A physician with two decades of longevity practice posted that NAD infusions are not safe. Why do patients feel better? In his view, the temporary release of inflammatory cytokines can feel like an energy rush. For every patient who feels better briefly, he said, about 20 report chest pain or nausea.
He shared a professional athlete case: consistent NAD+ use through the season, an unexpected UCL tear, and mitochondrial testing showing fatty acid oxidation and electron transport chain dysfunction. After addressing the root cause, recovery held.
His takeaway: fix the mitochondria first rather than forcing them with an IV push. Others noted early data on oral NR for ovarian aging may tell a different story.
Key takeaways
- Ask about chest pain and nausea in patients receiving NAD+ infusions.
- Consider mitochondrial assessment before escalating NAD+ therapy.
- Oral precursors may have a different risk profile; the data are early.
From Buzz in the chat, the longevitydocs™ Sunday newsletter, June 28, 2026. Member discussion, not clinical guidance.
Originally published in The Longevity Medicine Intelligence newsletter.
