If you’re involved in the wellness world—or a follower of celebrities like Hailey Bieber and Kendall Jenner, who have been seen touting its benefits—you’ve likely heard about NAD+ IV therapy. These IVs deliver a quick infusion of an essential coenzyme called nicotinamide adenine dinucleotide (NAD+), which is thought to support cellular health, energy metabolism, and physical performance.
However, as with any booming wellness trend, concerns about safety arise—especially when less reputable (or less knowledgeable) sellers enter the market. In recent months, the Food and Drug Administration (FDA) issued a reminder about the risks of using food-grade NAD+ in IV therapy instead of pharmaceutical-grade, citing reports of adverse effects.
This article dives deeper into the FDA’s concerns about food-grade NAD+ IVs, why pharmaceutical-grade Niagen IV is a more trusted option, and tips for ensuring your NAD+ IV therapy is safe.
Understanding the FDA's Recent Advisory
In the FDA’s recent reminder, the agency explicitly warned against the use of food-grade NAD+ in IV therapy. It emphasized that only sterile, pharmaceutical-grade NAD+ should be used to avoid contamination risks and adverse effects.
Sterile drugs, compounds, and ingredients are essential when creating intravenous solutions, as food-grade ingredients are more likely to be contaminated with microbes and endotoxins.
This elevated endotoxin contamination risk has been linked to significant adverse events after using non-sterile food-grade NAD+ IVs, with symptoms including chills, shaking, vomiting, and fatigue, with some requiring medical treatment.
So, what exactly sets pharmaceutical-grade NAD+ apart from food-grade? Let’s break down the key differences and why sterility matters.
The Critical Difference: Food-Grade vs. Pharmaceutical-Grade NAD+
The term “food grade” sounds pretty good, doesn’t it? After all, something safe enough to eat should be suitable to put elsewhere in bodies, right? Well, not quite.
While food-grade NAD+ is suitable for dietary supplements, this form of NAD+ is only intended for oral consumption.
Food-grade NAD+ is manufactured to meet dietary supplement regulations, which focus on purity for ingestion rather than sterility for injection. Pharmaceutical-grade NAD+ is required to meet higher standards, ensuring it is free from endotoxins and microbial contamination.
According to the U.S. Pharmacopeia (USP), “Medications that are required to be sterile include those administered through injection, intravenous infusion (IV), intraocular (injection in the eye) or intrathecal (injection in the spine).”
Essentially, “pharmaceutical-grade” is synonymous with sterile, meaning there is no risk of contamination with microbes or endotoxins that you might see with food-grade NAD+.
Why Sterility Matters
To better understand the difference between food-grade and pharmaceutical-grade NAD+, let’s look at an analogy using contact lenses and tap water. If you’re one of the 34 million Americans who wear contact lenses, you know the importance of using a specialized contact lens solution in your lens case every night instead of tap water.
While tap water is (generally) safe to drink, it’s completely unsafe for cleaning or storing contact lenses because it can introduce harmful microorganisms that cause serious eye infections.
This is similar to how food-grade formulations of NAD+ IVs meant for oral consumption can contain endotoxins or harmful microbes that lead to side effects like chills, shaking, vomiting, and fatigue when administered intravenously.
The dangers of this were seen in 2015 when seven cases of endotoxin poisoning from contaminated glutathione IVs were reported in Australia, leading to an endotoxin-induced systemic inflammatory response and bacterial sepsis.
These concerning cases highlight the critical risks of using non-pharmaceutical-grade NAD+ IVs—and that’s where Niagen IV comes in: a safer, first-of-its-kind pharmaceutical-grade intravenous therapy of nicotinamide riboside chloride (NRCl), available from Niagen Plus.
As a precursor to NAD+, nicotinamide riboside (NR) can effectively boost cellular and blood levels of NAD+ without adverse effects. Plus, a recent pilot study found that the Niagen IV takes one-quarter the time for infusions, is significantly better tolerated with fewer severe side effects, and elevates NAD+ more rapidly, making it a superior alternative to NAD+ IVs.
Our Commitment to Safety and Quality: Niagen IV
While NAD IV solutions should contain only NAD+ without contaminating microbes or endotoxins, the manufactured batches can be inconsistent and unreliable. Due to their growing popularity, many companies now compound or produce NAD+ solutions for IV use, but not all of them adhere to the same standards of quality and purity.
Conversely, Niagen IV consists of pharmaceutical-grade Niagen® (nicotinamide riboside chloride, or NRCl), which is mixed with bacteriostatic or sterile water prior to intravenous administration, and the treatments are always administered by qualified and licensed healthcare professionals.
Niagen Bioscience ensures the safety and quality of Niagen Plus through a partnership with an FDA-registered 503B outsourcing facility and adherence to detailed quality control processes that also comply with various USP standards, including <797>, <788>, and <85>. These processes include 17 steps of checking for safety and sterility, ensuring the end product is pharmaceutical-grade and safe to put in your body.
Overall, Niagen IV is specifically formulated for clinical use, ensuring that it is an effective and safe alternative to NAD+ IVs.
How to Ensure Your NAD+ IV Therapy is Safe
If you choose to use NAD+ IV therapy, there are some questions and red flags to look for before sitting down in the chair.
To ensure your NAD+ IV is safe, ask these questions first:
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Is this NAD+ IV pharmaceutical grade?
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What verification do you have that the product is free of contaminants and endotoxins?
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What verification of compounding pharmacy credentials do you have? Specifically, is the NAD+ sourced from an FDA-registered 503B outsourcing facility or a 503A compounding pharmacy registered with the state?
Some red flags that you should not use this NAD+ IV clinic or provider include the following:
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The provider or clinic does not explicitly state that they use pharmaceutical-grade, sterile NAD+ in their IVs.
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The provider is unwilling to provide information about whether or not they are pharmaceutical-grade. Reputable clinics will be willing and able to provide information on the source, purity, and sterility of the NAD+ they use.
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There is no medical supervision or administration by a trained healthcare professional.
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They do not have compounding pharmacy credentials (like USP or Pharmacy Compounding Accreditation Board [PCAB]).
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The NAD IVs are offered at a suspiciously low cost. Although higher cost does not always mean higher quality, a “too good to be true” deal on NAD+ IV therapy should make you seriously question the quality and sterility of the ingredients.
Don’t feel like you’re being annoying or demanding if you ask questions at your NAD+ IV clinic—your safety is on the line!
Key Takeaways: The Niagen IV Advantage
The bottom line is that your safety comes first. Always ensure that your NAD+ IV therapy uses pharmaceutical-grade ingredients—never food-grade. Cutting corners on sterility simply isn’t worth the risk.
Niagen IV, an alternative to NAD+ IV therapy that uses nicotinamide riboside chloride instead, is a pharmaceutical-grade IV therapy that undergoes a rigorous 17-step quality control process and partners with an FDA-registered 503B outsourcing facility. Tru Niagen’s commitment is first and foremost to transparency and consumer well-being, ensuring you can feel safe sitting down in a Niagen+ IV chair.
When considering NAD IV therapy, don’t just assume it’s safe—ask questions to verify the source, purity, and quality, and always, always, always choose a pharmaceutical-grade provider. Learn more about pharmaceutical-grade Niagen IVs at NiagenPlus.com or check out the Niagen Plus Store Locator to find a clinic that offers it near you.
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References:
Conze D, Brenner C, Kruger CL. Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults. Sci Rep. 2019;9(1):9772. Published 2019 Jul 5. doi:10.1038/s41598-019-46120-z
Hawkins J, Idoine R, Kwon J, et al. Randomized, placebo-controlled, pilot clinical study evaluating acute Niagen®+ IV and NAD+ IV in healthy adults. (Preprint bioRxiv). https://doi.org/10.1101/2024.06.06.24308565
Johnstone T, Quinn E, Tobin S, et al. Seven cases of probable endotoxin poisoning related to contaminated glutathione infusions. Epidemiol Infect. 2018;146(7):931-934. doi:10.1017/S0950268818000420
Mehmel M, Jovanović N, Spitz U. Nicotinamide Riboside-The Current State of Research and Therapeutic Uses. Nutrients. 2020;12(6):1616. Published 2020 May 31. doi:10.3390/nu12061616
U.S. Environmental Protection Agency (2024). The Danger of Using Tap Water with Contact Lenses. https://www.epa.gov/sdwa/danger-using-tap-water-contact-lenses
U.S. Food and Drug Administration (2024). FDA reminds compounders to use ingredients suitable for sterile compounding. https://www.fda.gov/drugs/human-drug-compounding/fda-reminds-compounders-use-ingredients-suitable-sterile-compounding