NAD+ Restoration: What the Research Shows
Cellular Energy & Mitochondrial Research
NAD+ sits at the centre of cellular energy metabolism, and the question researchers actually care about — can raising it change something measurable in humans — now has randomized-trial answers.
View product →Findings
- In the NICE randomized clinical trial (Nature Communications, 2024), the NAD+ precursor nicotinamide riboside improved six-minute walking distance by 31 metres versus placebo in people with peripheral artery disease.
- Adding resveratrol provided no extra benefit — the NAD+ precursor alone carried the effect.
- Multiple randomized trials show oral NAD+ precursors reliably raise NAD+ levels in humans.
- A 2026 systematic review catalogues a growing body of randomized trials across ageing-related outcomes.
Why NAD+ matters
NAD+ is the coenzyme every cell uses to shuttle electrons during energy production, and it doubles as the fuel for sirtuins and DNA-repair enzymes. Its decline with age is one of the most replicated observations in ageing biology — which is why restoring it became a serious research field rather than a supplement fad.
The walking trial (Nature Communications, 2024)
Peripheral artery disease restricts blood flow to the legs, and walking distance is the hard, functional endpoint trials use. In the NICE trial, participants randomized to nicotinamide riboside walked 31.0 metres farther in six minutes than the placebo group by the end of the study — a meaningful difference on an endpoint that does not respond to placebo effects easily. The authors call for a larger confirmatory trial, which is under way in the field.
How this maps to the research vial
The randomized data is built on oral NAD+ precursors — molecules the body converts into NAD+. Research on NAD+ itself, including the vial format in this catalogue, sits alongside that literature: same target molecule, different route into the pathway. Our NAD+ explainer covers what the molecule is and how its documentation works.
Frequently asked questions
Has raising NAD+ shown functional effects in trials?
Yes. In the randomized NICE trial, the NAD+ precursor nicotinamide riboside improved six-minute walk distance by 31 metres versus placebo in peripheral artery disease.
Do oral NAD+ precursors actually raise NAD+ levels?
Multiple randomized trials consistently show oral precursors raise blood NAD+ levels.
Sources: McDermott MM et al., Nat Commun 2024 (PMID 38871717); Geroscience 2024 (PMID 37994989); Ageing Res Rev 2026 (PMID 41655607).
References
Human NAD+ work is largely pharmacology and tolerability rather than clinical outcomes. A 2026 systematic review reports no eligible clinical-outcome trial of intravenous or intramuscular NAD+ itself for anti-ageing or wellness.
- NAD⁺ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidencePRISMA systematic review; 113 intervention studies including 33 human studies. Reports no eligible clinical-outcome trial of intravenous or intramuscular NAD+ itself for anti-ageing or wellness.
- A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NADHuman pilot pharmacology study; plasma and urine NAD+ metabolome during a 6-hour intravenous infusion. Not an efficacy trial.
- Intravenous infusion of nicotinamide adenine dinucleotide (NAD(+)) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world settingRetrospective tolerability pilot comparing four days of intravenous NAD+ with intravenous nicotinamide riboside in a real-world setting.
- Oral LNAD+ rapidly elevates whole blood intracellular NAD and metabolic flux without elevating plasma NAD: evidence from a randomized controlled trialRandomised controlled trial of a specific modified ORAL NAD+ formulation; clinical outcomes exploratory and formulation-specific.
Links open the study record on PubMed so the source can be checked directly. Listing a study is not a claim that its findings apply to any other use, product or route of administration. Research use only.
