Anti-Aging

NAD+

Also known as: Nicotinamide Adenine Dinucleotide, NAD

Clinical Trials
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Key Facts: NAD+

Category
Anti-Aging
FDA Status
Not FDA Approved
Clinical Status
Not FDA approved as a drug. Sold as a supplement in precursor form and administered off-label as IV or subcutaneous injection in clinics. The evidence base sits mainly with oral precursors, not with injected NAD+.
Administration
Subcutaneous injection or slow IV infusion. Fast infusion is the main cause of the flushing and chest tightness people report.
Typical Dose
50-100 mg subcutaneous, 2-3x weekly
Frequency
Two to three times weekly, or per clinic protocol for IV
Duration
Ongoing use is common. No controlled long-term injectable data exists.
Also Known As
Nicotinamide Adenine Dinucleotide, NAD

Mechanism of Action

NAD+ is a required cofactor in the reactions that turn food into ATP, and it is consumed as a substrate by two families of enzymes tied to ageing: sirtuins, which regulate DNA repair and metabolic signalling, and PARPs, which repair DNA damage. Because NAD+ is used up by these processes, sustained DNA damage or metabolic stress can deplete it. The theory is that restoring NAD+ restores the function of everything downstream. The unresolved problem is delivery: NAD+ is a large charged molecule that does not readily cross cell membranes, which is why most serious research uses precursors like nicotinamide riboside or NMN that cells can actually take up and convert internally.

Research Summary

The decline of NAD+ with age is well documented, and precursor supplementation reliably raises blood NAD+ levels in human trials. What those trials have not clearly shown is that raising NAD+ produces the functional benefits people are hoping for. Human studies on nicotinamide riboside and NMN show good safety and consistent biomarker changes, with inconsistent effects on measurable outcomes like muscle function, insulin sensitivity or fatigue. Direct injected or infused NAD+ has far thinner evidence than the precursors do: most of what exists is small, uncontrolled, or observational, and the widely reported subjective effects of IV NAD+ have not been separated from placebo in good trials. Anyone telling you injected NAD+ has strong human evidence is describing the precursor literature and attaching it to a different product.

Trial Progress:Preclinical
Pre
I
II
III
IV
FDA

Dosing Information

Human Trials·Good human data on oral precursors. Direct injected NAD+ is far less studied.

Typical Dosing

Community experience

Common Dose

50-100 mg subcutaneous, 2-3x weekly

Range

50-750 mg depending on route

Frequency

Two to three times weekly, or per clinic protocol for IV

Injected NAD+ and oral precursors are not interchangeable, and almost all the good human evidence belongs to the precursors, which are covered separately on our NAD+ Precursors profile. Where IV is used, the flushing and chest tightness people report is largely a function of infusion rate.

Research Dosing

Scientific studies

Community and clinic protocols. There is no established clinical dosing for injected NAD+.

Doses from Studies

50-100 mg subcutaneous

Community-reported protocols - No controlled trials of injected NAD+ at this dose

250-750 mg IV

Clinic protocols - Uncontrolled clinical practice, not trial-derived

Duration

Ongoing use is common. No controlled long-term injectable data exists.

Administration

Subcutaneous injection or slow IV infusion. Fast infusion is the main cause of the flushing and chest tightness people report.

Timing & Administration

Best Time to Take

Morning

Two to three times weekly in most subcutaneous protocols

Food Recommendation

With or without food

Why This Timing?

NAD+ is tied to energy metabolism and circadian signalling, and evening dosing is commonly reported to disturb sleep.

Possible Side Effects

Not everyone experiences these effects. Individual responses vary based on dosage, duration, and personal factors.

  • Flushing, nausea and chest tightness during IV infusion, worse when infused quickly
  • Injection site irritation
  • Headache
  • Fatigue after infusion in some people
  • Long-term safety of repeated high-dose injection is not established

References

Research This Peptide Further

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Frequently Asked Questions

What does NAD+ do?

NAD+ is not a peptide at all, it is a coenzyme every cell uses to move electrons around during energy production. It gets grouped with peptides because it is sold in the same places and injected the same way. Levels fall with age, which is the entire basis of the longevity interest, but the leap from that observation to injecting it is longer than most sellers admit.

How does NAD+ work?

NAD+ is a required cofactor in the reactions that turn food into ATP, and it is consumed as a substrate by two families of enzymes tied to ageing: sirtuins, which regulate DNA repair and metabolic signalling, and PARPs, which repair DNA damage. Because NAD+ is used up by these processes, sustained DNA damage or metabolic stress can deplete it. The theory is that restoring NAD+ restores the function of everything downstream. The unresolved problem is delivery: NAD+ is a large charged molecule that does not readily cross cell membranes, which is why most serious research uses precursors like nicotinamide riboside or NMN that cells can actually take up and convert internally.

Is NAD+ FDA approved?

No, NAD+ is not currently FDA approved. Current status: Not FDA approved as a drug. Sold as a supplement in precursor form and administered off-label as IV or subcutaneous injection in clinics. The evidence base sits mainly with oral precursors, not with injected NAD+.

What are the side effects of NAD+?

Reported side effects include: Flushing, nausea and chest tightness during IV infusion, worse when infused quickly, Injection site irritation, Headache, Fatigue after infusion in some people, Long-term safety of repeated high-dose injection is not established. Individual responses vary based on dosage, duration, and personal health factors.

What is the typical dose of NAD+?

Community-reported common dose: 50-100 mg subcutaneous, 2-3x weekly (Two to three times weekly, or per clinic protocol for IV). Range: 50-750 mg depending on route. Administration: Subcutaneous injection or slow IV infusion. Fast infusion is the main cause of the flushing and chest tightness people report.. Community-reported doses. Not medical advice. Consult healthcare provider.

Related Peptides

Peptides commonly compared with NAD+ or used in similar applications.

Glutathione

Clinical Trials

Glutathione is the body's main intracellular antioxidant, a tripeptide of glutamate, cysteine, and glycine (often written GSH). It is sold as oral, IV, topical, and inhaled products and marketed for everything from detox and immune support to skin lightening, but its real, evidence-backed role is as a redox buffer that neutralizes oxidative stress and supports liver detoxification. Some clinical evidence exists for specific uses, while many popular claims, especially IV skin whitening, rest on weak or risky data.

Anti-Aging

DSIP

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DSIP, or delta sleep-inducing peptide, is a small naturally occurring nonapeptide (sequence Trp-Ala-Gly-Gly-Asp-Ala-Ser-Gly-Glu) first isolated in the 1970s from the blood of sleeping rabbits. As the name suggests, it was named for its ability to promote delta-wave (deep, slow-wave) sleep in animals. Despite five decades of study it has no regulatory approval and the human evidence for it as a sleep aid is weak and inconsistent.

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Humanin

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Humanin is a 24-amino-acid peptide encoded inside mitochondrial DNA (in the 16S rRNA gene), discovered in 2001 and named for its ability to protect human neurons from Alzheimer-related cell death. It was the first member of the mitochondrial-derived peptide family and is studied mainly for neuroprotection, cell survival, and metabolic and age-related disease. The honest status: it has the deepest preclinical evidence base of any mitochondrial peptide, but human therapeutic trials are essentially absent.

Anti-Aging

NAD+ Precursors

Clinical Trials

NAD+ precursors are not peptides. They are small molecules, mainly nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), that the body converts into NAD+, a coenzyme every cell needs to make energy and run repair enzymes. NAD+ falls with age, so these precursors are sold as anti-aging and metabolic supplements. Human trials confirm they reliably raise blood NAD+ levels, but clear proof of real health benefits in people is still missing.

Anti-Aging

SS-31

FDA

SS-31 (sequence D-Arg-Dmt-Lys-Phe-NH2), known generically as elamipretide and sold as FORZINITY, is a synthetic tetrapeptide that homes in on the energy-producing machinery inside your cells. It works by binding cardiolipin, a fat unique to the inner mitochondrial membrane, to help mitochondria run cleaner and make more ATP with less oxidative damage. This is the rare research peptide with a real regulatory finish line: the FDA granted it accelerated approval in September 2025 for Barth syndrome, though it has failed several other major trials.

Anti-Aging

FOXO4-DRI

Preclinical

FOXO4-DRI is an experimental senolytic peptide, meaning it is designed to kill off worn-out 'zombie' cells (senescent cells) while leaving healthy ones alone. It comes from a single influential 2017 mouse study and is engineered with a clever stability trick. It has never been tested in a human clinical trial, so anything beyond 'promising in mice' is speculation.

Anti-Aging

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