What the amounts tested can tell you
NAD+ dosage studies cannot choose your treatment amount
Sickness after treatment may leave you wondering whether the amount was too much. These study findings describe unwanted effects, without settling which treatment would suit your health.
A study amount applies to its ingredient and way of giving treatment
An upset stomach makes you want to know what was given and how much. NAD+ dosage studies report amounts tested in research, rather than an amount chosen for your health.
The main pill trials give NMN or NR, ingredients cells use for producing NAD+. Little swallowed NAD+ itself reaches cells before breaking into smaller parts.
The same amount of medicine can act differently in a pill and a drip. A pill passes through digestion, while a drip enters your blood directly; a pill result can't predict a drip's effects.
Pill and drip amounts belong to separate studies
Human NMN trials often gave 250 milligrams daily within a 250-900 milligram daily range. Some tested up to 1200 milligrams daily.
A trial lasting 60 days gave 300 milligrams, 600 milligrams, or 900 milligrams daily [3]. Its authors favored 600 milligrams after considering both walking and blood results.
Women received 250 milligrams daily for 10 weeks, with muscles responding better to insulin, a hormone involved in controlling blood sugar [1]. The amount described that trial, rather than your personal care.
NR trials commonly gave 250-1000 milligrams daily, testing another ingredient for producing NAD+. Parkinson's disease trials tested safety at up to 3000 milligrams daily.
An eight-week NR trial gave 100 milligrams, 300 milligrams, or 1000 milligrams daily [4]. Skin cancer prevention research gave nicotinamide, a B vitamin, at 500 milligrams twice daily [6].
NAD+ drips supplied 250-1000 milligrams over several hours, with treatment entering blood directly. A six-hour drip ran at 3 micromoles per minute, a unit counting tiny NAD+ particles too small to see [13].
The drip rate wasn't reported as a weight in milligrams, so a direct comparison with pill amounts needs more information. Study amounts cannot choose treatment for your health.
Blood NAD+ rose with pills and fell again after pills stopped
During the opening two hours of an early drip study, almost no NAD+ remained in blood fluid, the liquid around blood cells [13]. Much had broken into smaller parts outside cells, so disappearance didn't prove that cells received NAD+.
Pill trials measured whole blood, including blood cells as well as blood liquid. The readings rose during days or weeks of continued pill use.
Across eight weeks of NR treatment, blood NAD+ rose by 22% at the lowest amount [4]. The middle amount raised the reading by 51%, and the highest by 142%.
The NR rise lasted through treatment; an NMN study also found higher blood NAD+ on days 30 and 60 [3]. The pills gave ingredients that cells used to produce fresh NAD+, rather than providing NAD+ itself.
Blood NAD+ fell back toward the starting level in the weeks after people stopped taking pills [13]. That fall doesn't show how long you would feel unwanted effects or hoped-for health gains.
Shots, patches, and skin products need their own evidence
Most trials comparing groups of people tested swallowed NMN, NR, or nicotinamide, ingredients cells can use for producing NAD+ [3][4]. Findings about clinic drips mainly come from small early studies or reviews of previous care [13].
Pharmacies also prepare NAD+ shots for a muscle or just beneath the skin. Few published studies have measured what follows these shots, including how quickly the NAD+ disappears [6].
Patches, skin creams, nose products, and products held beneath the tongue have few studies comparing treated and untreated groups [6]. Different ways of giving treatment can affect you differently, so pill findings don't establish whether those products help.
Brief pill safety checks leave doubts; NAD+ drips brought discomfort
During eight weeks, NR and placebo, pills without NR, caused much the same number of unwanted effects [4]. People taking NR had no skin flushing, meaning hot, red skin; “bad” cholesterol did not rise.
NMN caused no reported safety problem at 300-900 milligrams daily over 60 days [3]. A brief trial can't settle whether longer use would harm your health.
Reported NAD+ side effects were more common with drips, particularly when treatment flowed in too fast. Chest or stomach discomfort, hot red skin, and sickness ended as drips finished in a review of earlier care [13].
One pharmacy-prepared injection contained poisons from bacteria, posing a serious risk. The FDA's strongest recall warning, Class I, followed [13].
Long use of NMN in mice reduced the weight gain that came with aging [6]. Weight changes in mice don't settle the safety of a pill or drip for you.
Product damage and uncertain contents add to the risks
Warmth can break down NAD+ and NMN powders, which also draw in moisture from damp air [6]. NAD+ mixed for injection also breaks down without protection from heat and light [6].
A recall after bacterial poisons were found in an injection demonstrated a serious risk when preparing injections [13]. Researchers raise concern about whether someone outside the maker has tested a product's contents.
Supplement contents may be less pure or present in different amounts from what the bottle claims [13]. An outside check isn't guaranteed, and your bottle may differ from the product used in the trial.
Sale rules and sport permission do not prove a health benefit
NAD+ has no approval from the FDA for treating disease, including pharmacy-prepared shots and drips [13]. A product on a shop shelf isn't proof of a treatment that helps you.
Allowing NMN into drug research led to a disagreement over sales under supplement rules [13]. That disagreement concerns sale rules, rather than a finding that NMN is unsafe or medically useful.
Sport rules allow NAD+ and the related ingredients NR, NMN, and nicotinamide, a B vitamin. Permission in sport doesn't establish safety, medicine approval, or a health gain from taking these substances.