NAD+ IV therapy: the science, the evidence and what an infusion feels like

Nicotinamide adenine dinucleotide, or NAD+, is a molecule found in every living cell. It shuttles electrons in the reactions that turn food into usable energy, and it is consumed by enzymes involved in DNA repair and in cell signaling, including the sirtuin family that features heavily in aging research.

Because those enzymes use NAD+ up, cells constantly rebuild it from building blocks in the diet, mainly forms of vitamin B3. The balance between use and supply sets how much NAD+ a tissue has at any time.

Studies in animals and some human tissues show NAD+ levels falling with age, and a 2021 review in Nature Reviews Molecular Cell Biology traces how that decline connects to several processes associated with aging. In mice, restoring NAD+ with precursor molecules has improved a range of age-related measures.

Human results are more modest. A 2018 review of the evidence found that NAD+ precursors raise NAD+ levels and appear safe in the studies done so far, while clear clinical benefits in people had not yet been shown. That remains a fair summary of the field.

Oral supplements such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are precursors. Your cells convert them into NAD+. An IV delivers NAD+ itself.

The body handles infused NAD+ quickly. In a 2019 pilot study that measured blood and urine during a six-hour infusion, NAD+ was cleared from the plasma so fast that levels did not rise for the first two hours, and breakdown products appeared in the urine. The authors saw a pattern consistent with enzymes on cell surfaces processing NAD+ as it arrives. In other words, an infusion is an active exchange with your tissues, and researchers are still mapping what happens next.

NAD+ is known for producing noticeable sensations if it runs too fast: flushing, chest or stomach tightness, nausea or muscle cramping. These usually ease within minutes when the drip is slowed, which is why NAD+ is given gradually and why higher doses take longer.

At LYV we offer two NAD+ infusions on our IV menu, NAD+ Revive 500 and NAD+ Elite 1,000, which differ by dose. Higher doses run longer, so plan your afternoon around it. A clinician stays close by and adjusts the rate to how you feel. If you have had NAD+ elsewhere, tell us the dose and how it went, since that helps us set a comfortable starting rate.

Many people already take an oral precursor such as NR or NMN. Whether to continue alongside infusions depends on your goals, your labs and what else you take, so bring the bottle to your visit and ask. There is no strong evidence yet on how oral and IV forms compare head to head, and anyone claiming one is clearly better is getting ahead of the research.

• Eat a light meal first. Infusing on an empty stomach makes nausea more likely
• Allow plenty of time, especially for the higher dose
• Bring something to read or watch, and a layer in case you feel cool
• Tell your clinician right away if you feel tightness or nausea so they can slow the drip

Most people feel normal shortly after the infusion ends. Some feel tired for the rest of the day and others feel more alert, so see how your body responds before you plan a demanding evening.

NAD+ infusions run much longer than a standard vitamin drip, so it helps to know the plan before you sit down. Ask how long the infusion is expected to take, what dose is planned for a first visit and how the team adjusts the drip rate if you feel chest tightness, nausea or a flushed feeling. Those sensations are the most commonly described side effects, and they usually ease when the rate is slowed.

It is also fair to ask what the evidence does and does not show. Human research on IV NAD+ is still early, and much of what is known about NAD+ and aging comes from cell and animal studies. A good clinician will say so plainly and help you decide whether an infusion fits your goals, your schedule and your budget.

Before a first NAD+ infusion, our team reviews your history and medications. Pregnancy, breastfeeding, significant heart or kidney conditions and an active cancer diagnosis all call for a conversation with your own physician first. If you want a fuller picture of your health before you start, advanced testing is a good first step.

If you are weighing NAD+ alongside a membership or the 17-Week Restoration, your provider will explain how often it makes sense and what you can realistically expect.