Longevity
NAD+
Cellular coenzyme central to energy metabolism and DNA repair. Not actually a peptide, but a fixture of longevity peptide clinics and stacks.
Unregulated / not a peptide Longevity
- Full name
- Nicotinamide Adenine Dinucleotide (technically a coenzyme/dinucleotide, not a peptide)
- Also known as
- NAD+, NAD, often discussed alongside precursors NMN and NR
- Regulatory status
- NAD+ itself is used clinically (IV infusion clinics) and sold as an injectable/subcutaneous product in the wellness/longevity space; its precursors NMN and NR are sold as oral supplements. Not FDA-approved as a therapeutic for any anti-aging indication.
Origin
NAD+ is a coenzyme in every living cell, essential for redox reactions in energy metabolism (glycolysis, the citric acid cycle, oxidative phosphorylation) and as a substrate for DNA-repair enzymes (PARPs) and signaling enzymes (sirtuins, central to several longevity theories).
Mechanism
Cellular NAD+ declines measurably with age, linked to reduced mitochondrial function, impaired DNA repair, and reduced sirtuin activity. Restoring it, directly or via precursors NMN/NR that the body converts to NAD+, is theorized to support mitochondrial and metabolic health. Whether raising NAD+ alone meaningfully changes the human aging trajectory is unresolved.
Research summary
Evidence
Mouse studies show NMN or NR supplementation can improve metabolic health markers, mitochondrial function, and in some studies lifespan. Human trials of NMN and NR are more numerous than for most compounds in this wiki: NAD+ levels reliably rise with supplementation, and some metabolic markers (insulin sensitivity, blood pressure, physical performance) improve modestly in some but not all trials. Results are mixed, effect sizes small. Direct IV or subcutaneous NAD+ has far less rigorous human data than the oral precursor route; most 'NAD+ IV therapy' clinic use isn't backed by controlled trials, and self-reported effects (energy, mental clarity, less hangover-like fatigue) are the main evidence.
Evidence tier: Unregulated / not a peptide — see the methodology note for how this is assessed.
Citations
- Safety and efficacy of long-term nicotinamide mononucleotide supplementation on metabolism, sleep, and nicotinamide adenine dinucleotide biosynthesis in healthy, middle-aged Japanese men — Yamaguchi et al. 2024
- Nicotinamide adenine dinucleotide metabolism and arterial stiffness after long-term nicotinamide mononucleotide supplementation: a randomized, double-blind, placebo-controlled trial — Katayoshi et al. 2023
- Oral nicotinamide riboside raises NAD+ and lowers biomarkers of neurodegenerative pathology in plasma extracellular vesicles enriched for neuronal origin — Vreones et al. 2022
- Nicotinamide riboside does not alter mitochondrial respiration, content or morphology in skeletal muscle from obese and insulin-resistant men — Dollerup et al. 2019
Reported benefits
- Reported increase in energy and mental clarity, especially with IV/injectable administration
- Interest for supporting recovery from alcohol use, chronic fatigue, and long-COVID-type fatigue in wellness-clinic marketing (not clinically validated for these uses)
- Long-term interest as part of general metabolic-health/longevity stacks alongside exercise and caloric-restriction-mimetic strategies
Dosing protocols reported in the literature & community
These are protocols reported by compounding pharmacies, published trials, or self-experimentation communities — not a prescription. Start low, especially for anything new.
| Route | Reported protocol |
|---|---|
| IV infusion (clinic setting) | Typical clinic protocols range from 250 mg to 1000+ mg per infusion, sometimes over several hours due to infusion-rate-related side effects (flushing, chest tightness at faster rates); frequency varies from weekly to monthly. |
| Subcutaneous injection (self-administered) | Community-reported doses are much lower than IV, commonly in the 50-100 mg range per injection, a few times per week, partly because subcutaneous NAD+ injection is reported to be quite uncomfortable/stinging at higher concentrations. |
| Oral precursors (NMN/NR) | Typical studied oral doses are 250-1000 mg/day for NMN and 300-1000 mg/day for NR — these are the routes with the most actual human trial data. |
Side effects
- IV/injection: flushing, chest or throat tightness (especially with fast IV infusion rates), nausea
- Subcutaneous injection is frequently reported as painful/stinging
- Oral NMN/NR: generally very well tolerated, mild GI upset in some
Safety notes
Community & reddit notes (anecdotal — not clinical evidence)
A fixture of longevity clinics and stacks, often bundled with anti-aging peptides like Epithalon. Community opinion splits between people reporting strong subjective energy benefits from IV/injectable NAD+ and a growing skeptical contingent pointing to the thin controlled-trial evidence for the injectable route, favoring oral NMN/NR as the better-studied way to raise NAD+.
Related peptides
Mixing compatibility
Pulled from a community-charted mixing-compatibility reference (anecdotal, clinic-use, and community-reported signals) — not a safety guarantee. Verify independently before combining anything.
Used together in wellness-clinic protocols
Reported as a combination to avoid
- AOD-9604
- ARA-290
- BPC-157
- CJC-1295 / Mod-GRF (1-29)
- CJC-1295 with DAC
- DSIP
- Epithalon
- GHK-Cu
- GHRP-2
- GHRP-6
- Human Chorionic Gonadotropin
- Hexarelin
- Somatropin
- IGF-1 LR3
- Ipamorelin
- Kisspeptin
- KPV
- LL-37
- MGF
- Melanotan I
- Melanotan II
- P21
- PE 22-28
- Pinealon
- PT-141 (Bremelanotide)
- Selank
- Semax
- TB-500 / Thymosin Beta-4
- Tesamorelin
- Thymalin
- Thymosin Alpha-1