NAD+

Unregulated

Also known as: Nicotinamide Adenine Dinucleotide, NAD, NMN precursor

Metabolic & Longevity

Last reviewed: April 28, 2026

A coenzyme found in all living cells that plays a central role in energy metabolism and cellular repair. NAD+ levels decline significantly with age. Injectable NAD+ and its precursors (NMN, NR) have become widely used in longevity and anti-aging protocols.

Mechanism of Action

Serves as an electron carrier in cellular respiration (ATP production). Activates sirtuins (SIRT1-7), a family of proteins involved in DNA repair, inflammation regulation, and metabolic homeostasis. Also activates PARP enzymes involved in DNA damage repair.

Common Uses

  • Anti-aging and longevity protocols
  • Energy and cognitive enhancement
  • Addiction recovery support
  • Athletic performance and recovery
  • Metabolic health optimization

Known Risks

  • IV infusions can cause flushing, nausea, chest tightness (usually transient)
  • Oral precursors (NMN, NR) generally well-tolerated
  • Long-term effects of supraphysiological dosing unknown
  • Theoretical concern: NAD+ may support cancer cell metabolism
  • Quality varies significantly across suppliers

Regulatory Status

Unregulated

NAD+ itself is not FDA-approved as a drug. Injectable NAD+ is available through compounding pharmacies with a prescription. Oral precursors (NMN, NR) are sold as dietary supplements. Not on any FDA compounding category list — exists in a separate regulatory framework from the peptides affected by the 2026 reclassification.

Common Protocols

Protocol information is for educational reference only. Dosing varies significantly by individual, condition, and physician guidance. Always work with a licensed healthcare provider.

IV infusion

Typical Dose

250–1000 mg

Frequency

1–3x per week (loading), then monthly maintenance

Cycle Length

Loading: 4–10 sessions | Maintenance: monthly

Infuse slowly (over 2–4 hours) to minimize flushing, nausea, and chest tightness. Available through IV therapy clinics and some telehealth providers. Most dramatic effects reported for energy and cognitive clarity.

Subcutaneous injection

Typical Dose

100–300 mg

Frequency

Daily or every other day

Cycle Length

4–8 weeks

Less common than IV but more practical for home use. Lower peak levels than IV but more consistent daily exposure.

Oral (NMN or NR precursors)

Typical Dose

250–1000 mg NMN or NR

Frequency

Once daily

Cycle Length

Ongoing

Oral precursors (NMN, NR) are sold as dietary supplements without prescription. Bioavailability is lower than injectable NAD+ but convenient and well-tolerated. Take in the morning.

Related Compounds

Research References

This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any peptide therapy. Data is compiled from published research and regulatory sources and may not reflect the most recent developments.