NAD+

NAD+ is nicotinamide adenine dinucleotide, a coenzyme. We group it with our 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 levels fall with age and with chronic stress. Therapy raises circulating NAD+ acutely, either by direct subcutaneous injection or by intravenous infusion. Be clear-eyed about the evidence. The mechanistic case is well established in preclinical literature, but outcome data in healthy adults is more limited, and most controlled human work has used oral NAD+ precursors rather than direct injection. Wellness care here is supervised by Dr. Oliver Morris, our Medical Director.

No. NAD+ is not an FDA-approved drug, and we say that plainly before anyone starts. It has not been evaluated by the FDA for the diagnosis, treatment, cure, or prevention of any disease, and we treat its use as investigational and as part of an individualized wellness plan. That is not the same thing as unregulated. What we use is sourced through specialty peptide distributors that perform Certificate of Analysis testing on every lot to confirm identity, purity, and concentration, and that operate under the quality standards applicable to their industry. The products worth avoiding are the unprescribed vials sold online, where there is no way to verify contents, purity, or sterility. A real evaluation and a real prescription are what separate a supervised protocol from a gamble.

It depends on what you want out of it. Subcutaneous is the at-home format, small daily injections that keep levels up steadily. IV is the in-office format, a faster and larger dose, and some patients feel a noticeable shift in the same session. Many people combine the two during a loading series, then settle into maintenance. Doses differ between routes and are set per individual protocol. One practical note on each. Subcutaneous NAD+ stings, because the solution is acidic. Room-temperature vials, a slow push, and rotating sites all help, and most patients adapt within the first week. IV infusions run over an hour or more, because pushed too fast NAD+ produces chest tightness, flushing, and nausea. The first infusion is the one we go slowest on.

Most patients describe energy and clarity changes after the first week of consistent dosing, with effects that build over the first one to two weeks. IV is the exception. Acute IV doses produce a noticeable shift in the same session for some patients. What people report is fairly consistent: improvements in energy and mental clarity during the cycle, a subjective sense of better recovery from training or travel, and better tolerance of long, demanding days. Response is individual, and we do not guarantee outcomes. Cycle length is variable by goal. A loading series of several weeks is common, with weekly or monthly maintenance after that. If nothing has shifted after a fair trial, that is useful information too, and worth revisiting rather than just continuing.

We avoid NAD+ in pregnancy and breastfeeding, since there is no safety data. We are also cautious in patients with active malignancy or recent cancer treatment. NAD+ supports proliferation pathways alongside repair pathways, and the right answer for a cancer survivor depends on the cancer type and how recent treatment was. That is an individual conversation about timing and goals, not a blanket yes or no. Beyond those, the practical question is whether the format suits you, since subcutaneous dosing stings and IV means sitting for an hour or more. Most patients who pursue NAD+ are adults who feel that recovery, energy, and mental stamina have shifted with age or with a stressful stretch, often alongside hormone work, a GLP-1 program, or training.

We do not publish a price for NAD+, because the format changes the math. Pricing is set at your consultation once we know which route you are using and how often. Daily subcutaneous injections you do at home, weekly in-office IV infusions, and a loading series that combines both are three different plans with three different costs. Cycle length matters too. A loading series of several weeks followed by weekly or monthly maintenance looks very different on paper from a one-off infusion. At the consultation we will go through which format fits your goal, what a realistic loading and maintenance pattern looks like, and what that adds up to before you commit to anything. Call the Palm Harbor office and we will get you scheduled.