Energy · Longevity · Cognitive Rx · Prescription required

NAD+.

Nicotinamide Adenine Dinucleotide

The cofactor that powers cellular energy and DNA repair. Levels fall by ~50% between ages 20 and 50 — direct replacement restores the substrate sirtuins and PARPs need to work.

From $200 / month
MW 663.43 Molecular weightThe mass of one molecule of NAD+ in g/mol. Small for a coenzyme, large enough to need direct delivery.
Sequence Coenzyme Peptide chain lengthNAD+ is a coenzyme, not a peptide. It's a dinucleotide built from nicotinamide and adenine — the cofactor for hundreds of cellular enzymes.
Route Sub-Q How you take itSubcutaneous: under the skin. NAD+ is also given IV at higher doses; sub-Q is the at-home format with strong absorption.
Cycle Indefinite Cycle lengthLoading phase of 2–4 weeks daily, then 3× weekly maintenance. 8-week evaluation windows.
Discovered 1906 First isolatedFirst described in 1906 (Harden & Young) as 'cozymase' — the small heat-stable component of fermentation. Decades of biochemistry have followed.
Begin your protocol Free assessment · No card · Rx required
NAD+ Longevity
MW 663.43 Length Coenzyme Route Sub-Q Cycle 8 wk
Begin →

The cofactor ageing depletes.

NAD+ is not a stimulant. It is the substrate your mitochondria use to convert food into ATP and the substrate sirtuins and PARPs use to maintain the genome. Every cell in your body runs on it.

Levels fall steadily with age — by roughly half between twenty and fifty. The downstream consequences are predictable: less energy, slower DNA repair, dampened sirtuin signaling, drifting circadian rhythm. Most modern longevity protocols start here because everything else assumes there is enough NAD+ to do the work.

Sub-Q delivery sidesteps the absorption problem with oral precursors. The molecule arrives intact, refills the intracellular pool, and the rest of the longevity stack has a substrate to work against.

Where it matters.

NAD+ is a hub. Six downstream pathways all pull from the same intracellular pool.

NAD+ C₂₁H₂₇N₇O₁₄P₂
Mitochondrial ATP Cofactor for the electron transport chain
Sirtuin activation Substrate for SIRT1–7 deacetylases
PARP DNA repair Substrate for PARP-mediated genome maintenance
Circadian rhythm NAD+ oscillation drives the molecular clock
Redox balance NAD+/NADH governs cellular redox state
Cellular energy Substrate for 500+ enzymatic reactions

A century of biochemistry.

NAD+ has been studied since 1906. The longevity application is recent; the biochemistry is not.

50%

decline in NAD+ between ages 20 and 50 in tissue surveys

Zhu et al · 2015
500+

enzymatic reactions that use NAD+ as cofactor

Biochem review
7

sirtuins (SIRT1–7) activated by NAD+ availability

Guarente · 2014
Direct

intracellular delivery — sub-Q sidesteps oral absorption losses

Pharmacology

Built for the energy axis.

NAD+ is a foundation, not a feature. It belongs in nearly every longevity stack and stands alone for energy and cognitive concerns.

Cellular energy

The most-reported subjective effect: more usable energy.

Cognitive clarity

Brain mitochondrial output and focus.

DNA repair

PARP substrate availability.

Sirtuin activation

The longevity signaling pathway.

Athletic performance

Mitochondrial flexibility under load.

Metabolic support

Glucose and lipid handling improvement.

A sample protocol.

NAD+ is dosed in two phases: a daily loading phase then a maintenance schedule. Your physician sets the cadence.

Sample parameters

Illustrative
Route
Subcutaneous injection
Dose
50–100 mg
Frequency
1–2× per week
Cycle
Indefinite
Storage
Refrigerated, light-protected

Slow injection. Sub-Q NAD+ is dosed slowly to minimize transient flushing. Compounded fresh by a 503A pharmacy to USP 797 sterile standards.

The cadence

Your week Maintenance · 3× weekly
MAM
T
WAM
T
FAM
S
S
Your cycle 8 wk · continuous
1on
2on
3on
4on
5on
6on
7on
8on
Slow inject · ~5 min Site rotates: abdomen · thigh

In the box.

Compounded fresh, cold-chain shipped overnight from a U.S.-based 503A pharmacy. Everything you need to start the same week.

Compounded vials

Multi-dose vial · USP 797 sterile · beyond-use date printed.

Injection supplies

Insulin syringes, alcohol pads, bacteriostatic water for reconstitution.

Cold-pack shipping

Insulated overnight delivery with ice pack. Tracked door to door.

📖
Step-by-step guide

Reconstitution, dosing math, injection technique, sharps disposal.

Stacks that work.

NAD+ is the substrate. It pairs with anything that demands cellular energy — most longevity stacks layer it underneath.

Side effects, fine print, responsibility.

NAD+ is generally well tolerated. The most common report is transient flushing — manageable with slow administration.

What to expect

  • 01Transient flushing — warmth or pink skin during injection. Slow the rate to reduce.
  • 02Mild injection-site reactions — redness, light bruising at the rotation sites.
  • 03Subjective energy in 1–2 wk — the most common early effect during the loading phase.
  • 04Cognitive shifts in 4–8 wk — focus and clarity changes typically follow the energy change.
!

Not for

  • 01Pregnancy or breastfeeding. Insufficient safety data.
  • 02Active malignancy. Cellular metabolic stimulation requires oncologic oversight.
  • 03Severe renal or hepatic disease. Discuss clearance with your physician.
  • 04Use without oversight. Always under a licensed physician's supervision.

Compounded NAD+ is not an FDA-approved drug product. It is dispensed by a licensed 503A compounding pharmacy under a prescription written by a U.S.-licensed physician for individual investigational and off-label use under provider supervision. Statements on this page have not been evaluated by the FDA. Individual results vary.

Frequently asked.

What is NAD+?+

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in every cell. It is the cofactor for hundreds of enzymatic reactions, including mitochondrial ATP production, sirtuin activation, and PARP-mediated DNA repair.

Why does it decline with age?+

Synthesis slows and consumption rises. The result is a roughly 50% drop between ages 20 and 50 in surveyed tissues — the substrate for sirtuins, PARPs, and mitochondria becomes a bottleneck.

Why sub-Q instead of an oral precursor?+

Oral NMN and NR are precursors — a fraction is converted, the rest is lost to first-pass metabolism. Sub-Q NAD+ delivers the molecule itself, intact, into the intracellular pool.

What does the loading phase do?+

Refills depleted intracellular pools faster. After 2–4 weeks of daily dosing, the schedule drops to 3× weekly maintenance — enough to hold levels.

Can I stack it?+

Yes — NAD+ is foundational. Common pairings: Glutathione (redox foundation), Sermorelin (GH axis), MOTS-c (mitochondrial signaling). Your physician designs the stack.

Side effects?+

Transient flushing during injection is the most reported — slow administration helps. Mild injection-site reactions are common; serious adverse effects are not established in the literature.

Begin Ten minutes of intake

Begin your NAD+ protocol.

Free assessment. A board-certified U.S. physician on the prescription. Bloodwork only if your protocol calls for it. Compounded fresh and cold-chain shipped overnight.

Start your intake Free · No card required · Rx required to ship

Deeper guides on NAD+.

All guides →