Cellular Energy & Metabolic

NAD+

A coenzyme central to cellular energy and the body’s own repair machinery.

FormatVial or IV

FrequencyDaily SC or weekly IV

CycleVariable

RouteSC / IM / IV

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Not FDA-approved · Investigational use

What it is

A coenzyme, not a peptide.

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme. We group it with peptide protocols because we dose it the same way, but it is not a peptide. NAD+ sits at the center of mitochondrial energy production and is required by sirtuins, PARPs, and several other enzyme families involved in DNA repair and metabolic regulation.

Tissue NAD+ falls with age and with chronic stress. Therapy raises circulating NAD+ acutely, either by direct subcutaneous injection or by intravenous infusion. The mechanistic case is well established in preclinical literature. Outcome data in healthy adults is more limited, and most controlled human work has used oral NAD+ precursors rather than direct injection.

We offer NAD+ in two formats. Patients who want to dose at home use small daily subcutaneous injections. Patients who want a faster, larger dose receive in-office IV infusions delivered slowly to keep them comfortable.

Reported areas of support

What patients notice.

Reported improvements in energy and mental clarity during the cycle
A subjective sense of better recovery from training or travel
Improved tolerance of long, demanding days in some users
Effects that build over the first one to two weeks of dosing
Acute IV doses produce a noticeable shift in the same session for some patients

Response is individual; we don’t guarantee outcomes.

How the protocol works

The protocol, plainly.

Dosing summary

DoseProvider-determined per individual protocol. SC and IV doses differ.

FrequencyDaily subcutaneous at home, or weekly in-office IV. Many patients combine the two during a loading series.

RouteSubcutaneous, intramuscular, or intravenous, depending on the format

Cycle lengthVariable by goal. Loading series of several weeks is common, with weekly or monthly maintenance after.

Subcutaneous NAD+ stings. The solution is acidic, and a brief burning sensation at the injection site is common during dosing. Bringing the vial to room temperature, injecting slowly, and rotating sites all reduce it. Most patients adapt within the first week, but the sting is real and worth knowing about before starting.

Intravenous NAD+ is delivered slowly. Pushed too fast, it produces chest tightness, flushing, and nausea. Our infusions run over an hour or more, which keeps most patients comfortable. The first infusion is the one we go slowest on.

Most NAD+ users do best with a loading series, then a maintenance pattern. The maintenance pattern depends on the goal: ongoing daily SC for sustained levels, or periodic IV boosts for a different rhythm.

Most patients describe energy and clarity changes after the first week of consistent dosing.

Who tends to pursue this

The patient who fits.

Most patients who pursue NAD+ are adults who feel that recovery, energy, and mental stamina have shifted with age or with a stressful stretch. They are often combining it with hormone work, GLP-1 weight management, or training.

We’re cautious in patients with active malignancy or recent cancer treatment. NAD+ supports proliferation pathways alongside repair pathways, and the right answer in cancer survivors depends on the cancer type and how recent treatment was.

Considerations before starting

Subcutaneous NAD+ stings during injection. Slowing the push and rotating sites helps, but the sting is part of the dose.
IV NAD+ must be infused slowly to avoid chest tightness, flushing, and nausea
Avoid in pregnancy and breastfeeding (no safety data)
Caution in patients with active or recent cancer. We discuss timing and goals individually.

Pairs well with

What this is often used alongside.

Energy and recovery rarely come down to one molecule. This protocol is often used to supplement other services like wellness injectables and medical weight management.

Wellness InjectablesGlutathione, vitamin C, B12
Medical Weight ManagementGLP-1 program

NAD+ is not an FDA-approved drug. The peptides used in this protocol are sourced from specialty peptide distributors that perform Certificate of Analysis (COA) testing on every lot to confirm identity, purity, and concentration, and that operate under the regulatory and quality standards applicable to their industry. They have not been evaluated by the FDA for the diagnosis, treatment, cure, or prevention of any disease, and we treat their use as investigational and as part of an individualized wellness plan. The information on this page reflects published research, clinical experience, and what patients have reported. It is not a medical claim or a guarantee of any outcome.

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If you want to know whether NAD+ fits, what format makes sense for you, and what a realistic loading and maintenance pattern looks like, a consultation is the right place to start.

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