NAD+
NAD+ is a coenzyme central to cellular metabolism, studied extensively in mitochondrial and aging research.
We have not published an audit on NAD+. Everything below is reference material, not our own reading of the literature, treat it as a starting point for questions, not as a grade.
How it is thought to work
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell. Your body uses it to turn food into cellular energy (ATP), to fuel DNA repair, and to power a family of longevity-related enzymes called sirtuins. [Source: Peptide Dosing Protocols]
NAD+ is a coenzyme your cells use to make energy, repair DNA, and activate longevity-related enzymes called sirtuins. Giving it by injection or as oral precursors (NMN or NR) is intended to raise NAD+ levels that decline with age.
Reported side effects
The most common side effects are injection-site stinging and temporary redness with SubQ use, and flushing, chest tightness, or a brief increase in heart rate with IV use, most of which are reduced by injecting slowly and starting at a lower dose.
Who should avoid it
People who are pregnant or breastfeeding, have active cancer, severe liver or kidney problems, known hypersensitivity to formulation components, or who take high-dose niacin or glucose-lowering medications should not use NAD+ injections without consulting a licensed clinician.
What gets monitored
Liver markers (ALT, AST) in extended high-dose protocols; glucose markers if also using glucose-lowering medications; sleep quality and timing; subjective energy and recovery from training. [Source: Peptide Dosing Protocols]
What sources report
These are figures published elsewhere, reproduced with their source. Peppersite does not recommend an amount for NAD+ or for anything else, and nothing below has been checked against the study it came from.
| Amount | Frequency | Route | Reported by |
|---|---|---|---|
| 250-750 mg per IV session; 300-1000 mg daily for oral precursors (NR/NMN) | 1-2x weekly IV (loading), monthly (maintenance); daily oral4-8 week loading phase IV; ongoing for oral precursors | oral | Peptide Protocol WikiWhat it saysHide(secondary reference; provider confirmation required). |
| Standard: 100 mg · Low: 50 mg · High: 200 mg | 2-3x weekly4-8 weeks · 4 weeks, then escalate to 100 mg weekly. | SubQ | Peptide Dosing ProtocolsWhat it saysHide(secondary reference; provider confirmation required). The standard dose for NAD+ is 100 mg administered 2-3 times weekly. |
- 1-2x weekly IV (loading), monthly (maintenance); daily oral4-8 week loading phase IV; ongoing for oral precursors
- oral
- Peptide Protocol Wiki
What it saysHide
(secondary reference; provider confirmation required).
- 2-3x weekly4-8 weeks · 4 weeks, then escalate to 100 mg weekly.
- SubQ
- Peptide Dosing Protocols
What it saysHide
(secondary reference; provider confirmation required). The standard dose for NAD+ is 100 mg administered 2-3 times weekly.
- Normal saline (0.9% NaCl) 250-500 mL for IV
- 7.5 mL BAC water for 750 mg vial
Common questions
Is NAD+ a peptide?
No. NAD+ is a coenzyme, not a peptide.
What is a typical starting dose of NAD+ injections?
A common research-planning SubQ start is 50 mg once weekly or three times weekly.
How do you reconstitute a 750 mg NAD+ vial?
The most common mix is 7.5 mL of bacteriostatic water for a 750 mg vial.
Check 750 mg in 7.5 mL in the calculator →How much NAD+ should you take daily?
Research-planning SubQ models commonly stay at 50-100 mg per injection 2-3x weekly.
What are NAD+ injection side effects?
Common reports include injection-site stinging, nausea, headache, flushing, and short-term fatigue.
Is NAD+ FDA-approved?
Injectable NAD+ is not FDA-approved as a therapeutic.
How long does NAD+ take to work?
IV NAD+ commonly produces noticeable acute effects within 24-48 hours.
What is the maximum dose of NAD+ studied?
Historical IV protocols used 500-1,000 mg per session.
Sources
- 01Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications (2018)
- 02Conze D, Brenner C, Kruger CL. Safety and Metabolism of Long-term Administration of NIAGEN in Healthy Overweight Adults. Scientific Reports (2019)
- 03Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science (2021)
- 04Yi L, Maier AB, Tao R, et al. The efficacy and safety of beta-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial. GeroScience (2023)
- 05Brakedal B, Dolle C, Riber F, et al. The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease. Cell Metabolism (2022)
- 06Dollerup OL, Christensen B, Svart M, et al. A randomized placebo-controlled clinical trial of nicotinamide riboside in obese men. American Journal of Clinical Nutrition (2018)
- 07Elhassan YS, Kluckova K, Fletcher RS, et al. Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD+ Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Reports (2019)
- 08Yoshino J, Baur JA, Imai SI. NAD+ Intermediates: The Biology and Therapeutic Potential of NMN and NR. Cell Metabolism (2018)
- 09Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology (2021)
- 10Trammell SAJ, Schmidt MS, Weidemann BJ, et al. Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nature Communications (2016)
- 11Braidy N, Liu Y. NAD+ therapy in age-related degenerative disorders: A benefit/risk analysis. Experimental Gerontology (2020)
- 12Hong W, Mo F, Zhang Z, et al. The Safety and Antiaging Effects of Nicotinamide Mononucleotide in Human Clinical Trials: an Update. Advances in Nutrition (2023)
- 13Evaluation of safety and effectiveness of NAD in different clinical conditions (systematic review). Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review. American Journal of Physiology - Endocrinology and Metabolism (2024)
- 14ClinicalTrials.gov NCT07328100 — Efficacy and Safety of Coenzyme I (NAD) for Injection on Vascular Aging. ClinicalTrials.gov (2026)
- 15Cleveland Clinic Health Library NAD (Nicotinamide Adenine Dinucleotide) — function, anatomy, conditions and disorders. Cleveland Clinic (2026)
The reference sections above are imported from our compound knowledge base, which classes the evidence for NAD+ as emerging. That classification is the knowledge base’s, not ours, our own grade appears only where an audit is linked above. Research use only; nothing here is medical advice or a protocol.
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