NAD+ (1000 mg)

At a Glance

NAD+ (Nicotinamide Adenine Dinucleotide) is a cellular coenzyme required for ATP production, DNA repair via PARP enzymes, and sirtuin-mediated metabolic regulation. Intracellular NAD+ declines with age, and injectable NAD+ is used in research settings to achieve rapid systemic repletion that bypasses the limited oral bioavailability of the molecule itself.[1]

• Reconstitute: Add 10.0 mL bacteriostatic water → 100 mg/mL concentration.
• Subcutaneous dose range: 100–500 mg once daily (split across multiple sites for doses >2 mL).
• Easy measuring: At 100 mg/mL on a U-100 syringe, 1 unit = 0.01 mL = 1 mg. A 100 mg dose = 100 units / 1.0 mL.
• Storage: Lyophilised: freeze at −20 °C; reconstituted: refrigerate at 2–8 °C; use within 4 weeks.

Overview

• Goal: Restore intracellular NAD+ pool to support sirtuin and PARP activity, mitochondrial biogenesis, and oxidative metabolism.[1][2]
• Schedule: Once-daily subcutaneous injection or periodic IV infusion per research protocol.
• Dose range: 100–500 mg SC once daily; 500–1000 mg in 250–500 mL saline over 1–4 hours for IV use.
• Reconstitution: 10.0 mL BAC water per 1000 mg vial → 100 mg/mL.
• Injection site (SC): Abdomen, thigh, or upper arm; split large volumes across 2–3 sites.

What You'll Need

Plan based on a 4-week cycle at 250 mg once daily (28 injections, 7000 mg total).

• NAD+ Vials (1000 mg each): 7000 mg needed ÷ 1000 mg per vial → 7 vials.
• Insulin Syringes (U-100, 1 mL / 100-unit): 28 injections → 28 syringes (or more if splitting doses).
• Bacteriostatic Water (10 mL bottles): 10.0 mL per vial → 7 × 10 mL bottles.
• Alcohol Swabs: 2 per injection → 56 swabs per 4-week cycle.

How to Reconstitute

1. Allow frozen lyophilised vial to reach room temperature (10–15 minutes).
2. Draw 10.0 mL bacteriostatic water with a sterile syringe.
3. Inject slowly down the inner vial wall to avoid foaming.
4. Gently swirl until fully dissolved — do not shake. Solution should be clear and colourless.
5. Label with reconstitution date; refrigerate at 2–8 °C, protected from light. Use within 4 weeks.

Dosing Schedule

Start at 100 mg once daily for the first 3–5 days to assess for injection-site reactions and flush response before escalating. Splitting volumes >2 mL across two injection sites reduces local discomfort from the acidic pH of the solution.

Protocol Details

• Starting dose: 100 mg (100 units / 1.0 mL) once daily SC for Days 1–5.[1]
• Standard dose: 250 mg (250 units / 2.5 mL, split 2 sites) once daily from Day 6+.
• Higher dose: 500 mg (500 units / 5.0 mL, split 3–5 sites) once daily for advanced protocols.
• IV use: Dilute 500–1000 mg in 250–500 mL normal saline; infuse over 1–4 hours. Reduce infusion rate if flushing, chest tightness, or nausea occurs.
• Cycle: 4–8 weeks typical; evidence base does not define an optimal cycle length.

Storage

• Lyophilised: Store at −20 °C (−4 °F); protect from moisture and light.
• Reconstituted: Refrigerate at 2–8 °C. Do not freeze. Use within 4 weeks.
• Appearance: Clear, colourless solution. Discard if cloudy, discoloured, or particulate.

How NAD+ Works

NAD+ is a dinucleotide coenzyme (adenosine + nicotinamide) that participates in cellular metabolism in two distinct capacities. As a redox carrier, it accepts electrons during glycolysis and the tricarboxylic acid cycle (becoming NADH), then donates them to Complex I of the mitochondrial electron transport chain to drive ATP synthesis — the fundamental mechanism of aerobic energy production.

As a consumed substrate, NAD+ is cleaved by sirtuins (SIRT1–7) and poly(ADP-ribose) polymerases (PARPs) during DNA repair and gene expression control. SIRT1 deacetylates PGC-1α to drive mitochondrial biogenesis; SIRT3 activates antioxidant enzymes within mitochondria. Both require adequate NAD+ as a co-substrate. PARPs consume NAD+ at high rates during DNA strand-break repair; chronically activated PARPs under accumulated genotoxic stress accelerate depletion.[1]

Intracellular NAD+ declines approximately 50% between young adulthood and middle age across multiple tissues, driven by increased PARP activity and rising expression of CD38 (an NAD+-hydrolyzing ectoenzyme upregulated by age-related inflammatory signaling).[2] Injectable NAD+ bypasses gut-wall degradation that limits oral bioavailability, achieving rapid blood-level elevation.

For mechanism and evidence detail, see What Is NAD+?

Good to Know

• NAD+ solution is acidic (pH ~3–4) and commonly causes a burning sensation on SC injection; splitting larger doses across multiple sites reduces local discomfort.
• IV infusion rate-dependent reactions (flushing, chest tightness, nausea, palpitations) are common and resolve by slowing the drip — they are not allergic reactions.
• NAD+ is not FDA-approved as a drug in injectable form; it is a research compound.
• Oral precursors (NMN, NR) have published human RCT data that injectable NAD+ lacks; they are alternatives for research contexts where injection is not required.
• Sirtuins activated by NAD+ include SIRT1 (nuclear, regulates PGC-1α and FOXO) and SIRT3 (mitochondrial, activates SOD2 and IDH2); both are silenced when NAD+ is depleted.[1]

Tips for Best Results

• Administer in the morning; NAD+ drives mitochondrial biogenesis via SIRT1/PGC-1α activation, which may synergise with morning exercise.
• Allow reconstituted vial to reach room temperature before drawing; cold solution increases injection discomfort.
• Rotate injection sites daily and document site, dose, and time to track local reactions.
• Adequate dietary protein and B-vitamins (particularly niacin/B3) support the salvage pathway that recycles NAD+ intracellularly.

Injection Tips

• Clean the vial stopper and injection site with separate alcohol swabs; allow both to air-dry fully before proceeding.[4]
• Use a 29–31 gauge insulin syringe (5/16″ to 1/2″ needle); draw the calculated dose precisely.
• Pinch a fold of skin and insert the needle at 45° into subcutaneous fat; 90° is acceptable with a short needle into a well-pinched fold.
• Inject slowly over 3–5 seconds (the acidic solution benefits from a slower injection pace). Do not aspirate. Withdraw the needle, apply gentle pressure.
• Rotate injection sites (abdomen, thighs, upper arms) and dispose of each syringe in a sharps container immediately after use.