NAD+
Also known as: Nicotinamide Adenine Dinucleotide · NAD plus · NAD
NAD+ is a coenzyme in every living cell, central to energy metabolism and DNA repair. Levels decline with age. Sold as IV infusion (clinic), subcutaneous injection, oral precursors (NMN, NR), and nasal spray. Best-studied in IV form.
Last reviewed · Panya.health editorial
Panya scores vendors against an 11-signal rubric. Vendors at or above 70 out of 100 are routable; below 70 are documented but get no Panya affiliate link. For prescription peptides like Mounjaro and Wegovy, Panya routes today through licensed clinicians. For research peptides like NAD+, vendor scorecards land in a follow-up sprint after legal review and payment processor selection. Until then, the page surfaces commonly-mentioned vendor names so adults can do their own diligence. We do not yet earn commission on any NAD+ vendor.
Not medical advice. NAD+ is not approved for human medical use in most jurisdictions. The data below is what users do; it is not what regulators have validated. You decide your risk profile.
What it does, and how
NAD+ (nicotinamide adenine dinucleotide) is essential for over 500 enzymatic reactions, especially mitochondrial electron transport, sirtuins (SIRT1-7, including SIRT3 in mitochondria), and PARP-mediated DNA repair. Tissue NAD+ levels drop roughly 50 percent between age 40 and 60 in most measured tissues. Restoration strategies are: direct IV NAD+ infusion (rapid plasma rise, expensive), subcutaneous NAD+ injection (cheaper, slower), oral precursors NMN or NR (well-tolerated, modest plasma rise), or nasal spray (limited evidence). David Sinclair's lab (Harvard) has driven much of the longevity research; NAD+ supplementation is one of the most-studied longevity interventions in mice.
Typical practice
IV infusion at longevity clinics typically runs 250 to 1000 mg per session, sessions 1 to 5 hours, often weekly for 4 to 8 weeks then maintenance monthly. Subcutaneous community practice runs 50 to 100 mg per day in 2 to 4 week cycles. Oral NMN: 250 to 1000 mg per day; NR (Niagen): 300 to 600 mg per day. Nasal: 50 to 100 mg per spray, 1 to 2 sprays per day. There's no established 'optimal' dose in humans for longevity outcomes; all of this is community practice and clinic protocols, not validated by long-term outcome trials.
The dosing above is community practice, not a regulator-validated protocol. Trial-validated dosing for NAD+ in humans does not exist for most use cases listed.
Risks and contraindications
IV infusion: most common side effect is flushing, nausea, and chest tightness during infusion. These resolve when the drip slows. Allergic reactions are rare but real. Theoretical concerns: NAD+ is a substrate for sirtuins, which can affect cell proliferation; cancer-history users should consult an oncologist. Methylation considerations matter: NAD+ metabolism consumes methyl groups via NNMT, which can deplete SAMe in heavy users; some longevity protocols include trimethylglycine (TMG) co-supplementation. Pregnancy: avoid. Heavy users of nicotinamide can develop liver enzyme elevations; periodic LFTs are reasonable for chronic users.
Where this stands legally
NAD+ IV is widely sold by longevity and wellness clinics under physician supervision. NMN and NR sold OTC as supplements (NMN status with FDA in flux as of 2026 due to investigational drug classification dispute).
Available through private longevity clinics. NMN and NR sold as supplements. Not on NHS.
Bangkok longevity clinics offer NAD+ IV widely (BDMS Wellness, Chi Longevity, similar). Pricing 5,500 to 18,000 THB per session at premium clinics.
Dubai and Abu Dhabi private clinics offer NAD+ IV widely. AED 800 to 2,500 per session.
Available at private wellness and longevity clinics under physician supervision.
Where users say they source it
Names below are sourced from community discussion. None are currently scored against the Panya 11-signal rubric. Panya does not earn commission on any of these. You can search them yourself; treat the list as a starting point for your own diligence, not an endorsement.
- BDMS Wellness Clinic (Bangkok, IV)Pending Panya 11-signal audit
- Chi Longevity (Singapore, IV)Pending Panya 11-signal audit
- Renue By Science (oral NMN, US)Pending Panya 11-signal audit
- ProHealth (NR, US)Pending Panya 11-signal audit
- Pure Rawz (subcutaneous research peptide)Pending Panya 11-signal audit
Full vendor scorecards for NAD+ land in a follow-up sprint after lawyer review and payment processor selection. We will not route users to any vendor that scores below 70 on the rubric.
Papers worth reading directly
- Yoshino et al. — NAD+ Intermediates: The Biology and Therapeutic Potential of NMN and NR. Cell Metab, 2018 →
- Rajman, Chwalek, Sinclair — Therapeutic Potential of NAD-Boosting Molecules. Cell Metab, 2018 →
- Mills et al. — Long-term administration of NMN mitigates age-associated physiological decline in mice. Cell Metab, 2016 →
Panya blog posts
The credentialed clinicians have covered GLP-1 drugs for years. Here is what they actually say, not the clickbait version.
A working guide to Bangkok's longevity clinic landscape for expats: which clinics have real diagnostic depth, which ones rent the aesthetic, what the price bands look like, and how...
Adjacent reading
Track NAD+ in your peptide journal.
Panya users log their full stack at panya.health/journey. Public-by-default with per-entry privacy controls. Vote-validated by the community.