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.
Stay tuned — our full peptide therapy program is coming soon.