Evidence review
Do the nicotinamide riboside and nicotinamide mononucleotide trials support intravenous NAD+?
The answer
No. Those trials tested oral precursors. Counted separately, nicotinamide riboside has 42 clinical trials and nicotinamide mononucleotide 22, while the phrase set naming an infused NAD+ preparation returns 22 papers in total and one relevant randomized trial, in heart failure.
Nicotinamide riboside and nicotinamide mononucleotide are precursors. They are swallowed, absorbed through the gut, and converted inside cells into nicotinamide adenine dinucleotide. An NAD+ infusion delivers the finished coenzyme directly into a vein. Different molecule, different route, different pharmacokinetics, and therefore a different question.
The marketplace collapses that distinction routinely, and the collapse is not accidental: the precursor literature is the only substantial human evidence in the neighborhood, so it is the evidence that gets cited. A reader who meets a page listing clinical trials in support of an intravenous drip is usually reading a list of oral supplement trials. The monograph records the regulatory posture with the date it was verified; this page counts the literatures and keeps them apart.
They were searched in August 2026 in one session, and their counts were never added together. Nicotinamide riboside returns 952 indexed records, 418 carrying the Humans subject heading, 42 under the clinical-trial publication type and 32 under the stricter randomized-controlled-trial type [3].
Nicotinamide mononucleotide returns 1,713 records, 593 human-tagged, 22 clinical trials and 16 randomized trials [3]. Between them the two precursors account for a real body of interventional human research, and this index does not dispute it. A systematic review of the oral nicotinamide mononucleotide trials reports consistent safety and modest metabolic effects [4].
The phrase set naming an infused or intravenous NAD+ preparation returns 22 records in total, 11 human-tagged, 4 under the clinical-trial type and 1 under the randomized type [3]. Twenty-two papers is not a literature. It is a shelf.
The publication-type filter was proved live in the same run against a control term returning 8,904 records under the clinical-trial type and 6,113 under the randomized type; the invalid tag that once produced a false zero on this site returned 0 for that same control term, and a deliberately invalid record identifier errored in the same session [3].
Three of them are about something else. Reading each record rather than counting it returns a chemotherapy sequence in esophageal cancer, a topical preparation investigated for psoriasis, and a 1972 review of nicotinic acid in schizophrenia [3]. None concerns an intravenous NAD+ infusion given for the reasons the infusion is sold for.
The fourth is a genuine randomized placebo-controlled trial, and its subject is neither aging nor wellness nor energy. It enrolled 180 adults with heart failure from ischemic cardiomyopathy, a left ventricular ejection fraction at or below 45 percent, and New York Heart Association class II to III disease. They received intravenous NAD+ at 10 mg daily or a matched placebo for seven days alongside guideline-directed medical therapy, and the primary endpoint was the change in ejection fraction at one month [2].
That is a cardiology trial in a diagnosed population on background therapy, running for a week. It is not a reason to book an infusion, and it is not evidence about a person without heart failure. Its existence is worth reporting precisely because it is the strongest thing in the column, and because a page that cited it as support for wellness infusions would be doing the exact substitution this review is about.
One study asked the most basic question available: during an NAD+ infusion, what happens in the blood. It was a pilot investigation rather than an outcome trial, and it followed plasma and urine through a six-hour intravenous infusion at 3 micromoles per minute [1].
The result is the sentence a reader should take away from this page. Plasma NAD+ and the metabolites measured alongside it, among them nicotinamide, methylnicotinamide, and nicotinamide mononucleotide, did not change until after the second hour. The authors read that as the infused compound being removed from plasma rapidly and completely over the first two hours, and they reported increased urinary excretion of NAD+ and methylnicotinamide at six hours [1].
The authors describe their own study as the first to document the fate of directly infused NAD+ in a human cohort [1]. That is a statement about how little was known, made by the people who set out to find out, and it was published in 2019. It is difficult to reconcile with a market that had by then been selling the infusion for years on the strength of what the molecule does inside a cell.
NAD+ sits in Category 1 of the FDA's interim 503A bulks list, which means licensed pharmacies may compound it against a valid prescription while the agency's review continues. That is a permission to compound during review, and the compoundable page records it as such. It is not an approval, it is not a finding of efficacy, and it makes no claim about the infusion's effects.
This is the same reading discipline that runs through the index. A regulatory permission answers who may prepare a substance. A trial answers whether it does anything. Glutathione shares the Category 1 posture and has its own gap between route and evidence; MOTS-c, the other molecule in the mitochondrial group, has neither the permission nor the record. The category 1 entry defines the listing itself.
Monographs
Reference tables
Every source below is inherited from a monograph in this index, where it was verified at writing time; this review introduces none of its own. The pointer beside each entry names the monograph and the reference number it came from.