NAD+ Guide

NAD+ at a glance

What it is

Nicotinamide adenine dinucleotide, an endogenous coenzyme central to cellular energy metabolism, supplied as a lyophilized powder for subcutaneous or IV research use.

Researched for

Cellular energy metabolism, mitochondrial function, DNA repair and sirtuin activity in preclinical and early clinical contexts.

Commonly reported range

50-100 mg subcutaneous per injection (community-reported); higher amounts reported for IV in clinical settings.

Route reported

Subcutaneous injection most common in community protocols; intravenous infusion in clinical settings.

Reported frequency

2-3 times per week (subcutaneous), often after a low-dose tolerance start.

Reported cycle

Commonly described as 4-12 week courses, sometimes bridged with oral precursors (NMN/NR).

Plasma half-life

Short; serum half-life reported under ~1 hour, with rapid intracellular uptake.

Regulatory status

Not FDA-approved; available only via compounding pharmacies for research/clinical use. Not listed as prohibited by WADA (2026).

Reported ranges from research/community — examples, not recommendations.

What it is / mechanism

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell that acts as an electron carrier in the mitochondrial electron transport chain, where it is central to ATP (energy) production. Beyond bioenergetics, NAD+ is a required substrate for two important enzyme families: sirtuins (SIRT1-7), which are involved in DNA repair, metabolic regulation and gene expression, and PARP enzymes, which participate in DNA damage response. Cellular NAD+ levels are reported to decline with age, which has driven research interest in NAD+ and its precursors (NMN, NR) as tools for studying cellular aging and metabolism. Injectable NAD+ is proposed to bypass hepatic first-pass metabolism, with subcutaneous administration creating a depot that is absorbed gradually. The precise pharmacokinetics of injected NAD+ in humans remain incompletely characterized in the published literature.

Researched effects

In preclinical and early clinical research, restoring NAD+ availability has been associated with markers of improved mitochondrial function, cellular energy metabolism and DNA repair activity. Community-reported observations from injectable protocols include subjective changes in energy and physical performance, and one small randomized trial in adults over 45 reported improvements in self-reported energy and performance scores versus placebo. These are research findings and community reports, not guaranteed outcomes; controlled human trial data for injectable NAD+ remains limited, and individual responses vary.

Dosage — reported ranges (overview)

The figures below are examples of what is reported in community and clinical-planning contexts, not a recommendation or a personal dose. Subcutaneous protocols most commonly report 50-100 mg per injection, 2-3 times per week, frequently beginning with a lower dose (for example 50 mg) as a tolerance start before titrating upward. Because subcutaneous NAD+ is often associated with injection-site burning, some protocols split doses or use buffered formulations. Intravenous NAD+ in clinical settings uses substantially higher amounts (hundreds of mg to over 1,000 mg) infused slowly. None of these figures constitute medical advice.

The full step-by-step protocol examples, titration, and printable protocol sheet are planned for a future paid Protocol Playbook module.

Reconstitution — bac-water math

NAD+ is dosed in milligrams, so reconstitution is concentration math. After adding bacteriostatic water to the lyophilized vial, concentration (mg/mL) = total mg in the vial ÷ mL of water added. On a U-100 insulin syringe, 100 units = 1 mL, so the volume for a given dose is (dose in mg ÷ concentration in mg/mL), and units drawn = that volume in mL × 100. Worked example: a 500 mg vial reconstituted with 2 mL of bacteriostatic water gives 250 mg/mL. A 50 mg example dose is then 50 ÷ 250 = 0.2 mL, or 20 units on a U-100 syringe. This is concentration math only, not a personal dose recommendation.

This is concentration math, not a dose recommendation.

Injection / administration basics

In community protocols, reconstituted NAD+ is typically drawn into a U-100 insulin syringe and administered subcutaneously into fatty tissue such as the abdomen, with the vial stored refrigerated after mixing. Subcutaneous NAD+ is frequently reported to cause a burning or stinging sensation during injection; slower injection, smaller split doses and buffered formulations are commonly described as ways to reduce this. These are general handling notes for research context, not medical or administration advice; only a licensed professional can advise on injections.

Half-life & frequency rationale

Injectable NAD+ has a short serum presence, with reported half-life generally under about one hour and rapid intracellular incorporation (IV estimates around 45 minutes). Subcutaneous administration is thought to produce lower peak concentrations but more gradual, sustained tissue exposure via a depot effect. Overall, injectable NAD+ pharmacokinetics in humans are described in the literature as incompletely characterized.

Stacking — overview

NAD+ is commonly discussed in longevity and cellular-energy research contexts alongside other mitochondrial- and repair-focused compounds. The pairings below are examples reported in community protocols, not recommendations, and combining research compounds increases uncertainty around effects and tolerability.

Storage & handling

• Lyophilized (powder) vials are reported to be stable stored refrigerated (2-8°C) and protected from light; many sources note the powder can tolerate short periods at room temperature during shipping.
• Once reconstituted with bacteriostatic water, NAD+ should be kept refrigerated (2-8°C), protected from light, and used within a few weeks per common handling guidance.

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