NAD injections are becoming popular in longevity and wellness clinics, often promoted for energy, anti-aging, and recovery. But unless you're familiar with cellular biology, the terminology—and the treatment itself—can be confusing.
NAD stands for nicotinamide adenine dinucleotide. It's a molecule present in every cell of your body, essential for converting food into energy and regulating how cells respond to stress and aging. Without adequate NAD, your mitochondria (the energy factories in your cells) can't function properly.
The problem: NAD levels drop significantly as you age, declining roughly 50% between youth and old age. This decline appears directly linked to the fatigue, metabolic dysfunction, and cellular deterioration we associate with aging.
The premise behind NAD treatment is that if declining NAD drives aspects of aging, restoring it might help slow or reverse some of that decline. But getting NAD into your cells is more complicated than it sounds.
If you’re wondering, "What are NAD injections and why should I care?” This article will highlight everything you need to know.
NAD Basics: The Cellular Currency
To really understand what NAD injections are, we should first explore the role of NAD in general.
NAD powers energy production: Every time your cells convert glucose or fat into usable energy, NAD is involved in the electron transfer reactions that make it happen. Your mitochondria—the structures responsible for generating ATP, your body's direct energy currency—can't function without adequate NAD. Low NAD means compromised energy production, which manifests as fatigue and reduced capacity that characterize aging.
NAD activates longevity enzymes: NAD activates a family of enzymes called sirtuins, which regulate stress responses, DNA repair, inflammation, and gene expression. Sirtuins have been called "longevity genes" because activating them has proven to extend the lifespan of mammals. But sirtuins require NAD to function. When NAD drops, sirtuin activity drops with it, even if the enzymes themselves remain present.
NAD functions as a metabolic sensor: Your cells monitor NAD levels to gauge their energy status and adjust their behavior accordingly. It's a real-time indicator of cellular health that influences decisions about growth, repair, and survival.
Why NAD Declines With Age
NAD levels don't remain constant throughout life. Research consistently shows roughly a 50% decline between youth and old age across multiple tissues, including liver, skeletal muscle, and brain.
Lower NAD means impaired mitochondrial function, weakened stress responses, and accelerated cellular deterioration. The metabolic exhaustion, reduced recovery capacity, and progressive dysfunction we associate with aging may be substantially driven by NAD decline.
This is why NAD restoration has moved from theoretical longevity intervention to active clinical investigation.
So, What Are NAD Injections Exactly?
You can't simply take NAD orally and expect it to work—the molecule is large and breaks down in your digestive system before reaching your bloodstream. This is why most NAD supplements actually contain precursors—smaller molecules designed to convert into NAD once inside your cells.
NAD injections take a different approach.
NAD injections deliver nicotinamide adenine dinucleotide directly into your body through one of three methods: intramuscular (into muscle tissue), subcutaneous (under the skin), or intravenous (into the bloodstream via IV drip).
The solution contains NAD dissolved in sterile saline or a similar carrier solution. Some formulations include additional compounds like B vitamins or electrolytes, though NAD itself is the active component.
The 3 Injection Delivery Methods
Intramuscular (IM) injection: A needle delivers NAD directly into muscle tissue, typically the deltoid (shoulder), gluteal (buttock), or thigh. The muscle tissue has a rich blood supply, so NAD is absorbed into circulation over 30 minutes to several hours. This can be done in a clinical setting or self-administered at home.
Subcutaneous (SubQ) injection: NAD is injected into the fatty tissue just beneath the skin, usually in the abdomen or thigh. Absorption is slower than IM—creating a sustained release over several hours. This method is often better tolerated with less injection site discomfort and is commonly used for at-home protocols.
Intravenous (IV) infusion: NAD is delivered directly into a vein, entering your bloodstream immediately. This produces the highest blood levels fastest but requires clinical supervision and takes 1-4 hours depending on dose and tolerance. IV NAD is typically administered in medical offices or IV therapy clinics.
What Happens After Injection?
Once NAD enters your bloodstream via injection, it circulates throughout your body, becoming available to tissues and cells.
The molecule has a relatively short half-life in circulation, measured in hours rather than days. Cells take up NAD from the blood, though the efficiency of this uptake likely varies by tissue type. Some tissues may be better equipped to transport NAD across cell membranes than others.
Inside cells, NAD becomes available for mitochondrial energy production and sirtuin activation—the two primary pathways responsible for its effects on metabolism and aging.
Expected Timeline of Effects
Immediate (within hours): Many people report noticeable energy increase, mental clarity, or mild euphoria during or shortly after IV infusion. Injection effects typically appear within several hours as NAD absorbs.
Short-term (days to weeks): Some report improved energy levels, better sleep quality, enhanced recovery from exercise, and increased mental focus are commonly reported with repeated dosing.
Longer-term (weeks to months): Some report sustained metabolic improvements, body composition changes, and biomarker shifts that require consistent treatment over extended periods. Individual variation is significant here.
Who Might Benefit Most from NAD Injections
NAD injections aren't automatically better than oral supplements—it depends on your age, metabolism, and what you're trying to accomplish.
You Might Be a Good Candidate If:
You're over 45 with declining energy: The enzymes that convert oral precursors into NAD decline with age. If your conversion machinery is compromised, direct delivery makes more sense than asking your body to process supplements.
Oral NAD supplements didn't do much: If you've taken NMN or NR consistently without noticing anything, the problem might be conversion, not the concept. Injectable NAD removes that variable.
You're dealing with metabolic issues: Obesity, pre-diabetes, or metabolic syndrome typically mean higher inflammation and more active NAD degradation. Your body may burn through oral precursors before they convert. Direct injection gets around this.
Oral Supplements Might Work OK If:
You're young with good metabolic health: If you're in your 30s and metabolically healthy, your conversion enzymes probably work fine. Oral precursors may be enough at a fraction of the cost. However, at this age, declining NAD isn’t too much of a problem.
You want daily baseline support: Pills are convenient. Injectable protocols require more logistics. For ongoing maintenance rather than targeted intervention, oral makes sense.
Cost matters: NAD injections run $150-$200 per month. Quality oral precursors cost $1-3 daily. If budget is a constraint, you're young, reasonably healthy, try oral first.
Skip NAD Injections If:
You expect miracles: NAD addresses one mechanism of aging. It won't fix everything, reverse decades of poor health habits, or substitute for sleep, nutrition, and exercise.
You have cancer history: NAD promotes cellular metabolism, which could theoretically affect rapidly dividing cells. Don’t take NAD if you have active or recent cancer or tumor growth.
Your inflammation and metabolism are severe: If you're fighting severe obesity, uncontrolled diabetes, or active inflammatory disease, you're pouring NAD into a system that's actively degrading it. Best to address the foundation first.
Where Can I Get NAD Injections?
These days, you have a few options for where to get NAD injections: integrative medicine practices, wellness clinics, and IV therapy lounges. However, wellness clinics and IV lounges may operate with very little medical oversight, and aren't exactly cheap. Expect to pay premium prices—often $200-500+ per IV session. And not everyone can afford to work with an integrative medicine doctor who is knowledgeable about NAD.
For a lot of people, getting NAD injections through an online telemed service and delivered to your home seems to be the best of both worlds. There is real medical oversight, and it's affordable since it's dosed in 30-day supplies instead of one-offs.
Telemed services like Strut Health operate entirely online:
- Complete a medical assessment from home (typically 5-10 minutes)
- U.S.-licensed physicians review your information remotely
- If approved, NAD is compounded fresh at U.S. pharmacies and shipped directly to you
- Instructions for self-administration and start-up kit included
- No need to find local clinics or schedule in-person appointments
This model offers convenience and typically lower cost than clinic-based treatment. You handle the injection yourself (or have someone assist), which some people prefer and others find intimidating.
The trade-off: you're responsible for proper administering technique and monitoring your own response. This works well for motivated individuals comfortable with self-administration, but may not suit everyone.
Learn More: How to Buy NAD+ Injections Online Safely (What to Look For)
What to Look For When Finding a Provider
Regardless of source:
- Legitimate medical oversight: A licensed physician should review your health history and approve treatment. "Wellness consultants" without medical credentials don't count.
- Compounding quality: NAD should come from reputable U.S. compounding pharmacies following sterility and quality standards. Avoid gray-market sources or international suppliers with unclear origins.
- Clear protocols: You should receive specific dosing instructions, administration guidance, and information about expected effects and potential side effects.
- Reasonable claims: Providers making extreme promises about life extension or disease cure should raise red flags. Look for those who present NAD therapy realistically.
The Practical Reality
For most people, telemedicine platforms offer the best combination of accessibility, cost, and medical oversight. Traditional clinics provide more hands-on care, but at significantly higher cost and with geographic limitations.
The right choice depends on your comfort with self-administration, budget, and desire for in-person clinical support.
Conclusion: When NAD Injections Make Sense
NAD injections bypass digestion and the enzyme conversion that oral supplements require. For people whose conversion pathways don't work well anymore—especially older adults and those with metabolic problems—direct delivery restores NAD more reliably than pills.
But injections work best when you're also addressing what depletes NAD in the first place. Managing inflammation, improving metabolic health, and supporting lifestyle factors that preserve NAD—exercise, avoiding chronic metabolic stress—makes the injections more effective. Without that foundation, you're fighting an uphill battle.
What to expect: Some people report dramatic energy improvements. Others notice subtle shifts. Your metabolic state, inflammatory burden, and how active your NAD-degrading enzymes are all affect results.
NAD injections are a tool for optimization, most effective when the rest of your health foundation supports what you're trying to accomplish.
Start Your NAD Injection Therapy Online
Take a simple 5-minute online medical assessment to see if you qualify for NAD+ injection therapy.
A licensed physician reviews your health history and determines if this is appropriate for you.
If you qualify, your NAD+ injections are shipped directly to your door with clear administration instructions.
See if you qualify →
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