If you’re taking a GLP-1 medication and are also interested in NAD+, you may be wondering whether it’s safe, or even beneficial, to use the two together.
Right now, we don’t have clinical trials specifically studying NAD+ supplementation alongside GLP-1 medications. That means researchers haven’t established whether combining them provides additional benefits or introduces risks that wouldn’t occur when either is used on its own.
That doesn’t necessarily mean they can’t be used together. It means there isn’t enough research to make that decision based on the combination alone. If you’re taking a prescription GLP-1 medication, talk with your healthcare provider before adding NAD+ or an NAD+ precursor so they can consider your medications, health history, and treatment goals.
What to Know About NAD+ and GLP-1 Medications
- We don’t yet have clinical trials studying NAD+ and GLP-1 medications together. That means we don’t have enough evidence to say whether combining them provides additional benefits or introduces additional risks.
- There isn’t a known interaction between NAD+ and GLP-1 medications, but research is limited. A lack of documented interactions doesn’t guarantee that the combination is appropriate for everyone.
- GLP-1 medications can slow digestion. Because they delay gastric emptying, researchers have looked at whether medications such as semaglutide affect the absorption of oral medications. Studies haven’t found clinically meaningful effects for the specific medications tested, but that doesn’t tell us how every supplement or medication will behave.
- NAD+ hasn’t been shown to treat GLP-1-related fatigue. Fatigue can occur during semaglutide treatment, but there isn’t clinical evidence showing that NAD+ supplementation prevents or improves this side effect.
- Talk with your prescriber before adding NAD+ to your routine. If you’re taking a GLP-1 medication, your healthcare provider should know about any vitamins, supplements, or other products you’re using so they can consider your complete treatment plan.
What Are GLP-1 Medications and How Do They Work?
GLP-1 stands for glucagon-like peptide-1, a hormone your body naturally releases after you eat. Among other functions, it helps regulate appetite, blood sugar, and how quickly food moves through your stomach.
GLP-1 receptor agonists are medications designed to mimic the effects of this hormone. They can help:
- Reduce appetite and calorie intake by helping you feel fuller and less hungry
- Support blood sugar control by increasing insulin release when blood sugar is elevated and reducing glucagon
- Slow digestion so food leaves the stomach more gradually
You may be more familiar with the brand names. Ozempic and Wegovy both contain semaglutide, a GLP-1 receptor agonist. Mounjaro contains tirzepatide, which works on both GLP-1 and GIP receptors.
While these medications are often discussed together, they’re not interchangeable. Different medications can have different approved uses, dosing, and considerations. Their approved uses can also vary by country.
In Canada, GLP-1 medications are available by prescription and should be used under the guidance of a healthcare provider. A licensed Canadian clinician can determine whether a specific medication is appropriate based on your health history, current medications, and treatment goals.
How NAD+ and GLP-1 Medications Work Differently in the Body
NAD+ precursors and GLP-1 medications are sometimes discussed in the same conversations about metabolism, energy, and weight management, but they work very differently in the body.
NAD+ precursors, such as NR and NMN, are used to increase NAD+ levels in the body. NAD+ plays an important role inside cells, where it supports energy production, mitochondrial function, and other cellular processes. While researchers are studying NAD+ for its potential effects on metabolic health, human trials haven’t shown that NAD+ precursors produce meaningful weight loss.
GLP-1 medications work through hormone signaling involved in appetite, digestion, and blood sugar regulation. Depending on the medication and its approved use, these effects can help reduce appetite and calorie intake, improve blood sugar control, and support significant weight loss in some patients.
There are also important regulatory differences. In Canada, GLP-1 medications are prescription drugs that require clinical oversight. NAD+ precursors may be available as natural health products, depending on the specific ingredient and product.
Because these two approaches work through different biological pathways, we can’t assume that using them together will make either one more effective. Clinical trials haven’t established an added benefit from combining NAD+ with a GLP-1 medication, so anyone considering both should discuss the combination with their healthcare provider.
Is NAD+ Safe to Take with Semaglutide?
If you’re taking semaglutide, it’s understandable to wonder whether you can also take NAD+ or an NAD+ precursor such as NR or NMN. Right now, there isn’t enough research to give a definitive answer.
Clinical trials haven’t specifically studied NAD+ precursors in people taking semaglutide or other GLP-1 medications. NAD+ precursors themselves have generally been well tolerated in human trials, including studies of nicotinamide riboside (NR) at 2,000 mg daily for 12 weeks and NMN at 1,250 mg daily for four weeks. However, that doesn’t tell us whether taking them alongside semaglutide changes their safety, absorption, or effects.
One consideration is that GLP-1 medications such as semaglutide slow gastric emptying, meaning food and other substances may remain in the stomach longer. Researchers have studied whether this affects certain oral medications taken alongside semaglutide. For the specific medications tested, studies haven’t found clinically meaningful changes in absorption. However, NAD+ precursors weren’t included in those studies, so we can’t assume the results apply to NR or NMN.
If you’re taking semaglutide and considering adding NAD+, talk with your prescriber first. They can review the specific product you’re considering, along with your medications, health history, and treatment goals, to determine whether taking both makes sense for you.
Can NAD+ Help with Fatigue or Low Energy During GLP-1 Treatment?
Fatigue can occur while taking GLP-1 medications. In clinical trials of semaglutide 2.4 mg, fatigue was reported by 11% of patients taking semaglutide compared with 5% taking a placebo. Other common side effects included nausea, diarrhea, vomiting, constipation, and abdominal pain.
There are several reasons you might feel tired during GLP-1 treatment. Eating fewer calories, dehydration from gastrointestinal side effects, changes in nutrition, and the adjustment period after increasing your dose may all play a role. For people with type 2 diabetes who also take insulin or certain other diabetes medications, low blood sugar can be another concern.
Can NAD+ Help with GLP-1-Related Fatigue?
Right now, we don’t know. NAD+ plays an important role in cellular energy production, which may make it sound like a natural solution for low energy. However, NAD+ precursors haven’t been studied as a treatment for fatigue caused by GLP-1 medications.
If you’re experiencing fatigue while taking a GLP-1 medication, start with the basics: make sure you’re eating enough protein and nutrient-dense foods, staying hydrated, getting adequate sleep, and following your prescribed dosing schedule. If fatigue is persistent, severe, or interfering with your daily life, talk with your healthcare provider. They can help determine whether it’s related to your medication, nutrition, blood sugar, or something else that needs attention.
When to Speak with a Healthcare Provider About NAD+
Talk with your prescriber before adding NAD+ if you:
- Are currently taking any GLP-1 receptor agonist, because the combination has no evidence base
- Have type 2 diabetes, particularly if you also take insulin or a sulfonylurea
- Have kidney or liver disease
- Are pregnant, breastfeeding, or planning pregnancy
- Are experiencing significant nausea, vomiting, or diarrhea
- Have persistent or severe fatigue, which deserves clinical assessment rather than a supplement
Never stop or adjust a prescribed medication in order to try a supplement.
If you are considering treatment or already in a program, our body optimization and weight management program connects you with licensed Canadian clinicians who can review your full medication and supplement list.
Frequently Asked Questions
Can You Take NAD+ with Ozempic?
Ozempic is a brand name for semaglutide. No clinical study has tested NAD+ precursors alongside semaglutide, and no interaction has been documented. Because the combination is unstudied, ask your prescriber before adding it.
Can You Take NAD+ with Wegovy?
Wegovy is another brand of semaglutide, so the answer is the same. There is no documented interaction and no evidence of benefit. Your prescriber should know about any supplement you take during treatment.
Can You Take NAD+ While Taking Semaglutide?
There is no research on it either way. Semaglutide slows gastric emptying, which could theoretically affect absorption of oral products, though studies of specific oral medications found no clinically relevant effects. Speak with your clinician.
Can NAD+ and GLP-1 Medications Be Used Together?
There is no clinical evidence for or against using these medications together. They act through different mechanisms, but that is not the same as having evidence that the combination is safe or beneficial. This is a decision to make with a healthcare practitioner who knows your history.
What to Know Before Combining NAD+ and a GLP-1 Medication
NAD+ and GLP-1 medications work through different pathways in the body, but that doesn’t tell us whether combining them is beneficial, or appropriate for everyone. Right now, there simply isn’t enough research on using the two together to know whether NAD+ provides any additional benefit during GLP-1 treatment.
If you’re taking a GLP-1 medication and are interested in NAD+, talk with your prescriber before adding it to your routine. They can consider the specific medication you’re taking, other medications or supplements you use, your health history, and what you’re hoping to achieve with NAD+.
In treatment or considering it? A licensed MyRocky clinician will review your medications and supplements with you.
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References
- Health Canada. “Summary Basis of Decision for Ozempic.” Drug and Health Products Portal. SBD00388.
- Novo Nordisk. “Wegovy (Semaglutide) Prescribing Information.” Wegovy Prescribing Information.
- Health Canada. “Drug Product Database: Ozempic (Semaglutide), DIN 02471477.” Drug Product Database.
- Health Canada. “Licensed Natural Health Products Database: Nicotinamide Mononucleotide, NPN 80121612.” Licensed Natural Health Products Database.
- Dollerup OL, Christensen B, Svart M, et al. “A Randomized Placebo-Controlled Clinical Trial of Nicotinamide Riboside in Obese Men: Safety, Insulin-Sensitivity, and Lipid-Mobilizing Effects.” The American Journal of Clinical Nutrition. 2018;108(2):343–353.
- Fukamizu Y, Uchida Y, Shigekawa A, et al. “Safety Evaluation of β-Nicotinamide Mononucleotide Oral Administration in Healthy Adult Men and Women.” Scientific Reports. 2022;12:14442.
Disclaimer: This article is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider with any questions about a medical condition or treatment.
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