What Is NAD+? Energy, Brain Fog & Anti-Aging Explained

NAD+ has become one of the most talked-about treatments in functional and wellness medicine -- and unlike a lot of trends, the science behind it is genuinely interesting. But it's also easy to get lost in the hype. Here's a straightforward breakdown of what NAD+ is, what it actually does, and who it's most useful for.

What Is NAD+?

NAD+ stands for nicotinamide adenine dinucleotide. It's a coenzyme found in every single cell in your body -- it's not something you can run out of entirely, but your levels naturally decline with age, chronic stress, poor sleep, alcohol use, and certain health conditions.

NAD+ plays a central role in energy metabolism (it's involved in how your cells convert food into usable energy), DNA repair, and cellular communication. It also activates a group of proteins called sirtuins, which are involved in regulating aging-related processes at the cellular level.

The short version: NAD+ is foundational to how well your cells function, and most adults over 40 have meaningfully lower levels than they did at 20.

What Do People Report From NAD+ Therapy?

Patients who do NAD+ therapy -- especially IV infusions -- commonly report:

I want to be clear about what the evidence shows: the cellular mechanisms are well-studied and compelling, but large-scale human clinical trials on NAD+ therapy are still catching up. The patient reports are strong and consistent, and the biology makes sense, but we're not claiming it treats or cures anything.

IV vs. IM vs. Oral NAD+

NAD+ is available in oral supplements (NMN, NR), intramuscular (IM) injections, and IV infusions. The delivery method matters a lot:

Oral Supplements (NMN/NR)

Oral NAD+ precursors have to be absorbed through the gut and converted by the body. Absorption is variable, and the dose that actually reaches your cells is a fraction of what you take. Better than nothing for maintenance, but the weakest delivery option.

Intramuscular (IM) Injection

IM NAD+ is injected into a muscle (typically the glute or deltoid) and absorbed into the bloodstream from there. It bypasses the gut, so absorption is much better than oral. This is a good option for maintenance dosing between IV sessions -- faster appointment, lower cost.

IV Infusion

IV NAD+ goes directly into the bloodstream, so you get 100% bioavailability. This is the most powerful delivery method and what we use for loading doses and people looking for the strongest effect. Sessions run longer than a typical IV drip -- NAD+ needs to be infused slowly to avoid nausea -- but patients consistently report the most significant results from IV.

Who Is NAD+ For?

NAD+ therapy tends to be a good fit for people who:

• Are 35+ and noticing energy or cognitive changes that don't resolve with sleep and diet alone
• Are recovering from burnout, chronic stress, or a prolonged illness
• Are athletes looking for a recovery and performance edge
• Are using it as part of a longevity or anti-aging wellness protocol
• Have struggled with alcohol or substance use (NAD+ has been studied in this context)

How Often Should You Do It?

For a loading protocol, many patients start with 2-3 IV sessions in close proximity to build levels, then maintain with monthly IV or bi-weekly IM injections. For general wellness, once a month IV or IM every 2-3 weeks is a common maintenance cadence. We'll talk through your goals and recommend a schedule that makes sense for you.