NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell. At Skin Art MD in Burnaby, it is offered two ways: a NAD+ IV, given slowly over a 90-minute appointment ($300), and a NAD+ shot, a small injection in a 20-minute appointment ($130). Human evidence for either is limited, infusion side effects are common if it runs too fast, and screening comes first.
People searching "NAD IV Burnaby" or "NAD+ IV therapy Vancouver" will find plenty of strong claims online. This article does not repeat them. It explains what NAD+ is, how the two menu options differ in practice, what each costs, what research in people has and has not measured, the side effects to expect, and who should talk to their doctor before considering it.
What is NAD+?
NAD+ is a molecule the body makes and uses as a coenzyme, a helper that many enzymes need to carry out chemical reactions. It shuttles electrons in the reactions that turn food into usable energy, and it is used by enzymes involved in DNA repair and cell signalling.
The body builds NAD+ from forms of vitamin B3 (niacin and nicotinamide) and from the amino acid tryptophan, then recycles it continuously. NAD+ itself is not something you need to eat; the raw materials come from a normal diet.
Much of the public interest in NAD+ comes from laboratory and animal research on how NAD+ levels change over the lifespan and with illness. That research is genuinely active, but findings in cells and mice do not tell us what happens when a person receives NAD+ through a vein or a needle. Those are different questions, and they have been studied far less.
What is the difference between a NAD+ IV and a NAD+ shot?
The IV delivers NAD+ diluted in fluid through a vein over a long appointment; the shot delivers a small volume with a needle in a short appointment. The amount, route and time in the clinic are different, and so is the experience.
| NAD+ IV | NAD+ Shot | |
|---|---|---|
| Appointment length | 90 min | 20 min |
| Price | $300 | $130 |
| How it is given | Diluted in fluid, through a cannula in a vein | Small-volume injection (into muscle or under the skin, as the ND decides) |
| Why the time | NAD+ is infused slowly; the rate is reduced if you feel discomfort | Preparation, injection and a short observation period |
Additional charges may apply for customized IV nutrients.
The shot is not a shortcut to the same thing as the IV. It contains a much smaller amount, and the two should not be compared as if one were simply a faster version of the other. The ND can explain the specific amount in each before you decide.
Why does a NAD+ IV take 90 minutes?
Because NAD+ given quickly into a vein commonly causes uncomfortable symptoms, and slowing the infusion is the main way to reduce them. The appointment length reflects a slow rate rather than a large volume.
In practice, the drip is started slowly, and the practitioner adjusts the rate according to how you feel. If symptoms appear, the drip is slowed or paused, and they usually ease within minutes. This is also why a NAD+ IV is not something to fit into a lunch break; if you are short on time, it is better to reschedule than to rush it.
What does the human research actually show?
Very little, so far. Published studies of NAD+ given intravenously in people are few and small, and they mostly measure what happens to NAD+ and related compounds in the blood and urine rather than any health outcome.
The most frequently cited example is a 2019 pilot study in Frontiers in Aging Neuroscience (Grant and colleagues), in which a small group of healthy men received a 6-hour IV infusion of NAD+. The researchers tracked NAD+ and its breakdown products in blood and urine. They also reported that participants had side effects such as nausea and abdominal discomfort when the infusion ran faster. The study was not designed to show, and did not show, that NAD+ improves energy, ageing, thinking or any other outcome.
There is more published research on oral NAD+ precursors, such as nicotinamide riboside and nicotinamide mononucleotide, than on IV or injected NAD+. Those studies have generally shown changes in blood NAD+ levels, with mixed or inconclusive results for health outcomes. They also do not tell us what an injection or an IV does.
For NAD+ shots specifically, we are not aware of controlled human trials of health outcomes. Our position is therefore simple: we describe what NAD+ is and how the appointment works, we do not claim it does any particular thing, and individual experiences vary.
What side effects can happen with a NAD+ IV or shot?
During an IV, the most common effects are related to the rate of infusion: chest tightness or pressure, nausea, stomach cramping, flushing, headache and a general feeling of unease. With a shot, the most common effects are at the injection site.
During or after a NAD+ IV:
- Chest tightness, pressure or a racing feeling, usually rate-related and easing when the drip slows.
- Nausea, abdominal cramping or an urge to use the bathroom.
- Flushing, warmth, light-headedness or headache.
- The usual IV-line effects: bruising, tenderness, a cool feeling or irritation along the vein.
After a NAD+ shot:
- Stinging, redness, soreness or a small lump at the injection site.
- Flushing or mild nausea in some people.
Tell the practitioner immediately about chest pain, shortness of breath, palpitations that do not settle or swelling of the face or throat. Chest symptoms that do not ease when the drip is stopped need urgent assessment, and after you leave, call 9-1-1 for emergencies.
Who should not have NAD+ by IV or injection?
People who are pregnant or breastfeeding, people with significant heart, kidney or liver conditions, and people having active cancer treatment are generally advised against elective NAD+ IVs or shots, or should only consider them with their physician's input. This list is general, not personal advice.
The ND will ask about:
- Pregnancy and breastfeeding. There is no safety information to support elective NAD+ in pregnancy.
- Heart conditions. Because chest tightness and palpitations are recognised infusion effects, a history of heart disease or rhythm problems needs careful discussion.
- Kidney and liver function. These organs process and clear what is infused.
- Cancer and cancer treatment. NAD+ is involved in cell metabolism and repair, and its role in cancer is an open research question. Anyone with current or recent cancer should talk to their oncology team first.
- Medications and supplements, including high-dose niacin or other B3 products.
The screening process is explained in more detail in our article on why screening and lab work come before any infusion.
How do I decide between the IV, the shot, or neither?
Start with what you are hoping for and whether there is a diagnosis behind it. Fatigue, poor concentration and low mood have many possible causes, including iron deficiency, thyroid problems, sleep disorders and depression, and those deserve investigation before any elective IV or injection.
You can book either option directly; each treatment starts with a review of your health history and medications, and Dr. Krantsevich Riehl confirms it is suitable for you before it is given. If you want a fuller conversation first, at an Initial Naturopathic Visit (60 minutes, $250) the ND reviews your history and medications, may suggest bloodwork, and explains what is and is not known about NAD+. If you then want to proceed and it is appropriate for you, the ND can explain why the IV or the shot fits better, or why neither does. If low iron is a possibility, our article on low ferritin and when IV iron is considered may be more relevant than NAD+.
Does extended health insurance cover NAD+?
Possibly in part, depending on your plan. Some extended health plans reimburse visits with a registered naturopathic doctor up to a set amount; whether a NAD+ IV or shot counts as a covered naturopathic service, and whether the cost of the ingredients is included, varies.
MSP does not cover elective NAD+ treatments. Skin Art MD does not bill insurers directly; you receive an official receipt after each visit and submit it yourself. Ask your insurer before booking whether IV or injection treatments given by an ND are included.
Frequently asked questions
Is the NAD+ shot a cheaper version of the NAD+ IV?
Not exactly. It contains a much smaller amount and is given by a different route. They are different menu items, not a large and small size of the same treatment.
Why do I feel chest tightness during a NAD+ drip?
It is a recognised effect, usually related to how quickly NAD+ is entering the vein. Tell the practitioner; slowing or pausing the drip usually eases it. If it does not ease, the infusion is stopped and you are assessed.
Can I have a NAD+ IV and a Myers cocktail on the same day?
That is a clinical decision for the ND, based on your health and how you tolerate each. It is not offered as a bundle.
How many NAD+ sessions do people have?
There is no evidence-based schedule for NAD+ IVs or shots. Any repeat treatment is discussed individually.
Can I bring my own NAD+ product?
No. The clinic only uses products it has sourced and prepared under its own standards.
Booking
Skin Art MD is in Burnaby near Metrotown and serves Greater Vancouver. NAD+ treatments are provided by our naturopathic physician, Dr. Ekaterina Krantsevich Riehl, BSc, ND. The booking page lists every menu item; you can book a treatment or an Initial Naturopathic Visit online or learn more about naturopathic medicine at Skin Art MD. If you have a family physician, consider letting them know what you are exploring.
