. Clinics charge anywhere from £350 to £1,000 for a single infusion. The global NAD+ therapy market is projected to grow exponentially over the coming decade.
But does the science back up the hype?
What NAD+ actually does
NAD+ is a coenzyme found in every cell of the body. It’s essential for cellular energy production, DNA repair, immune function and the regulation of circadian rhythms. Without it, cells cannot convert food into energy, and repair mechanisms grind to a halt.
The problem is that NAD+ levels decline with age. By middle age, most people have roughly half the NAD+ they had in their youth. This decline is associated with many hallmarks of aging: mitochondrial dysfunction, DNA damage accumulation, chronic inflammation and metabolic disorders.
The theory behind NAD+ therapy is straightforward: if declining NAD+ drives aging, then replenishing it should slow or reverse the process. It’s an appealing logic, and animal studies have provided some support.
The animal evidence
In mice, boosting NAD+ levels through precursors like NMN (nicotinamide mononucleotide) and NR (nicotinamide riboside) has shown impressive results. Treated mice showed improved mitochondrial function, better insulin sensitivity, enhanced DNA repair capacity and increased endurance.
A landmark 2013 study by David Sinclair at Harvard found that raising NAD+ levels in older mice made their muscle tissue look and function like that of younger animals. The findings generated enormous excitement and launched a global research effort.
But mouse results don’t always translate to humans. Mice live about two years and have fundamentally different metabolic rates. What works in a short-lived rodent may not have the same effect in a human with a lifespan of 80+ years.
The human reality
Clinical trials in humans have been far less convincing. A 2022 randomized controlled trial published in the Journal of Clinical Endocrinology and Metabolism gave NR supplements to overweight adults for six weeks and found no meaningful improvements in insulin sensitivity, mitochondrial function or metabolic health compared with placebo.
A 2024 meta-analysis reviewing all available human trials of NAD+ precursors concluded that while oral supplements reliably raise blood NAD+ levels, the downstream health benefits remain largely unproven. Most trials were small, short-term and showed no significant clinical improvements.
As for intravenous NAD+ infusions specifically, the evidence is even thinner. No large-scale randomized controlled trial has demonstrated that IV NAD+ produces lasting anti-aging benefits in humans. Much of the evidence is anecdotal or comes from small observational studies without proper controls.
The bioavailability question
One of the key scientific debates centers on bioavailability. When NAD+ is infused directly into the bloodstream, it’s broken down rapidly by enzymes in the blood. Most of it is degraded before it can reach the cells where it’s needed.
Researchers at the University of Iowa found that intravenous NAD+ is metabolized so quickly that very little intact NAD+ actually enters cells. Instead, the body breaks it down into its component parts—nicotinamide and other metabolites—which cells then use to rebuild NAD+ internally.
This raises an obvious question: why pay hundreds of pounds for an IV infusion when a simple oral supplement of NMN or NR might achieve the same result at a fraction of the cost?
What might actually work
Rather than expensive infusions, the evidence points toward simpler approaches to supporting NAD+ levels. Regular exercise is one of the most reliable ways to boost NAD+ naturally. Caloric restriction and time-restricted eating also appear to support NAD+ metabolism.
Foods rich in niacin (vitamin B3)—a direct NAD+ precursor—include chicken, tuna, turkey, salmon, beef, peanuts, mushrooms, green peas and avocados. Fermented foods may also support the NAD+ pathway through their impact on gut bacteria.
The bottom line is that while NAD+ is genuinely important for health and aging, the expensive clinical interventions being marketed may not deliver what they promise. As with most aspects of health, the fundamentals—good food, regular movement, adequate sleep—remain the most evidence-based approach.
References
Cell, 2013; 155(7): 1624–1638
J Clin Endocrinol Metab, 2022; 107(12): 3321–3331
Aging Cell, 2024; 23(4): e14087
