NAD Injections Guide: Benefits, Risks and Costs

Nicotinamide adenine dinucleotide (NAD+) injections give cells extra fuel without the long wait of an IV drip. A shot into muscle or under the skin puts NAD+ building blocks straight into tissue before the gut has a chance to break them down first.

People choose NAD shots for many reasons. Some want more energy and better mental clarity. Others want support during addiction recovery or help with chronic fatigue.

However most research on NAD+ benefits comes from studies using oral NMN and NR supplements, not injections. Clinical trials that examine NAD+ injections in humans remain limited.

What Are NAD Injections?

NAD+ injections deliver nicotinamide adenine dinucleotide directly into muscle or fat tissue. This coenzyme exists in every living cell and is a driving force for hundreds of metabolic reactions.

Your body uses NAD+ for:

• Converting food into cellular energy (ATP)
• Repairing damaged DNA
• Activating sirtuins (proteins that regulate cellular health)
• Controlling circadian rhythms and gene expression

Research shows NAD levels decline with age across the pancreas, skeletal muscle, liver, skin, and brain^[1]. Studies link this decline to mitochondrial decline, reduced cognitive performance, and metabolic diseases^[2].

How NAD+ Injections Work in Your Body

NAD+ molecules are too large to cross cell membranes intact. Here’s how NAD injections work:

• Enzymes (CD38 and CD157) break down NAD+ into smaller molecules like nicotinamide
• Cells absorb these smaller molecules
• Your cells rebuild them into NAD+ through biosynthetic pathways
• Some specialized tissues like heart muscle can absorb NAD+ directly

A pilot study found urine NAD+ levels jumped 538% during IV infusion, showing substantial amounts pass through unabsorbed^[3].

Whether you use injections or oral supplements, NAD+ precursors convert to NAD+ through the same pathways.

Types of NAD+ Injections: SubQ vs. IM

You can receive NAD injection through subcutaneous (SubQ) or intramuscular (IM) routes.

Subcutaneous Injection (SubQ)

• Injection site: Fatty tissue under skin (abdomen, thigh, upper arm)
• Needle: Short (25-27 gauge, half inch or less)
• Absorption: Slow over several hours
• Comfort: Less soreness, easier self-administration

Intramuscular Injection (IM)

• Injection site: Muscle tissue (thigh, glute, shoulder)
• Needle: Longer (one to one and a half inches), 90-degree angle
• Absorption: Faster (effects within 1-2 hours)
• Comfort: More potential soreness

Both routes bypass digestive metabolism and deliver NAD+ precursors into circulation. Clinical research comparing SubQ versus IM for NAD+ is limited.

What Are the Benefits of NAD+ Injections?

Though the benefits of NAD+ are extensively documented, it is important to consider that the majority of studies analyzing the benefits of NAD+ therapy are based on oral supplementation studies done with NMN and NR.

There is a lack of clinical trials investigating NAD+ injections in human subjects. The benefits outlined in the following sections are primarily from research on oral NAD+ precursors and studies involving animals.

1. Increased Energy and Cellular Function

Multiple preclinical studies show that NAD+ restoration improves mitochondrial health and ATP production. Research in mice found NAD+ treatment reversed age-related decline, boosted muscle function and endurance, and improved muscle stem cell quality^[4].

A 12-week randomized trial of healthy middle-aged adults taking oral NR showed it increased blood NAD+ levels by 60% in a dose-dependent manner^[5].

Another study confirmed that oral NR supplementation is well-tolerated and efficiently stimulates NAD+ metabolism in middle-aged and older adults^[6].

A trial of 207 patients with chronic fatigue syndrome found that 200 mg CoQ10 plus 20 mg NADH daily reduced cognitive fatigue and improved quality of life^[7].

Researchers suggest ME/CFS patients have compromised NAD+ levels, which may explain their cellular energy production failures.

2. Brain Health and Mental Clarity

NAD+ plays an important role in keeping neurons healthy.

Early evidence suggests NAD+ may support cognitive function in people with neurodegenerative conditions^[8].

A study on oral NR supplementation (500 mg twice daily for 6 weeks) raised NAD+ levels in plasma and decreased Alzheimer’s biomarkers including Aβ42 and phosphorylated proteins^[9].

Clinical research shows oral NAD+ precursors can cross the blood-brain barrier and increase neuronal NAD+ levels^[10].

A 2025 trial in patients with Werner syndrome found that 1,000 mg daily oral NR improved arterial stiffness and showed trends toward better cognitive markers^[11].

Dr. Sapna Patel at the University of Colorado cautions that more research is needed to confirm whether supplements deliver on anti-aging and disease prevention claims.

3. Support for Addiction Recovery

NAD+ therapy has been used in addiction treatment since 2001. A Louisiana clinic developed protocols using IV NAD+ for patients with acute withdrawal symptoms from chronic opioid and alcohol abuse.

A 2022 study of 50 patients receiving NAD+ infusions found reductions in craving scores, anxiety, and depression. The results showed strong statistical significance across all three measures^[12].

Dr. Mark Collins, who works in addiction medicine, states: “I have now witnessed its use in many patients and am very impressed with the short-term results.” He adds that longer-term outcome studies are needed.

Patient testimonials suggest NAD+ helps reduce withdrawal symptoms and cravings. Experts stress it must combine with therapy and other treatments, not serve as a standalone solution.

4. DNA Repair and Cellular Health

Your cells need NAD+ for DNA repair through multiple pathways. The enzyme PARP1 handles about 90% of total repair activity and consumes large amounts of cellular NAD+ when fixing DNA damage.

Proteins called sirtuins (especially SIRT1, SIRT6, and SIRT7) require NAD+ to maintain genomic stability. Research in Nature shows that restoring NAD+ improves cellular antioxidant capacity and reduces oxidative stress markers^[13].

This repair work happens constantly in your body. NAD+ gives your cells the fuel they need to fix damage before it accumulates. Studies suggest that maintaining NAD+ levels through supplementation may help preserve these protective mechanisms^[14].

What Are the Risks and Side Effects?

NAD+ injections are generally well-tolerated, but you should know the possible reactions before starting therapy.

Common Side Effects

Most side effects are mild and temporary. The injection site may feel sore, burn, or look red. Some people develop firm lumps where the NAD+ fluid hasn’t dispersed properly or a sterile abscess (a non-infectious fluid pocket).

Systemic reactions include:

• Headache (pressure or throbbing)
• Nausea or stomach upset
• Facial flushing or warmth
• Dizziness or lightheadedness
• Tiredness

A systematic review examining NAD+ supplementation safety found the most common side effects were muscle pain, nervous system issues, fatigue, sleep problems, and headaches. Adverse events did not create serious health risks for participants^[15].

Rare but serious reactions include heart palpitations, blood pressure changes, and allergic reactions ranging from rashes to anaphylaxis in extreme cases. Infection at the injection site happens rarely with proper sterile technique.

High doses can potentially disrupt metabolic balance. Some research suggests decreased insulin sensitivity, raising concerns for people with prediabetes or diabetes. Potential liver strain with excessive dosing remains under investigation.

Who Should Avoid NAD+ Injections?

Several groups should not receive NAD+ therapy or need medical clearance first.

Absolute contraindications:

• Known allergy to NAD+ or its components
• Severe liver or kidney disease
• History of cancer (including skin cancer)
• Pregnancy or breastfeeding

Relative contraindications (require doctor consultation):

• Heart disease or bleeding disorders
• Autoimmune conditions
• Liver or kidney problems
• Children and teens (insufficient safety data)

NAD+ supplements may interact with several medication classes. Diabetes medications might have altered effects due to insulin sensitivity changes. Blood pressure drugs could combine with NAD+ to lower pressure too much. Anticoagulants like warfarin may have affected metabolism. Cancer treatments might be less effective, and antidepressants could interact with NAD+ production pathways.

Always discuss your medications and health conditions with a doctor before starting NAD injection therapy.

How Much Do NAD+ Injections Cost?

Pricing varies widely based on where you get treatment and whether you choose online or in-person options.

Online vs. In-Person Pricing

The most affordable route is through online telehealth clinics. Monthly costs typically range from $105 to $350.

Provider Type	Cost Range	Details
Online Telehealth	$105-$350/month	Includes prescription and supplies shipped to you
Single IM/SubQ Injection (clinic)	$25-$190	One-time or pay-per-visit pricing
IV Therapy Session	$250-$1,500	Requires 1-4 hours at clinic
Loading Phase Packages	$1,500-$6,000	Typically 4-6 sessions over weeks

Location affects pricing. Major cities like Chicago charge $600 to $1,000 per IV session. Smaller towns offer more budget-friendly options at $300 to $500.

NAD injection costs less than IV therapy while offering a different delivery method than oral supplements. You can self-administer after proper training, saving both time and money compared to clinic visits.

NAD+ Injections vs. Other Delivery Methods

Different NAD+ delivery methods have distinct advantages and limitations. Keep in mind that clinical evidence varies significantly by delivery route.

How Do Injections Compare to IV Therapy?

IV therapy delivers higher doses (typically 500-1,000 mg) directly into your bloodstream with immediate availability. Sessions last 1 to 4 hours but provide rapid delivery for people needing fast intervention.

Injections offer several practical advantages:

• Takes minutes instead of hours
• Costs much less per treatment
• You can do it yourself at home after training
• Fewer side effects from lower peak blood concentrations
• Regular smaller doses provide steadier NAD+ levels

The main benefit of IV therapy is the higher dose and immediate bloodstream access. Some people prefer that intensity for acute situations like severe fatigue or addiction recovery support.

Both IV and injection methods share a limitation: minimal published clinical research compared to oral supplementation studies.

How Do Injections Compare to Oral Supplements?

Oral NAD+ precursors like NR and NMN have been extensively studied in human clinical trials. Research shows that oral administration of these precursors effectively raises NAD+ levels in a dose-dependent manner^[16].

Clinical trials demonstrate that oral NR supplementation significantly increases blood NAD+ within 2 weeks, with effects maintained throughout multi-week studies^[6]. A randomized trial found that 1,000 mg of oral NR raised NAD+ levels by approximately 60% in healthy adults^[17].

Dr. Charles Brenner discovered NR as a NAD+ precursor and led the first human trial showing safe oral availability^[18]. His work at City of Hope focuses on NAD+ metabolism in metabolic diseases.

Oral supplements have the most extensive clinical evidence base. Injections may appeal to those seeking alternatives to pills or IV therapy, though research on injections remains limited.

What’s the Recommended Dosage?

Clinical protocols for injections vary based on what you’re trying to achieve, though these recommendations are adapted largely from IV therapy protocols and oral supplementation research rather than injection-specific studies.

Health Goal	Dosage Range	Frequency	Duration
General Wellness	50-100 mg	2-3x per week	Ongoing
Loading Phase	100-200 mg	Daily	7-10 days
Athletic Recovery	200-500 mg	2-3x per week	2-4 weeks
Cognitive Support	100-250 mg	1-2x per week	4-6 weeks

For subcutaneous injections, most protocols start conservatively. Begin with 0.1 mL (20 mg) to check your tolerance. Gradually increase to 0.25 mL up to three times weekly. The target dose is usually 0.5 mL (100 mg), typically 2-3 times weekly.

Never exceed 0.5 mL within any 24-hour period.

Some intensive protocols involve 500-1,000 mg daily for four consecutive days, followed by twice-weekly injections for one month. After that, you transition to a maintenance schedule.

Dose needs differ between people based on age, weight, metabolism, and baseline NAD+ levels. Working with a healthcare provider helps you find the right amount for your health goals.

See our NAD injection dosage chart for a more detailed breakdown.

The Bottom Line

NAD+ injections offer an alternative delivery method for boosting cellular NAD+ levels, though most clinical evidence comes from oral supplementation studies rather than injection research. Before starting any NAD+ therapy, test your baseline levels to understand where you stand.

Jinfiniti’s CLIA-Certified Intracellular NAD+ Test measures your cellular NAD+ and provides personalized dosage recommendations. This data-driven approach helps you avoid guessing and ensures your intervention matches your actual needs.

Work with a healthcare provider to interpret results and choose the right therapy for your health goals.