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Supplement

NAD+

NAD+ is a coenzyme central to cellular metabolism, studied extensively in mitochondrial and aging research.

Researched for
LongevityMetabolic HealthCognitive SupportRecovery
Not yet audited

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

Reference, not a recommendation

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.

250-750 mg per IV session; 300-1000 mg daily for oral precursors (NR/NMN)
Frequency
1-2x weekly IV (loading), monthly (maintenance); daily oral4-8 week loading phase IV; ongoing for oral precursors
Route
oral
Reported by
Peptide Protocol Wiki
What it says(secondary reference; provider confirmation required).
Standard: 100 mg · Low: 50 mg · High: 200 mg
Frequency
2-3x weekly4-8 weeks · 4 weeks, then escalate to 100 mg weekly.
Route
SubQ
Reported by
Peptide Dosing Protocols
What it says(secondary reference; provider confirmation required). The standard dose for NAD+ is 100 mg administered 2-3 times weekly.
Reconstitution, as reported
  • 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

  1. 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)
  2. 02Conze D, Brenner C, Kruger CL. Safety and Metabolism of Long-term Administration of NIAGEN in Healthy Overweight Adults. Scientific Reports (2019)
  3. 03Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science (2021)
  4. 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)
  5. 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)
  6. 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)
  7. 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)
  8. 08Yoshino J, Baur JA, Imai SI. NAD+ Intermediates: The Biology and Therapeutic Potential of NMN and NR. Cell Metabolism (2018)
  9. 09Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology (2021)
  10. 10Trammell SAJ, Schmidt MS, Weidemann BJ, et al. Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nature Communications (2016)
  11. 11Braidy N, Liu Y. NAD+ therapy in age-related degenerative disorders: A benefit/risk analysis. Experimental Gerontology (2020)
  12. 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)
  13. 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)
  14. 14ClinicalTrials.gov NCT07328100 — Efficacy and Safety of Coenzyme I (NAD) for Injection on Vascular Aging. ClinicalTrials.gov (2026)
  15. 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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