NAD+ Therapy: Hype vs. Evidence
Telehealth brands are bundling NAD+ with peptides like sermorelin and glutathione. NAD+ itself is a coenzyme — not a peptide. Here's what controlled human trials actually show about raising NAD+ and what it does.
How It Works
NAD+ (nicotinamide adenine dinucleotide) is a dinucleotide coenzyme for redox reactions and a cofactor for sirtuins, PARPs and CD38 — central to energy metabolism and DNA repair. It is not a peptide. In a telehealth "NAD+ therapy" stack, the peptides are sermorelin (a GHRH analog) and glutathione (a tripeptide).
Tissue and cellular NAD+ decline gradually with age in rodents and humans, a drop linked to metabolic disease, cognitive decline, sarcopenia and frailty. Blood NAD+ is measurably lower in the very old — the rationale behind precursor supplements and IV drips.
You cannot absorb NAD+ itself efficiently by mouth, so the studied route is precursors. Nicotinamide riboside is orally bioavailable and raises the blood NAD+ metabolome dose-dependently in humans; NMN also raised blood NAD+ versus placebo in a randomized trial. That the biomarker moves is well established.
The gap is downstream. A meta-analysis of 8 NMN RCTs (342 adults) found no significant benefit on fasting glucose, insulin, HbA1c or lipids. Some trials hint at modest gains in gait speed and liver enzymes, but rigorous outcome data are thin, and clinician reviews still call NAD+ clinical translation an open question.
What the Data Shows
Key Takeaways
- NAD+ is a coenzyme (a dinucleotide), not a peptide, and it declines with age in humans and rodents.
- You cannot absorb NAD+ efficiently by mouth — the evidence base is on precursors (NR, NMN), which reliably raise blood NAD+ in humans.
- A single oral dose of NR raised blood NAD+ up to 2.7-fold in humans; NMN 300–900 mg/day raised NAD+ versus placebo in a randomized trial.
- Sermorelin, a GHRH-analog peptide often bundled in these stacks, raises IGF-1; glutathione is a tripeptide antioxidant.
- Telehealth brands (e.g., Hims & Hers) are packaging NAD+ + sermorelin + glutathione as longevity offerings, bringing the category mainstream.
- Whether raising NAD+ slows human aging is unproven — a meta-analysis of 8 NMN RCTs found no significant metabolic benefit.
- IV NAD+ drips sold by clinics have no controlled human trials supporting anti-aging or "cellular repair" claims.
- Long-term safety of high-dose, chronic NAD+-precursor use is not established.
- Optimal dose, route (oral vs IV vs injection) and who actually benefits remain open questions clinicians flag.
- "NAD+ peptide therapy" is a marketing label — NAD+ itself is not a peptide, so the phrase conflates distinct compounds.
Frequently Asked Questions
Is NAD+ a peptide?
No. NAD+ (nicotinamide adenine dinucleotide) is a dinucleotide coenzyme built from two nucleotides, not amino acids. The "peptide therapy" label comes from clinics bundling NAD+ with actual peptides — sermorelin (a growth-hormone-releasing-hormone analog) and glutathione (a tripeptide).
Does NAD+ therapy actually work?
It reliably raises blood NAD+ levels — oral precursors like NR and NMN do this in randomized human trials. Whether that higher NAD+ translates into anti-aging or metabolic benefits is unproven: a meta-analysis of 8 NMN RCTs found no significant effect on glucose, insulin or lipids.
Oral, injection, or IV NAD+ — which is best?
You cannot absorb NAD+ itself well by mouth, so oral products use precursors (NR/NMN), which have the most human data. Injectable and IV NAD+ are marketed heavily but lack controlled trials for the anti-aging claims made about them.
What is in the Hims & Hers “NAD+” stack?
Reports describe NAD+ paired with sermorelin and glutathione. Sermorelin nudges natural growth-hormone and IGF-1 output; glutathione is an antioxidant tripeptide; NAD+ targets cellular energy metabolism. Only sermorelin and glutathione are peptides.
Is NAD+ therapy safe?
Short-term precursor studies report good tolerability, but long-term safety of chronic high-dose use is not established, and IV protocols carry the usual infusion risks. Educational only — talk to a licensed clinician.
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Educational purposes only. Not medical advice.
NAD+ precursors and peptides discussed here are research compounds; consult a licensed clinician before use.
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