NAD+
Nicotinamide adenine dinucleotide · NAD
NAD+ is not a peptide and not a drug. It is a coenzyme your cells already make and use constantly, central to how they convert food into usable energy and to the activity of several repair enzymes. Cellular NAD+ declines with age, and the reasoning behind supplementing it is that restoring the decline might restore some of what declines with it.
The reasoning is plausible and the delivery is the problem. NAD+ is a large — charged molecule that does not readily cross cell membranes — so injecting it does not straightforwardly raise the level inside cells where it matters. Most serious research in this area uses precursors instead: nicotinamide riboside and nicotinamide mononucleotide, both of which cells can take up and convert. Very little of it uses NAD+ itself.
It is included here because it is widely sold and injected in this community. What is thin is evidence that the injected form does what people want it to.
How it works
NAD+ shuttles electrons in the reactions that turn food into ATP, and it is consumed as a substrate by sirtuins and PARPs, enzyme families involved in DNA repair and in regulating gene expression. When NAD+ is scarce, those enzymes work less.
Whether raising blood NAD+ raises intracellular NAD+ is the unresolved question, and it is the one that matters. Current understanding is that NAD+ is largely broken down to precursors before entering cells, which means an injection may be an inefficient way of delivering the precursors that oral supplements provide directly.
Regulatory status — United States
Not approved as a medicine for any indication in the United States. Oral precursors are sold as dietary supplements; injectable NAD+ is compounded or sold as a research chemical and has no approval behind it.
Last reviewed 12 Aug 2026. Regulatory positions in this category change frequently; we date this line so you can see how current it is.
What it is studied for
Each entry states the evidence behind it. We do not rank indications by effectiveness — for most compounds here, that would be a claim nobody can support.
Age-related NAD+ decline
Published reviewThe rationale most often given.
EvidenceThe decline itself is well documented. That restoring it via injection produces a clinical benefit is not established.
Energy and cognition
Community practiceCommonly reported subjectively after infusions.
EvidenceNo controlled trial supports it. Infusions are long, expensive and highly noticeable. That is close to ideal conditions for a placebo response.
Identity and clearance
Molecule
- Class
- Dinucleotide coenzyme — not a peptide
- Molecular weight
- 663.43 Da
Large and charged. That is precisely why cellular uptake is the sticking point.
Pharmacokinetics
Published reviewCleared rapidly from plasma, largely by breakdown to precursors. Infusions are given slowly over hours partly for this reason and partly because rapid administration is poorly tolerated.
Dose protocols reported in sources
Displayed for reference only. Every row says where it came from, and a trial protocol and a community convention are not the same kind of information. None of this is fed into the calculator, and none of it is a recommendation.
| Goal | Dose | Frequency | Route | Units, 500 mg vial | Source | Start this protocol |
|---|---|---|---|---|---|---|
| Subcutaneous, commonly described | 50 mg – 100 mg | Daily to a few times weekly | SubcutaneousInjection site stinging is very commonly reported and is the usual reason people stop. | 10–20 u | Community practice | Start this |
| Intravenous infusion, as offered by clinics | 250 mg – 1000 mg | Weekly or less often, over several hours | IntramuscularGiven intravenously in practice, slowly. Rapid administration causes chest tightness, nausea and flushing. | from 50 u | Community practice | Start this |
Start this copies a row into a protocol of your own, which you can then edit. Where a source gave a dose range or an ambiguous frequency, those fields arrive empty — we will not pick a number on your behalf.
CheckRows marked community practice describe what people commonly do, drawn from public discussion. They are not derived from any trial and are not evidence that a dose is safe or effective.
Calculator
Work out what to draw
Pre-filled with a 500 mg vial as a worked example. These are not recommended values — change them to match the vial in front of you.
Draw to 50 units on a 1 mL U-100 syringe. That is 0.5 mL, containing 50 mg of NAD+.
Check500 mg in 5 mL is unusually concentrated. Double-check the vial label and the amount of water you added.
Bioalmanac performs arithmetic on values you enter. It does not recommend doses, schedules or compounds, and nothing here is medical advice. Confirm every calculation against your vial and syringe before drawing, and speak with a licensed healthcare provider.
Open this calculation in the full calculator
Units, concentration, bacteriostatic water — the glossary defines the vocabulary, and a unit is not a fixed volume.
Safety
Reported effects
- Injection site stinging or burningCommunity practice
Very commonly reported
Reported more consistently than for almost anything else in this category, and the usual reason people abandon subcutaneous use.
- Chest tightness, nausea and flushing during infusionCommunity practice
Common with intravenous administration
Strongly rate-dependent. This is why clinic infusions run over hours rather than minutes.
- Headache and fatigue afterwardsCommunity practice
Occasionally reported
- Long-term effectsCommunity practice
Unknown
No long-term safety data for injected NAD+ at these doses.
When to stop
- Chest tightness or pain that does not settle when an infusion is slowed or stopped. Seek urgent care.
- Any allergic response: rash, hives, facial swelling or difficulty breathing. Seek urgent care.
- Injection site reactions that worsen with each dose or leave lasting hardness.
- Persistent nausea, palpitations or lightheadedness after dosing.
Interactions and situations that need care
- Active or previous cancerUse caution
NAD+ is a substrate for PARP enzymes involved in DNA repair, and DNA repair cuts both ways in cancer. It protects healthy cells, and it can help damaged ones survive. This has not been studied in people with cancer, in either direction.
- Pregnancy and breastfeedingAvoid
No reproductive or developmental safety data for injected use.
- Cardiac arrhythmiaUse caution
Palpitations and chest tightness during infusion are commonly reported. In someone with an existing arrhythmia that is a poor combination and warrants medical supervision rather than self-administration.
What to expect
HonestlyThere is no human efficacy data for this compound, so there is no evidence-based timeline to give. Any site publishing a week-by-week schedule of expected effects has invented it.
- There is no controlled evidence that injected NAD+ produces a clinical benefit, so there is no honest timeline to give.
- Injection site stinging is the most consistently reported experience, and it is often described as severe.
- Research into raising cellular NAD+ mostly uses oral precursors rather than NAD+ itself, because uptake of the intact molecule is the unsolved problem.
- Long, expensive, physically noticeable infusions are close to ideal conditions for a placebo effect, which is worth holding in mind when reading testimonials.
Storage and handling
- Freeze-dried powder
- Refrigerated at 2–8 °C, protected from light.
- After mixing
- Refrigerated at 2–8 °C. Do not freeze once mixed.
- Long-term, frozen
- Unopened powder is stable at −20 °C or colder.
With other peptides
- 5-Amino-1MQcaution
Both target the same pathway from opposite ends. One supplies NAD+ precursor; the other blocks the enzyme that depletes it. Combining them is not obviously additive, has never been studied in any species, and doubles down on a mechanism with no human outcome data behind it.
In use
Stacks with NAD+ in them
Documented combinations, with full schedules.
Checking your vial
Research chemicals carry no manufacturing standard, so what the vial looks like is often the only quality signal available before you use it. More on assessing quality and COAs.
White to off-white powder, clear solution
Some batches mix to a very faint yellow, which is not itself a fault.
Deep yellow or brown solution
Marked discolouration suggests degradation.
Questions
- Is NAD+ a peptide?
- No. It is a dinucleotide coenzyme your cells already make. It appears alongside peptides because it is sold and injected in the same communities.
- Why do people say injections sting so much?
- Injection site stinging is the single most consistently reported effect, and it is often described as severe rather than mild. It is the usual reason people move to infusions or stop.
- Is injecting it better than taking a precursor orally?
- Not established, and there is a mechanistic argument the other way. NAD+ is large and charged and does not readily enter cells intact; precursors are what cells actually take up and convert. Most serious research uses precursors for that reason.
References
NAD+ metabolism and its roles in cellular processes during ageing
Nature Reviews Molecular Cell Biology, 2021 · Review
Humans and animal models
Reviews the decline of cellular NAD+ with age, its role as a substrate for sirtuins and PARPs, and the pharmacological difficulty of raising intracellular levels.
10.1038/s41580-020-00313-x
Commonly reported community protocols
Bioalmanac editorial summary of public community sources, 2026 · Not a study
Summarises subcutaneous and infusion dose ranges described in public discussion and by clinics. Carries no evidential weight about safety or effect.
NAD+ compared with
Related compounds
5-Amino-1MQ
An oral NNMT inhibitor with striking results in obese mice and no human data whatsoever. Not a peptide, despite where it is sold.
GHK-Cu
A naturally occurring copper-binding tripeptide with a long history in topical skincare research. Injected use is not what the research studied.
Ipamorelin
A selective growth hormone secretagogue that prompts a short pulse of GH release. Widely used, and supported almost entirely by early pharmacology rather than outcome trials.
CJC-1295
A GHRH analogue that raises growth hormone by amplifying the body's own release signal. Sold in two forms whose durations differ by two orders of magnitude.
Next
What to do with NAD+
- Keep a record of itTurn a dose and a schedule into a protocol, then log what you actually take. NAD+ is filled in for you.
- See what it costsPer-milligram prices read from vendor sites and confirmed by a person, so vial sizes compare.
- Check a combinationWhat our profiles record about NAD+ alongside each other compound — including the pairs where nothing is recorded.
Keep this page honest
If something here is wrong, out of date, or missing a source, tell us and we will fix it and say that we did.
This page is educational. It describes what published research reports, not what you should do. Peptides discussed here are largely not approved for human use, and nothing on Bioalmanac is medical advice. No clinician reviews these pages.
Page last updated 12 Aug 2026