NAD+

Definition

Nicotinamide adenine dinucleotide is a coenzyme central to cellular energy metabolism and a substrate for enzymes implicated in aging biology; it is not a peptide, and it appears in this index because it is prescribed and marketed alongside peptide therapy by the same providers.

Levels decline with age in many tissues, which is the observation the injectable market is built on; whether raising circulating NAD+ changes any clinical outcome is a separate question.

Evidence

The interventional evidence comes almost entirely from oral precursors rather than NAD+ itself: a 2026 systematic review of nicotinamide mononucleotide trials reports consistent safety and modest metabolic effects ^[1], and reviews of NAD+ biology note that direct intravenous or injectable NAD+ has little published human trial data behind it ^[2].

The gap matters when reading marketing: trial results for oral precursors are routinely cited in support of injections and infusions that those trials did not study.

Lawful access

NAD+ is listed in Category 1 of the FDA's interim 503A bulks list; licensed pharmacies may compound it with a valid prescription while the agency's review continues. No telehealth supplier is listed in this index yet; programs carrying NAD+ are under review.

Category 1 is a permission to compound during review, not an approval, and the index records it as such.

Related molecules

NAD+ sits in the mitochondrial group beside MOTS-c, whose regulatory position is far more restrictive; glutathione shares its Category 1 posture, and the compoundable page lists both.