NAD Therapy Side Effects | Risks & Considerations

NAD (nicotinamide adenine dinucleotide) therapy is a medical intervention that increases nicotinamide adenine dinucleotide (NAD+) levels in the body. In most cases, this is done with IV infusions, injections, or nasal sprays in clinical settings.

NAD therapy is considered a safe treatment when conducted professionally, but it can come with side effects like flushing, nausea, fatigue, muscle cramping, and digestive upset when administered in high doses or done too quickly.

Side Effects of NAD Therapy

The most common side effects of NAD therapy are:

• Nausea

• Digestive upset

• Headaches

• Flushing (warming sensation on the skin)

• Muscle cramps and soreness

• Lightheadedness and dizziness

In more severe cases (although rare), it's possible that some people may experience the following:

• Drop in blood pressure (hypotension)

• Heart palpitations

• Anxiety

• Shortness of breath

To be clear, NAD therapy and NAD supplements are different. 

NAD therapy is a medically supervised treatment. The most common form is IV NAD treatments, where NAD+ is infused directly into the bloodstream through an IV drip. Because this is an injection treatment, there's also a risk of infection (but this is also rare if done at an accredited facility).

Other forms of NAD therapy treatment and their potential side effects include:

NAD Supplement/Pills Side Effects

NAD pills are generally very safe and don't have many side effects if you find a reputable source and use them as directed.

NAD supplements like nicotinamide mononucleotide (NMN), nicotinamide riboside (NR), or more direct NAD are commonly found in capsule or tablet form to support cellular health and aging.

For precursor compounds like NMN and NR, you allow the body to convert them into NAD+ naturally rather than injecting them into the bloodstream like IV therapy.

NAD pills containing actual nicotinamide adenine dinucleotide bypass the body's natural conversion as it’s already in the form our cells need. 

The only problem is that NAD+ is a larger molecule, making absorption through the gut more difficult. This is why liposomal NAD (which helps to protect the molecule through the digestive tract with a lipid layer) and higher doses are generally the go-to to get around this issue.

The possible side effects of NAD pills are rare and mild:

• Digestive discomfort: bloating, nausea, cramping

• Headaches

• Fatigue

• Flushing

To minimize the chances of experiencing these side effects, you might want to take your NAD pills with food and start with a lower dosage than you think you need and build it up over a few days as a way of easing it into your system.

If you notice a change in your sleep patterns, you could also try taking your NAD first thing in the morning to align with your body's natural circadian rhythm and the demand of your cells for more energy.

Can you Take Too Much NAD?

Our bodies naturally produce NAD+, a coenzyme all our cells need to produce energy and maintain metabolic health. That being said, you can overdo too much of a good thing, which can cause the temporary NAD side effects we've mentioned.

The good news is that the research shows that NAD, whether from forms of therapy or NAD pills, is generally well tolerated, and the body naturally regulates NAD+ levels to prevent excessive build-up, so there's no risk of a lethal dose of NAD+.

Can NAD Be Harmful?

Too much NAD⁺ (from therapy or dietary supplements) is not a huge concern because the body regulates its levels naturally. There haven't been any reported deaths or major accidents linked to NAD IV therapy or NAD pills.

The only concern we can gather is that extremely high doses or frequent IV NAD therapy or muscular NAD injections can cause temporary side effects like muscle cramping and soreness, nausea, dizziness, low blood pressure, or headaches.

Oral NAD — including precursors like NR and NMN — is much safer in terms of side effects, with mild digestive discomfort being the most common issue.