Why everyone calls it a peptide
It’s simple. The clinics and vendors that sell NAD+ injections sell them on the same shelf as sermorelin, BPC-157 and the GLP-1s. So the word “peptide” gets attached to everything on that shelf. People read the shelf label. They don’t read the chemistry.
We do it too, and I’ll own that. Our NAD+ page lives at /peptides/nad-plus. I put it there because that’s where people look, and a page nobody finds helps nobody. So we kept the address and explained the chemistry on the page. In other words, the name is a shelf label.
What NAD+ is
NAD+ stands for nicotinamide adenine dinucleotide. It’s in every living cell. Your body makes it from vitamin B3 and from an amino acid called tryptophan.
Think of it as a bucket in a bucket brigade. Its job is to carry electrons from one reaction to the next. It picks up electrons and becomes NADH, the full bucket. It hands them off and goes back to NAD+, the empty bucket. Then it gets back in line. Thousands of reactions in a cell run on that handoff.
So why would anyone care how many buckets a cell has? Because a separate set of enzymes, the sirtuins and the PARPs, don’t pass the bucket along. They use it up. A bucket that gets used up has to be replaced.
What I mean by “a coenzyme” is a helper molecule, a tool the enzyme uses. A peptide is a short chain of amino acids that works like a message fitting a receptor. Different thing, different job.
Does the amount of NAD+ in tissue go down with age? In the studies that have measured it, yes, in several tissues. What that means for a person who raises it back up, I don’t know. Nobody does yet. The research is early, and I’m not going to tell you an outcome.
What people ask me, in their words
A patient texted me last summer: what’s the difference between NAD in pill form and the injection? That’s the most common question, and it’s a good one. The pills in stores are usually precursors, NMN or NR, which are supplements. The injection is NAD+ itself, compounded by a pharmacy under a prescription. They’re different products with different rules around them.
Another patient told me she’d been taking half the prescribed amount, once a week instead of three times, because she wanted to ease into it. I was glad she told me. We paused her next month at her request, and I told her the dosing question is one for her clinician and the pharmacy, since I can’t give medical advice. It also tells you something true about injectable NAD+: people feel the injection site, and starting slow is a normal thing to want.
The third question is price, usually with a competitor’s price list pasted in. Fair enough. Our prices are on the NAD+ page, and the cost article below walks through what an injection and a nasal spray run across the market.
The fourth is whether NAD+ can go in the same syringe as another injection. Never mix without the pharmacy’s directions. The pharmacy that fills your prescription answers that, and they answer it fast.
What happens when you ask us for it
Here’s the path, step by step.
You take the free three-minute assessment. A US-licensed clinician reads it, typically within 24 hours. In most states that review is online, with no call to schedule. The clinician looks at your history, your medications, your goals and your state, because licensing is by state.
Then the clinician decides. Sometimes the answer is no. If it’s no, you pay nothing. The online visit is free, and the card you entered is held at zero dollars and never charged without a prescription.
If it’s yes, the prescription goes to a licensed 503A pharmacy. When 503A pharmacies make it to order, there’s a pack window of about two business days. Then it ships cold chain, overnight or two-day depending on the carrier, in one box with the supplies and the dosing directions. You get the tracking number by text and email the moment the label is made.
So the order is assessment, clinician, pharmacy, box. The clinician is the gate at step two. I can’t give medical advice, and I don’t. I can tell you where your box is.
Injection or nasal spray
Both forms exist and both are prescribed. The injection is subcutaneous, a small needle under the skin, on a schedule the clinician sets. The nasal spray is the easier one to live with, and it’s the one people who dislike needles pick. Which is right for you is the clinician’s call, from your history. The nasal spray article below lays out what’s known about each route.
What I don’t know
I don’t know how much NAD+ helps any one person. The trials are small and they measure different things. But I do know what it is, who prescribes it, where it’s made and how it gets to your door. That’s the part I can stand behind, and it’s the part most clinics leave vague.
Where it’s made
Every prescription is filled by a licensed 503A pharmacy, and medications are compounded in the USA by licensed 503A pharmacies and FDA-registered facilities. No hidden overseas supply chain. Compounded NAD+ is a prescription product and is not an FDA-approved drug. NAD+ is on FDA’s Category 1 list, the bulk substances FDA allows in 503A compounding under its interim policy while it evaluates them, as of the May 14, 2026 update. Our pharmacy partners are listed at /pharmacy-partners.
Frequently asked questions
Is NAD+ a peptide?
No. NAD+ is a coenzyme, a dinucleotide, made from vitamin B3 in the body. Peptides are chains of amino acids. The name comes from the shelf it is sold on.
Is NAD+ FDA-approved?
Compounded NAD+ is not an FDA-approved drug. NAD+ is on FDA’s Category 1 list as of May 14, 2026: the bulk substances FDA allows in 503A compounding under its interim policy while it evaluates them. It is dispensed only with a prescription.
Do I need a prescription for NAD+ injections?
Yes. The injection and the nasal spray are prescription products. Oral NMN and NR sold in stores are supplements and are a different product.
How long does it take to arrive?
The clinician reviews within about 24 hours in most cases. After a prescription, the pharmacy packs within about two business days and ships cold chain overnight or two-day depending on the carrier. Tracking arrives by text and email when the label is made.
Can I take NAD+ with other peptides?
Ask your clinician before combining anything, and never mix injections in one syringe without the pharmacy’s directions.
