NAD+

Nicotinamide adenine dinucleotide

NAD+ is in every cell in your body and it declines about 50% between ages 40 and 60. The pitch: restore NAD+ levels, restore cellular function. The reality: systematic reviews keep finding insufficient evidence that injecting it beats oral precursors. NMN and NR capsules actually absorb better than people expect, at a fraction of the cost. IV clinics charge $200-600 per session, SubQ runs $150-400/month, and the evidence that either beats a $30 bottle of NMN isn't there yet. Start with oral before spending clinic money.

Protocol

Dose: IV: 250-500mg per session. SubQ: 50-200mg per injection. Oral (NMN/NR): 250-1000mg daily. | Frequency: IV: 1-2x per week for loading, then monthly. SubQ: 2-3x per week. Oral: daily. | Cycle: No standard cycling. Most people run continuous with oral precursors. | Route: IV (clinic), SubQ (home), Oral (NMN/NR supplements)

Reconstitution: SubQ: Follow vial-specific instructions. IV: Clinical administration only.. Use our free reconstitution calculator for exact syringe units.

Effects

• Cellular energy (55%) — NAD+ is literally required for mitochondrial energy production. Levels decline 50% between ages 40-60. Restoring them makes theoretical sense.
• Anti-aging support (40%) — Sirtuin activation, DNA repair, and mitochondrial function all depend on NAD+. The mechanism is real, the delivery method debate is not settled.
• Addiction recovery support (35%) — IV NAD+ has a following in addiction medicine. Anecdotal reports are strong but controlled trials are scarce.
• Mental clarity (30%) — Many people report improved cognitive function, especially from IV. Placebo-controlled data is lacking.

Side Effects

• Flushing (IV) (30%) — Hot, flushed feeling during the drip — like a niacin flush. Uncomfortable but not dangerous. Gone when the IV's done.
• Chest tightness (IV) (15%) — Some people feel chest pressure if the drip is running too fast. Tell them to slow it down and it stops.
• Nausea (12%) — More common with oral at high doses. SubQ is usually easier on your stomach.
• Injection-site pain (SubQ) (20%) — NAD+ stings more than most peptides when you pin it. Ice the spot first, seriously.

Evidence

Early research — A 2024 systematic review found zero eligible human trials evaluating injectable NAD+ for anti-aging or wellness outcomes. Oral precursors (NMN, NR) have some RCT data showing elevated blood NAD+ levels, but clinically relevant outcomes weren't significantly different from placebo. The theoretical advantage of injection over oral hasn't been established. This is the most overhyped molecule in the longevity space relative to its actual evidence base.

Approval status: Not approved as injectable therapeutic. NMN/NR sold as supplements.

References

1. Verdin E et al. NAD+ in aging, metabolism, and neurodegeneration Science, 2015. PMID: 26785480
2. Gallagher C et al. NAD+ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence Ageing Res Rev, 2026. PMID: 41655607
3. Yi L et al. The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial GeroScience, 2023. PMID: 36482258
4. Yamaguchi S et al. Safety and efficacy of long-term nicotinamide mononucleotide supplementation on metabolism, sleep, and nicotinamide adenine dinucleotide biosynthesis in healthy, middle-aged Japanese men Endocr J, 2024. PMID: 38191197
5. Radenkovic D et al. Clinical Evidence for Targeting NAD Therapeutically Pharmaceuticals (Basel), 2020. PMID: 32942582
6. Dellinger RW et al. Repeat dose NRPT (nicotinamide riboside and pterostilbene) increases NAD+ levels in humans safely and sustainably: a randomized, double-blind, placebo-controlled study NPJ Aging Mech Dis, 2017. PMID: 29184669

Storage

• Lyophilized: Refrigerate 2-8C. Freeze for long-term storage. Light-sensitive — keep in original vial.
• Reconstituted: Refrigerate at 2-8C. Use within 2-4 weeks depending on formulation.
• Water: Bacteriostatic water or sterile saline depending on route. Follow vial instructions.
• Needle: 27-29 gauge for SubQ (thicker gauge because the solution can be viscous)

← Browse all peptides | Dose calculator →

These statements have not been evaluated by the FDA. This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Consult a healthcare professional before starting any protocol.

vialprep research · Sources: PubMed, FDA, peer-reviewed trials · How we verify