What NAD+ is and what it is studied for
Nicotinamide adenine dinucleotide — NAD+ — sits at the centre of mitochondrial ATP production and of the cellular repair pathways that depend on it. Levels decline with age and with sustained stress, and subcutaneous NAD+ is studied for energy metabolism, recovery, mental clarity and the kind of fatigue that sleep alone does not fix. It is not a stimulant: no spike, no crash. The effect, when it comes, is steadier afternoons and better sleep.
Pushed in fast, NAD+ can cause flushing, chest tightness and nausea within a minute. Pushed in slowly, over 60 to 90 seconds, almost all of that disappears. Everything else in the house protocol exists to support that one rule.
Who it suits — and who should not run it
Written for adult women and men who want mitochondrial and energy support over an eight-week cycle and are willing to inject slowly, in the morning, after food, twice a week. The house exclusions:
Not for
- Pregnant, breastfeeding, or planning pregnancy.
- Under 18.
- Active cancer — whether to use an energy-metabolism signalling molecule during active cancer treatment is a physician decision, not a general-protocol one.
- Uncontrolled hypertension.
The house protocol
The 500 mg pen holds 300 clicks at 1,667 mcg (1.67 mg) per click. Twice weekly, subcutaneous in the abdomen, mornings only, Monday and Thursday, after eating. The push is slow — count 60 to 90 seconds, every time. House dosing never exceeds three doses a week.
Two phases: a two-week run-in at the lowest dose in the window, then six weeks on the hold dose with no further steps.
| Pen | Dose per injection | Clicks | Frequency | Timing | Cycle |
|---|---|---|---|---|---|
| NAD+ 500 mg (1.67 mg/click) | 50 mg | 30 | Monday + Thursday | Morning, fed, 60–90 s push | Weeks 1–2 — run-in |
| NAD+ 500 mg | 100 mg | 60 | Monday + Thursday | Morning, fed, 60–90 s push | Weeks 3–8 — hold |
| NAD+ 500 mg | 50 mg | 30 | Optional third dose, Saturday | Morning | Advanced researchers only, from week 3 — not part of the general protocol |
Total clicks: 4 doses × 30 + 12 doses × 60 = 840 → 3 pens (900 clicks). About 60 clicks (100 mg) remain — one spare dose, useful if one is ever missed. Do not step up early even if week 1 felt easy; the run-in is two full weeks.
Flushing, warmth or mild chest tightness during the push is a sign to slow down further, not to stop the cycle. If it persists beyond the first two or three doses despite a full 90-second push taken after food, hold at the current dose and message your coach. Keep the pen in the fridge between uses.
Week by week — what people typically notice and when
| When | What is typically reported |
|---|---|
| Week 1 (doses 1–2) | Some notice a subtle effect within a day or two — usually sleep quality or a slightly clearer head. Many notice nothing yet, which is normal at the run-in dose. |
| Weeks 2–3 | Most people who respond feel it by now: better sleep quality, steadier afternoon energy, less mid-afternoon fog. |
| Weeks 4–6 | The hold dose is fully established. Effects, where present, are consistent rather than building further. |
| Week 6 onward | Plateau. Expected, not a sign the compound has stopped working — NAD+ support maintains a baseline, it does not chase a growing effect. |
| End of cycle | A decision to cycle off for 4–8 weeks before any repeat, made on how the eight weeks went. |
Training is normal training; nothing is built around the pen. Zone-2 sessions — a pace where conversation is still possible — sit closest to the mitochondrial systems NAD+ is involved in, and many researchers notice the clearest signal there first. A consistent wake time, consistent bedtime and morning daylight will move brain fog and afternoon energy further than any dose adjustment.
Labs we ask for before and during
| Marker | When | Why it is on the list |
|---|---|---|
| Full blood count | Baseline | General health baseline before starting |
| Liver panel (ALT, AST, GGT, bilirubin) | Baseline · week 8 | NAD+ metabolism runs partly through the liver |
| Cystatin C (never creatinine alone) | Baseline · week 8 | Kidney measure not distorted by muscle or creatine |
| Fasting glucose | Baseline | General metabolic baseline |
| hs-CRP | Baseline | General inflammation baseline |
| Homocysteine | Baseline | B12 and folate context relevant to NAD+ pathways |
Same lab, same time of day, before the injection, so the week-8 comparison means something. B-vitamins from food rather than supplements — leafy greens, eggs, meat, fish and whole grains cover the B12, folate and niacin context NAD+ metabolism draws on. Limit alcohol: its metabolism consumes NAD+ directly.
Stacking: what it pairs with
NAD+ belongs to the "energy and reset" corner of the library, with MOTS-c and epithalon. The common pairing for the researcher who trains is MOTS-c on training mornings alongside NAD+ on Monday and Thursday — different mechanisms, both quiet, both judged on energy and training numbers rather than the scale. Epithalon fits as a ten-day course at the start of an NAD+ cycle for the researcher coming off travel or burnout, since both are aimed at the same tired-and-foggy picture from different sides.
NAD+ has no interaction with the fat-loss compounds and is a reasonable companion to a retatrutide or tirzepatide cycle when energy dips in the ramp weeks, though that is a personalised-protocol decision rather than a default.
Common mistakes
- Pushing it in fast. This is the mistake. Sixty to ninety seconds, counted, every dose.
- Injecting fasted. Nausea is more likely on an empty stomach. Eat first.
- Dosing in the afternoon. Later doses can make it harder to wind down at night. Miss the morning window and wait for the next scheduled day.
- Stepping up after an easy week 1. The run-in is two weeks at 30 clicks regardless of how it felt.
- Expecting a kick. NAD+ is not a stimulant; it delivers steadier days, not a buzz. Judge it at week 3, not dose 1.
- Running it back to back. It is a maintenance-style compound meant to be cycled with a 4–8 week break, not run indefinitely.
Frequently asked questions
How many clicks is an NAD+ injection on the 500 mg pen?
The 500 mg pen holds 300 clicks at 1.67 mg per click. The house protocol is 30 clicks (50 mg) on Monday and Thursday for weeks 1–2, then 60 clicks (100 mg) on the same days for weeks 3–8.
Why does NAD+ cause flushing or chest tightness?
Almost always because it was injected too fast. A slow subcutaneous push over 60 to 90 seconds, taken after food, removes most of the flushing, warmth and nausea people associate with NAD+. If it persists after the first two or three doses despite a slow push, hold and message your coach.
How many pens does an 8-week NAD+ cycle take?
Three. The cycle uses 840 of the 900 clicks in three pens, leaving about 60 clicks — one spare 100 mg dose.
Can I inject NAD+ more than twice a week?
House dosing never exceeds three doses a week. An optional third dose on Saturday from week 3 is for advanced researchers working with a coach, not part of the general protocol.
When should I feel something from NAD+ injections?
Some notice sleep quality or a clearer head within a day or two; most who respond feel it by weeks 2–3. From week 6 the effect plateaus — that is expected, because NAD+ support maintains a baseline rather than building a growing effect.
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