NAD+ IV Therapy
NAD+ is a vital molecule found in every cell of your body, essential for producing energy, repairing DNA, and responding to stress. IV NAD+ therapy has gained attention for anti-aging, brain health, addiction recovery, metabolic support, and chronic fatigue.
NAD+ levels naturally decline with age and are further depleted by chronic stress, illness, substance use, and metabolic issues. Low NAD+ levels are linked to age-related diseases, brain health problems, and metabolic dysfunction. IV administration delivers NAD+ directly into your bloodstream for rapid absorption and higher levels than oral supplements can achieve.
Overview
NAD+ consists of two nucleotide moieties: one containing an adenine base and the other containing nicotinamide. These are linked through their phosphate groups, creating a molecule capable of accepting and donating electrons. NAD+ exists in oxidized (NAD+) and reduced (NADH) forms, with the NAD+/NADH ratio serving as a critical indicator of cellular redox state and metabolic health.
The molecule's structure allows it to function as a hydride acceptor, accepting two electrons and one proton to form NADH during catabolic reactions. This fundamental property enables NAD+ to drive cellular respiration and energy production in mitochondria while supporting hundreds of enzymatic reactions throughout the body.
Chemical structure & Properties
- Molecular Formula: C₂₁H₂₇N₇O₁₄P₂
- Molecular Weight: 663.43 g/mol
- Chemical Name: β-Nicotinamide adenine dinucleotide
- Chemical Class: Dinucleotide coenzyme
- Structure: Composed of two nucleotides joined by phosphate groups
- Stability: Stable in solution when properly prepared; light-sensitive
Mechanism of Action
Clinical Applications
Expected Results and Therapeutic Benefits
Protocol Considerations: Initial intensive protocols (daily infusions for 5-10 days) may provide rapid NAD+ restoration with more pronounced acute benefits. Monthly maintenance infusions help sustain elevated NAD+ levels and ongoing therapeutic effects. Individual responses vary based on baseline NAD+ status, age, health conditions, and lifestyle factors.
Safety Profile and Considerations
Regulatory Status and
Clinical Use
FDA Status
Not FDA-approved as a therapeutic agent; classified as a dietary supplement ingredient
Off-Label Medical Use
Employed by healthcare providers in clinical settings for various therapeutic indications
Compounding Status
Available through compounding pharmacies for IV formulation under physician supervision
Quality Considerations
Available through compounding pharmacies for IV formulation under physician supervision
IV NAD+ therapy represents an off-label application based on established biochemical importance, growing clinical experience, and emerging research evidence. Healthcare providers may recommend NAD+ therapy when potential benefits align with patient needs and standard treatments are insufficient.
Clinical Considerations
The Paragon Method: Step-by-Step
Administration and Treatment
- Route: Intravenous infusion administered slowly over extended period
- Infusion Rate: Typically 2-4 hours per session; rate adjusted based on tolerance (slower rates reduce side effects)
- Initial Protocol: Common approach involves 5-10 consecutive daily infusions for acute restoration
- Maintenance: Monthly or bi-monthly infusions to sustain elevated NAD+ levels
- Timing: Morning or early afternoon administration preferred to avoid sleep interference
Patient Selection
Appropriate candidates include individuals with age-related energy decline, chronic fatigue or mitochondrial dysfunction syndromes, neurodegenerative or cognitive concerns, those in addiction recovery programs, patients with metabolic disorders, and those pursuing preventive health optimization. Best results in patients with documented NAD+ depletion or conditions associated with mitochondrial dysfunction.
Pre-Treatment Assessment
- Comprehensive medical and medication history
- Baseline energy, cognitive, and functional assessment
- Cardiovascular screening for significant heart disease
- Discussion of realistic expectations and protocol commitment
- Evaluation of methylation status and supplementation needs
- Informed consent regarding off-label use
Optimization Strategies
- Adequate hydration before infusion
- Light meal 1-2 hours prior (not on empty stomach)
- Comfortable setting with ability to recline
- Entertainment or relaxation activities during lengthy infusion
- Methylation support supplementation (B vitamins) when appropriate
- Lifestyle modifications supporting NAD+ levels (exercise, sleep, stress management, dietary optimization)
- Avoidance of NAD+-depleting substances (excessive alcohol, smoking)
During Infusion Management
- Start with slower infusion rates and increase as tolerated
- Immediate rate reduction if discomfort develops
- Patient communication and comfort monitoring
- Availability of anti-nausea medication if needed
- Vital sign monitoring at regular intervals
Post-Treatment Care
- Brief observation period after infusion completion
- Hydration encouragement
- Rest if fatigue present (typically brief)
- Assessment of immediate response and side effects
- Scheduling of subsequent treatments in protocol
- Ongoing evaluation of cumulative therapeutic benefits
Monitoring
- Session-by-session tolerance and side effect assessment
- Progressive evaluation of energy, cognitive function, and primary treatment goals
- Adjustment of infusion rate or protocol based on response
- Long-term monitoring of sustained benefits with maintenance protocols
Conclusion
NAD+ IV therapy addresses cellular energy deficits, supports healthy aging, and optimizes metabolic and neurological function. As an essential coenzyme in hundreds of cellular processes, NAD+ restoration addresses cellular health that declines with age and is depleted by stress, illness, and metabolic disorders.
The therapy supports mitochondrial function, activates longevity pathways through sirtuins, enables DNA repair, and enhances neurological function, providing strong scientific rationale for applications in chronic fatigue, neurodegenerative conditions, addiction recovery, metabolic disorders, and anti-aging medicine.
Infusion-related side effects are common but manageable through rate adjustment and resolve quickly. The therapy demonstrates favorable safety with experienced practitioners and appropriate monitoring. Extended infusion times and multiple sessions require patient commitment and proper expectations.
References
Verdin E. NAD⁺ in aging, metabolism, and neurodegeneration. Science. 2015;350(6265):1208-1213.
Braidy N, et al. NAD+ therapy in age-related degenerative disorders: A benefit/risk analysis. Exp Gerontol. 2020;132:110831.
Rajman L, et al. Therapeutic potential of NAD-boosting molecules: The in vivo evidence. Cell Metab. 2018;27(3):529-547.
Yoshino J, et al. NAD+ intermediates: The biology and therapeutic potential of NMN and NR. Cell Metab. 2018;27(3):513-528.
Cantó C, et al. NAD+ metabolism and the control of energy homeostasis: A balancing act between mitochondria and the nucleus. Cell Metab. 2015;22(1):31-53.
Imai S, Guarente L. NAD+ and sirtuins in aging and disease. Trends Cell Biol. 2014;24(8):464-471.
Disclaimer: This information is provided for educational purposes only and does not constitute medical advice. NAD+ IV therapy is not FDA-approved for the treatment of any disease and represents off-label use of a dietary supplement ingredient. Patients should consult with qualified healthcare providers before considering any IV therapy. The content reflects current scientific literature and clinical practice as of 2025. Individual results may vary, and treatment appropriateness should be determined on a case-by-case basis by licensed medical professionals. NAD+ IV therapy requires extended infusion times and multiple sessions for optimal results, necessitating significant time commitment and proper medical supervision.