NAD+ (nicotinamide adenine dinucleotide) is a molecule every cell uses to turn food into energy and to repair DNA. Levels fall with age in some tissues, which is why NAD+ has become popular for energy and healthy aging. MultiGen Wellness prescribes NAD+ as an injection you give at home, a nasal spray, capsules or dissolving tablets. NAD+ is not FDA-approved to treat any condition, and the human research is still early.
NAD+ at a glance
| What it is | A coenzyme the body makes from vitamin B3 (niacin) and related nutrients. |
|---|---|
| Forms we prescribe | Injection in several strengths, nasal spray, capsules and rapid-dissolve tablets. |
| How it’s taken | At home, on a schedule your provider sets. Injections go under the skin or into a muscle. |
| FDA status | Not FDA-approved for any condition. Prescription NAD+ is made by compounding pharmacies. |
| Controlled substance | No. |
| Cost | Medication is priced separately from visits. See current prices on our pharmacy page. |
What NAD+ does in the body
NAD+ has two main jobs. In the mitochondria, it carries electrons in the chain of reactions that turns food into usable energy. It’s also the fuel for enzymes called sirtuins and PARPs, which help repair damaged DNA and manage how cells respond to stress. When NAD+ runs low, those processes slow down.
Studies in mice found that raising NAD+ improved several markers of aging, including muscle function and blood sugar control. That research is the reason for the interest, but results in animals don’t always carry over to people.
What the research in people shows
Most human studies have tested NAD+ precursors, such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), rather than NAD+ itself. These reliably raise NAD+ in the blood. Clinical benefits so far are modest: a small 2021 trial in women with prediabetes, published in Science, found NMN improved how well their muscles responded to insulin. Other trials found little change in energy or exercise performance.
Far fewer studies have looked at NAD+ injections or nasal spray. Some people report better energy and focus, but there isn’t strong evidence yet. We’d rather tell you that up front than promise results.
Choosing a form
- Injection: the most direct way to get NAD+ into the body. Injecting too much too fast can cause flushing, cramping or a feeling of chest pressure, so doses start low.
- Nasal spray: no needles. It absorbs through the lining of the nose and may sting briefly.
- Capsules and dissolving tablets: the easiest to take. Much of a swallowed dose is likely broken down before it reaches the blood, so these may be gentler but less potent.
Side effects
With injections: stinging or redness at the injection site, flushing, nausea, headache, stomach cramps, and chest tightness or pressure, usually when a dose goes in quickly. These tend to fade within minutes to hours. With oral forms: mild nausea or stomach upset. Tell your provider if any side effect doesn’t go away.
Who should not use NAD+
- Women who are pregnant or breastfeeding, since there’s no safety data
- People being treated for cancer, unless their oncologist agrees. NAD+ supports cell growth processes, and its effect on tumors isn’t known.
- People with severe kidney or liver disease
- Anyone allergic to an ingredient in the product
Check the basics first
Fatigue and brain fog have many causes, including low testosterone, low estrogen and progesterone around menopause, thyroid problems, iron deficiency and sleep apnea. Labs can find these, and treating the actual cause usually does more than any supplement. Many of our patients use NAD+ alongside TRT, HRT or sermorelin, after labs rule out other problems.
How to get NAD+ through MultiGen Wellness
- Book a free 15-minute consult. Pick a time online or call 1-800-259-0015. We go over your symptoms, goals and medical history.
- Labs and a provider visit. A licensed provider reviews your history and lab results and decides whether NAD+ is a safe fit. Getting started is $247, which includes your first provider visit. Follow-up visits are $97 each, with no monthly membership.
- Medication shipped to your door. If it’s prescribed, a state-licensed partner pharmacy ships it to you. Your provider follows up with labs and visits to adjust the plan.
Frequently asked questions
Is NAD+ the same as niacin?
No. Niacin (vitamin B3) is one of the raw materials the body uses to make NAD+. Taking high-dose niacin can cause flushing and other side effects, and it is not the same as taking NAD+.
How long does NAD+ take to work?
Some people say they feel more energy within days to weeks, but there is no proven timeline. Your provider will check in on how you feel and adjust or stop it if it is not helping.
Can I take NAD+ with TRT or HRT?
There is no known interaction, and many people use them together. Your provider reviews every medication you take before prescribing.
Are NAD+ injections painful?
They can sting more than other injections. Injecting slowly and using a lower strength usually helps.
Other medications we prescribe
This page is for education and isn’t medical advice. Only a licensed provider who has reviewed your history and labs can decide whether a medication is right for you. Availability depends on your state. Last reviewed November 7, 2026.
Want to talk it through with our team?
Book a free 15-minute video consult. $197 if you sign up the same day as your consult, normally $247, and that includes your first doctor visit. No membership.