NAD Drips and NAD Injections: What They Are, What the Evidence Says and What to Expect

NAD has become the most talked-about drip on the wellness circuit, with claims attached to it that range from the plausible to the absurd. It is also the drip with the longest list of people who should not have it, the longest chair time and the highest price. This guide sets out what NAD actually is, why clinics give it, what the human evidence does and does not show, who is ruled out, and what the 2 to 3 hours in the chair feel like. I give NAD drips in clinic and I turn people away from them regularly, so this is not a sales page.

What NAD is

NAD stands for nicotinamide adenine dinucleotide. It is a coenzyme, a helper molecule, found in every cell of the body. Its central job is in energy production: it shuttles electrons inside the mitochondria as food is turned into usable energy. It is also used by enzymes involved in DNA repair, in the regulation of genes, and in the body's response to stress. Cells cycle it constantly between two forms, NAD+ and NADH, which is why you see it written both ways. Without it, cells simply stop working, so the molecule itself is not in any doubt. The arguments are about whether adding more from outside does anything useful.

Why levels fall

Measured NAD+ levels in tissue decline with age, roughly halving between young adulthood and old age in the studies that have looked. Heavy alcohol use consumes NAD+ as the liver processes it. Chronic stress, poor sleep, inflammation and some medicines are also thought to lower it, although the human data on those is thinner. The theory behind NAD therapy is that restoring the level restores what the cell can do. It is a sensible theory, and it has been tested properly in animals. In people, the testing has barely started.

What the evidence actually says

This is the part most clinics skip. The honest summary is:

• In animals, raising NAD+ improves measures of metabolism, muscle function and lifespan in mice. Those results are real and are why the field exists.
• In humans, the trials are small, short and mostly use oral precursors such as nicotinamide riboside or NMN rather than intravenous NAD+. They show that blood NAD+ can be raised safely. They do not yet show a consistent benefit on energy, mood, cognition or ageing that you would notice.
• For intravenous NAD+ specifically, the published human evidence is a handful of small studies and case series, largely in addiction clinics, with no large randomised trial. The best of them show the infusion is tolerable when given slowly. None of them proves it works for any condition.

Intravenous NAD+ is unlicensed in the UK. It is not a treatment for addiction, depression, anxiety, long Covid, chronic fatigue or ageing, and we do not offer it as one. If you have any of those conditions, the right first step is a GP appointment, not a drip. What we offer is a supervised infusion for healthy adults who understand the evidence and want to try it. Some people report feeling clearer or more energetic for a week or two afterwards. I cannot tell you from the science whether that is the NAD, the fluid, the three hours of rest or expectation, and I will not pretend otherwise.

Drip or injection?

Searches for "NAD injection" now outnumber searches for the drip, so it is worth being clear. Some clinics offer NAD+ as a subcutaneous injection, a small dose under the skin that people can repeat at home, and others sell it as a nasal spray or a patch. We offer the intravenous route only. The reason is supervision: the infusion delivers a full 500mg dose, it has well-recognised effects during the infusion that need a doctor in the room to manage, and the suitability rules are strict enough that I want to take the history myself before any of it goes in. That is a choice about how we practise rather than a judgement on anyone who does it differently.

The three NAD+ products

• NAD+ 500mg Infusion, £299. 500mg of NAD+ in saline, run slowly over 2 to 3 hours with the rate adjusted to how you feel. Allow about 3 and a half hours for the appointment.
• NAD+ Reset, £349. The same infusion, then a glutathione injection and a vitamin B12 injection once the NAD+ has finished. Allow about 3 and three-quarter hours.
• NAD+ Ultimate, £399. The infusion, then a vitamin C drip, a glutathione injection and a B12 injection, each given separately once the NAD+ has finished. Allow about 4 and a half hours.

The NAD+ is made up fresh on the day from a powder, which keeps it stable. B vitamins are never given within an hour of the NAD+ finishing, which is why the Reset and Ultimate bundles sequence the B12 at the end and why the NAD+ drips do not take a B-vitamin add-on. NAD+ is usually booked as a weekly course of 4 to 6 infusions; a single session is a reasonable way to find out how you tolerate it.

Who cannot have it

The suitability list for NAD+ is longer than for any other drip, and we apply it. Every infusion starts with a short consultation with the doctor, and if any of these apply you will be advised or rebooked without charge, so please tell us beforehand:

• You are under 18 or over 55.
• You have a history of bipolar disorder or psychosis, or you take antidepressants.
• You have cancer, or an inflammatory condition such as rheumatoid arthritis. NAD+ feeds cell metabolism indiscriminately, and until the science is clearer we do not give it to anyone with active cancer or autoimmune inflammation.
• You are pregnant or breastfeeding.
• You have a kidney or liver condition, or heart failure.
• You have a known allergy to NAD+ or to any vitamin or mineral.
• You have a haemolytic condition such as G6PD deficiency, sickle cell, spherocytosis or thalassaemia.
• You take a GLP-1 weight-loss injection. You can still have the infusion, but the NAD+ dose is capped at 250mg.

What it feels like

NAD+ is not like a vitamin drip. Run quickly it causes chest tightness, pressure in the ears, nausea, flushing and a feeling of dread that patients describe vividly. Run slowly, those effects are mild or absent, which is why the infusion takes 2 to 3 hours and why the doctor is on hand throughout. Tell us straight away if you feel chest tightness, pressure in your ears, nausea or flushing; we slow the drip and it settles within a few minutes. Most people settle into it after the first half hour and read, work or sleep for the rest.

Eat something and drink water before you come; do not arrive fasting. Bring a list of your medications and supplements. The appointment starts with the consultation and a check of your pulse and blood pressure, and you are checked again before you leave. You can drive home afterwards. Mild tiredness or a headache for a day is common. A hot, swollen or painful cannula site, a fever, or a rash in the days afterwards: contact us. Severe breathing difficulty or swelling of the face: call 999.

Where we do it

NAD+ infusions are given by Dr Ahmed in the Infusions and Vitamins Room at OneMedicine, 1 High Street, Kings Heath, Birmingham B14 7AR, a CQC-registered clinic opposite Kings Heath railway station with free parking at the rear. Because the session is long, bring something to do, and tell us at booking if you would prefer a morning or afternoon start.

Frequently asked questions

What does an NAD drip do?

It raises the blood level of NAD+, a coenzyme every cell uses to make energy and repair itself. Whether that translates into a benefit you can feel is not yet proven in people. Some patients report clearer thinking or more energy for a week or two; the science cannot yet separate that from the fluid, the rest and expectation.

What are the benefits of NAD+?

In animal studies, raising NAD+ improves metabolism, muscle function and lifespan. In humans the trials are small and mostly show that levels can be raised safely rather than that anything improves. We do not claim benefits beyond that.

NAD infusion or NAD injection?

Subcutaneous NAD injections, patches and nasal sprays deliver small doses that some people use at home. The infusion delivers the full 500mg dose under supervision, which is the only route we offer, because the infusion needs a doctor to manage the rate and the suitability rules need a proper history.

How long does an NAD drip take?

The infusion itself runs 2 to 3 hours, slowed if you feel any of the effects. Allow about 3 and a half hours for the appointment, longer for the Reset and Ultimate bundles.

How many NAD infusions do I need?

Clinics usually suggest a weekly course of 4 to 6. There is no trial that fixes the right number. A single infusion is a sensible way to find out how you tolerate it before committing to a course.

What are the side effects of NAD?

During the infusion: chest tightness, ear pressure, nausea, flushing and anxiety, all of which settle when the drip is slowed. Afterwards: tiredness or a headache for a day. Serious reactions are rare and are mostly avoided by the suitability list.

How much does an NAD infusion cost?

£299 for the 500mg infusion, £349 for the Reset bundle with glutathione and B12, and £399 for the Ultimate with a vitamin C drip as well. Each price includes the GP consultation and the observation.

Is NAD therapy worth it?

If you want a proven treatment for tiredness, low mood or ageing, no, because there is not one yet, and a blood test for the common treatable causes of fatigue is a far better first spend. If you are a healthy adult who understands the evidence and wants to try it under supervision, it is a reasonable, if expensive, experiment.

Written by Dr Ibrar Ahmed — MBChB MRCP MRCGP PhD PG Dip (Cardiology)
Specialist interest: Cardiovascular Medicine · OneMedicine, CQC-registered clinic