Cellular Energy
NAD+ helps mitochondria produce energy in cells. Whether supplements improve fatigue depends on its cause. Research has not established this benefit for all patients.
NAD+ Therapy With Once-Weekly At-Home Injections
After an individualized evaluation, eligible patients may be prescribed NAD+ therapy as a small subcutaneous injection given at home once a week, with realistic expectations and careful attention to safety and tolerability.
- Individualized medical review
- Once-weekly at-home injection
- Clinically supervised care
The essentials
What Is NAD+?
Nicotinamide adenine dinucleotide, or NAD+, is a coenzyme in every living cell. It helps turn nutrients into energy. It also supports enzymes involved in DNA repair, cell signals, and metabolism.
Scientists actively study NAD+ in aging and metabolism. Oral precursors can raise certain NAD-related markers in people. However, research has not established that commercial NAD+ therapy reverses aging, prevents cancer or heart disease, treats depression, or extends human life.
Evidence matters: A biological mechanism is not the same as a proven clinical benefit. Before treatment, review goals, other options, uncertainty, product quality, and cost with your clinician. NAD+ therapy is one part of our longevity and hormone services; see pricing and insurance for visit costs.
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Why Patients Ask About NAD+
Patients often ask about NAD+ for energy, clear thinking, recovery, and healthy aging. Responses vary, and evidence for specific wellness benefits remains limited.
Cognitive Wellness
Researchers study NAD+ pathways in brain aging and nerve health. However, NAD+ therapy is not an established treatment for memory loss, depression, or diseases that damage nerve cells.
Metabolic Health
Research continues in glucose regulation, inflammation, and lipid metabolism. Human trials of NMN have not consistently shown improvements in glucose or lipid measures.
Exercise and Recovery
Some precursor studies report changes in selected performance measures, while overall evidence for strength, muscle mass, and recovery remains mixed.
Healthy Aging Research
NAD+ levels and metabolism change with age. It remains unknown whether raising NAD+ through commercial therapy meaningfully changes human healthspan or lifespan.
Personal Follow-Up
Your starting health, medicines, treatment route, tolerance, and goals should guide decisions. A higher NAD+ level does not always mean a better outcome.
Delivery methods
How NAD+ Therapy Delivery Options Compare
The routes are not interchangeable. They differ in how the body absorbs NAD+, evidence, ease of use, cost, and side effects. The best option depends on your health and clinical needs.
Precursors and nutrition
Supporting NAD+ Production
The body makes NAD+ from vitamin B3 compounds and tryptophan. Food sources include poultry, fish, meat, dairy, legumes, peanuts, seeds, mushrooms, and whole grains. A varied diet supplies niacin and other nutrients needed for normal energy metabolism.
High-dose niacin or nicotinamide can cause side effects and may affect liver enzymes, glucose, uric acid, or medication tolerance. NR and NMN products vary in quality, and long-term outcome data are still developing. Your clinician should review supplements alongside kidney or liver disease, pregnancy, cancer treatment, diabetes, gout, and current medicines.
IV safety
Infusion Rate Matters
NAD+ should not be infused rapidly or pushed through significant discomfort. A slower, individualized rate may improve tolerability.
Symptoms during infusion require attention
- Chest pressure, tightness, or shortness of breath
- Abdominal cramping, nausea, or vomiting
- Flushing, sweating, headache, or dizziness
- Increased heart rate, anxiety, or marked restlessness
- Severe chills, shaking, weakness, or unusual fatigue
- IV-site pain, swelling, redness, or burning
The infusion should be paused or slowed and the patient reassessed. Chest pain, breathing difficulty, fainting, severe shaking, low blood pressure, persistent vomiting, or signs of an allergic or contamination-related reaction require prompt medical evaluation.
Sterility and sourcing: FDA has reported severe chills, shaking, vomiting, and fatigue after compounded injectable NAD+ products and has warned that food-grade ingredients are not suitable for sterile compounding without appropriate processing. Injectable products should come from a qualified source using ingredients appropriate for sterile drug preparation.
Medical review first
Is NAD+ Therapy Appropriate for You?
First, a consultation should clarify what you want to improve. Your clinician can then assess whether established tests or treatments should come first. Fatigue, brain fog, low mood, and poor exercise tolerance have many possible causes. These include sleep disorders, anemia, thyroid disease, medicine effects, nutrient deficiencies, and heart or metabolic conditions.
- Review diagnoses and current symptoms
- Discuss prescriptions and supplements
- Assess pregnancy or breastfeeding status
- Review kidney and liver function
- Consider cancer history or active treatment
- Set realistic, measurable goals
- Compare route, cost, and evidence
- Plan monitoring and stopping criteria
Common Questions
NAD+ Therapy FAQs
How is NAD+ therapy given?
After an individualized evaluation, eligible patients may be prescribed NAD+ as a small subcutaneous injection given at home once a week. Your provider shows you how to give it and plans follow-up.
Is NAD+ therapy FDA-approved?
No. NAD+ injections are not FDA-approved to treat aging, fatigue, cognitive decline or any other condition. Injectable NAD+ is a compounded medication, and compounded medications are not FDA-approved.
What does the research show about NAD+?
NAD+ is essential for cellular energy, and research on aging and metabolism is ongoing. However, studies have not established that NAD+ therapy reverses aging or treats disease, and individual responses vary.
What side effects can occur?
Reported effects can include injection-site discomfort or redness, flushing, nausea and headache. Your provider reviews safety and tolerability with you and adjusts or stops treatment if needed.
Who may not be a candidate for NAD+ therapy?
Before prescribing, your provider reviews pregnancy or breastfeeding status, kidney and liver function, cancer history or active cancer treatment, and your current medications and supplements.
Are there alternatives to NAD+ injections?
Yes. Oral NAD+ precursors such as nicotinamide riboside (NR) or NMN can raise some NAD-related markers. Your provider can compare routes, evidence and cost to help you decide.
Is NAD+ therapy covered by insurance?
NAD+ therapy is typically self-pay. Visit fees and program options are listed on our pricing page. Questions? Call or text (213) 334-4111.
Still have questions? Call or text (213) 334-4111 or email support@alphahormones.com.
Your next step
Schedule Your NAD+ Consultation
Meet with our medical team to compare routes and review safety. Together, you can decide whether NAD+ therapy or a precursor option fits your goals.
Book An Appointment