IV NAD+ Therapy: What It Is and What the Research Supports
Short Answer
- IV NAD+ therapy is a slow infusion of nicotinamide adenine dinucleotide (NAD+), a coenzyme every cell uses to turn food into energy and to run its DNA-repair and signaling enzymes, delivered into a vein over several hours
- The published human IV studies measured blood levels and tolerability. The randomized trials that measured how people felt used oral NAD+ precursors, and their results are mixed. A Parkinson's disease safety trial met its safety goal, while a long-COVID trial raised NAD+ levels without improving fatigue or thinking compared with placebo
- IV NAD+ is one tool a physician may incorporate into a care plan once the cause of your symptoms is understood. It is not a standalone drip, and the evidence for benefit is thinner than many people expect
If you have been searching for NAD IV therapy from Gilbert or anywhere else because you are worn down, foggy, and tired of being told your labs look fine, the research deserves a look before any infusion is scheduled.
Whether you have already tried the reasonable things, sleeping more, cleaning up your diet, adding a few supplements, a round of bloodwork that came back normal, or you never knew there was anything to test in the first place, feeling depleted for months is not something a normal-looking panel rules out. It usually means the question of what is draining your energy has not been fully worked up yet, and an infusion chosen before that question is answered is a guess, which is why physician-supervised IV therapy at a medical practice starts with the evaluation rather than the drip.
IV NAD+ therapy is the slow intravenous infusion of nicotinamide adenine dinucleotide, a coenzyme central to cellular energy metabolism, DNA repair, and immune signaling. At Regenerative Performance in Gilbert, AZ, IV NAD+ is administered under physician supervision as one component of a care plan that follows a full evaluation, most often for adults with persistent fatigue, cognitive slowing, or a slow recovery from a prolonged illness, and it is paired with supportive nutrients rather than given as a single ingredient. The evidence for benefit is limited. Human IV studies to date report on blood levels and tolerability, and the disease-context trials that measured symptoms used oral NAD+ precursors, with mixed results.
For persistent fatigue or brain fog, the useful first step is identifying what is driving it. Once that is understood, IV NAD+ is one tool that can fit into a care plan.
Schedule a 2-hour evaluation for your persistent fatigue and low energy at our Gilbert, AZ clinic (also serving Chandler, Mesa, Queen Creek, and the greater Phoenix area).
We limit how many new patients we accept each month to devote sufficient time and attention to each case.
By the time patients ask Dr. Myers about NAD+, many have already been through months of normal labs and a shelf of supplements. What most of them needed first was a clearer answer about why they were depleted, and the infusion, when it belongs in the plan, comes after that.
Key Facts About IV NAD+ Therapy
Here is what you need to know about IV NAD+ therapy before deciding whether it is worth exploring.
- What IV NAD+ therapy is: A slow intravenous infusion of NAD+ (nicotinamide adenine dinucleotide), the coenzyme cells depend on to produce energy and to run their DNA-repair enzymes, delivered directly into the bloodstream over several hours.
- Who it helps: Adults with persistent fatigue, brain fog, or a slow recovery from a prolonged illness, once an evaluation has looked for the more common and more correctable causes first. It is not used in active cancer.
- How it works: NAD+ sits at the start of the chain that converts food into usable cellular energy and is consumed by the enzymes that repair DNA and regulate cell signaling. An infusion raises NAD+ in the blood, though how much of it enters cells intact remains an open scientific question.
- Goal of treatment: Support cellular energy production and recovery as one part of a plan that also addresses sleep, nutrition, and whatever the workup uncovered.
- Clinical outcomes: Human IV NAD+ studies to date report tolerability and blood levels, and the randomized trials that measured symptoms used oral precursors, with mixed results.
- Timeline: Any change in energy tends to be gradual and is reviewed at follow-up rather than judged from a single infusion. There is no fixed timeline, and individual results may vary.
- Typical treatments: IV NAD+ is given as part of a physician-directed care plan, with the frequency and duration set at your evaluation and adjusted from your response and follow-up labs. It is not a standalone drip you book on your own.
- Where: Regenerative Performance, a naturopathic medical clinic in Gilbert, AZ, serving the East Valley and the greater Phoenix area.
- Next step: Call 480-508-4226 to schedule a 2-hour evaluation for your persistent fatigue and low energy in Gilbert, AZ.
This article is especially useful if you have been offered an NAD drip at a wellness clinic, you want to know what the research does and does not support before saying yes, and you would rather have a physician decide whether it belongs in your plan.
What Does IV NAD+ Therapy Do in the Body?
IV NAD+ therapy delivers nicotinamide adenine dinucleotide, a coenzyme that every cell uses to convert nutrients into usable energy, straight into the bloodstream. NAD+ shuttles electrons through the reactions that generate cellular energy, and it is also a cofactor for NAD+-dependent enzymes that regulate DNA repair, cellular metabolism, and immune function (Reyna et al., Frontiers in Aging, 2026). Raising NAD+ in the blood is the easy part. What an infusion does for how you feel is the harder question.
Inside each cell, the mitochondria, the structures that produce most of that energy, cycle NAD+ back and forth between its two forms constantly, and the tissues with the highest energy demand, the heart, the brain, and working muscle, tend to be the most dependent on that supply. When NAD+ runs low, those reactions run less efficiently, and the enzymes that draw on the same pool for repair and signaling compete for what is left.
Levels of NAD+ tend to fall with age and under sustained illness and inflammation. That decline is the rationale behind every NAD+ product on the market, from oral precursors to infusions, and the rationale is sound as far as it goes. That reasoning shows the molecule matters. It does not show that adding more of it through a vein changes how a person feels.
Why Is IV NAD+ Given Instead of an Oral Supplement?
IV NAD+ is given instead of an oral supplement because the infusion bypasses digestion and puts the intact molecule into the bloodstream directly. Whether that translates into more NAD+ inside your cells is a real and unresolved scientific question, and any clinic offering the infusion should be willing to say so.
The complication is that NAD+ is large, it does its work inside cells, and cells build most of their own NAD+ from smaller precursors rather than importing the finished molecule. Tracer studies of NAD+ metabolism in animals suggest that much of the NAD+ circulating in the blood is broken down, with the liver converting it to nicotinamide, a form of vitamin B3, that other tissues then take up and rebuild into NAD+. If that is what happens to an infusion, the IV route is delivering raw material at scale. The older view that intact NAD+ cannot enter cells at all has been challenged in the laboratory: a 2023 cell-culture study found that NAD+ itself, and not its precursors, directly changed mitochondrial activity, which is consistent with cells taking up the whole molecule (Munk et al., Nature Cell Biology, 2023). That was shown in cultured cells, not after an infusion in a person, so how much of an infused dose reaches your cells intact is still an open question.
The one published study that tracked NAD+ levels in the blood after an IV infusion in humans adds a detail worth knowing. When healthy men received 750 mg of NAD+ infused over 6 hours, no change in plasma NAD+ or its metabolites was measurable until after the 2-hour mark, and no side effects occurred during the infusion in either the NAD+ or the saline group (Grant et al., Frontiers in Aging Neuroscience, 2019).
That open question is one reason the dose, the pace of the drip, and what NAD+ is paired with are clinical decisions. The infusion earns a place in a plan when a physician has a specific reason to want more of this pathway running in a specific patient, and it does not earn one because a molecule sounds impressive.
Is IV NAD+ Therapy FDA Approved?
IV NAD+ therapy is not FDA approved, because IV NAD+ is not an FDA-approved product for the uses discussed here, and no NAD+ infusion protocol, at any clinic, carries FDA approval for energy, fatigue, or longevity.
That is a different regulatory category from off-label use, and the difference matters when you compare it with other infusions. Off-label means an FDA-approved drug prescribed for a condition outside its approved label. High-dose IV vitamin C is the clearest example in IV medicine, because an approved injectable ascorbic acid product exists and is used outside its approved indication. IV NAD+ has no approved product behind it at all. It is administered as part of physician-directed care under the rules that govern the practice of medicine in each state, which is legal and common, and it means the evidence you weigh is the published research rather than a regulatory decision.
Schedule a 2-hour evaluation for your persistent fatigue and low energy at our Gilbert, AZ clinic.
Does IV NAD+ Therapy Work According to the Research?
According to the research published so far, IV NAD+ therapy has not been tested in a randomized trial that measured symptoms, so whether it works is an open question that the evidence has not answered in either direction. The human IV studies report tolerability and blood levels. The trials that did measure how patients felt used oral NAD+ precursors, and they are worth reading closely because their results are mixed.
Here is where the evidence stands based on what has actually been studied so far.
- The best safety and tolerability information about the IV route comes from small studies, and it describes real side effects during the drip rather than harm afterward.
- The trials that measured how people felt gave the precursor by mouth, so their results speak to NAD+ biology in general and not to the infusion specifically.
- One of those trials raised NAD+ levels substantially and still did not improve fatigue or thinking compared with placebo, which is the single most important caution against overpromising.
- A history of cancer changes the calculation entirely, and it is one of the first things a physician should ask about.
What IV NAD+ studies report on tolerability
IV NAD+ studies report that the infusion is uncomfortable for many people while it runs, and that the discomfort resolves when it ends. The small blood-level study described earlier reported no side effects during a slow infusion in healthy volunteers, which is reassuring as far as it goes and is also the ceiling of what a study of that size can tell you.
In the real world, the picture is less comfortable. A small retrospective review of infusion records at one clinic suggests that the patients who received IV NAD+ reported moderate to severe symptoms during the drip, including stomach cramping and nausea, a faster heart rate, and chest pressure, while some of the patients receiving IV nicotinamide riboside (NR) reported only minor tingling and mild cramping, and all symptoms resolved once the infusion was complete. Because those symptoms lengthened the infusions, average visit time in this small sample was 97 minutes for NAD+ against 37 minutes for NR (Reyna et al., Frontiers in Aging, 2026).
That is the practical reason a properly run NAD+ infusion is slow, paced to how you feel, and monitored by clinical staff throughout, and it is a fair question to ask any clinic offering one.
What the Parkinson's disease trials report
The Parkinson's disease trials show that raising NAD+ with an oral precursor is possible and, at high doses, did not cause serious side effects over the short term. An early hint of symptom benefit did not hold up when a larger trial tested it. All of these trials used oral NR rather than IV NAD+, so they speak to NAD+ biology and not to the infusion.
The first, the NADPARK trial, randomized 30 newly diagnosed patients to 1,000 mg of oral NR or placebo for 30 days. NR raised NAD+ in the brain of some participants, and the participants whose brain levels rose also showed mild improvement in their movement symptoms (Brakedal et al., Cell Metabolism, 2022). The authors framed that as a signal to test in a larger trial.
That larger trial, NOPARK, reported its results in JAMA in October 2026. People with early-stage Parkinson's disease took oral NR or a placebo for a year, and NR did not improve the disease-severity score the trial was built to measure. The score worsened slightly more in the NR group than in the placebo group, and the authors concluded that the findings do not support NR as a treatment to slow Parkinson's disease. The early signal did not hold.
A separate trial was built to answer the safety question at a much higher dose. In NR-SAFE, patients with Parkinson's disease took 1500 mg of NR twice a day or a placebo for four weeks, and the trial met all of its planned safety goals. NR caused no moderate or severe side effects (Berven et al., Nature Communications, 2023). The trial was designed to test safety, so it indicates that high-dose NR can be given safely for a month, and it does not, by design, indicate that NR improves symptoms.
What the fatigue and long-COVID trials report
The fatigue and long-COVID trials report the mixed picture most clearly. One raised NAD+ levels without improving how people felt, and another, using a different oral compound in a different condition, reported less fatigue within the treated group. Neither used IV NAD+.
The long-COVID trial is the one to sit with. A small randomized trial in adults with long COVID suggests that oral NR raised blood NAD+ 2.6- to 3.1-fold after 5 to 10 weeks, with levels still elevated at 20 weeks, and that despite that rise there were no significant differences between the NR and placebo groups in cognition, fatigue severity, sleep quality, anxiety, or depression (Wu et al., eClinicalMedicine, 2025).
A different oral combination, in a different fatigue condition, landed more favorably. In a 12-week randomized, placebo-controlled trial in women with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), participants took 200 mg of coenzyme Q10 plus 20 mg of NADH, the reduced form of NAD+, each day for an 8-week treatment phase, and the supplemented group reported a significant reduction in cognitive fatigue and in overall fatigue scores, along with improved health-related quality of life, over time compared with their own starting point (Castro-Marrero et al., Nutrients, 2021). It was taken by mouth and combined with CoQ10, so this is adjacent evidence about the NAD family in a fatigue condition rather than evidence for IV NAD+.
If your own fatigue followed an infection you never fully recovered from, that history deserves its own workup before any infusion, and the pattern is covered in our article on EBV reactivation and chronic fatigue.
Why a history of cancer changes the answer
A history of cancer changes the answer because NAD metabolism is not only a human energy pathway. Cancer cells use it too, and the research on boosting NAD+ in the presence of a tumor is early and points in an uncomfortable direction.
Reviews of NAD biology in cancer describe NAD-dependent signaling as central to how tumor cells manage DNA repair, cell division, and metabolism, with different tumor types leaning on different parts of the pathway. Preliminary animal research adds a concrete caution. In a mouse model of triple-negative breast cancer, supplementing with the precursor NR was associated with more spread of the cancer to the brain than in unsupplemented animals. That is a mouse study of one tumor type, so it does not settle the question for people, and it is more than enough reason to be careful.
At Regenerative Performance, IV NAD+ is not offered to patients with active cancer. For patients who have completed cancer treatment, any consideration of NAD+ support is a conversation that includes your oncologist, and any course would run for a defined period rather than continuing indefinitely.
What Is in an IV NAD+ Infusion at Regenerative Performance?
An IV NAD+ infusion at Regenerative Performance is a standardized NAD+ formulation paired with supportive nutrients, run slowly over a longer visit and adjusted when your clinical picture calls for it. It is physician-supervised, it follows a full evaluation, and it is one component of a care plan rather than an item you order.
The pairing follows from the mechanism, because rebuilding NAD+ inside cells draws on B vitamins as helper molecules, and in our clinical experience running that pathway harder can also draw on glutathione, the cell's main antioxidant, so NAD+ at the practice is given alongside supportive B vitamins and glutathione instead of as a single molecule in a bag. The base formulation is the same for most patients, and the additions and the pace of the drip are where clinical judgment comes in.
The rest of the plan matters as much as the bag. When a patient is depleted, the foundations come first, including sleep, nutrition, hydration, and stress load, plus correction of whatever the labs uncovered, whether that is thyroid, hormones, iron, or a viral reactivation that never fully resolved. Where an infusion fits, it fits into that, and where the workup points somewhere else entirely, the plan follows the workup. You can read more about how IV therapy is structured at the practice.
What to Expect at an IV NAD+ Therapy Appointment
An IV NAD+ therapy appointment at Regenerative Performance comes after a new-patient evaluation, never instead of one, and the infusion itself is a slow, monitored visit that runs longer than most other infusions. The sequence has four steps.
The 2-Hour Evaluation
Every new patient starts with a detailed history, a symptom timeline that pays attention to when the fatigue began and what preceded it, and a review of the labs you have already had. The purpose of this visit is to identify what may be driving your symptoms, because an infusion chosen before that is known is aimed at nothing in particular. Where indicated, additional lab testing is ordered to fill in the gaps.
Individualized Treatment Plan
Based on the evaluation and your results, your physician builds the plan, including the foundations, targeted support for what the workup uncovered, and, when the clinical picture calls for it, IV therapy. If IV NAD+ belongs in that plan, the reasoning is explained to you, including what it is expected to do and what the evidence does and does not support. A history of cancer, pregnancy, kidney disease, or an active infection is reviewed here, because each changes whether an infusion is appropriate.
The Infusion Visit
NAD+ is infused slowly through a small IV line while you rest in the IV suite, and the drip is paced to how you feel. Cramping, flushing, a racing heart, or chest pressure during the infusion are the signal to slow it down, and those symptoms typically ease as the rate drops and resolve once the infusion ends. Expect the visit to run considerably longer than a micronutrient or hydration infusion, and plan your day around it. Clinical staff monitor you throughout.
Follow-Up and Adjustment
Your response is reviewed at follow-up along with any repeat labs, and the frequency, the pairing, and whether to continue at all are adjusted from what you report and what the labs say. Any change in energy tends to be gradual, so the plan is judged over a course of care rather than after a single visit.
Schedule a 2-hour evaluation for your persistent fatigue and low energy at our Gilbert, AZ clinic.
Who Might a Physician Consider IV NAD+ Therapy For?
A physician might consider IV NAD+ therapy for an adult with persistent fatigue, brain fog, or a slow recovery from a prolonged illness, once the more common and more correctable causes have been looked for. The evaluation exists to sort that out for your specific situation, and it is designed to tell you when an infusion is not the right tool.
An evaluation may be worth exploring if any of the following describes you.
- Persistent fatigue or low energy that has lasted for months and has not been explained by the testing you have already had
- Brain fog or slowed thinking that arrived with, or after, a period of illness or intense stress
- A prolonged illness, including a viral infection, that you never fully recovered from
- Supplements, including oral NAD+ precursors, that did not change how you feel
- A wish to have a physician weigh the research and your labs before you commit to any infusion
- A willingness to invest in IV NAD+ as a cash-pay treatment
IV NAD+ is not offered to patients with active cancer, and a cancer history, pregnancy, or kidney disease is reviewed carefully before any infusion is considered.
During your evaluation, we will assess whether IV NAD+ belongs in your plan at all, or whether a thyroid, hormonal, nutritional, or infectious driver explains more of the picture and deserves the attention first.
If you are unsure whether IV NAD+ therapy is the right starting point, or you are traveling from outside the Phoenix area, you can also call and ask about a brief 15 minute discovery call.
Frequently Asked Questions About IV NAD+ Therapy
Does IV NAD+ therapy actually work?
IV NAD+ therapy has not been tested in a randomized trial that measured how patients feel afterward, so whether it works for fatigue or energy is an open question that the evidence has not yet answered. The human IV studies published so far measured blood levels and tolerability. The disease-context trials that did measure symptoms used oral precursors, and their results were mixed. A Parkinson's disease safety trial met its safety goal, while a long-COVID trial raised NAD+ levels without improving fatigue or cognition compared with placebo.
Does IV NAD+ therapy have FDA approval?
IV NAD+ therapy is not FDA approved, and IV NAD+ is not an FDA-approved product for the uses discussed here. That is different from off-label use, which refers to an FDA-approved drug prescribed for a condition outside its approved label. IV NAD+ is administered as part of physician-directed care rather than under any FDA approval.
What is the difference between IV NAD+ and oral precursors like NR or NMN?
IV NAD+ delivers the finished NAD+ molecule into the bloodstream, while oral precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are smaller building blocks that cells absorb and convert into NAD+ themselves. NAD+ is a large molecule that lives inside cells, and how much of an infused dose enters cells intact remains an open scientific question. Most of the randomized trials that measured symptoms used oral NR, not IV NAD+.
What are the side effects of IV NAD+ therapy?
The most common side effects of IV NAD+ therapy occur during the infusion itself, including abdominal cramping, nausea, a racing or pounding heart, chest pressure, and flushing, and they typically ease when the drip is slowed and resolve once it ends. A real-world comparison of IV NAD+ against IV nicotinamide riboside reported moderate to severe symptoms in the NAD+ group and only mild tingling and cramping with NR, which is why NAD+ is infused slowly over a longer visit.
Is IV NAD+ therapy safe if I have a history of cancer?
A history of cancer is a reason for caution with IV NAD+ therapy, and active cancer is generally treated as a reason not to use it. NAD metabolism is also used by cancer cells, and preliminary animal research has raised the possibility that boosting NAD+ could support tumor spread in some settings. Anyone with a cancer history should raise it with the treating oncologist and the prescribing physician before any NAD+ therapy is considered.
Are NAD injections the same as IV NAD+ therapy?
NAD injections and IV NAD+ therapy are two different routes for the same molecule. An injection usually means a small shot of NAD+ under the skin or into a muscle, while IV NAD+ therapy is a slow infusion into a vein that runs over several hours. Clinics and patients often use the word "injections" for both, so it is worth confirming which one a provider is offering, because the dose, the session length, and the side effects differ.
Can IV NAD+ therapy help with chronic fatigue?
IV NAD+ therapy has not been studied in a randomized trial for chronic fatigue, so any benefit for fatigue is unproven rather than disproven. The closest evidence comes from oral compounds. A 12-week trial of oral CoQ10 plus NADH in women with ME/CFS reported reduced fatigue scores within the supplemented group, while a long-COVID trial of oral NR raised NAD+ levels without improving fatigue compared with placebo. Fatigue also has many causes, from thyroid and hormone problems to nutrient depletion and viral reactivation, so an evaluation of what is driving it comes before any infusion.
Is IV NAD+ therapy at Regenerative Performance covered by insurance?
IV NAD+ therapy at Regenerative Performance is not covered by insurance, because the practice is cash-pay and does not bill, verify, or contract with insurance plans. IV NAD+ is not an FDA-approved product for the uses discussed here, which is part of why infusions like this are rarely reimbursed anywhere. HSA and FSA funds can often be applied, and an itemized superbill is available on request for you to submit to your plan.
Still have questions? The best way to get answers is a conversation. Call 480-508-4226.
About Dr. Kaitlyn Myers
Dr. Kaitlyn Myers, ND
Dr. Kaitlyn Myers, ND, is a naturopathic physician and co-founder at Regenerative Performance in Gilbert, AZ. She leads the practice's hormone therapy, functional-medicine, and internal-medicine care, including the IV therapy program, working with women through perimenopause and menopause, treating thyroid and adrenal dysfunction, addressing chronic infections and viral reactivation, and using functional labs to investigate the causes of persistent fatigue.
She is a graduate of Southwest College of Naturopathic Medicine (SCNM) and practices an investigative, systems-based approach to complex chronic illness, weighing the research for each tool against the patient in front of her before it goes into the plan.
References
- Grant R, Berg J, Mestayer R, et al. A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+. Frontiers in Aging Neuroscience. 2019;11:257. DOI: 10.3389/fnagi.2019.00257.
- Reyna K, Heinzen G, Patel N, et al. Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. Frontiers in Aging. 2026;7:1652582. DOI: 10.3389/fragi.2026.1652582.
- Brakedal B, Dölle C, Riemer F, et al. The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease. Cell Metabolism. 2022;34(3):396-407.e6. DOI: 10.1016/j.cmet.2022.02.001.
- Munk SHN, Merchut-Maya JM, Adelantado Rubio A, et al. NAD+ regulates nucleotide metabolism and genomic DNA replication. Nature Cell Biology. 2023;25(12):1774-1786. DOI: 10.1038/s41556-023-01280-z.
- Berven H, Kverneng S, Sheard E, et al. NR-SAFE: a randomized, double-blind safety trial of high dose nicotinamide riboside in Parkinson's disease. Nature Communications. 2023;14(1):7793. DOI: 10.1038/s41467-023-43514-6.
- Wu CY, Reynolds M, Abril A, et al. Effects of nicotinamide riboside on NAD+ levels, cognition, and symptom recovery in long-COVID: a randomized controlled trial. eClinicalMedicine. 2025;89:103633. DOI: 10.1016/j.eclinm.2025.103633.
- Castro-Marrero J, Segundo MJ, Lacasa M, Martinez-Martinez A, Sentañes RS, Alegre-Martin J. Effect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related Quality of Life in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021;13(8):2658. DOI: 10.3390/nu13082658.
NOTE: This article provides general information to help the reader better understand IV nutrient therapy, NAD+ metabolism, persistent fatigue, naturopathic approaches to chronic symptoms, and related subjects. All content provided in this article, website, or any linked materials, including text, graphics, images, research, and outcomes, are not intended, and should not be used, as a substitute for direct medical advice, diagnosis, or treatment. Please always consult with a professional and licensed healthcare provider to discuss if any treatment is right for you.