NAD+ therapy
A coenzyme your cells use for energy and DNA repair, given by injection or IV. The biology of its decline is well documented. What topping it up achieves is a smaller and less certain claim, and this page keeps those two apart.
Medically reviewed by Lindsay Short, NP-BC, Board-Certified Nurse Practitioner · last reviewed September 2026
Injection or IV
The practical question people arrive with, and the answer is less about which is better than about what each is for.
| Injection | IV infusion | |
|---|---|---|
| Time | A few minutes | One to three hours |
| Dose | Modest | Substantially larger |
| Side effects | Mild flushing at most | Chest tightness, nausea if run quickly |
| Best for | Finding out if you respond, then maintenance | A loading approach, if you already know you do |
| Cost | The lower of the two | Considerably higher |
We usually suggest starting with injections, and not because they are what we sell. They are the inexpensive way to establish whether you personally notice anything, before committing hours and a great deal more money to infusions. If you feel nothing after a few, that is useful information and it cost you very little to get.
What the evidence supports, separated from what it does not
Well established: NAD+ is essential to cellular energy production and to the enzymes that carry out DNA repair. Levels fall with age. None of that is contested.
Reasonable but early: that raising levels improves energy and cognitive clarity. The mechanism is coherent, patient reports are consistent, and the controlled human data is thinner than the confidence with which it is sold.
Not supported: that it reverses aging, extends lifespan, or treats a disease. Those claims appear regularly in this category and none of them is established in humans.
We keep offering it because the first is solid, the second is plausible and patients report it consistently, and it is inexpensive to test. We are not going to tell you it is the third.
Rule out the boring explanations first
Most people asking about NAD+ are asking because they are tired. That is worth taking seriously, and it is worth taking seriously in the right order.
Thyroid and iron
Both cause exactly this fatigue, both are common, both are fixable, and both are a simple blood test away. Treating them beats any peptide.
Sleep
Undiagnosed sleep apnea is far more common than people expect and produces precisely the afternoon collapse NAD+ is sold for. No injection fixes it.
Hormones
Low testosterone in men and the perimenopausal transition in women both present as fatigue and low motivation. That is a hormone panel rather than a peptide.
Then NAD+
If the panel is clean and you still feel flat, this is a reasonable and inexpensive thing to try. It is a much better answer at step four than at step one.
Finding a thyroid problem instead of selling a course is a better outcome for you and a worse one for us. It is also the correct order, which is why bloodwork comes first here.
What a session is like
- Injection time
- A few minutes, subcutaneous
- Common feeling
- Brief warmth or flushing
- Starting rhythm
- Weekly, then spaced out
- When to judge it
- Over several weeks, not on the day
Rotate the injection site as you would with any subcutaneous injection. Tell us about flushing that is more than brief, and about any chest tightness, which is the one effect worth reporting promptly rather than at the next visit.
Book your free consultationAnswers before you book
What does NAD+ actually do?
NAD+ is a coenzyme every cell uses to turn food into usable energy and to run DNA repair. Levels decline with age, which is documented. The claim that topping it up reverses the consequences of that decline is where the evidence thins considerably, and we will describe it that way rather than as an anti-aging breakthrough.
Injection or IV, which is better?
An IV delivers a much larger dose over an hour or more and is what most of the enthusiasm is built on. An injection is a few minutes, costs far less, and suits maintenance once you know whether you respond. We usually suggest starting with injections precisely because they are the cheap way to find out if this does anything for you.
Why does the IV feel so unpleasant?
Pushed quickly, NAD+ produces chest tightness, flushing, nausea and a strong urge to move. It is dose-rate related rather than dangerous, and it is why a proper NAD+ IV is slow. Anyone offering a rapid one has not understood the drug. Injections largely avoid this because the dose is smaller.
What do patients actually report?
Mental clarity and steadier energy through the afternoon are the two most consistent, usually within the first few sessions. Sleep quality comes up often. These are real reports and they are also exactly the things most susceptible to expectation, which is why we ask you to judge over weeks rather than on the day.
How often would I have it?
Weekly is the usual starting rhythm for injections, then spaced out once you know how you respond. We would rather you tried a few and judged honestly than committed to a long package before knowing whether you notice anything.
Is it safe?
Generally well tolerated at the doses used here. The common effects are flushing, a brief wave of nausea and injection site soreness. It is not appropriate in pregnancy or breastfeeding, and anyone with a significant cardiac history should discuss it first because of the flushing response.
Will it help me lose weight?
No. It is not an appetite or metabolic drug in the way a GLP-1 is, and it does not produce weight loss on its own. Where it helps a weight loss program is indirectly, by making you feel well enough to train and eat properly, which is a real contribution and not the same as a treatment.
Is oral NAD+ worth taking instead?
Oral NAD+ itself is poorly absorbed, which is the reason injections and IVs exist. Precursor supplements are a different question and have their own evidence, thinner than their marketing. If you want the honest version: the delivery problem is real, and it is why anyone serious about this route injects it.
Try a few before you buy a course
A free consultation covers whether NAD+ addresses what is actually bothering you. If fatigue is thyroid, iron, sleep apnea or a hormone problem, we would rather find that in bloodwork than sell you injections.