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NAD+
NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme naturally found in every living cell. It is involved in cellular energy production, DNA repair, mitochondrial function, and cellular signaling. NAD+ levels naturally decline with age and may also decrease due to chronic illness, inflammation, alcohol use, poor sleep, and metabolic dysfunction.
NAD+ therapy is commonly used for:
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Fatigue and low energy
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Recovery from illness or intense exercise
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Cognitive support and mental clarity
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Healthy aging and longevity protocols
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Cellular health and mitochondrial support
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Wellness and performance optimization
While NAD+ has become popular in wellness medicine, many uses remain investigational and are not FDA-approved indications.
How Is NAD+ Administered?
Most commonly administered as:
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Intramuscular injection (IM) – available through Aureum
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Subcutaneous injection (SQ)
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Oral NAD+ precursors
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Intravenous infusion (IV) (slowly)
Why doesn't Aureum offer IV NAD+?
NAD+ is not offered because it should be administered as a slow IV infusion, not an IV push, to minimize the risk of uncomfortable side effects such as flushing, chest tightness, nausea, or abdominal discomfort. At Aureum, patient comfort and safety are a priority, so we do not administer NAD+ as an IV push.
While slow IV infusion is the appropriate method, even relatively low doses of NAD+ typically require 1–2 hours or longer to administer. Because these extended infusion times do not align with Aureum's mobile, convenience-focused model, we have chosen not to offer IV NAD+ at this time.
Why doesn't Aureum offer subcutaneous NAD+?
Aureum does not currently offer subcutaneous NAD+ because it is commonly associated with local injection-site discomfort, including burning, redness, swelling, tenderness, and temporary nodules. While these reactions are generally mild and self-limited, they can negatively impact the patient experience. Because patient comfort is a priority, we have chosen not to offer this route of administration at this time.
Further, common side effects are usually related to infusion speed rather than the NAD+ itself.
Possible side effects:
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Flushing
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Chest tightness
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Nausea
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Abdominal cramping
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Headache
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Anxiety-like sensations
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Increased heart rate
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Lightheadedness
These effects typically improve when the infusion rate is slowed. For this reason, Aureum offers NAD+ exclusively via the intramuscular (IM) route, which avoids local injection-site and infusion rate–related adverse effects.
How Does NAD+ Work In The Body?
1. What Is NAD+?
NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme present in virtually every cell of the body. A coenzyme is a molecule that helps enzymes perform chemical reactions. Without NAD+, many of the reactions necessary for life would slow dramatically or stop entirely. NAD+ is particularly important because it participates in hundreds of metabolic reactions throughout the body.
2. NAD+ and Energy Production
The primary role of NAD+ is helping cells convert nutrients into usable energy. When carbohydrates, fats, and proteins are broken down, the energy they contain cannot be used directly. Instead, cells transfer electrons from nutrients onto NAD+, converting it into NADH.
NAD+
↓
Accepts electrons
↓
NADH
NADH then transports these electrons into the mitochondria. Inside the mitochondria, these electrons drive the electron transport chain, ultimately producing ATP. ATP (adenosine triphosphate) is the body's primary energy currency. Without sufficient NAD+, ATP production becomes less efficient. This is why NAD+ is often associated with cellular energy and mitochondrial health. Importantly, NAD+ is not energy itself—it helps cells extract energy from food.
3. NAD+ and Mitochondrial Function
Mitochondria are often referred to as the "powerhouses" of the cell. Because NAD+ is central to ATP production, mitochondrial function depends heavily on adequate NAD+ availability.
As NAD+ levels decline:
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Mitochondrial efficiency may decrease
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Cellular energy production may decline
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Recovery processes may become less efficient
This relationship is one reason NAD+ has gained attention in longevity and performance medicine.
4. NAD+ and DNA Repair
DNA is constantly being damaged by:
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UV radiation
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Environmental toxins
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Normal metabolism
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Oxidative stress
The body continuously repairs this damage using specialized enzymes. One important group is called PARPs (Poly ADP-ribose Polymerases). PARPs require NAD+ to function.
When DNA damage occurs:
DNA damage
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PARP activation
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NAD+ consumption
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DNA repair
Without adequate NAD+, these repair pathways become less efficient.
5. NAD+ and Sirtuins
Sirtuins are proteins involved in:
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Cellular repair
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Stress resistance
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Metabolic regulation
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Healthy aging
Sirtuins require NAD+ to function. As NAD+ levels decrease, sirtuin activity may also decrease. This relationship is one reason NAD+ has become popular in longevity research. Many of the anti-aging discussions surrounding NAD+ stem from its relationship with sirtuin biology. However, it is important to note that increasing NAD+ has not been proven to stop aging in humans.
6. NAD+ and Brain Function
The brain consumes a tremendous amount of energy. Because neurons depend heavily on mitochondrial function, adequate NAD+ is important for normal brain activity.
NAD+ contributes to:
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Neuronal energy production
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Neurotransmitter synthesis
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Cellular repair processes
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Stress response pathways
Some individuals report improved mental clarity following NAD+ therapy, although evidence remains mixed and ongoing research is continuing.Because NAD+ levels naturally decline with age and may be influenced by factors such as chronic stress, inflammation, poor sleep, alcohol use, and metabolic dysfunction, some individuals may choose NAD+ supplementation as part of their wellness routine to support the body’s natural cellular processes. While research continues to explore the full potential of NAD+ optimization, ongoing use may be considered based on individual goals, response, and guidance from a qualified healthcare provider.
Key Points
Is NAD+ energy?
No. NAD+ is not energy itself. It is a coenzyme that helps cells convert nutrients into ATP.
Does NAD+ increase energy immediately?
Not like caffeine. NAD+ is not a stimulant. Any improvement in energy typically occurs through its role in cellular metabolism rather than direct stimulation.
Can healthy people benefit from NAD+?
Possibly. However, the greatest theoretical benefit is likely in individuals experiencing increased metabolic stress, aging-related declines, chronic illness, poor sleep, heavy training, or significant oxidative stress.
When should I stop NAD+?
Treatment is generally discontinued if:
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Significant side effects develop
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Treatment goals are achieved
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Cost outweighs perceived benefit
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A provider recommends discontinuation
Stopping NAD+ does not cause dependence or withdrawal.
However, if no side effects occur, many people may continue using NAD+ unless they stop because they are not experiencing noticeable benefits, feel they have achieved their desired results, or no longer feel the need for continued supplementation.
How Can NAD+ Support Athletes?
Athletes place significant demands on their cells through intense training, repeated muscle contractions, and periods of physical stress. NAD+ plays an important role in cellular energy metabolism by supporting mitochondrial function and the processes involved in converting nutrients into energy.
By supporting normal cellular energy pathways, NAD+ may help optimize the body's ability to respond to physical stress, maintain cellular function, and support recovery processes following demanding activity.
While research is ongoing regarding NAD+ supplementation and athletic performance, maintaining healthy NAD+ levels is an area of growing interest among athletes seeking to support cellular health, recovery, and overall performance longevity.
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