MetabolicLegally CompoundedClinical Trials

NAD+

About

About NAD+

A coenzyme present in all living cells, nicotinamide adenine dinucleotide (NAD+) functions as a critical electron carrier in cellular metabolism and serves as a substrate for enzymes involved in DNA repair, cellular signaling, and epigenetic regulation. Cellular NAD+ levels decline with age, which has been associated with metabolic dysfunction and age-related pathologies. Research focuses on NAD+ precursor supplementation (such as nicotinamide riboside and nicotinamide mononucleotide) to investigate potential therapeutic applications in metabolic disorders, neurodegeneration, and aging-related conditions.

Science

Mechanism of Action

NAD+ serves as a hydride carrier in glycolysis, the TCA cycle, and the electron transport chain — the core pathways of cellular energy production. As a substrate for sirtuins (SIRT1–7), it activates deacetylase activity that regulates gene expression, mitochondrial biogenesis (via PGC-1α), and stress resistance. PARP enzyme activity for DNA repair requires NAD+ as a substrate. NAD+ also activates NNMT and CD38 pathways. Cellular NAD+ replenishment through supplementation supports all of these functions.

Dosing

Typical Protocol

IV infusion: 500–1000 mg NAD+ over 2–4 hours, 1–2 times monthly for loading, then quarterly maintenance. SC/IM injection: 50–100 mg 2–3 times weekly. Oral NMN: 500–1000 mg daily. Oral NR: 300–600 mg daily. Most clinicians recommend starting with IV loading then transitioning to oral or injectable maintenance.

⚠ Protocol information is for educational purposes only. Dosing must be determined by a licensed physician based on individual health status and goals.

Regulatory

Legal Status in 2026

Legally Compounded

This compound is legal to prescribe and dispense through a licensed 503A or 503B compounding pharmacy with a valid prescription. It is not FDA-approved as a finished drug product, but compounding is explicitly permitted under federal law. Quality and sterility standards vary by pharmacy — look for PCAB-accredited compounders.

Evidence

Evidence Tier

Clinical Trials

Evidence from randomized controlled trials (RCTs) or large observational studies in humans. This is the gold standard — effects have been measured in controlled conditions and results are peer-reviewed and reproducible.