NAD+
Also called Nicotinamide adenine dinucleotide; related precursors NR and NMN
NAD+ is not a peptide; it is a coenzyme every cell uses for energy reactions. Some interventions raise NAD-related markers, but that has not been shown to reverse aging or reliably improve energy or memory.
Overview
What it is
A coenzyme the body makes from vitamin B3 forms and tryptophan. NAD+ itself, NADH, nicotinamide riboside (NR) and NMN are different substances with separate evidence.
How it works
NAD+ accepts electrons and becomes NADH, helping cells turn food into usable energy. It is also used in cell signaling and DNA repair.
What the research shows
A small 6-hour IV infusion study tracked NAD+ metabolites in blood and urine. An NR trial in middle-aged and older adults raised NAD+ levels. An NMN study improved muscle insulin sensitivity in women with prediabetes. A 24-week NMN trial (Sept 2026) raised NAD markers but did not improve its main clinical outcome.
Studied for
- NAD metabolism after IV infusionpilot
- NR supplementation in older adults
- NMN and muscle insulin sensitivity
- NMN 24-week trialprimary outcome not met
Safety and regulatory status
Safety and side effects
The FDA has received reports of severe chills, shaking, vomiting and fatigue after NAD+ injections, consistent with endotoxin contamination from ingredients unsuitable for sterile use. These are not a "detox" reaction; seek care for severe symptoms.
Regulatory status
Not an FDA-approved drug. FDA has warned compounders about ingredients unsuitable for sterile NAD+ preparations.
Mixing and dosing reference
Reference information only. Read before using this section.
NAD+ (1000 mg Vial) Dosage Protocol
- Vial
- 1000 mg NAD+
- Add diluent
- 3 mL
- Concentration
- 333.33 mg/mL
- 1 unit (U-100)
- 3.33 mg in 0.01 mL
- Route
- Subcutaneous
Community-Reported Use
| Week / Phase | Amount per Administration | U-100 Units (mL) | Frequency |
|---|---|---|---|
| Week 1 | 50 mg | 15 units (0.15 mL) | Once daily |
| Week 2 | 75 mg | 22.5 units (0.225 mL) | Once daily |
| Weeks 3–8 | 100 mg | 30 units (0.30 mL) | Once daily |
| Weeks 9–12 | 100 mg | 30 units (0.30 mL) | Once daily |
| Weeks 13–16 | 100 mg | 30 units (0.30 mL) | Once daily |
How to mix
- Clean the vial stopper with an alcohol swab and gather sterile supplies.
- Add 3 mL bacteriostatic water slowly down the inside wall of the vial.
- Gently swirl or roll until fully dissolved. Do not shake.
- Label the vial 333.33 mg/mL with the preparation date and keep it refrigerated.
Protocol source: PeptideDosages.com
Common questions
Is NAD+ a peptide?
No. It is a coenzyme.
Does a higher NAD level mean better health?
Not necessarily. Trials show markers can rise without clinical benefit.
Are NR and NMN the same as NAD+?
No. They are precursors with their own evidence.
Related in Energy and Wellness
Sources and further reading (7)
- NIH ODS. Niacin fact sheet.
- Grant R, et al. NAD+ metabolites during six-hour IV infusion. Front Aging Neurosci, 2019.
- Martens CR, et al. Nicotinamide riboside in middle-aged and older adults. Nat Commun, 2018.
- Yoshino M, et al. NMN and muscle insulin sensitivity in women. Science, 2021.
- Igarashi M, et al. 24-week NMN randomized trial. npj Aging, 2026.
- FDA. Ingredients suitable for sterile compounding (NAD+ notice).
- Source summary: PeptideDosages.com research overview (rewritten for NVO).
Laboratory research material: NAD+ Research Use Only