These days, everyone is looking for an edge – whether for more energy, sharper focus or a longer life. To get one, social media recommendations are usually as varied as they are enticing, with some supported
by solid science while others rely heavily on theories, anecdotal reports and clever marketing.
Sometimes, even an essential nutrient such as vitamin B3 can be repackaged to seem more transformative than the science really suggests. NAD IV therapy is a prime example. While NAD is indispensable to human health, "there is no strong evidence that there is any health benefit to NAD infusions," says Dr. Zachary Mulvihill, an integrative health and well-being physician at NewYork-Presbyterian and Weill Cornell Medicine.
Here’s what to know before paying to get one.
What is NAD?
NAD is short for nicotinamide adenine dinucleotide, and is a molecule that helps enzymes carry out a variety of essential chemical reactions. Your body converts the vitamin B3 (niacin) you eat as part of your diet into NAD, Mulvihill explains.
The molecule helps support more than 400 enzyme reactions and is especially important for shifting energy from carbohydrates, fats and proteins into a form your cells can use. NAD contributes to cell signaling, gene activity regulation and plays essential roles in "energy production, metabolic function and improved inflammation," notes Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine.
Niacin is found in numerous foods that many people eat often, including poultry, fish, beef, nuts, legumes and fortified cereal and other grains. Because most Americans obtain enough niacin through these and other common food sources, the U.S. National Institutes of Health notes that deficiency is rare in the United States.
What is NAD IV therapy?
Still, interest in NAD IV therapy has grown after researchers discovered that NAD levels can decline or become dysregulated in certain tissues with age. Then, studies in animals suggested that raising NAD might improve some aspects of metabolic health, age-related cellular function and even physical performance.
Those findings then helped fuel interest in possible anti-aging applications across social media, as Klein notes that study results in mice fostered the belief that raising NAD could slow or improve "aging-related diseases, and perhaps even extend human lifespan."
Animal studies cannot establish that NAD infusions provide the same benefits in people, and much of the animal research has examined NAD precursors rather than intravenous NAD itself. "We still have no research that shows NAD extends lifespan in humans," Mulvihill says.
There is a 2026 retrospective study that had only 14 participants, but it was not designed to show the potential benefits of NAD therapy, instead done to evaluate short-term safety and tolerability.
Despite the lack of supporting evidence, some older adults worried about aging, athletes hoping to improve performance and people looking for more energy are still trying NAD infusions anyway. The treatment involves administering NAD, usually mixed with saline and sometimes with vitamins or other ingredients, directly into a vein through an injection and connected IV.
"Taking NAD orally is not useful because it is degraded by the intestine and not absorbed, so it needs to be given intravenously to allow delivery into the body," Klein says. He adds that an infusion may last an hour or longer because faster administration can be difficult to tolerate.
Wellness clinics and social media influencers often promote these NAD infusions as a way to increase energy, accelerate recovery, sharpen mental clarity and even defy aging, but Klein again stresses that any research supporting these assertions is lacking. What's more, he adds, "NAD IV therapy is not approved by the U.S. Food and Drug Administration (FDA) for the treatment of any medical condition."
Does NAD IV therapy really work?
Not only is NAD IV therapy unproven to deliver the sweeping benefits frequently promised, but "there are many potential downsides to NAD in general and specifically to NAD IV," Mulvihill cautions.
Treatments can cost hundreds of dollars per session, are rarely covered by insurance and are often offered in multi-infusion packages despite the absence of established, evidence-based dosing standards for the benefits clinics advertise.
Side effects can also be substantial. In the aforementioned 2026 study, for instance, all NAD recipients experienced moderate-to-severe symptoms during their infusions, including abdominal cramping, nausea, vomiting, diarrhea, an increased heart rate, throat pain and chest pressure, though the symptoms resolved after the infusions ended.
Product quality presents another concern as compounded NAD injections do not undergo the same FDA review for safety, effectiveness and manufacturing quality as food products or FDA-approved medications. What's more, in 2024, the agency warned compounders against certain NAD to produce sterile injectable drugs because such ingredients may be contaminated with microbes or bacterial toxins known as endotoxins, which the agency says have likely contributed to reports of severe chills, shaking, vomiting and fatigue following injectable NAD use.
People with heart, liver or kidney disease should be especially cautious because the added fluid and infused ingredients could pose additional risks, Mulvihill says.
Due to these and other factors, he says, anyone considering treatment should discuss its alleged benefits, dosage, ingredients, sterility standards, clinical oversight and possible alternatives with a licensed health care provider.
This article originally appeared on USA TODAY: NAD IV therapy promises more energy. But it could come at a cost
