NAD – a molecule lauded as a breakthrough in longevity, mental clarity and even disease prevention is de rigueur for the wellness crowd. It seems that if you’re not taking NAD, you can’t seriously call yourself a health enthusiast.
Scroll Instagram and you’ll see it dripping from IV bags in plush clinics, ground into expensive supplements, or inside anti-ageing skincare. It’s pitched as futuristic, almost magical, a biochemical fix for everything from burnout to biological decline. But behind the sleek marketing and celebrity endorsements lies a more complex story.
I’ve taken NAD capsules for several months and I’m frequently offered NAD injections and IV drips, so I’ve been keen to understand whether these delivery methods actually work, whether they’re safe and if NAD is the miracle molecule that wellness influencers make it out to be.
I spoke with three experts – longevity doctor Dr Harpal Bains, registered nutritionist Sahar Berjis and Dr Sophie Shotter, aesthetic physician and host of the Age Well podcast – to understand whether NAD can actually reverse biological age or if all the hype is just slick marketing.
What is NAD?
Through the mid-20th century, NAD became a cornerstone of biochemistry. Researchers learned that it plays a vital role in redox reactions – the energy transfers that keep cells alive. In the 1960s and 70s, NAD was further linked to DNA repair and aging, setting the stage for its rebranding decades later.
By the early aughts, geneticist David Sinclair popularised research showing that NAD+ activates sirtuins, sometimes called “longevity genes”. By the 2010s, the biohacking community had embraced NAD. Silicon Valley entrepreneurs, elite athletes and wellness influencers were using IV drips and supplements, claiming that this obscure coenzyme had the power to sharpen focus, ward off disease and even reverse aging.
At its simplest, NAD is chemistry. As Berjis explains: “NAD is found in every cell of your body. It plays a crucial role in energy production (think: helping your mitochondria turn food into fuel) and cellular repair.”
This molecule exists in two forms: NAD+ (the oxidised, active version) and NADH (the reduced, electron-carrying version). “So when we say ‘NAD’ in the body,” Berjis clarifies, “we’re usually talking about the balance between NAD+ and NADH. But in supplements and IV drips, NAD+ is what you’ll see emphasised, because it’s the form that directly fuels repair and renewal.”
In other words, NAD+ is the golden child – the one we’re told can restore youthful vitality, sharpen our focus, and slow ageing itself.
Dr Harpal Bains explains that, “NAD is essential for energy production and also activates sirtuins – key genes linked to longevity. It is hugely important for proper cell function and for protecting the body from aging and disease, and is a powerful coenzyme and metabolic regulator found in the mitochondria (the ‘powerhouse’ of each cell that provides energy for your body). Stress, aging, chronic disease and your environment can all influence NAD levels.”
In other words, without NAD, we don’t function. Which is why pills, drips and injections might feel like the holy grail, especially as levels begin to decline with age.
Few molecules present as much futuristic promise as NAD+. In a culture obsessed with “biohacking” and optimisation, its role in activating “longevity genes” means it’s been easy to frame NAD as a hack for extended youth.
Dr Sophie Shotter notes that it is your cellular energy currency. It is crucial for every single process which goes on in the human body, and without NAD+ you would die quicker than if you were deprived of oxygen.” However, as we age, levels decline and this has tangible effects such as poorer sleep, less physical energy and mental fatigue.”
By midlife, you’re running on a fraction of the NAD+ you were born with. Add to that the chronic stress, poor sleep and environmental toxins of modern life, and the appeal of boosting those levels is obvious. But methods of raising NAD+ levels and whether they actually work is far less straightforward.
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Which delivery method actually delivers?
Walk into a wellness clinic in London, LA, or New York and you’ll likely be offered an NAD+ drip. Marketed as the fastest, most effective way to “refuel” your cells, it’s become a status treatment for executives, athletes and wellness enthusiasts with money to spend. But do these drips actually work?
Berjis explains that the commonly accepted view on delivery is this: “Capsules or powders typically aim to boost NAD+ indirectly through precursors like NMN or NR, while IV clinics often infuse NAD+ directly for faster absorption, bypassing the digestive tract.”
However, Dr Shotter believes that this delivery method is ineffective. “The first thing I should say is that taking actual NAD+ in any form doesn’t work. NAD+ is inherently unstable – it doesn’t survive outside of a freezer for more than about 30 minutes. To date there is no company I have come across who has shown me they are able to stabilise NAD in liquid, topical or ingestible forms.
“So I would say any supplement or skincare stating that they contain NAD+ are not worth the investment, home injections are not worth the investment. Surprisingly to many, IV administered NAD+ is also not worth the investment.”
The molecule itself, she argues, simply doesn’t cross into the cells where it’s needed.
“NAD+ is a molecule which belongs inside cells, and it is also a very large molecule. If it’s infused into the veins, it cannot be absorbed into the cells except under very rare basically unachievable conditions. So this means that the NAD+ is trapped in the veins where it can’t have any impact at all.
“More worryingly, there is a new study about to be published showing that NAD+ inside the veins causes inflammation, which is the exact opposite of what we want to achieve when thinking about longevity medicine.”
Shotter’s verdict is unequivocal – trendy NAD IVs are not just ineffective, they may actually be harmful, as well as expensive.
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NAD side effects
The glossy marketing around NAD rarely mentions risks. But each expert I spoke with raised caveats. Berjis warned that minor symptoms include nausea, headaches and muscle cramps. She also explained that, “oral supplements are still being studied [but] some studies have shown long term impacting insulin resistance in the body”.
Dr Bains advises a cautious approach, especially for people with pre-existing health conditions.
“Those with kidney or liver diseases have to be more cautious when taking NAD, mainly due to the potential load of clearance than can happen when a cell goes into functional mode after being sluggish for so long.”
The risks may not be dramatic, but some do seem to undermine the idealistic “fountain of youth” narrative that often NAD+ clinics and companies seem to push.
It’s also worth pausing to ask – why are NAD drips being promoted so aggressively despite contrasting studies? The answer lies in economics. IV therapy has become a booming sector in the wellness industry, with clinics charging anywhere from £250 to £1000 per session.
For clients seeking quick fixes for fatigue, burnout or jet lag, NAD+ slots neatly into the luxury optimisation package. But as Shotter points out, “there is also a huge amount of misinformation out there which is concerning as it can lead to people investing in things that don’t have the expected benefits”.
Miracle molecule or marketing?
For all three experts, NAD precursors (nutrients that convert into NAD in the body) , lifestyle and sustainable practices all need to be taken into consideration before taking NAD. Bains recommends starting conservatively with supplements that are precursors to NAD.
“Start with nicotinamide mononucleotide (NMN) or nicotinamide riboside (NR) at 250–500 mg per day, from a reputable brand. Or even niacin which can pass through your gut more successfully and let your body do the work of converting to NAD. And pair it with lifestyle practices like good sleep, movement and time-restricted eating to support your body’s natural NAD pathways,” she advises.
Shotter agrees that boosting your natural NAD+ levels is a much better strategy than ingesting NAD or inserting an IV. She explains that taking the precursors of NAD+, as Dr Bains suggests, can work for a while, but she says that unfortunately with time, this can burn through our own ability to produce more.
“I recommend Nuchido Time + as it contains a blend of ingredients which boost NAD+ production, but also works to boost our cellular salvage and recycling of NAD+. So it allows us to work more efficiently. It also helps that it has a double blind, placebo controlled randomised study – the gold standard – showing efficacy and a reduction in biological age of 1.26 years at 1 month,” she says.
“You can also look to boost the levels of the NAD+ building blocks through diet. Including things like tryptophan, nicotinamide mononucleotide (NMN) and niacin (vitamin B3) can help you to boost NAD+ levels. Look for foods like beef, eggs, avocados and salmon. Also consider including fermented foods in your diet, as these naturally contain NAD.”
NAD really does work wonders in the body, but ultimately, this is all happening on the inside naturally and via precursor supplements and diet. So far, it doesn’t seem that upping our levels from the outside using the NAD molecule itself in supplements and drips could make that much of a difference to our long-term health.
In the end, it’s the familiar strategies like good sleep, exercise and diet that prove most effective for longevity. Which raises a critical question, if lifestyle remains the strongest lever, how much of a role should expensive, unproven IV drips really be playing in our lives?
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