Vol. IV · iii Longevity 2 min read
NAD+ Injections: Do They Work, and What Do They Cost?
Your cells do not run out of energy so much as they run out of the currency that moves it.
NAD+ is a coenzyme, not a stimulant. It shuttles electrons through the reactions that turn food into usable energy, and it is consumed by the enzymes that repair DNA. Levels decline with age and under metabolic stress. Patients rarely describe replenishment as energising — they describe the afternoon no longer being a problem.
What NAD+ actually does
NAD+ is a coenzyme present in every cell. It carries electrons through the reactions that convert what you eat into usable energy, and it is consumed by repair enzymes that maintain DNA.
Every cell holds a limited pool of it. That pool is not a fuel tank you top up for a burst of performance; it is closer to working capital, and running short lowers the ceiling on what a cell can do before it needs to recover.
Why the pool falls
Levels decline with age, and faster under metabolic stress u2014 poor sleep, alcohol, chronic inflammation, a sustained calorie deficit.
That is worth noticing, because a depleted pool is usually a symptom of something else that is also worth fixing. Treating the marker while the cause continues is a familiar and expensive mistake.
Patients rarely describe NAD+ as energizing. They describe the afternoon as no longer being a problem.
What patients actually report
The result is not fatigue relief in the way caffeine addresses fatigue. Patients rarely describe NAD+ as energising. They describe the afternoon no longer being a problem.
Because it is replenishment rather than stimulation, the timeline is different. Most patients notice something in the second or third week, and what they notice tends to be the absence of a low rather than the presence of a high.
Being honest about the evidence
NAD+ is a genuinely active area of research and also a heavily marketed one, and those two facts are frequently confused. The cellular biology is well established; the clinical claims made in consumer marketing often run well ahead of it.
We dose it weekly and review it alongside sleep, training load and B12 status, because those are the things most likely to be producing the same complaint. If one of them is the answer, it is a cheaper and more durable answer.
Common questions
Does NAD+ therapy actually work?
The cellular biology is well established: NAD+ is essential to energy metabolism and DNA repair, and levels decline with age and metabolic stress. Consumer marketing claims often run ahead of the clinical evidence, which is why we review it alongside sleep and B12 rather than treating it as a first move.
How long does NAD+ take to work?
Most patients who notice a change report it in the second or third week. It is described as the absence of an afternoon low rather than a stimulant effect, because it is replenishment rather than stimulation.
Is injection better than an oral NAD+ supplement?
Absorption differs substantially between routes, which is the usual argument for injection. Which is appropriate depends on your situation and should be a conversation with your provider rather than a default.
Educational — not medical advice.