Barrett’s Research
Guide 8 min read·

NAD+ Dosage: What No Clinic Can Tell You Either

There is no approved NAD+ dosage for the injected form anywhere, so a clinic quoting one is quoting a bag size. Here is where those figures came from instead.

By Rihab Yassin, Ph.D. · Health Technology Researcher & Publisher

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The short version8 min read

Ask three providers for an NAD+ dosage and you will get three different figures, delivered with equal confidence. None of them is wrong, exactly, because none of them is answering the question you think you asked.

Why NAD+ dosage has no source document for the injected form

No regulator anywhere has approved injected NAD+ as a medicine. That single fact removes the document a dose normally comes from. What you are quoted instead is a commercial decision made by whoever built the menu.

An approved amount is the output of a process, not an opinion. A manufacturer submits a file to a regulator. The file has to show what the product contains, how consistently it can be made, what happens to it in the body, what happened when defined amounts were given to people, and what harms appeared at each amount. The regulator argues with it, sometimes for years, then permits a specific range for a specific use in a specific population and requires that it be printed on the box.

For the injected form of this coenzyme, none of that has happened in any market. There is no approved use, so no amount can be approved for it. There is no monograph, no leaflet and no defined range.

That does not mean nobody has an amount. It means everyone with an amount is the author of it.

The number you are quoted is a bag, not a dose

An infusion is a container of fluid with a quantity of substance dissolved in it, delivered over a period through a line. Three separate quantities are in play, and a menu usually prints one.

The total in the bag is what gets advertised. The rate is how quickly it goes in, and providers control it, often slowly, because pushing it faster is reported by clinicians themselves to bring on nausea, flushing and chest tightness. How much reaches the inside of a cell in usable form is the quantity anyone actually cares about, and nobody in the room can measure it.

Comparing two quotes on the advertised total alone is therefore comparing container sizes. Two clinics quoting the same total, over an hour in one case and three in the other, have not given the same treatment.

Four quantities that all get written as a number

The rows do not convert into each other. A person who has read that a certain milligram amount of an oral precursor was used in human trials, and who then reasons their way to a figure for an infusion, has crossed between two rows with no bridge.

The figure you are shownWhat it measuresWhat it cannot tell youWho chose it
Grams in the bagContents of a containerAnything about exposure inside cellsThe clinic
Millilitres per hour, or session lengthDelivery speedWhether that speed matters for effectThe clinic, usually for comfort
Milligrams per capsule of an oral precursorA different molecule, a different routeNothing transferable to the bagThe supplement maker, sometimes following trial amounts
Milligrams per millilitre in a research vialConcentration claimed on a labelWhether the vial contains thatThe supplier

Why the oral precursor figures cannot be converted across

This is the specific error worth naming, because it is committed sincerely and often.

Human trials of nicotinamide riboside and nicotinamide mononucleotide used defined oral amounts, and those amounts are published. They belong to a different molecule taken by a different route, and the whole point of a precursor is that the body converts it, on its own schedule, through a pathway with its own limits. Delivering the finished coenzyme into a vein skips that conversion and skips whatever regulation the conversion imposes.

There is a further complication that any honest page has to include. Whether circulating coenzyme enters cells intact is still debated by researchers, and a well supported view holds that it is broken down outside the cell and reassembled inside. If that is right, an infusion is a slow and expensive delivery of precursors, and the arithmetic connecting a bag to an oral trial amount is even less meaningful than it looks.

What has to be decided before a regulator will print an amount

It is worth being concrete about what is missing, because the absence is easy to state and hard to feel.

A licensed amount carries with it a defined condition being treated, so the amount has a target. It carries an identified population, so the reader knows who it was studied in. It carries a maximum, because someone had to decide where harm outweighed benefit. It carries an interval, a duration, and instructions on what to do if a dose is missed. It carries interactions, because a regulator required that they be investigated. It carries a manufacturing standard, so the amount in the box is the amount on the box.

An infusion menu carries a price and a duration. Everything in the previous paragraph is absent, and no consultation fee generates it, because a practice cannot manufacture a regulatory file.

The rate is the part that hurts

If you take one practical thing from this page, take this one. The complaints people report during these sessions cluster around speed rather than total.

Providers themselves manage it by slowing down. That is a sensible response, and it tells you something about where the sharp edge of this intervention sits. It also means that a person comparing a cheaper faster session against a longer one is not comparing value for money in a simple way. The longer session may be the one that has thought about the reason it is long.

A clinician who explains why they run at the rate they do, and who tells you what they will do if you start feeling unwell, is demonstrating something a printed figure cannot. That is worth more than the number on the menu, and it is a fair thing to ask about before you agree.

The buyers who never go near a clinic

A large share of the people searching for this figure are not comparing providers at all. They have bought a vial from a research supplier, it arrived with a label and no instructions, and they are looking for a number to put into a syringe.

Their situation is worse than the clinic customer's in a way that is easy to overlook. The clinic at least knows what it put in the bag, because it made the bag. A research vial carries a claimed contents from a manufacturer no regulator has inspected, and the claim is the only evidence that the claim is true. Independent testing of grey market vials across this whole category has repeatedly found material that does not match its label, in both directions. A figure calculated to two decimal places from an unverified starting quantity is precise and meaningless at the same time.

Then there is what surrounds the number. A clinic session has a trained person present who can stop. Someone working from a forum post at home has nobody watching, no plan for a bad reaction, and no route to report one afterwards. The arithmetic is the least uncertain part of what they are doing.

This is why the page will not print a figure that could be lifted out of context. The people most likely to lift it are the people with the least around them if it goes wrong.

Frequently Asked Questions

No, and not out of caution for its own sake. Publishing a figure would give it the appearance of a standard, and there is no standard for it to reflect. The circulating figures are commercial choices, and repeating them would launder them into something they are not.
It reflects a business model. Packages exist in every service industry, and their structure tells you about pricing rather than pharmacology. Ask what would change the plan if you responded badly to the first session, and listen to whether the answer is clinical or commercial.
It is a clinician's judgement, which has value, and it is not a dose in the regulatory sense because there is nothing for them to be judging against. Their licence covers their practice. It does not create an approved amount for an unapproved product.
Not automatically, because the rate matters at least as much as the total, and because the risks that are not about the substance at all, a cannula, an unverified solution, a missed reason for your symptoms, do not shrink with the number.
Dose ranging work in people with the injected form, followed by a regulatory review of a manufactured product. That sequence produces an amount that means something. Nothing shorter does.

From all of us at Barrett's Research: this is friendly, educational information, not medical advice. The figures here are seed data, so please double-check them and talk with your own clinician before you start or change any medication.

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