NAD⁺ IV Infusion for Injury Recovery: What We Know (So Far)
- Margaret McLain, NP-C
- Oct 9
- 3 min read
When you’re healing from an injury, cells are working overtime to make energy, repair DNA, calm inflammation, and rebuild tissue. One molecule sits at the center of all of that: NAD⁺ (nicotinamide adenine dinucleotide). It’s a coenzyme found in every cell that powers metabolism and supports repair enzymes (like sirtuins and PARPs). NAD⁺ levels can fall with age, stress, and illness, which is why therapies that restore NAD⁺—including IV infusions and oral precursors—have drawn interest for recovery. PMC+1
How could NAD⁺ help tissue repair?
Energizes healing cells. NAD⁺ shuttles electrons to make ATP—the fuel your cells need for repair. PMC
Supports repair pathways. Sirtuins and PARPs (NAD⁺-dependent enzymes) help regulate inflammation, protect mitochondria, and coordinate regeneration signals. In muscle, sirtuin activity is tied to regeneration and metabolic resilience. PMC
Counters age-related decline. Multiple reviews document that NAD⁺ pools drop with age and metabolic stress; restoring them can improve cellular stress resistance in models. PMC
What does the human evidence say?
Direct IV NAD⁺:
A pilot human study tracked blood and urine during a 6-hour IV NAD⁺ infusion. It confirmed systemic increases in NAD⁺ metabolites during and after the drip, demonstrating that infused NAD⁺ enters circulation and is metabolized. Clinical recovery outcomes weren’t tested in this study, but it establishes pharmacokinetics for IV use. PMC
Oral NAD⁺ precursors (related to injury):
In a randomized, placebo-controlled trial in older adults with a standardized muscle injury, a combo of nicotinamide riboside + pterostilbene (NRPT) modulated the muscle NAD⁺ metabolome and was associated with signals relevant to regeneration (e.g., satellite cell responses and inflammation markers). While functional outcomes are still being clarified, it’s the best human model to date linking NAD⁺ augmentation to muscle repair biology. PMC
Additional trials show that oral NR is bioavailable and safe while shifting skeletal-muscle NAD⁺ signatures toward anti-inflammatory and pro-metabolic profiles in older adults. PMC
Bottom line on benefits:
For injury recovery, evidence in humans is promising but preliminary. We have (a) direct pharmacokinetic data for IV NAD⁺, and (b) controlled human trials with oral NAD⁺ precursors showing muscle-repair-relevant biological effects. Larger, outcomes-focused studies—especially head-to-head IV vs. oral—are still needed. PMC+2PMC+2
Safety & side effects
A recent review of clinical studies found mostly mild, transient side effects (e.g., headache, fatigue, sleep disturbance, myalgias) and no serious safety signals across NAD⁺ approaches studied. As with any IV therapy, there’s a small procedural risk (e.g., phlebitis/infection) that should be minimized by using trained medical staff and clean technique. PubMed
Oral NR has a good short-term safety profile up to 2,000 mg/day in trials. PMC
Who might consider NAD⁺ IV during recovery?
Adults recovering from muscle strains, orthopedic procedures, or overuse injuries who want to support cellular energy and repair pathways may consider an IV series during early healing, often alongside evidence-based care (rest/rehab, nutrition, sleep).
Patients should discuss medications, underlying conditions, and whether oral precursors (NR/NMN) might be more appropriate, lower-cost, or sufficient for their goals.
Practical takeaways for athletes & patients
Think of NAD⁺ as cellular support, not a stand-alone cure. Pair it with a comprehensive rehab plan.
Dosing and protocols vary. Because best practices aren’t standardized yet, work with clinicians who can tailor frequency, rate (slower rates are typically more comfortable), and integration with other therapies.
Measure what matters. Where possible, track functional outcomes (strength, ROM, soreness, time-to-return) and consider baseline/follow-up labs as appropriate.
References (NIH/PubMed)
Human IV NAD⁺ pharmacokinetics: Grant et al., 2019, pilot infusion study documenting plasma/urine NAD⁺ metabolites during a 6-hour IV infusion. PMC
Muscle injury & regeneration (human RCT with precursors): Jensen et al., 2022, randomized, placebo-controlled trial of NR+pterostilbene after experimental muscle injury in older adults. PMC
Sirtuins & skeletal muscle regeneration (review): Gibril et al., 2024. PMC
NAD⁺ in regenerative medicine (review): Conlon et al., 2021. PMC
Clinical evidence for targeting NAD therapeutically (overview): Radenkovic et al., 2020. PMC
Safety overview across NAD approaches: de Mello Gindri et al., 2024. PubMed
Important context: Direct IV NAD⁺ for injury recovery has limited outcomes-level evidence so far; most human data tying NAD⁺ biology to muscle repair comes from oral precursors. Clinics should present this transparently. PMC+1
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