NAD+ is a coenzyme. According to a review in Nature Reviews Molecular Cell Biology (2021), it is central to the energy metabolism of cells. With age, NAD+ levels in tissue decline, in rodents and in humans. According to a review in Cell Metabolism (2018), the precursors nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) showed preventive and therapeutic effects in laboratory and animal studies. Whether this carries over to humans still has to be tested, according to the authors. The 2021 review also leaves open whether raising NAD+ levels in humans is safe and beneficial.
According to the German consumer advice centre Verbraucherzentrale, NAD levels in the blood rise when NMN is taken. A randomised, placebo-controlled, double-blind trial in Nature Communications (2018) showed a rise in NAD+ under NR in healthy middle-aged and older adults. According to the Verbraucherzentrale, it is open whether NMN reaches heart muscle cells or the brain from the blood. According to the review in Cell Metabolism, the fate of NMN and NR appears to depend on the tissue. For intravenous or intramuscular NAD+, a systematic review in Ageing Research Reviews (2026) found no outcome trial meeting its inclusion criteria for anti-aging or wellness purposes. According to this review, NAD+ is offered, among others, in wellness settings, also as an infusion.
A placebo-controlled, double-blind trial in long COVID in eClinicalMedicine (2025) shows how far experience and proof can lie apart. In the group that received NR from the start, NAD+ levels rose 2.6-fold after 5 weeks and 3.1-fold after 10 weeks. Fatigue, sleep, mood and thinking did not improve significantly compared with placebo. Improvements from baseline appeared only in a post-hoc exploratory analysis that pooled both groups and was not adjusted for multiple testing. Before-and-after comparisons, like personal reports, lack a placebo comparison. In the group with NR from the start, about half of the participants dropped out by week 20. The trial was co-funded, among others, by Niagen Bioscience.
A pilot study with 36 people with persistent fatigue after COVID-19 (Brain, Behavior, & Immunity – Health, 2024) combined low-dose naltrexone with NAD+ via skin patches. Fatigue and quality of life improved compared with the starting point. The comparison was only with the starting point. Six of the seven authors were employees of AgelessRx, a longevity-focused telemedicine platform.
A personal report describes how someone feels after a treatment. Whether things would have gone similarly without the treatment, it cannot tell. A Cochrane review (2010) found that placebo treatments can influence self-reported complaints in certain settings, especially pain and nausea. Fatigue, too, is recorded mainly through people’s own reports. That is why comparisons with placebo are needed.
A review in Antioxidants (2024) describes, in healthcare professionals under work overload, a link between stress, oxidative stress and declining energy. It does not examine burnout or NAD+. None of the studies named here tests treatment with NAD+ in burnout.
The trial registry ClinicalTrials.gov lists studies on partial questions, last updated in 2025. A small randomised pilot study at Haukeland University Hospital in Bergen tests NR against placebo in healthy adults, measured among other things by polysomnography (NCT06971224). Another randomised trial compares absorption and tolerability of NR and NAD+ as injections in healthy but fatigued adults. ChromaDex is listed there as a collaborator (NCT06919328). None of these studies examines people with burnout.
In the EU, NAD+/NADH is permitted as an ingredient in food supplements. Health claims for it are not authorised (Verbraucherzentrale, as of January 2026). According to the EU Novel Food Catalogue, NMN is a novel ingredient. According to the Verbraucherzentrale (as of January 2026), it may be used neither in food supplements nor in other foods. In May 2026, the European Food Safety Authority EFSA assessed one form of NMN as a source of niacin in food supplements. It considers up to 300 mg a day safe for adults, excluding pregnant and breastfeeding women. The EU decides on authorisation. The assessment concerns safety. An effect against burnout was not part of it.
This question belongs to the topic Conditions alongside burnout. It lists further questions.
What can be raised at a medical check-up about whether NAD+ for burnout rests on folk experience or on scientific evidence?
- NAD+ products, NMN or NR taken, with dose and duration
- infusions or injections received, with number and period
- changes noticed and possible side effects
- pregnancy or breastfeeding
- other medicines and food supplements
Exhaustion can have many causes, including illnesses that need treatment. For this reason a medical assessment comes before coaching, usually starting at the GP practice.
When can exhaustion become an emergency? · Why see a doctor before coaching for burnout?
Which prompt can be given to an AI assistant about whether NAD+ for burnout rests on folk experience or on scientific evidence?
At the start of your answer, point out that this topic needs medical review and that your information may contain errors. Explain which effects of NAD+ and its precursors NR and NMN have been described in laboratory and animal studies, which are supported by placebo-controlled trials in humans, and what is known about the legal status of NMN in the EU. Give the source for every piece of information and mark what is uncertain. Do not make a diagnosis and do not recommend any treatment. Separately, tell me which questions I should ask at the doctor’s practice.
With some services, the prompt needs to be pasted after signing in. The AI services belong to third parties. Depending on the service and the extent of use, signing in and costs may apply. AI answers can contain errors.
Which sources support the answer on whether NAD+ for burnout rests on folk experience or on scientific evidence?
- Covarrubias AJ, Perrone R, Grozio A, Verdin E (2021): NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology 22(2), 119–141
- Yoshino J, Baur JA, Imai SI (2018): NAD+ intermediates: the biology and therapeutic potential of NMN and NR. Cell Metabolism 27(3), 513–528
- Martens CR et al. (2018): Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications 9, 1286
- Gallagher C, Emmanuel OO (2026): NAD⁺ supplementation for anti-aging and wellness: a PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Research Reviews 116, 103057
- Effects of nicotinamide riboside on NAD+ levels, cognition, and symptom recovery in long-COVID: a randomized controlled trial (2025). eClinicalMedicine, 103633
- Low-dose naltrexone and NAD+ for the treatment of patients with persistent fatigue symptoms after COVID-19 (2024). Brain, Behavior, & Immunity – Health, 100733
- Hróbjartsson A, Gøtzsche PC (2010): Placebo interventions for all clinical conditions. Cochrane Database of Systematic Reviews, CD003974
- Kalogerakou T, Antoniadou M (2024): The role of dietary antioxidants, food supplements and functional foods for energy enhancement in healthcare professionals. Antioxidants 13(12), 1508
- ClinicalTrials.gov NCT06971224: NADream – Effects of NAD supplementation on sleep quality in healthy individuals (Haukeland University Hospital)
- ClinicalTrials.gov NCT06919328: Absorption and tolerability of injectable nicotinamide riboside compared to NAD+
- EFSA NDA Panel (2026): Safety of beta-nicotinamide mononucleotide (β-NMN) pursuant to Regulation (EU) 2015/2283. EFSA Journal
- Verbraucherzentrale (2026): NAD und NMN in Nahrungsergänzungsmitteln? (in German)