NAD+
Nicotinamide Adenine Dinucleotide is a coenzyme central to metabolism. Levels decline with age.
Common Dosage
50mg - 100mg (subq) or IV protocols
Category
Longevity
- Cellular energy
- DNA repair
- Anti-aging
Nicotinamide adenine dinucleotide (NAD+) is not a peptide in the classical sense but is typically categorized alongside peptide therapies in the longevity and wellness space. It was first identified by Sir Arthur Harden in 1906 as a 'co-ferment' in yeast fermentation and its full structure was determined by Otto Warburg in 1934. The discovery of sirtuins in the 1990s and their NAD+ dependence — combined with research showing NAD+ declines 50% from youth to middle age — created intense interest in NAD+ restoration as a longevity strategy.
NAD+ is a fundamental coenzyme in cellular redox reactions — accepting and donating electrons in metabolic pathways including glycolysis, the TCA cycle, and electron transport chain. Beyond energy metabolism, it is the essential substrate for sirtuin deacylases (which regulate gene expression, DNA repair, and metabolic adaptation) and PARP enzymes (critical for DNA strand break repair). Its age-related decline impairs all of these functions simultaneously.
- Cellular energy metabolism support
- DNA damage repair enhancement
- Sirtuin activation for longevity signaling
- Mitochondrial function improvement
- Age-related metabolic decline management
- Addiction therapy and withdrawal support
- Neurodegenerative disease research
- Athletic performance and recovery
IV NAD+ in Addiction Recovery
Clinical programs using high-dose IV NAD+ (up to 1500mg over multiple days) in addiction recovery have reported dramatic reductions in cravings and withdrawal symptoms across alcohol, opioid, and stimulant dependencies. While controlled data is limited, clinical reports are consistent enough to sustain active treatment programs.
Energy and Cognition in Aging
Human trials with oral NAD+ precursors (NMN, NR) have demonstrated increased circulating NAD+ levels in middle-aged and older adults, correlated with improvements in physical performance, muscle strength, and cognitive function metrics — consistent with the role of NAD+ in mitochondrial function.
Post-COVID Fatigue
Emerging clinical use of IV NAD+ for Long COVID fatigue has generated anecdotal reports of significant improvement in energy, cognitive function, and exercise tolerance — consistent with NAD+'s role in mitochondrial and immune function, both impaired in Long COVID.
- IV administration carries significant flushing, chest pressure, and discomfort — slow infusion rates are essential
- Subcutaneous administration reduces flushing but is still often painful
- Very high costs for IV protocols
- Potential for stimulating NAD+ consumers (sirtuins, PARPs) to prioritize DNA repair pathways in ways that could theoretically affect cancer-relevant gene expression
- Oral bioavailability is low — precursors (NMN, NR) may be more practical for systemic effect
- Flushing
- Chest pressure (during rapid admin)