NAD + Deep Dive

NAD+ clinical evidence vs. real-world experience
Human studies show that NAD-raising supplements (like NR/NMN) reliably increase NAD+ levels, with some early signals for specific outcomes (e.g., insulin sensitivity in select groups, walking performance in peripheral artery disease, and exploratory changes in blood pressure/arterial stiffness). Other trials are neutral, and rigorous data for IV or injection protocols are still limited—so results can vary.

That said, there’s a large body of anecdotal reports from real users describing better daytime energy, mental clarity, sleep quality, and workout recovery. While anecdotes aren’t the same as randomized trials, they offer helpful real-world context and can guide individualized plans. If you’re considering NAD+, we’ll tailor dosing and monitor response to see what works best for you

Does supplementation raise NAD+ in humans?
Yes—multiple randomized trials show nicotinamide riboside (NR) increases NAD+ metabolites in blood and muscle; it’s generally well tolerated.
View RCT (Nature Communications, 2018) View Trial (npj Aging Mech Dis, 2017)
Cardiometabolic signals (blood pressure & arterial stiffness)
In healthy middle-aged/older adults, NR raised NAD+ and showed exploratory reductions in systolic blood pressure and aortic stiffness—mainly in those with higher baseline BP (needs larger confirmatory trials).
View RCT (Nature Communications, 2018)
Walking performance in Peripheral Artery Disease (PAD)
A 90-person, 6-month double-blind RCT found NR improved 6-minute walk distance vs placebo; adherence mattered (bigger gains in adherent participants).
View RCT (Nature Communications, 2024)
Insulin sensitivity (NMN in prediabetic women)
In a randomized, placebo-controlled trial, NMN increased skeletal-muscle insulin sensitivity in overweight/obese women with prediabetes.
View RCT (Science, 2021) Free full text (PMC)
Null or mixed results to know about
In obese men, 12 weeks of high-dose NR did not improve insulin sensitivity or body composition vs placebo.
Summary of RCT (AJCN 2018) in review
Exercise & performance data
Small crossover work in older adults reported acute improvements in redox markers and isometric performance after a single NR dose; other studies show no improvement in endurance metabolism/performance.
Older adults crossover (Eur J Nutr, 2020) No effect on endurance responses (bioRxiv, 2020)
What about IV NAD+?
Early pilot work suggests IV NR (a precursor) is safe acutely; stronger efficacy trials for IV NAD+ itself are still limited and ongoing.
Pilot (preprint, 2024) Narrative review (SUD/withdrawal), 2022
How strong is the research overall?
Research on NAD+ in humans is still limited for hard clinical outcomes. Several RCTs confirm NAD+ levels rise, with some promising signals (insulin sensitivity in a specific group, walking distance in PAD, exploratory BP/stiffness changes), but also multiple null findings.

That said, there’s a large body of anecdotal reports describing perceived benefits (energy, focus, sleep)—useful for hypothesis-building, but not a substitute for medical advice or randomized trials.
Anecdotes: Energy & focus improvements
Many users report steadier daytime energy and clearer focus with NR/NMN or NAD+ injections.
Read thread (NR energy/focus) Read thread (NMN energy) Read thread (NAD+ injections)
Anecdotes: Sleep & mood changes (mixed)
Some describe deeper sleep or calmer mood; others report fatigue or “no effect” after a few months—responses vary.
Read thread (fatigue after NAD+) Read thread (tolerance/waning effect)
Anecdotes: Gym/Performance
A subset report better workouts or recovery; others see no change—mirrors the mixed research.
Read thread (NR+NMN & workouts) Read thread (energy/performance)
Anecdotes: IV vs Subcutaneous vs Oral
Reports range from “expensive but noticeable” to “prefer SC/oral for cost and steadier effects”; experiences vary widely.
Read thread (IV NAD+) Read thread (SC vs IV)
Anecdotes: Skepticism / No benefit
Some users stop due to lack of perceived benefit or cost; discussions also raise concerns from preclinical papers.
Read thread (NR debate) Read thread (NR concerns)