Medically reviewed by Crea Rose, FNP-BC, APRN-FPA
· NPI 1366184053
· Last reviewed:
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in cellular energy production and DNA repair. Levels of NAD+ in the body decline with age. NAD+ supplementation by injection is offered as an elective wellness service for adults interested in supporting cellular metabolism and recovery — with the important caveat that the long-term clinical evidence for injectable NAD+ is still developing.
At Revival Health & Wellness Clinic in Salem, IL, Crea Rose, FNP-BC offers subcutaneous NAD+ injections after consultation, with an emphasis on honest expectations and appropriate patient selection.
WHAT NAD+ DOES IN THE BODY
NAD+ is a cofactor for hundreds of enzymes that govern energy metabolism, DNA repair, and cellular signaling. Lower NAD+ levels have been observed with normal aging and in some chronic disease states. Whether raising NAD+ through external supplementation produces meaningful clinical benefit is the question that ongoing research is still trying to answer.
WHAT NAD+ INJECTIONS ARE COMMONLY USED FOR
Patients pursue NAD+ therapy for one or more of:
- Subjective fatigue not explained by treatable causes (after thyroid, sleep, mood, anemia, and other workups are addressed)
- Recovery support during high-intensity training or athletic seasons
- Mental clarity or focus
- General “healthy aging” goals
What we tell every patient up front: NAD+ is not a treatment for any specific medical condition. If your fatigue or cognitive symptoms have not been worked up clinically, that comes first. Many patients who think they need NAD+ actually need their thyroid checked, their sleep apnea diagnosed, their iron stores corrected, or their mood addressed.
HOW NAD+ INJECTIONS WORK AT THE CLINIC
We offer subcutaneous (under-the-skin) NAD+ injections. Each injection takes a few minutes in the office. Some patients prefer a regimen of more frequent injections at the start (for example, weekly for a defined induction period) followed by a maintenance schedule based on response. Specific dosing and frequency are individualized — generic protocols are common in the industry but not always appropriate.
NAD+ can also be administered intravenously (IV) in higher doses, though IV NAD+ requires a longer infusion and is more commonly associated with infusion-related side effects. We recommend subcutaneous injection as the more practical and tolerable starting point for most patients.
WHAT TO EXPECT
- Consultation. We review your symptoms, current medications, supplements, and what you’ve already ruled out. If clinical workup gaps exist (TSH, iron, vitamin D, sleep history, etc.), we address those first.
- Baseline labs if indicated. Not every patient needs labs before starting NAD+, but some do — particularly if symptoms are significant.
- Injection visit. The injection itself takes a few minutes. Some patients feel a transient warm flush or mild nausea right after — these are short-lived.
- Follow-up. We re-evaluate response after a defined number of injections. If you’re not noticing meaningful change, we don’t keep pushing the same intervention indefinitely.
WHO IS A CANDIDATE
Adults in generally good health who:
- Have had a basic clinical workup for fatigue or related symptoms
- Understand NAD+ is supportive, not curative, and not FDA-approved as a treatment
- Are comfortable with self-pay (NAD+ is not insurance-covered)
- Have no contraindications (see below)
RISKS, SIDE EFFECTS, AND CONTRAINDICATIONS
Common short-lived reactions include flushing, mild nausea, headache, brief light-headedness, and injection-site soreness. These typically resolve within minutes to hours.
Less common reactions can include allergic responses to the preparation, more pronounced GI symptoms, or injection-site bruising or infection.
Contraindications and cautions include:
- Pregnancy or breastfeeding (no adequate safety data)
- Active malignancy unless cleared by the treating oncologist
- Significant kidney or liver disease
- History of severe allergic reaction to similar compounds
If you take prescription medications — particularly anything affecting heart rate, blood pressure, or coagulation — disclose those during consultation.
FDA STATUS OF INJECTABLE NAD+
Injectable NAD+ is not approved by the U.S. Food and Drug Administration as a treatment for any specific medical condition. NAD+ used in our clinic is sourced from licensed compounding pharmacies. Compounded preparations are regulated differently from FDA-approved drug products, and the FDA has periodically expressed concern about the quality of NAD+ from some compounding sources. We use established pharmacies and we do not present NAD+ as a substitute for evidence-based medical treatment.
We will not promise NAD+ will cure or prevent any disease, slow aging, or reverse a specific condition. Some patients feel meaningfully better. Some don’t. Honest expectations are part of the deal.
COST AND INSURANCE
NAD+ injections are self-pay. Insurance does not cover wellness-indication NAD+. Pricing is provided during consultation and varies with dose. HSA and FSA payment may be acceptable depending on your plan administrator’s policies on wellness-indication services.
FREQUENTLY ASKED QUESTIONS
How quickly will I notice a difference?
Most patients who do respond notice changes in energy, sleep quality, or mental clarity within the first 1–3 injections. If you’ve completed a defined series and notice nothing, NAD+ is probably not the right tool for what you’re trying to address.
Is this the same as the NAD+ IV drip I’ve seen advertised?
Different delivery, same active ingredient. IV NAD+ requires a longer (often 2–4 hour) infusion and tends to be more uncomfortable during administration. Subcutaneous injection is faster, gentler, and produces a different absorption curve. Neither is FDA-approved.
Should I take an oral NMN or NR supplement instead?
Oral nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are NAD+ precursors with a growing — but still modest — body of human research. They are an option to discuss; some patients use them alongside or instead of injections.
Does NAD+ help with addiction recovery or post-COVID fatigue?
Both are areas where NAD+ has received attention, but the published evidence is preliminary. We do not market NAD+ as an addiction treatment. If you are in active recovery, please work primarily with an addiction specialist, and treat NAD+ as an adjunct only if your recovery team agrees.
Can I drive after an injection?
Yes. Most patients return to normal activity immediately. If you experience light-headedness in the office, we keep you for a few minutes longer before sending you on your way.
SCHEDULE A CONSULTATION
If you’re considering NAD+, the right first step is a consultation, not an injection. We want to make sure your fatigue or cognitive symptoms have been worked up appropriately and that you’re a sensible candidate. Call (618) 740-2240 to schedule with Crea Rose, FNP-BC.
SOURCES AND FURTHER READING
- Rajman L, Chwalek K, Sinclair DA. Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence. Cell Metab. 2018;27(3):529–547.
- Yoshino J et al. NAD+ Intermediates: The Biology and Therapeutic Potential of NMN and NR. Cell Metab. 2018;27(3):513–528.
- U.S. Food and Drug Administration. Compounding and the FDA: Questions and Answers. fda.gov
- National Institute on Aging. NIH-funded research on NAD+ and aging. nia.nih.gov
FDA status & intended use.
NAD+ (nicotinamide adenine dinucleotide) injection is not approved by the U.S. Food and Drug Administration as a treatment for any specific medical condition. Use at Revival Health & Wellness Clinic is provided as an off-label wellness intervention to support cellular energy and recovery. Individual response varies. Discuss medical history, current medications, and pregnancy/nursing status with Crea Rose, FNP-BC during consultation. NAD+ therapy is not intended to diagnose, treat, cure, or prevent any disease.