What is NAD+?

The coenzyme that accepts electrons at complex I.

NAD+ in the library · · Human Trials · What are peptides?

129 registered trials · 111 indexed papers · 456 human / 1275 animal studies

From the PeptideWhiz library entry. "As described" sections summarize claims made in the sources; they are not PeptideWhiz endorsements.

What it is

The coenzyme that accepts electrons at complex I. Without it, the electron transport chain jams and ATP production stalls. Framed as the "fuel" or substrate for mitochondrial protocols.

Mechanism (as described)

  • Energy: needed at several TCA-cycle steps and in the electron transport chain.
  • Sirtuins: powers SIRT1 (DNA repair, mitochondrial biogenesis), SIRT3 (mitochondrial efficiency) and SIRT6 (DNA/telomere protection).
  • Decline: levels drop ~50% by middle age, partly through CD38 (worse with inflammation). Also used up by stress, infection and DNA repair. Insulin resistance overdrives NNMT, which drains NAD+.
  • When low: a sluggish immune system and failed new mitochondria.

Additional points (as described)

  • Without NAD+, pyruvate can't enter mitochondria and turns to lactate (burn, weakness). NADH feeds complex I.
  • Low-NAD+ signs listed: slower thinking, poor power and recovery, poor glucose handling, frequent colds. Decline starts in the 20s.
  • Foundation stack: NAD+ + CJC-1295 (no DAC) no-DAC + BPC-157 + SS-31. Cerebrolysin + alpha-GPC are described as additions for cognition. NAD+ + MOTS-c + retatrutide is called a strong insulin-sensitivity trio.

Registered human trials (129)

TrialPhaseStatusYearEnrolled
Effects of Trigonelline Monohydrate on NAD+ Metabolism, Pharmacokinetics, Safety, and Tolerability in Healthy AdultsPhase 1not yet recruiting202660
Nicotinamide Mononucleotide Supplementation for Exercise Tolerance Improvement in Healthy Older Adultsrecruiting202640
PEDIatric Cardiac Dysfunction Treated With Injectable Nicotinamide Adenine DinucleotidePhase 2not yet recruiting2026180
Milk Volume Outcomes Following Oral Nicotinamide Riboside Supplementation in Mothers of Extremely Preterm InfantsPhase 2/Phase 3recruiting202640
The NICE-PAD II TrialPhase 3not yet recruiting2026250
Efficacy of Topical Niacinamide Riboside on the Signs of Facial Skin Agingrecruiting2026140
N-AD: Orally Administered Nicotinamide Riboside Over Two Years as a Potential Disease Modifying Treatment for Alzheimer's DiseasePhase 2recruiting2026270
NAD Supplementation in Parkinson's Diseaseenrolling by invitation202640
A Clinical Trial to Assess the Absorption, Safety, and Efficacy of an Oral Nicotinamide Adenine Dinucleotide (NAD+) Supplement in Healthy Adultsnot yet recruiting202680
Nicotinamide Riboside Supplementation in Chronic Kidney DiseasePhase 2not yet recruiting202630
Assessing the Safety and Tolerability of NMN in DHDDS-CDGPhase 1recruiting20268
Research On Nicotinamide Riboside Supplement Support in MDS (ROSS Trial)Phase 2recruiting202610
Mechanistic Study of Nicotinamide Riboside on NAD+ Biology in Individuals With Combined Pulmonary Hypertensionrecruiting202610
Effects of NR Supplementation on Metabolic Flexibility in Zone 2 Trainingrecruiting202616
NR and Exercise for Blood Pressurenot yet recruiting2026112
Effects of Single-Dose Nicotinamide Riboside (NR) on Sleepcompleted202528
ACEs, SIRT1, and Premature Vascular Aging in Humansrecruiting202530
Nicotinamide Riboside Oral Supplementation in Macula Off Retinal DetachmentPhase 4recruiting2025144
Combination Gerotherapeutic Interventions for Healthspan ImprovementPhase 3active not recruiting202530
PRecision gerOMedicinE: Tailored Healthy agEing With Lifestyle, sUpplements and drugS (PROMETHEUS)recruiting202520
Evaluation of the Combined Therapy of EH-301 and N-acetylcysteine Together With Riluzole in Amyotrophic Lateral Sclerosis (ALS)Phase 1/Phase 2recruiting202590
Zinc and Nicotinamide Riboside for Idiopathic Pulmonary FibrosisPhase 2recruiting202560
NADream: Effects of Nicotinamide Adenine Dinucleotide Supplementation on Sleep Quality in Healthy IndividualsPhase 2recruiting202516
Effect of the Combination of Pterostilbene Cocrystal With Silybin and Nicotinamide Riboside on Exercise-Induced Oxidative Stressrecruiting202514
A Clinical Study of NAD in the Treatment of Immune ThrombocytopeniaPhase 1/Phase 2recruiting202520
Comparisons of NAD Precursors for Neuroenhancement in Glaucoma PatientsPhase 2recruiting2025138
Tracing the Metabolic Flux of Orally Administered NAD+ PrecursorsPhase 1recruiting202532
Impact of NMN Supplementation on CD4+ T Cell Recovery in HIV Patients With Immunological Failurenot yet recruiting20257
The NAD-HD Study: A Study to Investigate Efficacy and Safety of Nicotinamide Riboside Compared With Placebo in Huntington's DiseasePhase 2recruiting2025120
The NADage Study: Nicotinamide Riboside Replenishment Therapy Against Functional Decline in AgingPhase 2recruiting2025100
Effectiveness of Qualia NAD+ Supplementation on Intracellular NAD Levelscompleted2024170
Effect of Nicotinamide Riboside on Ketosis, Fat Oxidation & Metabolic Raterecruiting2024100
Nicotinamide Riboside in Ulcerative Colitisterminated202419
Double-blind Placebo Controlled Study to Evaluate the Effect of NAD+ Boosting With Nicotinamide Riboside on Immunometabolism and Immunity in Systemic Lupus ErythematosusPhase 1/Phase 2recruiting202478
Protective Effect of Nicotinamide Riboside Against Acetaminophen ToxicityPhase 1completed202426
NRM on Vascular Perfusion in Healthy Adultsenrolling by invitation2024200
NAD+ Oral Supplement Pilot Intervention in Adult Femalescompleted202453
Nicotinamide Adenine Dinucleotide (NAD+) Metabolism in Human Brown Adipose Tissuerecruiting202468
Nicotinamide Riboside (NR) to Treat Moyamoya-like Cerebrovascular Disease in Smooth Muscle Dysfunction Syndrome (SMDS)Phase 1recruiting202415
Nicotinamide Riboside Supplementation and Exercise Training to Promote Healthy Longevityrecruiting202428

Peer-reviewed studies (111)

PaperAuthorsJournalYearType
Does nicotinamide riboside supplementation increase milk production in postpartum women with infants admitted to a neonatal intensive care unit? Protocol for the MOONRISE randomised, double-blind, placebo-controlled pilot feasibility trialKhanal L et al.BMJ open2026Clinical Study
A phase-II randomized controlled pilot study of nicotinamide riboside supplementation in older adults with amnestic mild cognitive impairmentMartens CR et al.Alzheimer's & dementia : the journal of the Alzheimer's Association2026Randomized Controlled Trial
Sublingual NMN administration increases early circulating terminal catabolites 2PY and 4PY compared with oral administration in healthy adult menWakabayashi J et al.Scientific reports2026Randomized Controlled Trial
DHDDS-related juvenile parkinsonism is caused by impaired lipid metabolism, glycosylation, and mitochondrial dysfunction, which can be rescued by NAD⁺ treatmentMuffels IJJ et al.medRxiv : the preprint server for health sciences2026Preprint
Effect of Nicotinamide Mononucleotide on Retinal Thickness of Older Patients With Diabetes Mellitus: A Placebo-Controlled, Double-Blind StudyShiraki A et al.Geriatrics & gerontology international2026Randomized Controlled Trial
Low-dose oral nicotinamide mononucleotide for immune thrombocytopenia: a phase 1/2 trialLi H et al.Nature medicine2026Clinical Trial, Phase II
NAD+ augmentation by nicotinamide riboside engages SLIT2/ROBO1 signaling to attenuate Th17 inflammation in psoriasisHan K et al.JCI insight2026Randomized Controlled Trial
Safety and efficacy of individualised exercise and NAD(+) precursor supplementation in patients with Friedreich's ataxia in the USA: a single-centre, 2 × 2 factorial, randomised controlled trialLin KY et al.The Lancet. Neurology2026Randomized Controlled Trial
Anti-inflammatory effects of nicotinamide mononucleotide (NMN) in human skeletal muscle after BFR-exerciseYang DL et al.Journal of the International Society of Sports Nutrition2026Randomized Controlled Trial
The effects of pyrroloquinoline quinone and nicotinamide mononucleotide supplementation on interoception following acute exhaustive exercise: a randomised, double-blind, placebo-controlled studyZhao C et al.Scientific reports2026Randomized Controlled Trial
The differential impact of three different NAD(+) boosters on circulatory NAD and microbial metabolism in humansChristen S et al.Nature metabolism2026Randomized Controlled Trial
Evaluation of Nicotinamide Riboside in Prevention of Small Nerve Fiber Axon Degeneration and Promotion of Nerve RegenerationThomas S et al.Journal of the peripheral nervous system : JPNS2026Randomized Controlled Trial
Association between blood nicotinamide adenine dinucleotide levels and blood laboratory parameters at baseline and after nicotinamide mononucleotide supplementation in middle-aged healthy individuals: post hoc analysis of a randomized, double-blinded, placebo-controlled clinical trialKuerec AH et al.GeroScience2026Randomized Controlled Trial
NAD+ Enhanced on Hearing Recovery in Sudden Sensorineural Hearing Loss: Randomized Controlled TrialGao M et al.The Laryngoscope2026Randomized Controlled Trial
Effect of Nicotinamide Adenine Dinucleotide on Heart Failure Caused by Ischemic Cardiomyopathy: A Randomized, Placebo-Controlled TrialYu X et al.American journal of cardiovascular drugs : drugs, devices, and other interventions2026Randomized Controlled Trial
Nicotinamide riboside combined with exercise to treat hypertension in middle-aged and older adults: a pilot randomized clinical trialLin Y et al.GeroScience2025Randomized Controlled Trial
Effects of NAD(+) supplementation with oral nicotinamide riboside on vascular health and cognitive function in older adults with peripheral artery disease: Results from a pilot 4-week open-label clinical trialSzarvas Z et al.The Journal of pharmacology and experimental therapeutics2025Clinical Trial
Nicotinamide Riboside Supplementation Benefits in Patients With Werner Syndrome: A Double-Blind Randomized Crossover Placebo-Controlled TrialShoji M et al.Aging cell2025Randomized Controlled Trial
Acute exercise boosts NAD(+) metabolism of human peripheral blood mononuclear cellsWalzik D et al.Brain, behavior, and immunity2025Randomized Controlled Trial
Feasibility of telehealth exercise and nicotinamide riboside supplementation in survivors of childhood cancer at risk for diabetes: A pilot randomized controlled trialBhandari R et al.Pediatric blood & cancer2025Randomized Controlled Trial
Effects of intradialytic bicycle ergometer exercise on transcription factors NF-ĸB and Nrf2 in patients with chronic kidney disease: A randomized crossover clinical trialBrito JS et al.Journal of bodywork and movement therapies2024Randomized Controlled Trial
Effect of nicotinamide riboside on airway inflammation in COPD: a randomized, placebo-controlled trialNorheim KL et al.Nature aging2024Randomized Controlled Trial
Randomized Crossover Clinical Trial of Nicotinamide Riboside and Coenzyme Q10 on Metabolic Health and Mitochondrial Bioenergetics in CKDAhmadi A et al.medRxiv : the preprint server for health sciences2024Preprint
Novel insight into nicotinamide adenine dinucleotide and related metabolites in cancer patients undergoing surgeryFujita H et al.Scientific reports2024Observational Study
Nicotinamide riboside for peripheral artery disease: the NICE randomized clinical trialMcDermott MM et al.Nature communications2024Randomized Controlled Trial
Ingestion of β-nicotinamide mononucleotide increased blood NAD levels, maintained walking speed, and improved sleep quality in older adults in a double-blind randomized, placebo-controlled studyMorifuji M et al.GeroScience2024Randomized Controlled Trial
A randomized placebo-controlled trial of nicotinamide riboside in older adults with mild cognitive impairmentOrr ME et al.GeroScience2024Randomized Controlled Trial
Long-Term Nicotinamide Riboside Use Improves Coordination and Eye Movements in Ataxia TelangiectasiaPresterud R et al.Movement disorders : official journal of the Movement Disorder Society2024Clinical Trial
Evidence of brain target engagement in Parkinson's disease and multiple sclerosis by the investigational nanomedicine, CNM-Au8, in the REPAIR phase 2 clinical trialsRen J et al.Journal of nanobiotechnology2023Clinical Trial, Phase II
NR-SAFE: a randomized, double-blind safety trial of high dose nicotinamide riboside in Parkinson's diseaseBerven H et al.Nature communications2023Randomized Controlled Trial

More cited research

Conditions researched

Related compounds

FAQ

What is NAD+?

The coenzyme that accepts electrons at complex I.

How many registered human trials study NAD+?

The PeptideWhiz trial index lists 129 registered trials for NAD+, the most recent from 2026.

How much published research exists on NAD+?

The PeptideWhiz paper index links 111 PubMed papers to NAD+; by study type, 456 human and 1275 animal studies.

Which conditions is NAD+ researched for?

Fatigue & low energy (incl. midlife), Insulin resistance, prediabetes & type 2 diabetes, Dementia, Alzheimer's & cognitive decline, Multiple sclerosis, Chronic pain: fibromyalgia & CRPS, Menopause & perimenopause, High-demand jobs: military, fire, police, EMT (and combat-sport athletes), Anti-aging & longevity, Gut: IBD (Crohn's, colitis), leaky gut, IBS & ulcers, Chronic fatigue syndrome and ME, Lymphedema and swelling, Neuropathy and CRPS, Atherosclerosis, cardiovascular disease & high blood pressure, Cognition, focus & brain performance, High cholesterol and statins, Anemia, Chronic and systemic inflammation, Concussion, traumatic brain injury & stroke recovery, Diabetic retinopathy and glaucoma, Fat loss, obesity & body recomposition, Fatty liver & elevated liver enzymes, Heart repair: after heart attack, heart failure & enlarged heart, Immune system (general), Kidney protection (CKD, diabetic kidney, lupus kidney), Loose skin, Lung health, asthma & COPD, Lupus (SLE), Mitochondrial dysfunction, Muscle gain, sarcopenia & building muscle after 40, Muscle disease (myopathy), Osteoporosis and bone density, Parkinson's disease, Post-surgical inflammation and surgery recovery, Psoriasis and psoriatic arthritis, Sleep problems (incl. insomnia on peptides), Tendon, ligament, muscle & joint injuries (incl. athletes).

Research and education only. Not medical advice. No dosing guidance. Data: ClinicalTrials.gov registry and PubMed via the PeptideWhiz index (204,289 studies).

Reported dosing ranges from research