NAD+: Side Effects & Safety

NAD+ is a naturally occurring molecule present in every living cell, and supplementation aims to restore levels that decline with age. The safety profile is generally favorable, with most adverse effects related to the route of administration rather than the molecule itself. However, injectable NAD+ is notably more uncomfortable than most peptide injections.

• Injection site pain/stinging: The most commonly reported effect — NAD+ subcutaneous injections produce a stinging or burning sensation that can last several minutes. This is more pronounced than typical peptide injections
• Flushing: Warmth and facial flushing, particularly with higher doses or IV administration
• Nausea: Reported with IV infusions, especially at faster infusion rates. Usually managed by slowing the drip
• Chest tightness: Transient chest pressure or tightness reported with IV NAD+ infusions
• Headache: Occasional headache, typically mild and self-limiting
• Insomnia: Some users report difficulty sleeping with evening dosing, likely related to NAD+'s role in circadian regulation and energy metabolism

Key safety considerations:

• Cancer considerations: NAD+ is required by rapidly dividing cells, including cancer cells. Some researchers have raised theoretical concerns about supplementation in individuals with active cancer. This remains an area of active investigation — no clinical evidence has established harm, but caution is warranted
• Drug interactions: NAD+ metabolism intersects with pathways affected by certain medications. Consult healthcare providers regarding potential interactions
• Long-term data: While NAD+ precursor supplements (NMN, NR) have accumulating clinical trial data, long-term safety data for high-dose injectable NAD+ is limited
• Quality control: Injectable NAD+ requires pharmaceutical-grade purity. Source from reputable suppliers with third-party certificates of analysis

• Active cancer (theoretical concern — consult oncologist)
• Uncontrolled cardiovascular conditions (due to transient hemodynamic effects during IV infusion)
• Pregnancy and breastfeeding (insufficient safety data)

Return to the NAD+ overview for general information.