NAD+ injections: real metabolic tool or overhyped wellness shot?

What did @court.nurse actually say?

A nurse practitioner on TikTok made three core claims about NAD: that it acts as a "universal cellular electron transporter" that produces ATP, that oral NAD supplements are poorly absorbed and don't reach cells, and that NAD injections offer benefits including energy, cognitive function, athletic recovery, and anti-aging effects. The video is clearly promotional in tone, hashtagged with NAD injections and IV infusion content.

The creator stops short of citing any specific studies or dosing protocols, which keeps things vague enough to avoid obvious red flags. But vague isn't the same as accurate, and a few of these claims deserve a closer look before you book an infusion appointment.

Does the science back this up?

Partially, yes. NAD+ (nicotinamide adenine dinucleotide) does play a documented role in cellular energy metabolism, and the electron transport chain claim is broadly grounded in biochemistry. The oral bioavailability question is more complicated than the video suggests, and the anti-aging claim is being stretched well beyond what current human data supports.

On the energy side, NAD+ is a well-established coenzyme in mitochondrial function. A 2018 review by Rajman et al. in Cell Metabolism confirmed NAD+'s role in ATP synthesis and noted that NAD+ levels decline with age in multiple tissues. That part checks out. The IV delivery question is trickier. A 2023 study by Pencina et al. in the New England Journal of Medicine looked at NMN supplementation (an NAD+ precursor) orally and found it did raise NAD+ levels in muscle tissue in older men, which directly complicates the "pills don't work" narrative the creator pushes.

What did they get wrong (or right)?

The claim that oral NAD supplements are "not absorbed by the digestive system and not taken up directly by the cells" is the most problematic statement in the video. It is overstated and not well-supported by current literature.

NAD+ itself is not efficiently absorbed orally as a free molecule, that part is fair. But NAD+ precursors like NMN and NR (nicotinamide riboside) are absorbed and do raise intracellular NAD+ levels. The Pencina et al. 2023 NEJM study showed measurable muscle NAD+ increases with oral NMN. A 2020 clinical trial by Martens et al. in Nature Communications found that oral NR raised blood NAD+ metabolites in healthy middle-aged adults. Lumping all oral forms together as useless is a sales pitch, not a science briefing.

Credit where it's due: the electron transporter description, while simplified, is not wrong. NAD+ cycling between its oxidized and reduced forms (NADH) is central to how cells generate energy. That core biochemistry is accurate.

What should you actually know?

IV NAD+ infusions are being used clinically and in wellness settings, but the human trial evidence for most of the benefits listed in this video is still thin. "Cognitive function," "athletic performance," and "anti-aging" are marketing categories, not FDA-approved indications. No large randomized controlled trials in humans have confirmed that IV NAD+ infusions produce superior outcomes to well-studied oral precursors for healthy adults.

There are also safety considerations the video skips entirely. IV NAD+ infusions are known to cause uncomfortable side effects during administration, including chest tightness, nausea, and flushing, which are common enough to be documented in clinical protocols. The infusions are not without risk, and "nurse practitioner does it" is not a substitute for a formal risk-benefit conversation with a provider who knows your health history.

If you're genuinely interested in NAD+ optimization, the oral precursor literature is growing and more accessible than IV therapy. Talk to a licensed clinician who will actually review your labs, not just sell you a drip.

What's the bottom line on this video?

This video mixes solid basic biochemistry with an oversimplified dismissal of oral NAD precursors that appears designed to steer viewers toward injectable or IV products. The anti-aging framing is speculative in humans. The safety picture is incomplete. The creator has nursing credentials, which adds credibility to tone, but credentials don't make marketing claims into clinical evidence. Approach with skepticism.