NAD+
Dosage Protocol
Nicotinamide adenine dinucleotide (NAD+) is a coenzyme present in all living cells and central to cellular energy metabolism, DNA repair, and mitochondrial function. NAD+ levels decline significantly with age. Injectable NAD+ has been studied in the context of sirtuin activation, cognitive function, metabolic health, and longevity research. This guide covers reconstitution, dosing, administration routes, and safety considerations.
What is NAD+?
NAD+ (nicotinamide adenine dinucleotide) is a dinucleotide coenzyme found in every cell of the human body. It plays a central role in redox reactions powering the electron transport chain and ATP synthesis, and serves as a required cofactor for sirtuins (SIRT1–7) — the longevity-associated deacylases linked to caloric restriction and lifespan extension in animal models.
NAD+ levels decline approximately 50% between age 20 and 50, a trajectory associated with mitochondrial dysfunction, increased DNA damage, and metabolic decline. Research has explored whether restoring NAD+ levels via direct injection (bypassing gut absorption) can recapitulate benefits observed in preclinical studies. While oral precursors (NMN, NR) are widely available, injectable NAD+ provides more direct tissue delivery with faster onset — with onset characteristics studied in early clinical investigations.
Dosing Schedule
Parameters documented in published preclinical and clinical research.
| Protocol | Dose | Frequency | Route | Notes |
|---|---|---|---|---|
| Conservative start | 100–250 mg | Once daily | IV slow push / IM | Begin low to assess flush response. IV onset is rapid; dilute in 100 mL saline and push over 1–2 hrs. |
| Standard | 250–500 mg | Daily or 2–3×/week | IV / IM / SubQ | Most commonly reported research dose range. IM and SubQ offer comparable bioavailability with easier administration. |
| High dose | 500–1000 mg | Daily (loading phase) | IV (diluted) | Used in some clinical NAD+ infusion protocols. Must be diluted and administered slowly to minimise side effects. |
| Maintenance | 100–250 mg | 2–3×/week | IM / SubQ | After initial loading, lower frequency maintenance is sufficient for most research purposes. |
Safety & Side Effects
Academic References
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[1]
Yoshino J, et al. (2018). NAD+ Intermediates: The Biology and Therapeutic Potential of NMN and NR. Cell Metab. 27(3):513–528. PubMed ↗
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[2]
Verdin E. (2015). NAD+ in aging, metabolism, and neurodegeneration. Science. 350(6265):1208–13. PubMed ↗
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[3]
Rajman L, et al. (2018). Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence. Cell Metab. 27(3):529–547. PubMed ↗
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[4]
Lautrup S, et al. (2019). NAD+ in Brain Aging and Neurodegenerative Disorders. Cell Metab. 30(4):630–655. PubMed ↗