# NAD+ IV Therapy: Clinical Protocols and Research Evidence

> NAD+ IV therapy — intravenous infusion protocols, pharmacokinetics, infusion-rate tolerability, and clinical outcomes in addiction and metabolic research. Evidence cited.

## What Is IV NAD+ Therapy?

NAD+ IV therapy is the intravenous infusion of pharmaceutical-grade NAD+ solution directly into the bloodstream, bypassing the gastrointestinal degradation and first-pass metabolism that limits the oral route. Oral NAD+ is hydrolyzed by intestinal NADases (CD38, CD73) before systemic absorption; intravenous delivery produces NAD+ and metabolite elevations orders of magnitude above what oral dosing achieves.

IV NAD+ is not FDA-approved for any indication. It is administered in compounding-pharmacy and wellness-clinic settings by licensed practitioners.

## What Does the Clinical Evidence Say?

The first human pharmacokinetic characterization of IV NAD+ was published by Grant et al. (2019, Frontiers in Aging Neuroscience). In healthy males, 750 mg NAD+ was infused over 6 hours at approximately 2 mg/min. Plasma NAD+ and its metabolites (NMN, AMP, NAM) rose substantially throughout the infusion and were detectable in urine post-infusion [9].

Blum et al. (2022) reported a 50-case series in which IV NAD+ (combined with enkephalinase inhibition) produced statistically significant reductions in craving (p=1.06×10⁻⁹), anxiety (p=5.49×10⁻⁷), and depression (p=1.76×10⁻⁴) in treatment-resistant substance use disorder patients. In a 40-patient subset, 100% of urine samples tested negative for illicit substances midway through treatment [11].

**Infusion rate note:** Rates exceeding 2 mg/min are associated with increased nausea, chest pressure, and heart rate elevation. A 2026 real-world comparison found IV NAD+ (500 mg) required mean 97-minute infusion for moderate-to-severe symptoms; IV NR (500 mg) required only 37 minutes with mild tingling only [10].

## NAD+ IV Infusion vs. Oral Precursors

Oral precursors NMN and NR produce blood NAD+ increases of roughly 2-fold over baseline with daily dosing [4, 16]. IV NAD+ bypasses GI degradation entirely and produces plasma NAD+ elevations substantially higher. The practical tradeoff is clinical infrastructure requirement and infusion-rate-dependent side effects.

IV NR offers faster, better-tolerated IV delivery of a NAD+ precursor; IV NAD+ achieves direct plasma NAD+ elevation but requires slower rates and greater clinical monitoring [10].

## NAD+ IV Therapy in Addiction Treatment Research

O'Hollaren's 1961 series (reviewed Braidy et al. 2020) documented 104+ cases using 500–1000 mg IV NAD+ daily for 4 days, reporting craving removal and withdrawal symptom reduction [12]. The Blum 2022 publication formalized this in 50 treatment-resistant cases. No large RCT of IV NAD+ for addiction has been published as of 2026 [12].

## Documented Research Benefits of NAD+ IV Therapy

- Plasma NAD+ and metabolite elevation during and after infusion [9]
- Significant reduction in craving, anxiety, and depression scores in substance use disorder (n=50) [11]
- Withdrawal symptom reduction in historical addiction case series (n>104) [12]

Clinical outcomes in wellness contexts (cognitive clarity, energy, mood) have not been confirmed in published controlled trials. The 2025 Vinten et al. systematic review concluded clinical benefit evidence is limited [19].

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Chrome-console readings of the peer-reviewed NAD+ record — clinical trials indexed, infusion rates logged, no prescriptions filled.