If you have spent any time looking into longevity, IV therapy, or cellular health recently, you have probably seen the three letters: NAD+. It’s a frequent topic in functional medicine circles and praised by everyone from high-performance athletes to individuals recovering from chronic illness.

If you are wondering what NAD+ is, whether an IV NAD+ infusion is worth your time, or if there is a more comfortable way to get the same cellular results, here is a closer look at what we know.

What is NAD+ and Why Do We Need It?

Nicotinamide adenine dinucleotide (NAD+) is a vital coenzyme found naturally inside every living cell of your body. Derived from Vitamin B3, its primary job is turning the food you eat into usable cellular energy in the form of Adenosine triphosphate (ATP). ATP serves as the primary currency for the body, driving heart function, skeletal muscle movement, and brain performance. In total, NAD+ is required for more than 700 metabolic functions across our human biochemistry.

Unfortunately, your body doesn’t maintain a permanent supply of it. 

  • The Midlife Drop: By the time you reach middle age, your natural NAD+ levels have declined by roughly 50% compared to your young adulthood. 
  • The Environmental Drain: Modern living places a subtle, continuous load on our biology. While oxidative stress doesn’t account for every health issue, free radical wear-and-tear is a major contributing factor across a wide spectrum of chronic issues. Our cells are constantly adapting to external inputs, including pesticides, heavy metals, and household synthetic chemicals, while simultaneously managing the free radicals produced during normal energy production. When this cumulative burden outpaces your natural cellular defenses, systemic fatigue and cellular drain are often the result.

A lack of this essential coenzyme directly impairs the mitochondrial Krebs cycle, accelerating the negative effects of oxidative stress and leading to widespread cellular decline. The downstream effects often include: chronic fatigue, brain fog, insulin resistance, and slower recovery from physical exertion. 

Side Effects of NAD+ IV Therapy

Intravenous (IV) therapy is the preferred delivery method for NAD+ repletion, because it completely bypasses the digestive tract, delivering the coenzyme straight into your bloodstream where your cells can access it immediately. 

However, traditional NAD+ drips are known for being highly uncomfortable while the IV is running. When standard NAD+ is infused, it can trigger moderate to severe side effects in real-time, including:

  • Chest pressure
  • A racing heart rate
  • Nausea
  • Intestinal cramping

You are monitored throughout the IV treatment by nursing staff, who will often slow down the rate of the infusion accordingly if side effects arise. Everyone’s tolerance is different, but we always want our patients to be informed and as comfortable as possible in the IV room. 

An Alternative to NAD+: Niagen (NR) IV Infusion

Recent advancements have introduced a well-tolerated alternative called Niagen. Niagen is the clinical name for Nicotinamide Riboside Chloride (NR-Cl), a form of Vitamin B3 that functions as a direct precursor to NAD+.

What Makes Niagen (NR) Different From NAD+?

  • It crosses cell membranes differently: Standard NAD+ is a relatively large molecule that has difficulty entering cells directly. Niagen is significantly smaller, allowing it to cross cell membranes easily and convert to NAD+ intracellularly, where it has the most impact.
  • Shorter Infusion Time: Compared to traditional NAD+ IVs, Niagen infusions can be completed in a fraction of the time without compromising results.
  • Minimal Side Effects: Niagen bypasses the chest pressure and nausea associated with standard NAD+. The most commonly reported symptom is mild, transient tingling that resolves quickly when the infusion rate is adjusted slightly. It is exceptionally well tolerated in comparison to NAD+. 

Who Could Benefit from NAD+ or Niagen (NR)?

By bypassing the liver for direct systemic delivery, a Niagen IV produces a rapid increase in cellular NAD+ levels. Clinical research and real-world outcomes support its use for several key indications:

Severe Fatigue & Post-Viral Recovery (Long COVID)

Mitochondrial dysfunction is central to post-viral exhaustion. Double-blind clinical trials have shown that NR repletion significantly elevates cellular NAD+ levels, reduces brain fog, and supports physical recovery in Long COVID patients.

Neuroprotective Support & Mental Clarity

Because NR supports neuronal energy metabolism and DNA repair, it is used clinically to address early cognitive decline, persistent brain fog, and long-term brain health maintenance.

Metabolic Syndrome & Insulin Resistance

Low NAD+ levels cause your metabolism to stall, leading to increased fat storage and insulin resistance. Early research suggests NAD+ repletion may support healthier blood sugar regulation and metabolic timing. 

Proactive Longevity & Cellular Repair

Restoring NAD+ activates sirtuins, proteins involved in regulating systemic inflammation, managing cellular stress, and stimulating mitochondrial biogenesis.

Is NAD+ or Niagen (NR) Right for You?

If you’re dealing with chronic fatigue, metabolic sluggishness, brain fog, or if you’ve tried standard NAD+ IV therapy and found the infusion process too uncomfortable to continue,  Niagen IV is a well-supported option worth discussing with your provider.

At Meeting Point Health, we review your baseline metabolic markers, health history, and goals to build a therapeutic plan specific to your physiology.

Schedule a discovery call with Meeting Point Health to see whether NAD+ or Niagen Therapy is right for you. 

Helpful Links: 

Related Reading: 

References

McReynolds, M. R., Chellappa, K., & Baur, J. A. (2020). Age-related NAD+decline. Experimental gerontology, 134, 110888. https://doi.org/10.1016/j.exger.2020.110888

Meltzer, H., Shader, R., & Grinspoon, L. (1969). The behavioral effects of nicotinamide adenine dinucleotide in chronic schizophrenia. Psychopharmacologia, 15(2), 144–152. https://doi.org/10.1007/BF00407047 

Wu, C. Y., Reynolds, W. C., Abril, I., McManus, A. J., Brenner, C., González-Irizarry, G., Gutiérrez-Martínez, L., Sun, O., Rosand, J., Tanzi, R. E., Arnold, S. E., & Guzmán-Vélez, E. (2025). Effects of nicotinamide riboside on NAD+ levels, cognition, and symptom recovery in long-COVID: a randomized controlled trial.

Written by Amanda Bates, RN and medically reviewed by Dr. Stephen Matta