NAD+ IV Therapy: What to Expect During a Session

An NAD+ infusion is a slow intravenous drip that typically takes two to four hours, with the care team monitoring you throughout the session. The evidence for NAD+ IV therapy in healthy adults is limited, so the responsible approach is to review your health history first, set realistic expectations, and treat the session as one part of a broader wellness plan rather than a quick fix. At Zest Regen Health in Columbia, Maryland, NAD+ therapy is offered only after an evaluation with our clinical team.

What NAD+ is

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell in your body. It plays a central role in energy metabolism and in cellular processes related to repair and resilience, and NAD+ levels naturally decline with age. That decline is the reason NAD+ infusions became popular in wellness clinics.

What the evidence actually shows

The honest summary is that no rigorous outcomes trial has shown IV NAD+ improves energy, fatigue, or aging in healthy adults. A 2026 systematic review of NAD+ supplementation for anti-aging and wellness found that no eligible outcomes trial evaluated intravenous NAD+ itself; studies of oral precursors such as NMN and NR reliably raise NAD-related biomarkers, but effects on metabolic, vascular, and performance outcomes were mixed. A small 2024 randomized pilot of NAD+ IV in healthy adults showed only small, delayed increases in whole-blood NAD+ levels, and a 2026 retrospective review found NAD+ infusions were associated with longer infusion times and more infusion reactions than a comparison product.

• No FDA-approved indication exists for NAD+ as a treatment for energy, fatigue, or aging.
• Human outcomes data on IV NAD+ are very limited; most evidence comes from precursor supplements or animal models.
• What you feel during or after a session varies widely from person to person, and there are no guarantees.
• A 2025 FDA Class I recall of one manufacturer's NAD+ injection due to elevated endotoxin levels is a reminder that sourcing and compounding standards matter.

What happens during a session

1. Evaluation first: your history, medications, and goals are reviewed before any infusion is scheduled.
2. The IV is placed and the infusion is started at a slow rate, typically over two to four hours.
3. The care team monitors you during the infusion and can adjust the rate if needed.
4. After the session, you receive guidance on hydration, activity, and whether follow-up sessions may be appropriate.

What to expect after

Some people report feeling tired, flushed, or nauseated during or shortly after an infusion; others notice little immediate change. NAD+ is not a stimulant, so an energy 'rush' is not a reliable expectation. The realistic goal is to evaluate whether a series of sessions, combined with sleep, nutrition, and activity habits, supports how you feel over time.

Regulatory and safety notes

NAD+ is not FDA-approved as a drug for any wellness indication. In October 2024, the FDA reminded compounders that only ingredients suitable for sterile compounding may be used in injectables, noting adverse event reports after NAD+ injections. In October 2025, the FDA escalated one manufacturer's NAD+ product to a Class I recall because of elevated endotoxin levels. This is why the source and preparation of any infusion matter, and why a clinic should be able to explain both.

See how NAD+ therapy is offered at the Columbia clinic (/services/nad-therapy/).

Read the basics of NAD+ therapy and how it works (/blog/what-is-nad-therapy/).

Review what the evidence shows about NAD+ IV therapy (/blog/nad-therapy-evidence-what-patients-should-know/).

Meet our physicians, who evaluate patients at Zest Regen Health (/dr-francisco-ward/).

Next step

If you are curious whether NAD+ therapy fits your health goals, start with a conversation. Book a free 15-minute consultation at the Columbia clinic to discuss your history, expectations, and whether an infusion program is appropriate for you.