NAD+

Quickstart Highlights

NAD+ (nicotinamide adenine dinucleotide) is the central redox coenzyme of cellular energy metabolism and the substrate for sirtuin and PARP DNA-repair enzymes; it is a dinucleotide rather than a peptide, listed in peptide catalogs by convention. It is studied for cellular energy, fatigue, cognitive clarity and healthy aging, with human data drawn mostly from IV pilot studies and oral-precursor trials. This educational protocol presents the subcutaneous practitioner convention: 25–50 mg per injection for two ramp weeks, then up to 100 mg two to three times per week (100 mg is the per-injection ceiling; stay under roughly 300 mg per week in total), using a 5 mL reconstitution of the 1000 mg vial (200 mg/mL).

• Reconstitute: Add 5 mL bacteriostatic water → 200 mg/mL concentration.
• Dose range: 25–100 mg per injection, 2–3 times per week, subcutaneously (8–12 week course), titrating from 25–50 mg to 100 mg only if flushing and nausea are tolerable; stay under roughly 300 mg per week in total.
• Easy measuring: At 200 mg/mL, 1 unit = 0.01 mL = 2 mg on a U-100 insulin syringe.
• Storage: Lyophilized: freeze at −20 °C (−4 °F); after reconstitution, refrigerate at 2–8 °C (35.6–46.4 °F) and use within 28 days.
• Label: No approved injectable label exists. 100 mg (0.5 mL at 200 mg/mL) is the per-injection ceiling on this page, so keep each injection to 0.5 mL or less, and a reconstituted solution that stays cloudy should be discarded.

Protocol Overview

Concise summary of the two-to-three-times-weekly regimen.

• Goal: Raise cellular NAD+ availability to support mitochondrial energy production, sirtuin activity and DNA repair, bypassing gut degradation of the intact molecule.
• Schedule: Subcutaneous injections 2–3 times per week, in the morning, for 8–12 week courses; sources describe no strict off-period.
• Dose Range: 25–50 mg per injection in the two-week ramp, then 100 mg per injection from week 3 onward as the per-injection ceiling, 2–3 times per week; stay under roughly 300 mg per week in total (doses on this page are stated in mg; at 200 mg/mL, 1 unit = 2 mg, so mcg figures are not used).
• Reconstitution: 5 mL per 1000 mg vial (200 mg/mL) for accurate unit measurements on standard insulin syringes.
• Storage: Lyophilized frozen at −20 °C (−4 °F); reconstituted refrigerated at 2–8 °C (35.6–46.4 °F); use within 28 days; avoid repeated freeze–thaw cycles.
• Evidence: Human data are IV pilot studies and clinic practice plus randomized trials of oral precursors (NR, NMN); subcutaneous dosing is practitioner convention with no randomized trial. Confidence is medium: 50–100 mg 2–3 times per week is consistent across six of seven dosing sources, but none is evidence-based.

Dosing Protocol

Suggested two-to-three-times-weekly approach based on practitioner convention and IV pilot data; no controlled trial of subcutaneous NAD+ exists.

• Weeks 1–2 (ramp): 25–50 mg per injection (12.5–25 units, 0.125–0.25 mL), 2–3 times per week, to gauge flushing, nausea and injection-site stinging; 25 mg needs half-unit markings, so many start at 50 mg.
• Week 3 onward: 100 mg per injection (50 units, 0.5 mL), 2–3 times per week, the modal standard dose across sources and the per-injection ceiling on this page; step up only if the ramp dose was tolerable.
• Ceiling: 100 mg per injection is the maximum presented; stay under roughly 300 mg per week in total (for example 100 mg three times per week).
• Frequency: 2–3 times per week (subcutaneous); some sources use every other day.
• Timing: Morning; most sources report an energizing or wired effect that disturbs sleep when injected late in the day.
• Titration: Hold at 25–50 mg until flushing and nausea are tolerable, then move to 100 mg; back off a step for persistent nausea, flushing or insomnia.
• Cycle: 8–12 week courses; sources describe no strict off-period between courses.

Storage Instructions

Proper storage preserves product quality and efficacy.

• Lyophilized (powder): Store at −20 °C (−4 °F) protected from light and moisture; the powder is hygroscopic, so keep the vial sealed and dry. 2–8 °C (35.6–46.4 °F) refrigeration is acceptable for short-term storage.
• Reconstituted (solution): Refrigerate at 2–8 °C (35.6–46.4 °F) and do not freeze. Use within 28 days; sources range from 14 to 28 days, and compounding-pharmacy practice applies 28 days after first puncture.
• Allow vials to reach room temperature before opening to minimize condensation uptake.
• Dissolution and cloudiness: NAD+ dissolves slowly at 200 mg/mL; swirl, do not shake, and allow several minutes. A solution that stays cloudy or shows particles should be discarded.

Important Notes

Practical considerations for consistency and safety.

• Use new sterile insulin syringes for each injection; dispose in a proper sharps container.
• Rotate injection sites systematically (abdomen, thighs, upper arms) to reduce local irritation and avoid lipohypertrophy; NAD+ solution is acidic, so rotation matters more than with most peptides.
• Keep each injection at 100 mg or less: 100 mg (0.5 mL at 200 mg/mL) is the per-injection ceiling on this page; smaller volumes per site and slow injection limit stinging and local irritation.
• Stinging: A burning or stinging sensation for seconds to about 15 minutes is common because the solution is acidic; it is not a sign of contamination. Smaller volumes per site and slow injection reduce it.
• Route: The page presents subcutaneous injection, which sources report is better tolerated than intramuscular; IM is used by some clinics, and IV infusion is the route in the clinical literature. The dose table applies to the subcutaneous route.
• Regulatory status: Not an approved injectable drug in Canada or the US; available through compounding pharmacies in the US and research-use suppliers. Not approved by Health Canada or the FDA; research use only.
• Evidence caveat: No randomized trial of subcutaneous NAD+ exists; the human evidence most often cited is for oral precursors (for example, NR 1000 mg/day raised whole-blood NAD+ by about 60%) and does not transfer directly to injection.
• Not a peptide: NAD+ is a dinucleotide coenzyme; the 1000 mg vial is far larger than typical peptide vials, and the 5 mL reconstitution produces 200 mg/mL, so 1 unit on a U-100 syringe equals 2 mg.

How This Works

NAD+ is the central redox coenzyme for glycolysis, the TCA cycle and oxidative phosphorylation, cycling between NAD+ and NADH as it carries the electrons that drive ATP synthesis. It is also the obligatory substrate for the sirtuins (SIRT1–7), for PARP DNA-repair enzymes and for CD38 signaling, so cellular NAD+ availability sets the activity of pathways tied to metabolic regulation, genome maintenance and stress responses. Tissue NAD+ declines with age, and supplying the molecule directly is proposed to restore sirtuin and DNA-repair activity; injectable administration bypasses the gut degradation that limits the intact molecule when taken orally. Human evidence is thin: IV NAD+ has been studied in small pilot and clinic settings, while the only controlled human data are randomized trials of oral precursors such as NR and NMN, which raise blood NAD+ but do not establish an injectable dose. Subcutaneous dosing therefore rests on practitioner convention.

Potential Benefits & Side Effects

Observations from clinic practice, IV pilot work and oral-precursor trials; all investigational for the injectable route.

Potential Benefits:

• Support for cellular energy and mitochondrial function, with reduced fatigue reported in clinic practice and community accounts.
• Sirtuin- and PARP-mediated DNA-repair support, based on biochemical mechanism and animal data.
• Cognitive clarity and neuroprotection, investigational and drawn mainly from IV protocols.
• Healthy aging and metabolic support, investigational; oral-precursor RCTs show whole-blood NAD+ can be raised by about 60%.
• Exercise performance and recovery, a community claim without controlled data.

Potential Side Effects:

• Injection-site stinging or burning for seconds to about 15 minutes because the solution is acidic; redness and tenderness.
• Flushing, nausea, headache, dizziness and chest pressure, which are dose- and rate-dependent and reported mainly with IV infusion; systemic flushing is less common subcutaneously.
• Fatigue or lightheadedness after a dose.
• Insomnia or feeling wired when injected late in the day.
• No long-term human outcome data; the injectable is not licensed by the FDA, Health Canada or the MHRA.

Lifestyle Factors

Complementary strategies for energy and metabolic goals.

• Inject in the morning and keep a consistent sleep schedule; late-day dosing is the most common cause of insomnia in sources.
• Combine with regular aerobic and resistance exercise, the lifestyle inputs most tied to mitochondrial health.
• Prioritize 7–9 hours of sleep and manage stress; energy and clarity outcomes are hard to judge against poor sleep.
• Stay well hydrated on injection days.
• Some sources bridge with oral precursors (NR or NMN) between 8–12 week injectable courses.
• Track energy, sleep and injection-site tolerance in a simple log so that the step from 25–50 mg to 100 mg is made on evidence rather than habit.

Injection Technique

General subcutaneous injection guidance from clinical best-practice resources.

• Clean the vial stopper and chosen skin site with separate alcohol swabs; allow both to dry completely before proceeding.
• Pinch a fold of skin between your fingers; insert the needle at a 45–90° angle into the subcutaneous tissue (fatty layer, not muscle). IM alternative: some clinics give NAD+ intramuscularly into the deltoid or upper outer gluteal muscle with a longer needle at 90°; sources report the subcutaneous route is better tolerated, so this page presents it as the primary route and the dose table is unchanged.
• Do not aspirate (pull back the plunger) when giving a subcutaneous injection.
• Inject the solution slowly and steadily; NAD+ is acidic and a brief sting lasting seconds to a few minutes is common and not a sign of contamination. Wait at least 6 seconds after injection before withdrawing the needle to ensure complete delivery and minimize leakage.
• Volume per site: keep each injection to 0.5 mL (100 mg) or less at 200 mg/mL; 100 mg is the per-injection ceiling on this page.
• Withdraw the needle and apply light pressure with a clean swab; avoid rubbing vigorously. Rotate injection sites systematically (abdomen, thighs, upper arms) to prevent lipohypertrophy and maintain consistent absorption.
• Dispose of used syringes and needles immediately in a proper sharps container.

Recommended Source

We recommend Amino Labs for high-purity NAD+ (1000 mg vials).

Note: Product availability and specifications subject to change. Verify current product details on supplier website.

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