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Instead, the peer-reviewed pharmacology shows that circulating NAD+ is largely broken down in the extracellular space — hydrolyzed to nicotinamide mononucleotide (NMN), then cleaved to nicotinamide riboside (NR) — and it's chiefly that smaller NR fragment that cells take up, via nucleoside transporters, before rebuilding NAD+ inside.[4] Providing NR rather than NAD+ itself, the researchers note, appears to be the more efficient route to raising intracellular NAD+.[4] Charles Brenner — the biochemist who discovered NR as a vitamin precursor of NAD+, now Chief Scientific Advisor to ChromaDex (recently rebranded Niagen Bioscience) and, since 2026, a professor at the University of Helsinki — has argued for years that direct NAD+ approaches largely amount to an expensive, uncomfortable way of delivering what your cells will ultimately use as NR anyway.[9][10] A skeptic quoted in the trade press was blunter still, calling direct NAD injection "completely idiotic from a biochemistry point of view" precisely because NAD can't readily cross the membrane.[8] You don't have to accept the harshest framing to grasp the takeaway: the "100% bioavailability" claim for IV NAD+ is technically true in the bloodstream but potentially misleading at the cellular level

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Sources: Axel AMD, et al