NAD+ Side Effects: What Human Research Shows, by Route, and Who Should Check First
NAD+ is essential to every cell, but that doesn't make every dose or route side-effect-free. Here's what's known, route by route.
Key takeaways
- Side effects depend heavily on the route: IV, oral precursors and patches behave differently.
- IV NAD+ commonly causes discomfort such as flushing, nausea or chest tightness when infused quickly, which is why infusions are run slowly and supervised.
- Oral NR has been well tolerated in human trials over the periods studied.
- Patches mostly cause local skin effects. Published human safety data on transdermal NAD+ is limited.
- Talk to a clinician first if you're pregnant, nursing, managing a condition or taking medication.
NAD+ is a coenzyme your body makes and uses constantly, which makes it easy to assume more is harmless. Normal biology and taking NAD+ on purpose are different questions, and the answer changes with the route.
By route
| Route | What's commonly reported | What the evidence covers |
|---|---|---|
| IV infusion | Flushing, nausea, chest tightness or abdominal discomfort, especially when infused quickly; usually eases when the rate slows | Limited published studies; a human pilot study tracked how the body processes a 6-hour infusion [2] |
| Oral NR / NMN | Generally well tolerated in trials; occasional mild digestive upset | Several human trials over weeks to months [1][3] |
| Injection | Injection-site discomfort and the usual risks of injecting | Limited published human data |
| Transdermal patch | Mild redness, itching or irritation where the patch sat | Limited published human data on transdermal NAD+ |
IV NAD+
IV NAD+ is given in clinics over hours. The discomfort people describe usually comes on during the infusion and eases when it slows down, which is why infusions should be run slowly and supervised. Outcome and long-term safety evidence for IV NAD+ is limited [2].
Oral NR and NMN
These precursors have the largest human dataset. A 2018 trial found NR was well tolerated and raised blood NAD+ in healthy middle-aged and older adults [1], and NMN has also been studied in human trials [3]. Long-term safety beyond the study periods is still being researched.
NAD+ patches
With a patch, the most common effects are local: mild redness, itching or irritation, usually from the adhesive or gel. Iontophoresis can add tingling under the electrodes at higher currents [4]. LavION runs at a very low current, averaging about 0.1 mA, and most people feel little or nothing.
Because how much NAD+ any patch delivers into the bloodstream hasn't been measured in published human studies, including for LavION, side-effect data from IVs or capsules can't be assumed to apply to patches, in either direction.
Who should talk to a clinician first
- Anyone pregnant or nursing. NAD+ products haven't been well studied in pregnancy.
- Anyone managing a significant medical condition or taking prescription medication.
- Anyone with a pacemaker or implanted electronic device (for iontophoresis patches).
- Anyone with sensitive skin or a history of adhesive reactions (for patches).
Where LavION fits
AMPLIFY and IGNITE each contain 1,300 mg of NAD+ per patch, and TITAN, GLOW, BALANCE and PR1ME contain 250 mg. Those are loaded amounts, not measured exposure. Standard LavION use is one patch every 5 days, worn for up to 12 hours. A Good Faith Exam with a licensed provider is required before your first purchase. Stop use and contact your provider if you notice a concerning reaction.
References
- 1.Martens CR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications. 2018;9:1286. pmc.ncbi.nlm.nih.gov
- 2.Grant R, et al. A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD+. Frontiers in Aging Neuroscience. 2019. pubmed.ncbi.nlm.nih.gov
- 3.Yoshino M, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021;372(6547):1224-1229. Summary: source.washu.edu
- 4.Kalia YN, Naik A, Garrison J, Guy RH. Iontophoretic drug delivery. Advanced Drug Delivery Reviews. 2004;56(5):619-658. pubmed.ncbi.nlm.nih.gov
Frequently asked questions
Can NAD+ cause side effects?
Yes, depending on the route and dose. IV infusions most often cause flushing, nausea or chest tightness when run quickly. Oral precursors are generally well tolerated in trials. Patches mostly cause mild skin irritation.
Is an NAD+ patch safer than an IV?
That hasn't been established as a general rule. Patches avoid infusion-related discomfort and needles, but there's much less published safety data on transdermal NAD+.
Why does IV NAD+ cause chest tightness or nausea?
These effects are commonly reported when infusions run quickly and usually ease when the rate slows, which is why IV NAD+ should be supervised.
Is 1,300 mg of NAD+ from AMPLIFY the amount absorbed?
No. It's the amount loaded into the patch. How much reaches the bloodstream hasn't been measured for LavION.
Can I use NAD+ while pregnant?
Talk to your clinician first. NAD+ products haven't been well studied in pregnancy.
Does LavION require clinician review?
Yes. A Good Faith Exam with a licensed provider is required before your first purchase.
Keep reading
This article offers general wellness education and does not replace medical advice. Statements about LavION products have not been evaluated by the FDA, and these products are not intended to diagnose, treat, cure, or prevent disease. Peptide orders include a clinician review before fulfillment. If you are pregnant, nursing, managing a condition, or taking medication, speak with your clinician. See our medical disclaimer.