A few months ago, I found myself lying in a room at the Santa Monica Proper Hotel with an IV in my arm, watching a clear liquid drip slowly into my bloodstream. I was there for the hotel’s first curated wellness retreat, held in partnership with integrated health platform Hundred Health. The treatment was something called Niagen, a branded form of nicotinamide riboside, or NR, a compound the body converts into NAD, a molecule tied to cellular repair, energy production, and aging that has quickly become one of the buzziest treatments in longevity and wellness circles.
Until that weekend, I had heard the term NAD in fragments—on podcasts, in dermatology offices, in conversations about energy, skin, and aging—but I had never fully understood what it actually was or what it did. NAD has quickly become a fixture in high-end wellness clinics and longevity programs, often offered as an IV drip, injection, or supplement, but many people trying it cannot fully explain what it is supposed to do or how, exactly, it works.
Like collagen powder, Ozempic, and red light therapy before it, NAD has quickly moved from medical research into the cultural mainstream, where it now exists in a space somewhere between legitimate science, luxury wellness treatment, and social media trend.
Public figures, including Jennifer Aniston, Hailey Bieber, Gwyneth Paltrow, Kendall Jenner, and Kim Kardashian, have all spoken about using NAD IV therapy or NAD-boosting supplements, helping push the treatment into the mainstream wellness conversation. On an episode of The Kardashians, Kendall Jenner and Hailey Bieber were shown getting NAD IV drips together, a moment that helped introduce the treatment to a much wider audience. Paltrow, who says she uses NAD drips and injectable NAD, recently called it “obviously a buzz word in longevity,” adding that it is “an amazing compound for cellular metabolism and repair.” Meanwhile, the NAD IV clinic market alone is projected to grow from about $511 million in 2025 to more than $1 billion by 2032, a sign of how quickly a relatively obscure molecule has become a booming force in the wellness industry.
So what exactly is NAD, and why are so many people suddenly trying to increase it?
What Is NAD (and NAD+)?
NAD, short for nicotinamide adenine dinucleotide, is a molecule found in every cell in the body. When people talk about NAD in a wellness or longevity context, they are usually referring to NAD+, the active form the body uses for energy production and repair.
“It helps the cell to manage energy,” says Eric Verdin, a physician-scientist and CEO of the Buck Institute for Research on Aging, who studies metabolism and longevity. To describe how that energy actually moves through the body, he uses a transportation analogy. “It’s like a truck that carries energy from where it’s produced to where it’s needed,” he explains.
NAD+ also plays a role in activating enzymes involved in DNA repair and cellular stress responses. As explained by Andrew Shao, the SVP of Niagen Bioscience: “NAD+ helps convert food into cellular energy and activates key repair systems.” He continues, “It fuels mitochondria and supports enzymes responsible for DNA repair and stress response, making it foundational for how cells function and recover.”
The body already has built-in systems to both produce and recycle NAD, generating it from nutrients like vitamin B3 and amino acids such as tryptophan, and continuously breaking it down and rebuilding it as cells use it.
Why People Take NAD—and What It’s Supposed to Do
At its core, the appeal of NAD is about longevity. As NAD+ levels decline with age, some researchers believe that reduced NAD+ may contribute to lower energy production, slower cellular repair, and broader metabolic changes over time. That has led to a wave of treatments designed to increase NAD levels, with the goal of helping cells function more efficiently for longer.
“When NAD levels go down, your ability to use energy goes down as well,” Verdin says. “Energy is central to not only physical activity, but for your thinking, for your everything in your body. The repair processes that even when you’re sleeping, you’re generating energy.”
According to Shao, that decline is driven by multiple factors: “NAD+ levels naturally decline with age, starting in your late 20s and early 30s due to a combination of factors: increased cellular stress, accumulated DNA damage, inflammation, and reduced efficiency in the body’s ability to produce and recycle NAD+.”
In practice, people try to increase NAD in different ways. NAD itself is most often administered through IV drips or injections in clinical or wellness settings, while compounds like nicotinamide riboside—a precursor to NAD, often called NR—are more commonly taken as daily supplements, though some clinics also offer them in IV form.
NAD vs. Niagen: Why the Delivery Method Matters
Part of the confusion is that “NAD” is often used as shorthand for several related molecules and treatments that are not interchangeable. NAD+ is the form the body uses, while compounds like nicotinamide riboside, or NR, are precursors that help the body make more of it. Niagen is a branded form of nicotinamide riboside.
“The NAD+ molecule is too large to enter cells directly and must break down into precursors,” says Shao. That’s part of why precursors like nicotinamide riboside are often described as easier for the body to use; they feed into existing pathways that build NAD, rather than delivering the full molecule all at once.
That distinction becomes especially noticeable in how these treatments feel. NAD+ IV therapy is widely reported to be uncomfortable, with many patients describing chest tightness, nausea, cramping, and the need to slow the drip significantly to tolerate it. “When you take NAD, essentially, it is digested into its parts again, and it needs to be recycled,” Verdin explains.
During my own Niagen drip, I experienced a brief wave of chest pressure and a tingling sensation along my gums, particularly around my lower teeth, before it subsided—milder, but still noticeable, even though I was taking the more easily digestible precursor.
Does NAD Actually Work?
The biggest question is whether increasing NAD levels actually improves health. The answer is still evolving—and highly debated.
“All of the clinical trials that have been done in humans have mostly failed,” Verdin says. “There’s really no evidence that they will benefit your health,” he says.
Shao, on the other hand, points to clinical trials showing increases in NAD levels. “Randomized, double-blind, placebo-controlled clinical trials with healthy adults… led to an average 150 percent increase in NAD+ levels after just three weeks,” he says.
But raising NAD+ levels and improving long-term health outcomes are not the same thing. Outside of individual researchers and companies, the broader scientific community remains cautious. NAD boosters show promising mechanisms for energy production and cellular repair, but human evidence remains limited, with many studies focusing on biomarkers rather than long-term outcomes.
Unlike prescription treatments, NAD therapies are not approved by the U.S. Food and Drug Administration for anti-aging or longevity, and most NAD-related products are sold as dietary supplements, meaning they are not required to prove effectiveness before reaching consumers.
If you’re curious about NAD supplementation, this is the most popular and highly rated pick on Amazon.
The Bigger Picture
NAD+ may be a real and important molecule in the body, but how, and if boosting it translates into meaningful health benefits, is still an open question. “It indicates that people are no longer just trusting their doctors to take care of them and keep them healthy,” Verdin says.
At the same time, he cautions that not everything marketed under the longevity umbrella is grounded in evidence. “There are a whole series of shady characters who are capitalizing on this and trying to make a quick dollar,” he says. “I hate the whole idea of these drips. It’s what I call Instagram medicine—pseudo-scientific. There’s no scientific basis for this, and I think all these IV shops, as far as I’m concerned, should be shut down. I don’t think they bring anything to the equation except hype and somewhat of a lie.”
For now, NAD sits at the center of that tension: a legitimate area of scientific research that has quickly become a cultural and commercial phenomenon—and one that people are increasingly turning to in the hope of staying healthier for longer.
