NAD+ Dosing Chart: SubQ, IV, NMN & NR Compared (2026)

What NAD+ Actually Is (and Why Levels Decline With Age)

Nicotinamide adenine dinucleotide (NAD+) is a coenzyme present in every cell in the body. It does two main jobs: it shuttles electrons in metabolic reactions (think of it as a redox currency for converting food into ATP), and it serves as a substrate for a family of enzymes called sirtuins, plus PARPs and CD38. Those enzymes are involved in DNA repair, mitochondrial function, and cellular signaling.

Cellular NAD+ levels are not fixed. They are constantly synthesized, recycled through what's called the salvage pathway, and consumed by the enzymes that depend on them. Multiple studies in tissue samples — including muscle, brain, and skin — have observed that NAD+ concentrations tend to be lower in older adults than in younger ones. Researchers debate the exact magnitude of the decline and which tissues drop fastest, but the directional finding is consistent across labs.

The decline appears to come from a mix of reduced synthesis and increased consumption. CD38, an NAD+-consuming enzyme, becomes more active with age and inflammation. Chronic inflammatory states accelerate NAD+ turnover. The salvage pathway can struggle to keep up.

That observation — lower tissue NAD+ in older adults, plus a known mechanistic role in mitochondrial and DNA repair pathways — is what created the interest in raising NAD+ exogenously. Whether topping up the substrate pool meaningfully changes the downstream biology in humans is still an open scientific question. Animal studies are encouraging in some endpoints; human trials remain small, short, and mixed. None of the four forms below has been approved by the FDA for any longevity indication. Treat the dosing chart that follows as a snapshot of how researchers, compounding pharmacies, and clinics are currently using these compounds — not as a validated treatment protocol.

Forms Compared: SubQ Injection, IV, NMN, and NR

Subcutaneous NAD+ injection. Compounded NAD+ delivered into the subcutaneous tissue, typically the abdomen. Bypasses first-pass liver metabolism entirely. Bioavailability of injected NAD+ is high relative to oral, but the molecule's plasma half-life is short, which is why protocols call for daily or near-daily dosing. The clinical research base for SubQ NAD+ is thin — most evidence is anecdotal or comes from small case series — but it has become the most common at-home delivery format because it sits between IV (clinic-bound, expensive) and oral precursors (lower bioavailability).

IV NAD+ infusion. Slow intravenous drip of NAD+, almost always clinic-administered. Doses are dramatically higher than SubQ (250-1,000 mg per session is common), and infusions can take 2-8 hours because rapid administration is poorly tolerated. The peer-reviewed evidence base is small but growing, with most published data coming from addiction-medicine and neurology contexts rather than longevity. Practical drawback: cost and time. Per-session pricing varies widely, and clinics differ enormously in protocol design.

NMN (nicotinamide mononucleotide). Oral precursor. NMN is one biosynthetic step closer to NAD+ than nicotinamide. Bioavailability data is mixed — some studies show NMN reaches plasma intact, others suggest most is broken down to nicotinamide in the gut and liver before reaching cells. Multiple human trials have shown NMN can raise blood NAD+ levels at doses in the hundreds of milligrams per day. NMN's regulatory status in the US shifted in 2022-2023, which has affected supplement availability.

NR (nicotinamide riboside). Oral precursor. NR is the most studied of the oral forms in randomized human trials, with multiple published placebo-controlled studies showing it raises blood NAD+ at doses of 250-1,000 mg per day. Patent-protected and sold under specific brand names. Strongest formal research base of the oral options, though the clinical endpoint data (does the NAD+ rise translate into measurable functional change?) remains preliminary.

Dosing Chart

The numbers below reflect ranges that appear in published research, compounding pharmacy guidance, and clinic protocols as of early 2026. Wide ranges reflect genuine practitioner disagreement, not a single consensus figure.

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A few honest caveats worth attaching to that table. First, "typical research dose range" is a description of how the compound has been studied or used, not an endorsement of a specific number. Second, none of these forms has an established dose-response curve where doubling the dose reliably doubles a measurable benefit — the dose-finding work simply hasn't been done at the level it has been for, say, statins or metformin. Third, the optimal protocol for any individual is the conversation to have with a qualified clinician, not a number to pull from a chart.

Subcutaneous NAD+ Protocol Considerations

If you're running compounded SubQ NAD+, three practical issues come up over and over in patient reports.

The burning sensation. Most people describe a burning, stinging, or "rushing" feeling at the injection site that lasts 30 seconds to a few minutes after the push. This is dose-dependent and concentration-dependent — the more concentrated the solution, the more intense the burn. It is the single most common reason people abandon SubQ NAD+ protocols. It is generally considered a tolerability issue, not a safety signal, but it is worth tracking subjectively. If burn intensity escalates over a cycle, that's information.

Dilution and slow push. Most compounding pharmacies supply NAD+ in a relatively concentrated solution (often 100-200 mg/mL). Many users dilute their daily dose with sterile bacteriostatic water before injection to reduce the burn, then push slowly over 30-60 seconds rather than a fast injection. Some practitioners pre-mix with a small volume of sterile saline. Get specific dilution and push-rate guidance from the prescribing clinician — there's no universal standard.

Site rotation. SubQ NAD+ at near-daily frequency means you cycle through injection sites quickly. The lower abdomen is the most common site (avoid 1-2 inches around the navel). Rotate left-right and up-down across a grid pattern so no single area receives more than one injection per week if possible. Repeated injection in the same square inch causes lipohypertrophy and degraded absorption — the same rule that applies to GLP-1 protocols. Logging each injection's site (e.g., "right lower abdomen, lateral") makes rotation actually happen rather than drifting toward the most convenient spot.

A protocol logger that records dose, site, and a 1-10 burn rating per injection turns a fuzzy "I think it's burning less" into a tracked trend you can compare cycle over cycle. MyProtocolStack's dose logging supports site notes and free-text fields for exactly this purpose.

What to Track

NAD+ protocols sit in a frustrating measurement zone: subjective changes are commonly reported, objective measurement is hard, and the validated biomarker panel is thinner than for GH peptides or GLP-1s. Track both layers, and be honest with yourself about which signals are reliable.

Subjective markers (track weekly). Energy levels at a fixed time of day (a 1-10 scale logged at the same morning hour each week reduces noise). Sleep onset and total sleep time — wearable data is helpful here. Recovery from a standardized workout — perceived exertion at a fixed effort level. Cognitive markers like word-finding, focus duration, or mental clarity, even if you only score them on a 1-5 scale. Mood. None of these are validated NAD+ biomarkers in the clinical sense; they are how the people running these protocols report changes, and they can be tracked rigorously even when the underlying biology is uncertain.

Objective biomarkers (track at baseline, mid-cycle, and end of cycle). Direct serum NAD+ measurement is offered by a handful of specialty labs — Jinfiniti and a small number of research-affiliated labs are the most commonly cited. The methodology and reference ranges differ between providers, results are slow to return, and longitudinal interpretation is genuinely difficult. If you want to measure NAD+ directly, accept that you are getting a snapshot from a still-maturing assay, not a calibrated reference value.

The more practical tracking layer is the surrounding metabolic and inflammatory panel: hsCRP (general inflammation), HOMA-IR (calculated from fasting glucose and fasting insulin — gives an insulin sensitivity picture), fasting insulin alone, IGF-1 (relevant if you're stacking with anything that touches the GH axis), and a basic CBC and CMP. None of these will move dramatically from NAD+ alone in most cases, but having a clean baseline and a follow-up panel at the end of a cycle lets you separate "I feel different" from a measurable inflammatory or metabolic shift.

For lipid trends, ApoB and a fractionated lipid panel give a cleaner read than a basic cholesterol panel. If you're stacking NAD+ with other compounds that touch metabolism — GLP-1s, GH secretagogues, HRT — the surrounding biomarkers matter much more than NAD+ itself, because that's where you'll see the interaction effects.

The honest caveat: don't expect a single dramatic biomarker swing from NAD+. Compare your panel over time alongside your subjective tracking, and look for directional movement and consistency rather than one heroic data point. MyProtocolStack lets you log lab results alongside daily protocol entries, so you can visualize whether your subjective trend lines and your objective panel are pointing the same way.

Cycling Considerations

A common question on NAD+ forums is whether to run continuously or in cycles — typically eight to twelve weeks on, two to four weeks off. The honest answer is that the published research does not yet tell us which approach is better.

The argument for cycling rests on a few mechanistic ideas: that constant high substrate supply might down-regulate the salvage pathway, that pulsed dosing might mimic natural NAD+ rhythms more closely, and that periodic washout helps you reassess whether the protocol is actually doing anything. None of these has been rigorously tested in human longevity trials.

The argument for continuous dosing is simpler — most published trials of NR and NMN have used continuous daily protocols for 8-24 weeks and reported sustained NAD+ elevation without obvious tachyphylaxis. The longer-term data (years rather than months) is missing across the board.

If you cycle, log the off-period as deliberately as the on-period. Note subjective markers and any biomarker drift during washout. Re-test at the end of the off-window before starting the next cycle. That comparison — on-cycle endpoint versus off-cycle re-baseline — is the only practical way to answer "did this actually change anything for me" with the tools available today. Track it, then bring the data to your clinician before starting another cycle.

Frequently Asked Questions

Is NAD+ actually a peptide?

No. NAD+ is a dinucleotide coenzyme, not a peptide. It's grouped with peptide protocols in many longevity communities because it's often delivered by injection and is used alongside true peptides like ipamorelin or BPC-157, but biochemically it is a different class of molecule.

Do oral NMN and NR actually raise blood NAD+ levels?

Multiple randomized trials have shown both NMN and NR can raise blood NAD+ at doses in the 250-1,000 mg per day range. NR has the larger placebo-controlled trial base. Whether that blood-level rise translates into clinically meaningful functional change in humans is a separate question that current research has not yet answered conclusively.

Why does subcutaneous NAD+ burn so much?

The exact mechanism is debated, but the leading hypotheses involve local pH and the concentration of the injected solution. Diluting the dose with bacteriostatic water and pushing slowly are the two most-cited mitigation strategies. Burn intensity tends to be dose- and concentration-dependent.

Can I measure my NAD+ levels directly?

A small number of specialty labs offer direct NAD+ measurement, most commonly from whole blood or PBMCs (peripheral blood mononuclear cells). Methodology and reference ranges vary between providers, turnaround is slow, and longitudinal interpretation is challenging because the assay field is still maturing. Treat any single number as a snapshot rather than a calibrated benchmark.

Should I cycle on/off or run continuously?

There is no consensus answer in the published research. Most clinical trials have used continuous daily protocols. Cycling rationales (avoiding salvage pathway down-regulation, mimicking circadian rhythm, periodic washout to reassess) are mechanistically plausible but not rigorously tested. Discuss the choice with your prescribing clinician and track both phases if you do cycle.

Tracking Your NAD+ Protocol With MyProtocolStack

If you're running any NAD+ protocol — SubQ, IV, NMN, or NR — the difference between a tracked and an untracked cycle is the difference between data and vibes. MyProtocolStack gives you dose logging with site and free-text fields, lab result tracking with trendlines for the surrounding biomarker panel, and protocol cycle templates so on/off periods are explicit rather than improvised.

Browse the [MyProtocolStack calculators](/calculators) for reconstitution and dose-conversion math across your full stack, or [sign in](/auth/login) to start logging your current protocol. The platform is a tracking and education tool — it does not provide medical recommendations, and none of the dose ranges in this guide should be interpreted as clinical advice.

This article is for informational and educational purposes only and does not constitute medical advice. NAD+ research in humans is preliminary, and none of the forms discussed have been approved by the FDA for longevity indications. Always consult a licensed healthcare provider before starting, adjusting, or stopping any NAD+, NMN, NR, or related protocol. MyProtocolStack is a protocol tracking and blood work analysis platform — it is not a medical device and does not provide clinical recommendations.