NAD+
Nicotinamide Adenine Dinucleotide
Mechanism of Action
Central redox cofactor for hundreds of enzymatic reactions. Serves as substrate for sirtuins (SIRT1-7) and PARP enzymes governing DNA repair, mitochondrial biogenesis, and gene expression. NAD+ pools decline with age as consumption (PARP activation, CD38) outpaces synthesis; direct administration or precursor supplementation (NMN, NR) raises blood NAD+ levels with downstream effects on mitochondrial and metabolic function.
Key Benefits
- Restoration of age-related NAD+ decline
- Improved measures of mitochondrial/metabolic function in some trials (e.g., gait speed, liver enzymes)
- DNA repair and sirtuin pathway support
- Growing randomized-trial base for oral NMN precursor safety and NAD+ elevation
Dosing Protocol
On the 503A bulks list as a compoundable substance. IV/SubQ NAD+ is a popular clinic offering, but the strongest current clinical evidence — including randomized trials — is for oral NMN precursor dosing and blood NAD+ elevation, not for direct IV/SubQ protocols specifically. Category placement here is imperfect: NAD+ is fundamentally a metabolic/mitochondrial compound, grouped under Skin & Anti-Aging alongside Epitalon for its longevity framing.
Ideal Candidates
Adults interested in metabolic and cellular-aging support; the most robust current human data is for oral NMN precursor dosing rather than direct IV/SubQ NAD+.
Side Effects & Safety
IV NAD+ commonly causes transient flushing, chest tightness, or nausea, especially with rapid infusion. Oral NMN has been well-tolerated at studied doses (up to 900 mg/day) in short-term trials; long-term human safety data is still limited.
Regulatory Status
CompoundableOn the 503A bulks list. A normal endogenous coenzyme, not FDA-approved as a drug for any indication. IV and SubQ administration are common compounding-pharmacy services.
Evidence & Citations
- Okabe K, Yaku K, Uchida Y, et al. Oral Administration of Nicotinamide Mononucleotide Is Safe and Efficiently Increases Blood Nicotinamide Adenine Dinucleotide Levels in Healthy Subjects. Front Nutr. 2022;9:868640.
- Wang JP, Wang L, Wang T, et al. Effects of Nicotinamide Mononucleotide Supplementation on Muscle and Liver Functions Among the Middle-aged and Elderly: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Curr Pharm Biotechnol. 2025;26(13):2141-2152.
- Kuerec AH, Wang W, Yi L, et al. Towards personalized nicotinamide mononucleotide (NMN) supplementation: Nicotinamide adenine dinucleotide (NAD) concentration. Mech Ageing Dev. 2024;218:111917.
Frequently asked
What is NAD+?+
NAD+ (Nicotinamide Adenine Dinucleotide) is a peptide studied for mitochondrial function and cellular energy. Central redox cofactor for hundreds of enzymatic reactions. Serves as substrate for sirtuins (SIRT1-7) and PARP enzymes governing DNA repair, mitochondrial biogenesis, and gene expression. NAD+ pools decline with age as consumption (PARP activation, CD38) outpaces synthesis; direct administration or precursor supplementation (NMN, NR) raises blood NAD+ levels with downstream effects on mitochondrial and metabolic function.
What is the dosing protocol for NAD+?+
Literature commonly references 50 mg SubQ/day (low) to 250 mg IV (or 100 mg SubQ/day) (maintenance) via IV / SubQ / Intranasal, on a ongoing cycle. Educational reference only — a licensed Stackhaus Health provider sets any personalized protocol.
What is the regulatory status of NAD+?+
On the 503A bulks list. A normal endogenous coenzyme, not FDA-approved as a drug for any indication. IV and SubQ administration are common compounding-pharmacy services.
Where can I access NAD+?+
Research-grade NAD+ is available through Stackhaus Research. For a personalized, provider-reviewed protocol, consult a licensed clinician through Stackhaus Health.
More in Skin & Anti-Aging
Used in these stacks
NAD+ appears in 1 research protocol in the Stackhaus Academy library.