NAD+: Recharging Energy at the Cellular Level

Did you know there's a naturally-occuring molecule in your body that recharges your body’s energy “battery” at the cellular level? That molecule is known as nicotinamide adenine dinucleotide (NAD+), and it's essential to life itself. NAD+ is present in every one of our cells, fueling energy production, repairing DNA, supporting brain health, and helping protect against stress and toxins.

The challenge? NAD+ levels decline with age, stress, illness, and poor sleep. This decline has been associated with fatigue, brain fog, metabolic challenges, and accelerated aging [1].

Compounded NAD+ injection therapy may be something to talk about with your provider.

While oral supplements like niacin (vitamin B3) or nicotinamide mononucleotide (NMN) may help increase NAD+ levels, they are precursors to NAD+ and thus depend on conversion pathways that can be inefficient. Injection therapy delivers NAD+ directly into the body.

Typical Protocol

• Administration: NAD+ is given by subcutaneous or intramuscular injections (IV infusion may be used in some clinics). Often, doses are started low and slowly increased as tolerated to minimize side effects.
• Frequency: Subcutaneous injections are the most popular route due to patient ease and convenience. Protocols vary, but injections may be given several times per week, or even daily for short-term recovery, depending on the person's needs.
• Onset: Some people notice improvements after the first treatment, while others experience gradual changes over several weeks.

Mild side effects such as injection site discomfort, headache, flushing, or light-headedness are generally temporary and often resolve quickly.

Compounded NAD+: Quality Matters

NAD+ therapy should always involve collaboration between the patient, prescriber, and pharmacist. If your provider prescribes NAD+ therapy, it typically will be prepared by a compounding pharmacy. Compounded NAD+ injections are customized for patient-specific needs and materials are sourced from FDA-registered manufacturers with strict quality controls. This helps promote safety and purity — an important distinction since over-the-counter or non-pharmaceutical NAD+ products may not meet these same high standards.

A trusted compounding pharmacy follows rigorous processes, which may include testing for:

• Potency – the medication contains the concentration prescribed
• Sterility – free of bacteria or fungi
• Endotoxins – harmful bacterial byproducts are not present
• Purity – no heavy metals or unsafe contaminants

Choosing a pharmacy that is licensed, inspected, and compliant with regulatory standards helps to protect you. This is especially important because some unlicensed or internet-sourced NAD+ preparations may not meet regulatory quality and safety requirements and could pose serious health risks.

A Personalized Approach

NAD+ therapy is not a “magic bullet,” but it can be a powerful adjunct to an integrative care plan. Talk with your provider and compounding pharmacist about whether NAD+ injection therapy could be the right fit.

By Jonathan Head, PharmD, FAPC; Las Colinas Pharmacy

1. Rajman L, Chwalek K, Sinclair DA. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metab. 2018;27(3):529-547. doi:10.1016/j.cmet.2018.02.011
2. Yoshino J, Baur JA, Imai SI. NAD+ intermediates: The biology and therapeutic potential of NMN and NR. Cell Metab. 2018;27(3):513-528. doi:10.1016/j.cmet.2017.11.002