NAD+ Oral Precursor + IV
Mitochondrial energy. Sirtuins. DNA repair.
Three biological pathways depend on NAD+ in ways that matter for aging. First: mitochondrial energy production. Every ATP molecule your cells generate from food relies on NAD+ as an electron carrier in the citric-acid cycle and electron-transport chain. Second: the sirtuin family of NAD+-consuming enzymes — SIRT1 through SIRT7 — orchestrates DNA repair, gene-expression regulation, and metabolic adaptation. As NAD+ depletes, sirtuin activity falls, and the maintenance work of the genome slows. Third: PARP (poly-ADP-ribose polymerase) enzymes consume NAD+ to repair damaged DNA strands. Chronic low-grade DNA damage from environmental stressors steadily pulls NAD+ away from sirtuins toward PARP, accelerating the decline. Restoring NAD+ is therefore not about a single pathway but about restoring the cellular currency that all three depend on.
Daily oral maintenance plus IV for acute windows.
NMN (nicotinamide mononucleotide) 500-1,000 mg per day — or NR (nicotinamide riboside) 300 mg per day — taken orally raises tissue NAD+ levels over 4-8 weeks toward those of a younger adult. We use pharmaceutical-grade preparations only; off-the-shelf supplements vary widely in purity. For loading phases, post-illness windows, jet-lag recovery, cognitive-demand events, or post-procedure recovery, we add NAD+ IV infusion — 500-1,000 mg over a 2-4 hour slow drip in a private suite. The IV bypasses gut absorption and pushes serum NAD+ up by orders of magnitude within minutes. We routinely pair the protocol with TMG (trimethylglycine, 1-2 g/day) to support the methylation pathway that handles excess nicotinamide breakdown, plus resveratrol, fisetin, or urolithin A as sirtuin-pathway synergists.
Tracking what changes, not what people promise.
NAD+ optimization is one of the few longevity interventions where you can actually measure the input directly: whole-blood NAD+ levels. We check NAD+, methylation panel (homocysteine, MMA, folate, B12), and an extended longevity panel quarterly during the first year, then semi-annually. We also screen for the most common limiters: untreated B12 deficiency, MTHFR variants that alter methylation demand, and chronic alcohol use that drains the substrate. The protocol is adjusted based on response, not held to a fixed dose. For members combining NAD+ with hormone optimization, we coordinate dosing across the calendar so cofactor demand and lab timing line up — avoiding the common pitfall of independently prescribed protocols that compete for the same methylation budget.
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NMN 500-1,000 mg Daily
Pharmaceutical-grade oral precursor — raises tissue NAD+ over 4-8 weeks.
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NR 300 mg Daily (alt.)
Alternative oral precursor where NMN is contraindicated or not tolerated.
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NAD+ IV 500-1,000 mg
2-4 hour drip for acute windows, loading, or post-procedure recovery in a private suite.
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TMG Methyl-Donor Cofactor
1-2 g daily to support methylation that handles excess nicotinamide.
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Sirtuin-Pathway Synergists
Resveratrol, fisetin, urolithin A — paired according to your lab profile.
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Quarterly Monitoring
Whole-blood NAD+, methylation panel (homocysteine, MMA, folate, B12), extended longevity panel.
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Cross-Protocol Coordination
Dosing calendar aligns with hormone and IV-drip protocols to avoid cofactor competition.
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Genetic Variant Screening
MTHFR and other methylation variants screened before high-dose NAD+.
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Club Coordination
A health steward handles scheduling, labs, and dosing adjustments throughout the year.
Frequently Asked
Oral vs. IV — how to choose?
Oral NMN or NR raises tissue NAD+ steadily over weeks; IV pushes serum NAD+ up by orders of magnitude within minutes. Most clinicians use oral as daily maintenance — that is what builds the baseline. IV is reserved for acute windows: cognitive-demand events, recovery from illness, jet lag, post-surgical healing, or pre-event loading. The two are complementary, not interchangeable.
What's required before the first session?
Baseline whole-blood NAD+ if available, methylation panel (homocysteine, MMA, folate, B12), liver and kidney function, ECG for first-time IV recipients, and screening for MTHFR variants. The supervising physician reviews contraindications and titrates initial dosing.
Will I feel different on NAD+?
Effects are variable. Many members report improved energy, mental clarity, and sleep quality within 4-6 weeks of oral NMN. IV infusion often produces a noticeable cognitive lift the same day. We avoid overpromising — NAD+ is foundational biology, not a stimulant; the most durable benefits are quiet and accumulate.
Is NMN safe long-term?
Long-term human safety data for NMN extend to roughly 5-10 years of supplementation. We monitor liver enzymes, methylation markers, and homocysteine quarterly. There is no established lifetime ceiling, but we adjust dose downward when markers permit so the body is not chronically running on supplementation when endogenous synthesis improves.
Can I take NMN if I have cancer?
We do not offer NMN or NAD+ IV to patients with active cancer or recent (within 2 years) treated cancer without oncology clearance. NAD+ supports cellular bioenergetics — including, theoretically, in malignant cells — and the risk-benefit balance in active malignancy is unresolved.
Insurance coverage?
Not covered. NAD+ optimization is an elective longevity wellness service paid privately. We provide itemized receipts for extended-health benefit submission and the CRA Medical Expense Tax Credit.