NAD+ Dosing: 100mg SubQ, 2-3x/Week Protocol

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in every living cell, essential for mitochondrial energy production, DNA repair, and sirtuin activation. NAD+ levels decline approximately 50% between ages 40 and 60 (Massudi et al., 2012), driving interest in direct supplementation to restore youthful concentrations.

NAD+ is not FDA-approved as an anti-aging therapy. The protocols below reflect published research, clinical practice patterns, and community experience. This is not medical advice.

Quick Reference: Standard Protocol

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NAD+ Dosing by Route

NAD+ is unique among peptides in having five practical administration routes, each with different onset and bioavailability:

Cycling Details

NAD+ doesn't require strict cycling like most peptides. The "as needed" approach reflects that NAD+ is a coenzyme, not a receptor agonist — there's no desensitization concern in the same way.

A practical approach: 100-200 mg SC 2-3x/week for 8-12 weeks, then bridge with oral NMN (500 mg daily) for 4 weeks, then repeat injectable courses as desired.

Routes of Administration

Subcutaneous injection is the most practical injectable route. Expect injection site stinging lasting 5-15 minutes — this is the most common side effect and can be managed by injecting slowly and rotating sites. Morning dosing preferred for potential energizing effects.

IV infusion (250-500 mg over 2-4 hours) delivers the highest peak levels and is used in clinical settings. A single 3-hour infusion of 750 mg increased blood NAD+ approximately 398% above baseline (Grant et al., 2019). Loading protocols use 250-500 mg daily for 3-5 days.

Oral precursors (NMN/NR) are the most accessible route. NMN at 250 mg/day for 12 weeks significantly increased NAD+ metabolites and improved physical performance (Yoshino et al., 2021). NR at 1000 mg/day increased whole-blood NAD+ by ~60% over 6 weeks (Martens et al., 2018).

Reconstitution Quick Reference

Math: 500 mg / 5 mL = 100 mg/mL. For 100 mg: 100 / 100 = 1.0 mL = 100 units.

Refrigerate after mixing, use within 28 days. NAD+ is less stable in solution than many peptides — prompt refrigeration matters. For step-by-step instructions, see the full NAD+ Reconstitution Guide.

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Where These Numbers Come From

NAD+ replenishment targets several interconnected aging pathways, all driven by the age-related decline in NAD+ levels:

Sirtuin activation: NAD+ is required for SIRT1-7 function — deacetylases that regulate DNA repair, mitochondrial biogenesis, inflammation, and stress resistance. Age-related NAD+ decline impairs sirtuin function (Imai & Guarente, 2014).

Mitochondrial energy: NAD+ is a critical electron carrier in the electron transport chain. Declining levels directly impair oxidative phosphorylation and ATP production (Stein & Imai, 2012).

DNA repair: PARP enzymes consume NAD+ during DNA repair. As damage accumulates with age and NAD+ falls, repair capacity is compromised (Fang et al., 2017).

Cognitive function: NAD+ supports neuronal health through SIRT1-mediated neuroprotection and PARP-dependent DNA repair in neurons (Lautrup et al., 2019).

Exercise performance: NMN supplementation improved aerobic capacity in amateur runners (Liao et al., 2021).

Stacking Protocols

SS-31 optimizes mitochondrial machinery; NAD+ provides the fuel. MOTS-c enhances how cells use energy; NAD+ ensures there is energy to use.

Side Effects & Safety

• Injection site stinging/burning — very common, lasting 5-15 minutes (most frequently reported side effect)
• Mild flushing — occasional, less intense than IV route
• IV-specific: flushing, warmth, chest tightness, nausea — common and rate-dependent, managed by slowing infusion
• GI discomfort with oral precursors — mild and infrequent at standard doses
• Insomnia — occasional if taken late in the day (avoid evening dosing)
• No serious adverse events reported in published human trials for NR 1000 mg/day or NMN 250 mg/day

Frequently Asked Questions

What is the standard NAD+ injection dose?

100 mg subcutaneously in the morning, 2-3 times per week. Reconstitute a 500 mg vial with 5 mL BAC water (100 mg/mL) and draw 100 units per dose.

What is the best route of administration for NAD+?

Subcutaneous injection offers the best balance of bioavailability and convenience. IV delivers the highest peak levels but requires clinical supervision. Oral NMN/NR are the most accessible but rely on indirect NAD+ synthesis.

Why does IV NAD+ cause flushing and nausea?

NAD+ activates the GPR109A receptor (the niacin flush receptor), triggering prostaglandin release. Slower infusion rates (2-4 hours for 250-500 mg) significantly reduce these effects.

How do I reconstitute NAD+ for injection?

Add 5 mL bacteriostatic water to a 500 mg vial for 100 mg/mL concentration. Draw 100 units on an insulin syringe for a 100 mg dose. Store refrigerated, use within 28 days.

Should I take NMN or NR instead of injecting NAD+?

Oral NMN (250-1000 mg daily) and NR (300-1000 mg daily) are convenient precursors that raise NAD+ levels over days to weeks. Direct injection provides faster, higher peak levels. Many users combine oral precursors with periodic injections.

Do I need to cycle NAD+?

No strict cycling is required. NAD+ is dosed as needed. Some users run 8-12 week injectable courses with oral precursor bridges during off periods.

Can I combine NAD+ with other longevity peptides?

Yes. NAD+ is commonly stacked with SS-31 (mitochondrial membrane stabilization), MOTS-c (AMPK activation), or Epitalon (telomerase activation). These target different aging pathways and complement NAD+ replenishment.

Related Guides

• NAD+ Benefits — 8 research-backed effects of NAD+ supplementation
• NAD+ Results Timeline — Week-by-week expectations by route
• NAD+ Reconstitution Guide — Step-by-step mixing with dilution charts
• NAD+ Bloodwork Guide — What labs to track and optimal ranges
• SS-31 Dosing Guide — Mitochondrial peptide for cardiolipin stabilization
• MOTS-c Dosing Guide — Mitochondrial-derived metabolic peptide
• Peptide Stacking Guide — How to combine longevity peptides effectively
• Calculate Your NAD+ Cycle Cost — estimate vials needed and total cost for your protocol

References

For educational and research purposes only. This is not medical advice. NAD+ supplementation is not FDA-approved for any anti-aging indication.