NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell. It plays a central role in how your body produces energy, repairs DNA, and manages the gradual process of cellular aging. As you get older, NAD+ levels naturally decline. That decline is increasingly recognized as a core driver of fatigue, slower recovery, and reduced cellular resilience.
What is NAD+?
NAD+ is a helper molecule that sits at the intersection of virtually everything your cells do. It acts as a co-factor for proteins called sirtuins and PARPs, which regulate energy metabolism, DNA repair, and how cells respond to stress. Think of it as the spark plug your mitochondria need to run at full capacity.
Your body produces some NAD+ on its own, through foods like milk, fish, and leafy greens, but that production slows considerably with age. Research suggests that by your 60s, NAD+ levels may be roughly half of what they were at 20. That gap matters.
What does NAD+ do?
NAD+ participates in hundreds of biological reactions. The most clinically relevant include:
- Fueling your mitochondria, the energy-producing structures inside every cell
- Activating sirtuin proteins, which are linked to longevity and cellular protection
- Supporting DNA repair pathways that help cells recover from daily oxidative damage
- Regulating inflammation at the cellular level
- Supporting cognitive function and mental clarity
"By your 60s, your NAD+ levels may be roughly half what they were at 20. Restoring them is one of the most actively researched strategies in longevity medicine."
Who is it for?
NAD+ therapy is commonly used by adults who want to address age-related fatigue, support cognitive function, or improve overall cellular health. It is particularly popular with people in their 40s and beyond, though younger adults experiencing burnout or chronic low energy also find it helpful. It is not a treatment for any disease, and individual results vary. Always consult your physician to determine whether it is appropriate for your situation.
NAD+ injection vs. alternatives
| Tides NAD+ (injectable) | Oral NMN / NR | IV Clinic | |
|---|---|---|---|
| Bioavailability | High | Low to moderate | High |
| Physician supervised | Yes | No | Yes |
| Ships to your door | Yes | Yes | No |
| Monthly price | From $229 | $30 to $80 | $500 to $1,000+ |
| Prescription required | Yes | No | Yes |
How is NAD+ prescribed through Tides?
The process starts with a short health assessment you complete online. It covers your health history, current symptoms, goals, and any medications you take. The whole thing takes about five minutes. No appointment needed, no waiting room, no referral from another doctor.
A licensed physician from our network reviews your assessment the same day. If NAD+ is clinically appropriate for you, they write your prescription. Your medication is then filled at a licensed U.S. compounding pharmacy and shipped directly to your door, typically within five to seven business days. Everything is handled for you from the moment you submit your assessment.
Your subscription continues monthly. Your physician stays with you throughout your protocol and is available for check-ins at any point. You can pause or cancel anytime before your next billing cycle. There are no long-term contracts and no hidden fees. The price you see is the price you pay.
What should I expect?
Most people notice improvements in energy and mental clarity within two to four weeks of starting a NAD+ protocol. Physical recovery after exercise often improves within the first month. NAD+ is not a stimulant. The effect feels more like having more baseline energy than a caffeine-like boost. Benefits tend to build over time with consistent use. Individual results vary; your physician will help you set realistic expectations based on your health profile.
Good to know: Injectable NAD+ offers significantly higher bioavailability than oral supplements. This is why physician-prescribed protocols tend to produce more consistent results than over-the-counter NMN or NR products.
Is it safe?
NAD+ is a molecule your body produces naturally. It is not a foreign drug or synthetic compound. That makes its safety profile significantly different from many pharmaceutical treatments. Clinical use of injectable NAD+ has a long track record, and it is generally well-tolerated across a wide range of patients.
The most commonly reported side effects are mild and temporary, including brief flushing or a feeling of warmth at the injection site. These typically resolve quickly and decrease over time. Serious adverse reactions are rare. Every Tides prescription begins with a physician review of your full health history, and your physician remains available throughout your protocol to monitor your response and adjust dosing if needed.
As with any medical treatment, results and tolerability vary between individuals. NAD+ is not appropriate for everyone, and a physician evaluation is required before starting. Always consult a licensed healthcare provider before beginning any new treatment program.
What patients say
"I started noticing better energy by week three. Not a dramatic jolt, more like the fog lifting. I am sleeping better and feel more like myself at work."
"I was skeptical about the injection but it is genuinely easy. The whole process from assessment to delivery took less than a week. My recovery after workouts has improved noticeably."
"Three months in and I feel more consistent energy throughout the day. I was taking oral NMN before and the difference is real."