Anti-Aging
NAD+
The central coenzyme of cellular energy production, decline of which tracks with nearly every hallmark of ageing.
- Half-life
- Free NAD+ in plasma: minutes; the intracellular effect on pools persists for days, which is why intermittent dosing is standard.
- Route
- Subcutaneous, intramuscular, intravenous infusion
- Storage
- Lyophilised: refrigerated and protected from light. Reconstituted: 2–8 °C, use within 30 days.
Overview
NAD+ (nicotinamide adenine dinucleotide) is not a peptide but an essential coenzyme found in every cell. It shuttles electrons in mitochondrial respiration, fuels the sirtuin longevity enzymes, powers PARP-mediated DNA repair and supports immune-cell signalling. Intracellular NAD+ levels fall by roughly 50% between youth and later life, which is why NAD+ restoration has become one of the most actively researched longevity interventions.
Mechanism of action
NAD+ accepts electrons in glycolysis, the TCA cycle and oxidative phosphorylation, directly driving ATP synthesis. It is the obligate cosubstrate for sirtuins (SIRT1–7), which regulate mitochondrial biogenesis, inflammation and stress resistance, and for PARP enzymes that repair DNA strand breaks. Replenishing NAD+ restores these activities; precursor strategies (NMN, NR) and direct administration both converge on the same pool.
Evidence base
Human trials of oral precursors (NMN, nicotinamide riboside) reliably raise blood NAD+ levels and have shown improvements in insulin sensitivity, vascular function (brachial artery studies), physical performance in older adults and aerobic capacity in amateur runners. Direct NAD+ infusion studies show measurable effects on fatigue and cognition but remain small. Large outcome trials are still pending.
Typical dosing
Research protocols commonly cite 50–100 mg subcutaneously 2–3 times weekly in 8–12 week cycles, or 500–1000 mg intravenous infusion over 2–4 hours weekly for 4–8 weeks. Intravenous NAD+ is frequently uncomfortable (chest tightness, flushing, cramping) and must be given slowly. Oral precursors run 250–1000 mg daily as an alternative. Open the dose calculator →
Safety & contraindications
Generally well tolerated. Subcutaneous injection site reactions and flushing are the most common complaints; IV administration causes nausea, abdominal cramping and blood-pressure dips when pushed too fast. Theoretical concern exists that sustained NAD+ elevation could support existing tumour growth — anyone with an active or recent cancer history should not use NAD+ therapy without oncology input.
Common stacks
Frequently combined with resveratrol or other sirtuin activators, methylation support (methyl-B12, trimethylglycine) to offset nicotinamide clearance, and MOTS-c or SS-31 for mitochondrial protocols.
Featured in protocols
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Educational reference only. Nothing on this page is medical advice, a prescription, or an offer to sell. Discuss any peptide therapy with a qualified clinician who can evaluate your history and monitoring needs.