If you searched for NAD⁺ before-and-after pictures, you were probably hoping to see whether this works before spending a few hundred dollars on it. That is an entirely sensible thing to want. We are not going to show you a gallery, and the reason is the most useful thing on this page.
What a before/after photo actually establishes
One person changed between two photographs, and the company selling the product chose to publish that pair.
That is the complete list. It does not establish that NAD⁺ caused the change, because nothing controlled for what else happened in those weeks — sleep, training, diet, a new job, a GLP-1 prescription, the ordinary motivation that comes from spending money on your health. It does not show you the people for whom nothing happened, because those pairs do not get published. And it cannot separate the product from the placebo effect, which in a category sold on subjective feelings like energy and focus is not a small consideration.
This is not cynicism about NAD⁺ specifically. It is what a testimonial is worth in any category, and it is exactly why controlled trials exist.
What was measured, when somebody measured it
Here is the substitute for a gallery — the outcomes that have actually been recorded in randomized human trials, which is a much shorter list than the marketing implies and includes at least one result the marketing never mentions.
Blood NAD⁺ rises. In a randomized, double-blind, placebo-controlled trial of 80 healthy middle-aged adults (n = 80), blood NAD rose significantly in every NMN dose group at day 30 and day 60 against placebo and baseline (all p ≤ 0.001) [1]. Real, repeatable, and a blood marker rather than anything you would photograph.
Some metabolic markers moved. In overweight or obese middle-aged and older adults, an NMN formulation significantly reduced total LDL cholesterol, non-HDL cholesterol, body weight and diastolic blood pressure [2]. Genuine findings, in a specific population, on a lab report rather than in a mirror.
And cognition did not. In a placebo-controlled randomized trial in older adults with mild cognitive impairment, NR did not alter cognition — the placebo group’s scores improved across the study, consistent with a practice effect, while the NR group’s did not change [3]. You will not find that outcome in anybody’s before-and-after gallery.
What this means for the thing you were about to buy
Every trial above used an oral precursor. The injections and IV drips those galleries belong to have no controlled outcome trials at all — so for the exact product being marketed with the photos, the measured evidence is not thin, it is absent.
If you want to try NAD⁺ anyway, that is a reasonable personal decision, and the honest way to make it is on price and logistics rather than on transformations. Start with an oral precursor, which costs roughly a quarter of an injection and has the data. If you have decided on an injection, our injections ranking compares the providers on what they actually disclose.
And whatever you choose, decide in advance what you are measuring and when you will check. “Do I feel better?” three weeks into a purchase you wanted to work is the least reliable instrument in this whole category — which is, again, why trials use clamps and blood panels instead of photographs.