DIY NAD+ Injections

The idea of increasing NAD+ is popular in the longevity/nootropic cominities, but usually focuses on oral supplementation of NAD precursors with limited efficacy, injecting NAD is likely to be much more potent and potentially poses therapeutic effects for aging and a variety of mitochondrial disorders.

Roles of NAD:

Primarily a universal cellular electron transporter. It has major roles in DNA repair and telomere maintenance. It has extracellular functions such as sirtuin activation, which plays a role in ageing 1. Reduction of NAD leads to progressive and reversible loss of skeletal muscle.2 NAD+ acts extracellularly and intracellularly, "surprisingly, a number of NAD(P) metabolizing enzymes and NAD(P) targets have been found on the outer surface of the plasma membrane and the presence of NAD+ has been confirmed in extracellular fluids.2 “CD38 is a multifunctional enzyme able to generate a wide range of biologically active compounds using NAD" 4

Why inject? Because NAD+ is hydrolyzed to NR in the gut and the large volume makes in unsuitable for sublingual absorption. Clinics charge between $600-2000 for NAD+ injections, you can easily and safely make your own for about $10 per injection.

Benefits of increasing NAD+

It has a long history of use in treating addiction. NAD+/NADH ratio controls autophagy (replacement of damaged cells) 5. Progressive muscle dysfunction can be reversed by the NAD precursor NR 6. Exogenous NAD regulates appetite-regulating neuropeptides in an SIRT1-dependent manner.

Will it increase my athletic performance?

If you are aging, have dysfunctional mitochondria or addiction issues it may be helpful, in young healthy athletes I think it’s unlikely it could increase performance.

But Mike, nucleotides cannot enter cells so any benefit you are getting is do to hydrolysis to NR!

This is a good point but discounts the possibility of a mammalian NAD+ transport protein. This paper found Exogenous NAD is imported into hypothalamic neuronal cells 7. While this paper found that exogenous NAD+ is transported into human mitochondria 8.

How it’s made:

Obviously don’t attempt this if you don’t feel comfortable.

To make 20mL of 100mg/mL NAD+, dissolve 2g of NAD+ in 18mL of distilled water or normal saline. Attach 0.22um filter and filter into a sterile 20mL vial. When ready to inject, using sterile procedure draw the solution into a 20mL syringe, attach to butterfly needle and inject using correct procedure. Alternatively you can inject the solution into an iv bag and infuse that if you don’t want to manually push the solution (1-2 drops per second for 1L).

Injection procedures:

Infusion: 800-1800mg of NAD+ infused over 3-8 hours 9

Push iv: 1800mg of NAD injected as fast as tolerable

Experience: The push iv is quite painful and extremely intense, the only thing I could compare it to in terms of intensity is DMT. After pushing 3mL I experienced intense paresthesia, and involuntary muscle contraction which subsides within a minute, I struggled to inject the rest of the solution. If injected over a longer period this can be avoided, 1.5 hours was tolerable for 1.8g. Infusing over even longer periods 3+ hours has even less discomfort and may maintain elevated levels longer with a lower peak. I noticed having less appetite on days I infused the NAD.

Possible side Effects: NAD+ can act as a pro-inflammatory cytokine targeting human granulocytes, and is a vasoconstrictor 10.