NAD+
Also known as: Nicotinamide Adenine Dinucleotide, NAD, NAD+ Precursor, NMN, NR
NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme found in all living cells that declines dramatically with age. It is critical for energy metabolism, DNA repair, and sirtuin activation. IV and subcutaneous NAD+ supplementation is used in anti-aging protocols and addiction recovery programs.
Half-Life
Varies by route; IV provides direct cellular delivery
Route
IV, SubQ, Oral
Category
Anti-Aging & Longevity
Studies
50 references
Key Benefits
- Restored cellular energy production (ATP)
- Sirtuin activation for longevity and metabolic regulation
- Enhanced DNA repair capacity
- Improved mitochondrial function and biogenesis
- Cognitive clarity and mental energy
- Reduced inflammation
- Addiction withdrawal support (opioids, alcohol, benzodiazepines)
- Improved sleep quality
- Enhanced athletic endurance
Mechanism of Action
NAD+ is an essential coenzyme in hundreds of metabolic reactions, serving as an electron carrier in cellular respiration. It activates sirtuins (SIRT1-7) — longevity enzymes that regulate gene expression, DNA repair, and mitochondrial function. NAD+ also activates PARP enzymes for DNA damage repair and CD38/ADPRC for cell signaling. Levels decline ~50% between age 40 and 60, contributing to metabolic dysfunction, reduced energy, and impaired DNA repair. IV administration bypasses gut absorption limitations.
Dosing Protocols
IV Protocol (Clinical)
- Dose
- 500–1000 mg
- Frequency
- Daily for 4–10 days (loading), then monthly maintenance
- Timing
- Administered slowly over 2–4 hours IV
- Cycle
- Loading: 4–10 consecutive days. Maintenance: monthly or quarterly infusions.
IV administration requires clinical setting. Infusion must be slow (rushing causes chest tightness, nausea). 500 mg/day starting dose; increase to 1000 mg as tolerated. Dramatically more bioavailable than oral.
Subcutaneous Protocol
- Dose
- 25–100 mg
- Frequency
- Daily or several times per week
- Timing
- Any time
- Cycle
- Ongoing
SC injection is a practical alternative to IV. More bioavailable than oral NMN/NR. Stinging at injection site common.
Oral Precursors (NMN / NR)
- Dose
- 250–1000 mg NMN or 300–600 mg NR
- Frequency
- Once daily
- Timing
- Morning with or without food
- Cycle
- Ongoing
NMN and NR are NAD+ precursors. Less bioavailable than direct IV/SC but practical for daily maintenance. Sublingual NMN improves absorption.
Calculate your draw volume
Enter your vial size and BAC water to get exact injection volumes
Side Effects
- Flushing and warmth during IV infusion
- Nausea during rapid IV administration
- Chest tightness (from rapid infusion — slow the rate)
- Injection site irritation (subcutaneous)
- Headache
Contraindications
Active cancer (NAD+ supports DNA repair which may benefit cancer cells — theoretical concern). Pregnancy or breastfeeding (insufficient data).
Storage
IV solution: refrigerate, protect from light, use immediately after preparation. Lyophilized: store at −20°C. Oral capsules: room temperature away from heat and moisture.
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Clinical Research
- 1.Perceptions of assisted reproductive technologies in wildlife conservation: Public expectations and ethical implications across three EU countries
Biasetti P, Hildebrandt T, Seet S, Stejskal J, Giardullo P, Göritz F et al. · PloS one · 2026PubMed Verified
- 2.Fluence-Dependent Changes in Surface Wettability and Conductivity of Ion-Irradiated Carbon-Based Foils
Mikšová R, Malinský P, Štěpanovská E, Novák J, Aubrecht P, Mazánek V et al. · Polymers · 2026PubMed Verified
- 3.Micro- and Nanoplastics and Human Health: Role of Food Nutrients Targeting Nfe2l2 Gene in Diabetes
Scuto MC, Lombardo C, Musso N, Bonacci PG, Lupo G, Anfuso CD et al. · Nutrients · 2026ReviewPubMed Verified
- 4.Nitrogen Adsorption Measurement for Pore Structure Characterisation of Cement-Oil Shale Ash Composite Exposed to an Aggressive Salt Environment
Kalpokaitė-Dičkuvienė R · Materials (Basel, Switzerland) · 2026PubMed Verified
- 5.Possible Involvement of NAMPT in the Anti-Obesity Effect of Oral Administration of Fermented Rice with Lactobacillus kefiranofaciens (Rice Kefiran) in C57BL/6J Mice
Ben Othman M, Sakamoto K · International journal of molecular sciences · 2026PubMed Verified
- 6.Yeast as a Platform to Dissect Poly(ADP-Ribose) Polymerase Function from Magnaporthe oryzae and Evaluate PARP Inhibitors
Kalicharan RE, Payne N, Fernandez J · International journal of molecular sciences · 2026PubMed Verified
- 7.Metabolic Overdrive in Elite Sport: A Systems Model of AMPK-mTOR Oscillation, NAD(+) Economy, and Epigenetic Drift
Mănescu DC, Plăstoi CD, Petre RL, Mărgărit IR, Mănescu AM, Pîrvan A · International journal of molecular sciences · 2026ReviewPubMed Verified
- 8.Metabolite Profiling of Leaves of Irises and Cinquefoils of Hydrophytic and Mesophytic Nature
Vanisov SA, Smirnov PD, Puzanskiy RK, Butorlin OS, Shavarda AL, Shishova MF et al. · International journal of molecular sciences · 2026PubMed Verified
- 9.SIRT1 rs7069102 Polymorphism Confers Increased Risk of Diabetic Retinopathy in T2DM
Bešić M, Letonja J, Globočnik Petrovič M, Peterlin A, Šuligoj E, Stare S et al. · Genes · 2026PubMed Verified
- 10.Gender-Specific Gene Regulation of Ferroptosis in Non-Utilized Liver Donors
Nazzal H, Caliskan HK, Unes M, Manithody C, Onishi S, Rajalakshmi P et al. · Genes · 2026PubMed Verified
- 11.The Citric Acid Cycle Modulates Neurologic Health and Is a Therapeutic Target of Dietary and Genetic Modification in Metabolic Disease
Fogle KJ, Lindley SK, Satterfield SL, Amsalu BA, Figura JR, Eicher SL et al. · Genes · 2026PubMed Verified
- 12.Cornus officinalis Fruit Extract as an AMPK-Associated Mitochondrial Bioenergetic Modulator in Skin Aging Models
Ye R, Wang Q, Du L, Li L, Hu F · Biomedicines · 2026PubMed Verified
- 13.Receptor-Mitochondria Crosstalk in the Kynurenine Metabolic Pathway: Integrating Metabolomics and Clinical Mass Spectrometry
Juhász L, Galla Z, Tanaka M, Vécsei L · Antioxidants (Basel, Switzerland) · 2026ReviewPubMed Verified
- 14.Metabolomics of Multiple System Atrophy Patient-Derived Striatal Medium Spiny Neurons
Smandzich NJ, Bähre H, Gschwendtberger T, Greten S, Ye L, Klietz M et al. · Biomolecules · 2026PubMed Verified
- 15.Programmed cell death and risk of diabetic retinopathy: a Mendelian randomization study
Chen Y, Xu H, Wei H, Zhao R, Tan Y, Lin H et al. · Journal of translational medicine · 2026PubMed Verified
- 16.Navigating the complexities of ferroptosis in pancreatic ductal adenocarcinoma: roles, mechanisms and potential applications
Xiao Y, Wang W, Wang G, Liu Y, Gong J · Cell death discovery · 2026ReviewPubMed Verified
- 17.Responsible use of large language models in manuscript authorship, peer review, and editorial processes: a Delphi consensus among editors-in-chief of anaesthesia and pain medicine journals (RULE-AP)
De Cassai A, Dost B, Augoustides JG, Azamfirei L, Alanoğlu Z, Azi LM et al. · British journal of anaesthesia · 2026PubMed Verified
- 18.Vitamin B2 and B3 nutrigenomics reveals a therapy for NAXD disease
Garg A, Blume SY, Huynh H, Barrios AM, Karabulut OO, Zhao Q et al. · Cell · 2026PubMed Verified
- 19.SIRT1 mediates brain metabolic and developmental consequences of methionine synthase deficiency in inborn errors of cobalamin metabolism
Matmat K, Hassan Z, Pourié G, Atlasi Y, Seal SV, Jeandel M et al. · Cell reports. Medicine · 2026PubMed Verified
- 20.CD38 expression by neonatal human naïve CD4+ T cells shapes their distinct metabolic and tolerogenic properties
Dwyer LR, DeRogatis AM, Clancy S, Gouirand V, Chien C, Rogers EE et al. · The Journal of clinical investigation · 2026PubMed Verified
- 21.Mitochondrial Resilience in Glaucoma: Targeting NAD(+) Metabolism and Oxidative Stress in Retinal Ganglion Cell Degeneration with Nicotinamide Riboside and Berberine: Preliminary Clinical Evidence
Visalli F, Cappellani F, Gagliano G, Spinello A, Avitabile A, Cannizzaro L et al. · Diseases (Basel, Switzerland) · 2026PubMed Verified
- 22.Overcoming Clopidogrel Resistance in Carotid Artery Stenting: Experience with Ticagrelor and Ticlopidine
Vigláš P, Raupach J, Hejčl A, Černík D, Bradáčová P, Matras P et al. · Clinics and practice · 2026PubMed Verified
- 23.Shifting metabolism alters rRNA expression in malaria parasites
Hadjimichael E, Deitsch KW · Trends in parasitology · 2026PubMed Verified
- 24.Mitochondrial reverse electron transport regulates glioma stemness through Sirt3-HIF1α-SOX2 signaling
Khaket TP, Rimal S, Chavda V, Lu B · Cancer letters · 2026PubMed Verified
- 25.O-GlcNAc transferase orchestrates oocyte maturation by modulating the activity of mitochondrial respiratory chain complex I
Ding Z, Wu C, Li X, Xu Y, Su X, Ou H et al. · Free radical biology & medicine · 2026PubMed Verified
- 26.Sodium pentaborate pentahydrate ameliorates inflammaging-like phenotypes by modulating redox status in a D-galactose-induced accelerated aging rat model
Bayraktaroglu SB, Tasli PN, Can B, Özkan F, Temizkan İ, Bayraktar E et al. · Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) · 2026PubMed Verified
- 27.Reconstruction of the lifeways of Central European Late Bronze Age communities using ancient DNA, isotope and osteoarchaeological analyses
Orfanou E, Ghalichi A, Rohrlach AB, Paust E, Andrades Valtueña A, Ernée M et al. · Nature communications · 2026PubMed Verified
- 28.Axonal protection by nicotinamide riboside with the SIRT1-AMPK pathway in TNF-induced optic nerve damage
Kitaoka Y, Tsukahara C, Fujita N, Arizono I, Otsubo M, Sase K · Molecular biology reports · 2026PubMed Verified
- 29.SIRT1 Prevents Ferroptosis in Corneal Epithelial Cells by Enhancing HIF1α Protein Stability in Dry Eye Disease
Lian L, Le Z, Ye X, Wang Z, Li J, Dong C et al. · Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026PubMed Verified
- 30.NQO1-Mediated Oxidative Stress Resistance and Tumor Microenvironment Remodeling in Glioblastoma
Li Y, Kang T, Jia Z, Lu C, Cui G, Song K et al. · Neuro-oncology · 2026PubMed Verified
- 31.Progressive encephalopathy associated with novel compound heterozygous NAXE mutations in a Chinese patient: case report and literature review
Zhu Y, He P, Luo R, Chen X · Frontiers in pediatrics · 2026Case ReportPubMed Verified
- 32.Repeated Disuse Atrophy Imprints a Molecular Memory in Skeletal Muscle: Transcriptional Resilience in Young Adults and Susceptibility in Aged Muscle
Turner DC, Raastad T, Ullrich M, Christiansen SF, Sutherland H, Boot J et al. · Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026PubMed Verified
- 33.Unveiling the influence of salt concentration on the different stages of the catalytic cycle of a halophilic enzyme
Kaufman SB, Vallejos-Baccelliere G · The FEBS journal · 2026PubMed Verified
- 34.Characterization of cell adhesion phenomena at the dental abutment/soft tissue interface by means of a dynamic cell culture model
Angulo Salas LN, Kaiser F, Harrandt V, Mehta K, Garcia-Zintzun AI, Havlica J et al. · Biomaterials advances · 2026PubMed Verified
- 35.Involvements of dicyclohexylcarbodiimide and adenosine diphosphate-mediated respiration and organic acid metabolisms in pulp acidification of Phomopsis longanae Chi-infected longan fruit
Bi W, Sang Y, Lin W, Zhuo R, Lin M, Chen Y et al. · Food chemistry · 2026PubMed Verified
- 36.(P)ppGpp synthase Rsh promotes persister cells formation by regulating sulfur metabolism mediated by sulfate reductase CysI in Brucella abortus
Liu X, Cui C, Wang P, Wang H, Zhai Y, Yang Y et al. · Veterinary microbiology · 2026PubMed Verified
- 37.Repair of Corneal Epithelial Defects
Rabinovich M, Böhm EW, Ruan Y, Gericke A · Progress in molecular and subcellular biology · 2026ReviewPubMed Verified
- 38.Endoplasmic Reticulum-Mitochondria Calcium Drives Salivary Bioenergetics
Min SN, Mao XD, Su JZ, Wu LL, Yu GY, Cong X · Journal of dental research · 2026PubMed Verified
- 39.NAD+ capping of sibD transcripts in E. coli is mediated by its minimal promoter and enhanced by ppGpp
Liu W, Hu K, Nie S, Feng Z, Li Q, Zhang H et al. · Nucleic acids research · 2026PubMed Verified
- 40.Causal relationship between gut microbiome and childhood allergy: A bidirectional Mendelian randomization analysis
Zhou J, Wu P, Luo Z, Huang Z, Ma H, Fang H et al. · Medicine · 2026PubMed Verified
- 41.Vitamin B3 derivatives support pancreatic cancer cell survival and chemotherapy resistance
Nakazzi F, Zarei M, Lopes M, Graor HJ, Beegan WC, Gu E et al. · Cancer letters · 2026PubMed Verified
- 42."Metabolic memory" of aging: anchoring, transmission, and frontiers of transgenerational intervention
Zhao Y · Biogerontology · 2026ReviewPubMed Verified
- 43.Sarcopenia: An overview of emerging therapies and pathophysiological insights in age-related skeletal muscle decline
Mishra D, Mohapatra L · Biochemical pharmacology · 2026ReviewPubMed Verified
- 44.Carba-NAD binding activates SIR2 by reshaping conformational plasticity and rewiring long-range allosteric networks
Zhang BD, Zhao DR, Liu MT, Yang LQ, Sang P · PLoS computational biology · 2026PubMed Verified
- 45.Functional trihydroxyl germanium moiety in THGP confers novel enzyme activity inhibition abilities while also attenuating intracellular effects against multidrug-resistant Acinetobacter baumannii
Yamabe K, Arakawa Y, Shoji M, Miyamoto K, Tsuchiya T, Fujii S et al. · Metallomics : integrated biometal science · 2026PubMed Verified
- 46.An Exploratory Study of Six-Month Niacinamide Supplementation on Macular Structure and Electrophysiology in Primary Open-Angle Glaucoma
Nicola CA, Marinescu MC, Alexandrescu C, Firan AM, Alyamani W, Naidin MS et al. · Vision (Basel, Switzerland) · 2026PubMed Verified
- 47.Biosynthesis of ent-acu-dioxomorpholine A and its conversion to prenyl-rearranged and rare ketooxadiazepane products in heterologous host
Tao Q, Zou Y · Synthetic and systems biotechnology · 2026PubMed Verified
- 48.Changes in the brain [NAD(+)]/[NADH] and [NADPH]/[NADP(+)] with aging and anti-aging dietary restriction
Jamerson LE, Bradshaw TD, Bradshaw PC · Frontiers in aging neuroscience · 2026ReviewPubMed Verified
- 49.Tributyrin enhances growth and intestinal health in green mud crab (Scylla paramamosain) through butyrate-driven metabolic regulation
Peng H, Zhou Q, Cui X, Zhan W, Cao H, Deng Y et al. · Animal nutrition (Zhongguo xu mu shou yi xue hui) · 2026PubMed Verified
- 50.NMN protects cisplatin-associated AKI via NAD(+)/SIRT1 pathway
Wen Z, Wang J, Yang Y, Chen L, Ji X, Liu D et al. · Frontiers in immunology · 2026PubMed Verified
Medical disclaimer: This information is for educational purposes only and does not constitute medical advice. Many compounds listed are research chemicals not approved for human use. Always consult a qualified healthcare professional before starting any protocol.
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