NAD+

NAD+

Nicotinamide Adenine Dinucleotide

Cellular energy coenzyme for longevity protocols

LongevityAnti-Aging ★ 85
Half-life
Short plasma half-life (under 1 hour); biological effects extended through metabolite recycling
Cycle
Standard SubQ cycles run 4-8 weeks. Common stack: 8-12 weeks SubQ followed by 4 weeks oral NMN or NR for layered support. IV protocols often front-load with weekly sessions for a month, then maintenance every 4-8 weeks.
Storage
Lyophilized: room temperature short-term, refrigerated long-term. Reconstituted or pre-mixed solution: 2-8°C refrigerated, use within 14-30 days. Protect from light.
Research
Limited human RCT data on injectable forms; stronger evidence for oral NR precursor in tissue NAD+ elevation

About

A coenzyme present in every cell that shuttles electrons during ATP production, powers DNA repair via PARP enzymes, and activates the sirtuin family of longevity regulators. Tissue NAD+ levels decline progressively with age, motivating restoration protocols via direct injection or precursor supplementation (NR, NMN). Technically a small-molecule coenzyme rather than a peptide. Injectable NAD+ is not FDA-approved and is available only through compounding pharmacies.

Mechanism

Acts as an electron carrier in mitochondrial oxidative phosphorylation. Substrate for sirtuins (SIRT1-7) that regulate metabolism, inflammation, and DNA repair. Cofactor for PARP enzymes during DNA damage response. CD38 hydrolyzes NAD+ at increasing rates with age, contributing to decline.

Dosage

50 mg
1x weekly
0102030405060708090100

Draw to 50 units on a U-100 insulin syringe

750 mg lyophilized · 7.5 mL bacteriostatic water BAC

Route
Subcutaneous (slow inject over 5-10 sec)
Duration
2-4 weeks titration

When to take: Morning or early afternoon — energy-pathway activation can disrupt sleep if dosed late. Inject slowly to minimize site stinging. IV must be slow-drip; rapid infusion triggers chest tightness and flushing.

Reconstitution

Vial size (mg): 750 mg lyophilized · BAC water (mL): 7.5 mL bacteriostatic water · Concentration: 100 mg/mL

Some compounding pharmacies ship as pre-mixed solution — no reconstitution needed in that case. Inject water down vial wall, swirl gently. Discard if yellow or cloudy.

Benefits

  • Sustained energy and reduced fatigue (subjective)
  • Supports mitochondrial function and ATP synthesis
  • Activates sirtuin-mediated longevity pathways
  • Aids DNA damage repair via PARP cofactor role
  • Reported improvement in recovery and mental clarity

Side effects

  • Injection-site stinging, burning, or redness (SubQ)
  • Flushing, warmth, chest tightness (IV, especially fast infusion)
  • Nausea and headache during titration
  • Transient anxiety or jitteriness
  • Mild GI discomfort

Gender notes

No sex-specific dosing differences documented.

Cautions

  • Pregnancy and breastfeeding
  • Active malignancy (sirtuin and PARP activity uncertain in cancer biology)
  • Severe liver or kidney disease
  • Concurrent high-dose niacin
  • Glucose-lowering medications without monitoring

Research

Stacks well with

GlutathioneEpitalonMOTS-cSS-31
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