A 28-day double-blind, placebo-controlled pilot trial found that Qualia NAD+, a multi-ingredient nutraceutical containing B3 vitamins and botanical compounds, raised whole-blood NAD+ levels by an average of 74% compared to a 4% increase in the placebo group (p < 0.001) in 25 healthy adults aged 40–65. Secondary quality-of-life improvements were observed only in males, specifically in overall and somatic symptom categories (p = 0.02 and p = 0.04). No adverse events were reported.
NAD+ decline with aging is well-established, and simpler precursors like nicotinamide riboside (NR) and NMN have demonstrated reliable NAD+ elevation in previous trials — yet translating that biochemical signal into clinical benefit has proven stubbornly elusive. This study's multi-ingredient formulation complicates mechanistic interpretation: it is impossible to attribute the NAD+ rise to any single component. The effect size is notable, but the trial is critically underpowered — only 9 people received the active supplement — making every secondary finding, including the sex-specific quality-of-life result, exploratory at best. The remote, self-administered blood-spot measurement method also introduces variability not present in clinic-based venipuncture assays. Crucially, this is a preprint that has not yet undergone peer review, and the study was sponsored by the manufacturer of Qualia NAD+, raising conflict-of-interest concerns. Until a larger, independently funded trial with clinical endpoints is completed, the 74% NAD+ boost should be treated as a promising but preliminary signal rather than actionable evidence.