NAD+ 100mg/10ml/1vial Injectable

Description

What is NAD+ Injection?

NAD+ Injection is a compounded prescription formulation of nicotinamide adenine dinucleotide (NAD+), a coenzyme found in all living cells and crucial for fundamental biological processes. NAD+ helps drive cellular energy production by shuttling electrons in metabolic pathways like glycolysis and the Krebs cycle, ultimately enabling ATP synthesis for cell function. Beyond its metabolic role, NAD+ also participates in DNA repair and cell signaling, making it essential for maintaining cellular health and viability.[¹] Natural NAD+ levels decline progressively with age; by middle age, tissues may contain roughly half the NAD+ they had in youth. This age-related NAD+ depletion has prompted interest in NAD+ supplementation strategies to support cellular metabolism and possibly counteract aspects of aging.

Clinically, NAD+ Injection has been explored for a range of potential wellness benefits, although robust evidence in humans remains limited. Advocates propose that boosting NAD+ could increase energy levels, enhance mitochondrial function, and improve fatigue or cognitive clarity in some individuals. NAD+ therapy is also being investigated in contexts like healthy aging and neuroprotection, and it has been trialed as an adjunct in addiction recovery programs to reduce withdrawal symptoms, though formal clinical trial data are still sparse. Importantly, NAD+ Injection is not an FDA-approved drug; it is prepared by licensed 503A compounding pharmaciesand 503B outsourcing facilities for patient-specific and office use with a doctor’s prescription. All potential benefits therefore must be weighed cautiously, and treatment is undertaken under medical supervision given that safety and efficacy are not yet established by regulatory authorities.

How does NAD+ Injection work in the body?

NAD+ Injection works by providing additional NAD+ for the body’s cells to be used in metabolic and regulatory processes. NAD+ is crucial as a coenzyme in reactions that generate ATP (energy) in cells, and it also serves as a substrate for enzymes involved in DNA repair and gene regulation. When administered, NAD+ can be absorbed into tissues (or converted into precursor forms that enter cells) and may enhance the efficiency of mitochondrial energy metabolism. The exact mechanisms are complex, but broadly NAD+ injections may counteract NAD+ depletion and support better cellular function, especially in high-demand tissues like the brain and muscles.

Benefits of NAD+ Injection

As stated earlier, NAD+ is crucial for a number of key physiological processes within the human body. A deficiency in NAD+, or a disruption in NAD+ homeostasis in the body, may impair these physiologic processes, which may result in different illnesses or disease conditions. Discussed below are some of the many physiologic processes that are dependent on NAD+.

1. Genomic Stability

On a daily basis, reactive oxygen species (ROS) and reactive nitrogen species (RNS) are released endogenously within the body; these substances cause damage to cellular DNA. In addition, exogenous factors such as carcinogens, chemical mutagens, as well as radiation may also result in cellular DNA damage. When cellular DNA damage occurs due to either endogenous or exogenous factors, genomic instability occurs, which may result in cancer development and an increased rate of cellular aging.

In order to minimize cellular DNA damage and its consequences, there is a process in the body known as DNA-damage response (DDR). DDR is a process that detects and repairs any damaged DNA in the body. DDR is a process that is highly dependent on NAD+; when amounts of NAD+ are low in the body, the DDR process is impaired, resulting in increased damage to the cellular DNA.

2. Genetic Expression

The means by which genetic information in cellular DNA is used to produce the relevant proteins or substances in the human body is known as genetic expression. Genetic expression is the process that is responsible for the development of all the physical features that define an individual, such as hair and skin color, among other physical characteristics.

One of the mechanisms by which genetic expression successfully occurs in the body is through modifying a product known as histones. Histone modification is a NAD+ dependent process; a deficiency in NAD+ levels may disrupt histone modification, which may impair genetic expression. NAD+ deficiency may also result in the methylation of cellular DNA so that genes are not expressed appropriately; this is known as genetic silencing.

3. Immunity and Inflammation

Studies have shown that NAD+ levels in the human body determine the extent as well as the effectiveness of immune responses during infection. Increased levels of NAD+ during an infection increase oxidative phosphorylation in macrophages, which makes them better able to neutralize the organism causing the infection.

In addition to the increased expression of macrophages, NAD+ also exerts anti-inflammatory effects during an infectious process. Studies have shown that the expression of inflammatory markers such as Tumor Necrosis Factor alpha (TNF-a) and Interleukin-6 (IL-6) significantly diminish when there are high cellular levels of NAD+ and its precursors.

4. Energy Metabolism

Several metabolic pathways in the human body result in the release of energy. Some examples of the energy metabolic pathways are glycolysis, tricarboxylic acid (Krebs) cycle, oxidative phosphorylation, fatty acid oxidation, and ethanol metabolism. All the energy metabolic pathways require the presence of NAD+ as a coenzyme to function properly. In the glycolytic pathway, NAD+ facilitates the catalytic reactions of Glyceraldehyde-3-phosphate dehydrogenase (GADPH) and lactate dehydrogenase (LDH). In the Krebs cycle, NAD+ functions as a coenzyme for the rate-limiting enzymes alpha ketoglutarate dehydrogenase, isocitrate dehydrogenase, and malate dehydrogenase. Alcohol metabolism, which occurs in liver cells, also requires NAD+ as a cofactor for the process’s successful execution. A deficiency of NAD+ in the body may impact all these processes and negatively impact the effectiveness by which energy is generated and utilized by the body.

5. Circadian Clock

The circadian clock, also known as the biological clock or circadian rhythm, is an internal endogenous process that regulates the sleep-wake cycle in the human body. This internal clock helps the body adjust to different times of the day or the different seasons. The accuracy and effectiveness of the circadian clock are due in part to cellular levels of NAD+. A deficiency of NAD+ may disrupt the circadian rhythm and result in effects such as daytime sleepiness, restless sleep, hormonal imbalances, and mood alterations, among others.

6. Cardiovascular Function

The heart is the most metabolically active organ in the human body because it is constantly beating. Studies have shown that normal NAD+ levels are essential in maintaining the metabolic activity of the heart. Furthermore, in the event of a significant cardiac event such as a transient ischemic attack or myocardial infarction, normal levels of NAD+ help in the recovery from injury. Other studies have shown that a deficiency in NAD+ may result in cardiac disorders such as cardiac hypertrophy and fibrosis.

7. Kidney Function

Generally, renal function has a tendency to decrease as people get older. It is suspected that reduced levels of NAD+ in the elderly may have a role to play in the reduction in renal function. Research has indicated increased protection against acute renal injury when individuals were given NAD+ supplements. In addition, NAD+ supplements stimulated the release of prostaglandin E2, which serves to improve renal function after an acute renal injury.

8. Liver Function

Normal NAD+ levels in the body are essential for the optimal functioning of the liver. Specific enzymes in the NAD+ pathways protect the liver from conditions such as hepatic fibrosis, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. Several studies have been performed that show that giving individuals NAD+ supplements may boost the liver’s overall health, protect it from toxic illnesses, and enhance its capacity for regeneration after a hepatic injury.

9. Neurological Function

NAD+ and its precursors have been shown to have a protective effect on the neurons in the brain after a significant neurological event such as a stroke. Having normal levels of NAD+ in the body is essential to the normal functioning and survival of cerebral neurons. Additionally, NAD+ supplements have shown some benefits in treating and preventing some neurodegenerative diseases such as Alzheimer’s disease; this is not definite, however, and there are several ongoing studies still exploring this possibility.

Anticipated Side Effects and Management

1. Injection Site:

Discomfort, erythema, or small nodules.

2. Systemic Effects:

Mild fatigue, nausea, or headache (especially with higher doses).
Mitigation strategies:
Slow the injection rate.
Split doses if necessary.

3. Management:

Most side effects can be managed with OTC therapies.
Persistent or severe side effects should be escalated to a supervising clinician.

These localized reactions typically resolve quickly. Gastrointestinal upset is infrequent but has been noted (e.g. a few patients have reported stomach discomfort or loose stools).

Overall, these side effects are short-lived and manageable, often improving by slowing the rate of administration or taking breaks during an intravenous infusion if needed. NAD+ Injection’s side effects are mild and manageable, and serious side effects appear rare. Patients often finish NAD+ treatment reporting positive effects (such as increased energy or mental clarity) with few downsides aside from the transient discomforts noted above. Nevertheless, ongoing surveillance and research are important to fully characterize long-term safety as use of this therapy expands.

Dosage and Administration

1. Initial Dose:

Start with 50 mg (0.5 mL) subcutaneously once weekly for 4 weeks.

2. Titration Criteria:

Evaluate patient progress every 4 weeks:
No/minimal side effects: Increase dose to 100 mg (1 mL) once weekly.
Effective dose with no/minimal side effects: Maintain the current dose for the next 4 weeks.
Intolerance to side effects: Decrease the dose to 50 mg for the next 4 weeks or consider discontinuing treatment with medical consultation.

Maximum dose: 100 mg once weekly.

3. Injection Sites:

Recommended sites:
Abdomen (RUQ, RLQ, LUQ, LLQ).
Back of the upper arm.
Front of the thigh

Rotate injection sites at each appointment to prevent tissue irritation and nodule formation.
Avoid using the same injection site as another injection received on the same day.

NAD+ Storage and Stability

Store unopened/unreconstituted vials in a controlled room temperature environment as per manufacturer recommendations. Do not freeze.
Once reconstituted, store vials in the refrigerator at 36°F to 46°F (2°C to 8°C).

Note that the contents of a vial expire 30 days after opening. Discard expired vials and contact the supervisor for further instructions.

Summary

NAD+ is essential for regulating metabolism and circadian rhythm. As we age, levels of NAD+ decline. Reduced levels of NAD+ are associated with conditions like mental decline, diabetes, and heart disease. Niacin, niacinamide, NMN, and NR can all boost levels of NAD+ in the body.

In theory, these supplements could slow the effects of aging and combat diseases, but more research is needed. Without strong clinical trials in humans, informed decisions cannot be made about the risks versus benefits of various NAD+ supplements. Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.