Nicotinamide adenine dinucleotide — NAD+ — is a coenzyme found in every living cell. It plays a central role in energy metabolism, DNA repair, and the regulation of proteins that govern how quickly we age. Despite its critical importance, NAD+ levels decline significantly with age, a process researchers now believe is one of the primary drivers of the fatigue, cognitive slowing, and physical decline we associate with getting older.

What NAD+ Actually Does

NAD+ functions as a molecular shuttle, carrying electrons between reactions that generate ATP — the energy currency your cells run on. Without sufficient NAD+, your mitochondria (the cellular power plants) become less efficient, producing less energy and more oxidative waste. Beyond energy production, NAD+ is a required cofactor for a class of enzymes called sirtuins, which regulate inflammation, DNA repair, and cellular stress responses. When NAD+ is depleted, these protective pathways slow down.

A 2021 review published in the International Journal of Molecular Sciences described NAD+ as playing "a pivotal role in cellular metabolism" and noted its involvement in "pathways that modify aging," highlighting its importance in regenerative medicine.[1]

The Research on NAD+ Supplementation

The clinical evidence for NAD+ augmentation has grown substantially over the past decade. A 2026 PRISMA-guided systematic review in Ageing Research Reviews concluded that NAD+ augmentation "demonstrates clear biological activity" in humans, with consistent evidence of biochemical target engagement across multiple study designs.[2] A separate randomized, double-blind, placebo-controlled clinical trial published in 2025 found that a NAD+ supporting regimen increased NAD+ levels, improved well-being, and alleviated aging symptoms in participants.[3]

A 2020 review in Pharmaceuticals noted that "a number of clinical trials have been conducted recently, with more underway, to rigorously assess NAD pharmacology in the context of aging and various diseases," reflecting the growing scientific momentum behind this approach.[4]

Why Intravenous Delivery Matters

A 2019 pilot study published in Frontiers in Aging Neuroscience was among the first to characterize what happens in the human body during a 6-hour intravenous NAD+ infusion. The researchers found that at a standard infusion rate, NAD+ is "rapidly and completely removed from the plasma," indicating active metabolic uptake and processing throughout the body.[5] This rapid cellular uptake is one reason IV delivery is considered a more direct route than oral supplementation — it bypasses the digestive system entirely and delivers NAD+ directly into the bloodstream where it can be absorbed at the cellular level.

A 2026 pilot study comparing IV NAD+ to IV nicotinamide riboside (NR) found measurable metabolic changes in the NAD+ IV group, including significant shifts in alkaline phosphatase and HDL-C levels — both markers of metabolic activity — suggesting that IV administration produces systemic biological effects beyond what oral forms can achieve.[6]

Who May Benefit

NAD+ IV therapy is most commonly sought by individuals experiencing persistent fatigue, cognitive fog, difficulty recovering from physical exertion, or those with a general interest in longevity and healthy aging. It is also increasingly used by individuals managing the effects of chronic stress, which is known to accelerate NAD+ depletion.

At Nectar Wellness, our NAD+ infusions are administered by licensed registered nurses in a calm, comfortable lounge setting. Sessions typically run 2–4 hours, allowing for a slow, controlled infusion rate that maximizes comfort and absorption.

"NAD+ plays a pivotal role in cellular metabolism and is a co-substrate for enzymes that play key roles in pathways that modify aging." — Conlon & Conlon, International Journal of Molecular Sciences, 2021