NAD+ Injections Before and After: Energy, Sleep, Skin — What the Studies Show

No trial has measured energy, sleep or skin before and after NAD+ injections. A 2026 systematic review found no outcome trial of injected or IV NAD+ for anti-aging or wellness¹. The human studies that exist measured blood chemistry and side effects. On our NAD+ board, the lowest plain monthly price is $91.

What do people say changes after NAD+ injections?

Mostly more energy, clearer thinking, better sleep and better skin. Those reports come from clinics, sellers and social media. None of them has been tested against a placebo in a trial of NAD+ injections.

What did human NAD+ studies actually measure before and after?

The trials that did find a measurable change used oral precursors — nicotinamide riboside and NMN — not NAD+ itself. Those raised NAD-related markers in the blood. Their effects on function and health were mixed and "often null"¹. Our NAD+ evidence review covers them in full, and NMN vs. NAD+ explains the difference.

How fast would any effect show up?

Slower than the marketing suggests, if at all. In the only study that tracked NAD+ in the blood during an IV infusion, nothing changed for the first two hours of a six-hour drip². What did rise later was NAD+ and a breakdown product in the urine. That fits a body that breaks down and clears much of what is infused.

So a feeling of energy within minutes of a shot is hard to pin on a measured rise in NAD+.

Why are before-and-after NAD+ claims so hard to test?

Because the main claims are feelings. Energy, focus and sleep quality are exactly the outcomes most open to the placebo effect, especially after paying for a treatment. A fair test needs a blinded comparison group, and no such trial of NAD+ injections has been published¹. A "before" photo of skin has the same problems as any skin photo: lighting, angle and whatever else changed that month.

What side effects are common?

The best data are for IV infusions. In a 2026 review of clinic records, people given 500 mg of NAD+ by IV reported moderate to severe stomach symptoms, a faster heart rate and chest pressure during the drip³. Infusions had to be slowed, averaging 97 minutes against 37 for a comparison drip. Symptoms ended when the infusion did, and liver, kidney, thyroid and inflammation markers did not change.

For under-the-skin injections, see our NAD+ dosage and side effects article.

What does a month of NAD+ injections cost?

Only 42 of the 83 sellers on our NAD+ board publish one plain monthly price. The lowest is $91 and the median is $170. Many sellers offer more than one form, and the same company often charges differently for each:

Injections vs. nasal spray vs. IV — which gets studied?

Only IV, and only for blood levels and tolerability²³. No outcome trial has tested injected NAD+, and none has tested a nasal spray — see our NAD+ nasal spray article. There is no FDA-approved NAD+ drug in any form. NAD+ is also not a peptide, even though peptide sellers carry it — here is why. For more on the compound, see the NAD+ compound page.