Energy & Endurance

NAD+

Educational research reference. This page was restored from the structured compound dataset included with this site export. Protocol examples are context for review and are not medical advice.

At a glance

Route(s)

Subcutaneous

Target

Cellular Coenzyme

Timing window

Morning

Regulatory status

no approved label identified

Protocol context

Standard Protocol

Timeframe	Dose / exposure	Notes
Week 1	50 mg	Inject once daily subcutaneously.
Week 2	75 mg	Inject once daily subcutaneously.
Weeks 3-8	100 mg	Inject once daily subcutaneously.
Weeks 9-12	100 mg	Inject once daily subcutaneously.
Weeks 13-16	100 mg	Inject once daily subcutaneously.

Alternative: Aggressive Loading

Timeframe	Dose / exposure	Notes
Days 1-7	200mg - 250mg daily	Clinical loading protocol to rapidly restore NAD levels.
Week 2+	50mg daily	Drop to standard maintenance dose.

Alternative Titration 2

Timeframe	Dose / exposure	Notes
Week 1	50mg 1x Daily twice a week
Week 2	75mg 1x Daily twice a week
Weeks 3-6	75mg 1x Daily four times a week
Weeks 7-8	100mg 1x Daily four times a week
Weeks 9-12	100mg 1x Daily

Protocol logic

Energy protocols are usually about mitochondrial or metabolic signaling. The logic is timing around meals/training, avoiding late-day stimulation, and watching sleep, glucose, blood pressure, and overtraining signals. Entry context: target (Cellular Coenzyme); route Subcutaneous; timing Morning. Unapproved or source-dataset dosing tables are hypotheses, not recommendations. NAD+ protocol logic should separate energy/metabolic support from anti-aging hype. The goal is symptom or marker support, not age reversal, and the main filters are tolerance, flushing/nausea, methylation context, cancer history, and whether precursors or lifestyle basics already cover the need.

Side effects / cautions listed in dataset

Intense burning and cramping at the injection site: the defining and most universally reported adverse effect of injectable NAD+; caused by osmotic gradient formation and adenosine purinergic receptor activation at the injection site; intensity is directly rate-dependent: slower injection dramatically reduces pain; the subcutaneous route generally produces less burning than IV but is still significant at full doses.
Chest tightness or pressure: occurs with rapid injection; a vagal response to the acute NAD+ pulse; not a sign of cardiac event; resolves immediately upon slowing the injection rate; subjects should always inject slowly (over 2-5 minutes for subcutaneous, longer for IV).
Nausea: associated with rapid injection or higher loading doses; vagally mediated.
Flushing and sensation of warmth: NAD+ and its metabolites have mild vasodilatory effects; facial and truncal flushing within minutes of injection; typically transient.
Headache: reported in a significant minority of users, particularly with early doses; possibly related to cerebral vasodilation and NAD+ pathway flux.
Dizziness: vasodilation-related; particularly in the first minutes post-injection.
Fatigue in the immediate post-injection period: paradoxical given the energy restoration goal; a transient cellular metabolic reorganization response; typically resolves within 1-2 hours.
Insomnia: if administered in the afternoon or evening; sirtuin activation and mitochondrial biogenesis stimulation creates a wakefulness effect; mandatory morning dosing protocol exists specifically to prevent this.
Mild anxiety or jitteriness: reported in sensitive subjects at higher doses; related to CNS NAD+ restoration and noradrenergic pathway activation.
Potential CD38 activation: at sustained high NAD+ concentrations, CD38 may be upregulated as a homeostatic counter-regulation; this can paradoxically increase NAD+ consumption; not well characterized at subcutaneous doses.

Contraindications / risk flags listed in dataset

Active malignancy: NAD+ is the essential energy and DNA repair substrate for all cells including cancer cells; NAD+ supplementation in an active cancer context fuels the Warburg metabolism of tumor cells and enhances the PARP-mediated DNA repair that helps cancer cells evade chemotherapy and radiation-induced DNA damage.
Concurrent chemotherapy or radiation therapy: PARP is the primary target of PARP-inhibitor chemotherapy agents (olaparib, niraparib); providing excess NAD+ substrate to the tumor's PARP enzymes directly opposes the mechanism of these agents.
Known hypersensitivity to NAD+ or formulation excipients.
Severe hypotension: NAD+ has mild vasodilatory effects; subjects with baseline hypotension should inject slowly and remain supine.
Pregnancy: safety of supraphysiological NAD+ supplementation during fetal development is not established; the Preiss-Handler and Kynurenine synthesis pathways that regulate NAD+ biosynthesis have specific roles in early embryonic development.
Breastfeeding: no data.
Subjects on PARP inhibitor chemotherapy: exogenous NAD+ directly antagonizes the mechanism of PARP inhibitor drugs.
Severe cardiovascular instability: rapid NAD+ injection can trigger vagal response with chest tightness and nausea; unstable cardiac subjects should not use rapid injection protocols.

Related compounds

Synergistic / related

5-Amino-1MQ MOTS-c SS-31 (Elamipretide)Glutathionetri-heal-blend