Medically reviewed by our clinical team · Last reviewed Oct 19, 2026 · How we create and review content
What is NAD+?
Nicotinamide adenine dinucleotide (NAD+) is a coenzyme found in every cell. It's central to how cells turn food into energy and helps power enzymes involved in DNA repair. The body makes NAD+ from forms of vitamin B3 (niacin), including nicotinic acid, nicotinamide and nicotinamide riboside, as well as from the amino acid tryptophan. The NIH Office of Dietary Supplements covers how niacin forms relate to NAD.
NAD+ levels decline with age in some tissues, which is the basis for interest in raising them.
NAD+ infusions, injections and precursors
- IV NAD+ infusions are offered by wellness clinics. NAD+ is not FDA-approved to treat any condition, and rigorous human trials showing clinical benefit from infusions are limited.
- NAD+ injections raise the same questions with even less published data.
- Oral precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) have been studied in small human trials. These show they can raise blood NAD+ markers, but consistent improvements in energy, performance or aging outcomes in healthy adults haven't been established.
What the research does and doesn't show
Animal studies of NAD+ precursors have produced striking results, and that's where most of the hype comes from. Human studies have been smaller and shorter, with mixed results. Raising a blood marker isn't the same as improving health, so we treat NAD+ as an area of active research, not a proven therapy.
Side effects and safety
- IV infusions commonly cause flushing, nausea, abdominal cramping, chest tightness or headache, especially when infused quickly
- IV access carries risks of bruising, vein irritation and, rarely, infection
- High doses of niacin (nicotinic acid) can cause flushing and, at very high doses, liver problems
- Long-term safety data for high-dose precursors are limited
Who should consider an NAD+ consult
An NAD+ consult at TRT Houston is useful if you're considering infusions, already taking precursors, or dealing with persistent fatigue and want to know whether NAD+ is worth your money. Because fatigue is a symptom, not a diagnosis, your clinician will usually recommend checking for common treatable causes first:
- Low testosterone confirmed by repeat morning labs
- Thyroid disease, anemia or B12 deficiency
- Obstructive sleep apnea, which is very common in adult men
- Blood sugar problems, depression or medication side effects
How a consult works
- Online intake about symptoms, supplements, sleep and goals
- Optional labs at a Quest or Labcorp near you, from Memorial to Missouri City
- A video visit to review the evidence, the costs and your results
- A plan focused on the most likely causes of how you feel
Our position on NAD+ therapy in Houston
Houston has plenty of IV lounges. TRT Houston isn't one of them. We'd rather help you find the actual reason you feel run-down. If you still want to explore NAD+ after an informed discussion, your clinician will help you understand the risks and choose the safest approach. For a broader workup, see hormone optimization testing, or call (281) 670-9727.
NAD+ Therapy in Houston: FAQs
Does NAD+ therapy work?
It raises NAD+ markers, but strong evidence that infusions or supplements improve energy, cognition or aging in healthy adults is lacking. Research is ongoing.
Is NAD+ FDA-approved?
NAD+ isn't FDA-approved to treat any medical condition. Some precursors are sold as dietary supplements, which the FDA doesn't approve for effectiveness.
What does an NAD+ IV feel like?
Flushing, nausea, cramping or chest tightness are commonly reported, especially at faster infusion rates.
Is NR or NMN better than an IV?
Oral precursors are less invasive and have some small human trials, but neither has proven clinical benefits in healthy adults. Discuss your goals with a clinician.
What should I test before trying NAD+ for fatigue?
Common starting points are testosterone (in men), thyroid tests, a CBC, B12, and blood sugar. A sleep evaluation can also help, since sleep apnea is a frequent hidden cause.