NAD+ Therapy & Healthy Aging: What It Is and How It Works
What the NAD+ coenzyme does, why it declines with age, and how IV and injection therapies aim to raise it.
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Key takeaways
- NAD+ is a coenzyme in every cell that supports energy production, DNA repair, and antioxidant defenses — and it naturally declines with age.
- You can raise NAD+ directly through an IV, or with the precursor Niagen® (NR), which your body converts into NAD+.
- In published research, the NR precursor raised intracellular NAD+ by up to 20.7%, and a pilot study showed a 2.6-fold rise in blood NAD+.
- At Axiva, NAD+ and Niagen® (NR) are delivered by IV or injection under real-time medical supervision.
What is NAD+?
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every one of your cells. Think of it like the oil that keeps an engine running smoothly — it is central to turning food into usable cellular energy.
Beyond energy, NAD+ supports DNA repair, antioxidant defenses, and metabolic balance. Because it is so fundamental to how cells function, keeping levels healthy is a core idea in longevity medicine.
Why does NAD+ decline with age?
NAD+ levels fall as we get older, and researchers link that decline to reduced cellular energy and resilience over time.
That natural drop is part of the rationale behind replenishing NAD+ — the goal is to support the cellular machinery that tends to slow with age. These are elective wellness therapies, not treatments for any disease.
What’s the difference between NAD+ and Niagen® (NR)?
NAD+ delivers the active coenzyme directly to your cells. Niagen® (nicotinamide riboside, or NR) is a precursor your body converts into NAD+.
One way to picture it: NAD+ hands your cells the finished key, while Niagen® (NR) supplies the materials to make it. NAD+ IV offers immediate delivery; NR IV is a gentler, steady infusion. Which one fits depends on your goals and how you respond.
What does the research show?
Research into NAD+ biology is growing. In published research, the Niagen® (NR) precursor raised intracellular NAD+ by up to 20.7%, with a pilot study showing a 2.6-fold rise in blood NAD+.
A randomized, placebo-controlled pilot study of NR and NAD+ given intravenously also found that NR IV raised blood NAD+ within 24 hours. The science continues to evolve, which is why Axiva applies these therapies conservatively and under supervision. See our Clinical Evidence page for the studies.
How is NAD+ therapy delivered?
Axiva offers both IV and intramuscular (IM) options. A direct NAD+ IV runs about four hours; a Niagen® (NR) IV averages around 50 minutes; and NAD+ or NR IM injections offer a faster, lower-downtime alternative.
An optional Longevity Synergy Enhancement IV — B Complex, B12, Magnesium, Vitamin C, and Glutathione — can be added to optimize results. Infusions are given in comfort-first suites with real-time rate adjustments for your tolerance.
What does longevity care look like at Axiva?
Care begins with a consultation and health screening to confirm whether NAD+ or Niagen® (NR) therapy is appropriate for you, followed by a personalized protocol and frequency. Clinicians monitor every session in real time and guide ongoing maintenance through membership tiers. A thorough screening matters because contraindications include pregnancy, breastfeeding, and certain conditions.
Is NAD+ therapy safe?
Our therapies are grounded in clinical research and administered under physician supervision with monitoring and dose adjustments. Mild, temporary effects — warmth or tingling if an NAD+ IV runs too quickly (which we slow in real time), or early nausea, headache, or fatigue — can occur and typically pass. These are elective wellness therapies, not intended to diagnose, treat, cure, or prevent any disease, and individual results vary.
Glossary
- NAD+
- Nicotinamide adenine dinucleotide — a coenzyme central to cellular energy production and DNA repair that naturally declines with age.
- Coenzyme
- A helper molecule that enzymes need to carry out essential chemical reactions in your cells.
- Nicotinamide riboside (NR / Niagen®)
- A precursor the body converts into NAD+, used to support NAD+ levels.
- Precursor
- A substance the body converts into another — here, the raw material cells use to make NAD+.
- IV / IM
- Intravenous (into a vein) and intramuscular (into a muscle) delivery routes that bypass digestion for higher absorption.
- Mitochondria
- The structures inside cells that produce energy; NAD+ is essential to how they work.
Sources & references
- Randomized, placebo-controlled pilot study of Niagen® (NR) IV and NAD+ IV in healthy adults. medRxiv, 2024 — cited for NR IV raising blood NAD+ within 24 hours.
- NAD+ and DNA repair. PubMed (24813611) — cited for NAD+’s role in DNA repair.
- NAD+ and cellular energy production. PubMed (17161604) — cited for NAD+’s role in cellular energy.
- Further citations behind our Longevity Medicine: Axiva Clinical Evidence →
Medically reviewed by Dr. Deep Trivedi, MD
Chief Medical Officer & Medical Director, Axiva Wellness Centers
Last reviewed June 9, 2026.
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