What Is NAD+?
NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme found in every living cell. It plays a central role in oxidative phosphorylation, the process by which cells convert nutrients into ATP (energy). NAD+ levels naturally decline with age — falling by roughly 50% between age 40 and 60 — which has fueled significant research interest in supplementation and IV repletion.
Unlike most peptides on the compounding pathway, NAD+ is already legally compoundable by licensed 503A and 503B pharmacies. No reclassification is needed.
How It Works
NAD+ serves as an electron carrier in the mitochondrial electron transport chain, and as a substrate for several key enzyme families:
- Sirtuins (SIRT1–7) — longevity-associated proteins that regulate gene expression, DNA repair, and metabolic health
- PARPs — DNA repair enzymes that consume large amounts of NAD+ in response to cellular damage
- CD38 — an enzyme that degrades NAD+ and increases with age and inflammation
By maintaining adequate NAD+ levels, cells can sustain efficient energy production, robust DNA repair, and healthy sirtuin activity.
Research Areas
| Area | Summary |
|---|---|
| Cellular energy | Supports mitochondrial function and ATP production |
| DNA repair | PARP enzymes require NAD+ for genome maintenance |
| Metabolic health | Preclinical evidence for insulin sensitivity and fat metabolism |
| Neuroprotection | Research in age-related cognitive decline and neurodegeneration |
| Aging biology | Sirtuin activation linked to lifespan extension in model organisms |
| Addiction medicine | IV NAD+ protocols studied for withdrawal and brain repair |
Delivery Routes Available Through Compounding
| Route | Form | Notes |
|---|---|---|
| IV infusion | Sterile NAD+ solution | Fastest repletion; administered at a clinic |
| Subcutaneous injection | Compounded injectable | Home administration; slower than IV |
| Nasal spray | NAD+ solution | Emerging delivery route; localized absorption |
| Oral (precursors) | NMN or NR capsules | OTC options; convert to NAD+ in vivo |
IV NAD+ infusions are the most researched delivery method in clinical settings. Compounding pharmacies that produce IV NAD+ must meet USP 797 sterile compounding standards.
Regulatory Status
NAD+ has never been classified as a Category 2 substance by the FDA. It is currently legally compoundable through licensed 503A and 503B pharmacies and does not require a separate prescription pathway beyond a standard provider-issued Rx.
This makes it one of the most accessible compounded wellness compounds available today.
How Valitide Will Offer NAD+
Valitide will connect patients with licensed providers who can prescribe NAD+ injections or oversee IV protocols through vetted compounding pharmacies. All prescriptions will include provider supervision and sourcing from pharmacies meeting applicable USP sterility standards.
Join the waitlist to be notified when our full peptide therapy program launches.