NAD+

NAD+, or nicotinamide adenine dinucleotide, is a coenzyme essential to living cells. It supports cellular respiration, repair of DNA and sirtuin-dependent control of gene expression. Levels fall markedly with age. Intravenous and subcutaneous administration are used in clinical settings concerned with aging, metabolism, cognition and addiction recovery. NMN and NR, which cells convert into NAD+, are available as oral supplements.

Research schedules name a low starting amount and a titrated standard amount without numeric doses. Frequency depends on the protocol, and the route varies.

Responses differ between individuals. Begin with the lowest dose and observe your response carefully. Speak with your clinician before use and report unexpected symptoms. Human adverse effects are not fully characterized for every compound.

• Cellular Longevity

  Moderate

  Investigations assess telomere length and the processes associated with cellular senescence.

• Hormonal Balance

  Moderate

  Potential hormonal effects are being considered in the context of aging.

• Cognitive Aging

  Limited

  Preliminary investigations address preservation of cognition as people age.

• Medications

  Caution

  Ask your prescriber to review any medication before combining treatments.

• BPC-157

  Compatible

• NAD+

  Compatible

• Vitamin D

  Compatible

Diluent: Use bacteriostatic water; avoid saline because precipitation may occur.

1. Let the refrigerated vial stand at room temperature for 15–20 minutes before preparation.
2. Disinfect the stopper using an alcohol swab, then wait until it has dried fully in the air.
3. Measure the calculated quantity of bacteriostatic water with a sterile syringe. Use only this diluent; avoid saline because precipitation may occur.
4. Add the water gradually against the inner vial wall. Keep the stream away from the powder itself.
5. Rotate the vial with a gentle swirling motion. Do not shake forcefully, because this can degrade the contents.
6. Wait 2–3 minutes for the powder to dissolve completely, and check that the liquid is transparent and has no color.
7. Use an insulin syringe to withdraw the calculated amount for injection beneath the skin.
8. Inject in the thigh, abdomen or upper arm. Change the injection location each time to help prevent lipodystrophy.
9. Refrigerate the mixed solution at 2–8°C. Use it within a maximum of 28 days after preparation.

Week 1–2

During the first 1–2 weeks, early effects may accompany an adjustment period. Watch for adverse reactions.

Week 2–4

By weeks 2–4, the main effects may start becoming apparent. Make dose changes only according to your clinician’s guidance.

Week 4–8

During weeks 4–8, the principal effects are expected to be established. Review your progress with your clinician.

Week 8+

From week 8 onward, review the results and decide with your clinician whether to continue, cycle or change the dose.

• Mild pain, bruising or redness around the injection location
• Possible allergic reaction; stop use if hives or a rash develops

1. NAD(+) metabolism and its roles in cellular processes during ageing. (2021)

   PMID 33353981DOI 10.1038/s41580-020-00313-x

2. Safety and efficacy of NAD+ supplementation: a systematic review (2021)

3. NAD+ intermediates: The biology and therapeutic potential (2018)

   DOI 10.1016/j.cmet.2018.02.011

4. Nicotinamide Adenine Dinucleotide in Aging Biology: Potential Applications and Many Unknowns. (2023)

   PMID 37364580DOI 10.1210/endrev/bnad019

5. NAD⁺ in aging, metabolism, and neurodegeneration. (2015)

   PMID 26785480DOI 10.1126/science.aac4854

6. NAD+ and sirtuins in aging and disease. (2014)

   PMID 24786309DOI 10.1016/j.tcb.2014.04.002

7. The Safety and Antiaging Effects of Nicotinamide Mononucleotide in Human Clinical Trials: an Update. (2023)

   PMID 37619764DOI 10.1016/j.advnut.2023.08.008

8. Yoshino J et al. — NMN metabolism (Cell 2021) (2021)

9. NAD+ studies on ClinicalTrials.gov (2024)