library.onepin.app/nad-plus Peptide Education Library
Education only, not medical advice 21+ Every dose is an example to finalize with a licensed provider

OnePin Peptide Library · Mitochondrial

Mitochondrial Endogenous coenzyme Not FDA-approved · investigational

NAD+

NAD+ (Injectable) · NAD-Plus · NAD-Plus-Injectable

Endogenous coenzymeCellular energy currency cofactorSirtuin activator substratePARP substrate (DNA repair)

Nicotinamide adenine dinucleotide (NAD+) is a fundamental coenzyme present in every living cell, essential for over 500 enzymatic reactions including energy metabolism, DNA repair, gene expression regulation, and cellular signaling. NAD+ levels decline approximately 50% between ages 40-60, contributing to mitochondrial dysfunction, impaired DNA repair, and accelerated aging. Injectable NAD+ bypasses the oral bioavailability limitations of precursors (NMN, NR) to directly restore cellular NAD+ pools. Administration is via intramuscular (IM) injection due to the acidic pH (~3-4) that causes significant burning with subcutaneous delivery. NAD+ is a cornerstone of longevity and cellular health protocols.

Quick Start
Route
IM injection (not SubQ due to acidic pH causing burning)
Start low
50-100 mg IM
Frequency
2-3 times weekly or daily
Timing
No fasting requirement

IM or IV administration. Can cause flushing. Slower infusion reduces side effects. Pin alone. Not compatible with peptides.

Start here. Every protocol below is ordered lowest-first. Begin at the smallest effective dose, hold about a week to assess tolerance, and step up only if needed.

Tiered Protocols · lowest first
Quick Start
Conservative start
50-100 mg IM · IM injection (not SubQ due to acidic pH causing burning) · 2-3 times weekly or daily
Lowest starting point. Hold about a week to assess tolerance before stepping up.
50-100 mg IM
2-3 times weekly or daily
Standard
SubQ Longevity
50-100 mg · SubQ · 3x Weekly
anecdotal · community
50-100 mg
3x Weekly
Expert
IV Infusion
250-750 mg · IV · Weekly
human study · Grant et al. 2019 (Front Aging Neurosci)
250-750 mg
Weekly
Reconstitution CalculatorU-100
050100u
Draw to
units
01

How it works

NAD+ serves as a critical coenzyme in three major biological systems. In energy metabolism, it accepts electrons as NAD+ and donates them as NADH in glycolysis, the TCA cycle, and oxidative phosphorylation, directly fueling ATP production. As a substrate for sirtuins (SIRT1-7), NAD+ enables epigenetic regulation through histone deacetylation, controlling gene expression patterns associated with longevity, stress resistance, and metabolic health. As a substrate for PARPs (poly-ADP-ribose polymerases), NAD+ fuels DNA damage detection and repair. CD38, an NAD+-consuming enzyme that increases with age, is a major driver of age-related NAD+ decline. Injectable NAD+ directly replenishes cellular pools without relying on the rate-limited salvage pathway (NAMPT) that oral precursors depend on.

NAD+ serves as a critical coenzyme in three major biological systems. In energy metabolism, it accepts electrons as NAD+ and donates them as NADH in glycolysis, the TCA cycle, and oxidative phosphorylation, directly fueling ATP production. As a substrate for sirtuins (SIRT1-7), NAD+ enables epigenetic regulation through histone deacetylation, controlling gene expression patterns associated with longevity, stress resistance, and metabolic health. As a substrate for PARPs (poly-ADP-ribose polymerases), NAD+ fuels DNA damage detection and repair. CD38, an NAD+-consuming enzyme that increases with age, is a major driver of age-related NAD+ decline. Injectable NAD+ directly replenishes cellular pools without relying on the rate-limited salvage pathway (NAMPT) that oral precursors depend on.

02

What to expect

Early
Days 1–7

Days 1-7: Injection discomfort is the main experience. Some users report subtle energy improvement. Cellular NAD+ levels begin to restore.

Mid
Weeks 2–4

Weeks 2-4: Energy and recovery improvements become noticeable. Mental clarity improves. Exercise tolerance increases.

Later
Weeks 4–12

Weeks 4-12: Cumulative cellular benefits. Sirtuin activation and DNA repair effects compound. Best assessed via intracellular NAD+ testing if available.

03

Evidence

HumanModerate
AnimalStrong
In-vitroPresent
2019A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+ · Grant R et al, Frontiers in Aging Neuroscience ↗peer reviewed
2020Clinical Evidence for Targeting NAD Therapeutically · Mehmel M et al, Pharmaceuticals ↗review
2017NAD+ in aging: molecular mechanisms and translational implications · Fang EF et al, Trends in Molecular Medicine ↗review
2021Effect of Nicotinamide Mononucleotide on Insulin Sensitivity and Cerebral Vascular Function: A Randomized Clinical Trial in Postmenopausal Women · Yoshino M et al, Science ↗peer reviewed
04

The honest take

Anti-aging cornerstone

NAD+ decline is a recognized hallmark of aging. Restoration improves multiple aging biomarkers in animal studies. David Sinclair's research popularized NAD+ in longevity science. Human longevity outcomes not yet proven.

Addiction recovery

BR+ NAD protocol uses high-dose IV NAD+ for addiction treatment. Published case series show benefit. Not FDA-approved for addiction. Mechanism may involve neurotransmitter pathway restoration.

Direct vs precursor

Injectable NAD+ bypasses NAMPT rate-limiting step that oral NMN/NR depend on. Theoretically more efficient but IM bioavailability vs oral precursor bioavailability comparison data is limited.

05

Interactions & stacking

What's safe to combine, and what belongs in a separate pin.

Safe & synergistic

GlutathioneOften combined in IV protocols. Both support cellular detoxification and energy.
5-Amino-1MQ5-Amino-1MQ inhibits NNMT to redirect nicotinamide into NAD+ salvage pathway. Exogenous NAD+ provides direct supplementation.
NMN/NR (oral)Oral NAD+ precursors complement injectable NAD+ for sustained levels.

Keep separate

ALL (syringe)Acidic pH (~3) destabilizes other peptides. Must be administered IM or IV separately. Never mix with SubQ peptides.
06

Side effects & safety

Commonly reported

  • Burning/pain at injection site (acidic pH)
  • Mild nausea
  • Warmth or flushing
  • Headache

Less common & notes

  • Chest tightness or shortness of breath with IV infusions (rate-dependent, not typical with IM).
  • Muscle cramping at injection site.
  • Rare anxiety or agitation.
  • Inject slowly and start with lower doses.
07

Pharmacokinetics

Illustrative plasma concentration · 24 h
Half-life
0.75h
Peak · Tmax
0.5h
Elimination
3.75h
Activity
8-24 hours (cellular NAD+ pool elevation persists beyond plasma clearance)

Storage. Oxidation sensitive. Protect from light and air exposure. Refrigerate at 2-8C after reconstitution. Stable for 14-28 days. Minimize repeated vial punctures and air exposure. Solution should be clear; discard if discolored.

08

Regulatory status

NAD+ is available as a compounding ingredient and supplement precursor. Not FDA-approved as an injectable drug. IV NAD+ clinics operate under physician oversight. No WADA prohibition. Available through compounding pharmacies.

Put it to work

Calculate, log & track

Open NAD+ straight into OnePin with your vial and dose pre-filled, then let it handle the syringe math and remind you before the vial runs out.

Open NAD+ in the app →

Go deeper

The guide & community

The complete NAD+ walkthrough, real protocol discussion and coaching live inside the BlessUp community on Skool.

Join the community ↗
Open in app Community