NAD+ is the coenzyme your mitochondria run on. Levels decline with age and metabolic demand. Subcutaneous delivery restores what time takes. Prescribed. Compounded. Delivered monthly.
Individual results vary and are not guaranteed. Data reflects published research, not AnthologyRX-specific outcomes. All patients require physician evaluation before any prescription is issued.
NAD+ — nicotinamide adenine dinucleotide — is a coenzyme found in every cell in your body. It is not a vitamin or a supplement in the conventional sense. It is the core molecule your mitochondria require to convert nutrients into ATP, the energy currency that powers everything from muscle contraction to cognitive function to DNA repair.
Research consistently shows NAD+ levels decline approximately 50% between age 40 and 60 — independent of lifestyle or fitness level. As those levels drop, so does cellular energy production efficiency, sirtuin activation (the protein class central to longevity pathways), and the speed and accuracy of DNA repair mechanisms.
Oral NAD+ supplements are limited by poor bioavailability — significant degradation occurs before the compound reaches systemic circulation. Subcutaneous injection, the delivery method used in AnthologyRX protocols, bypasses GI absorption entirely, delivering the compound directly into tissue where it can be utilized. Prescribed by a licensed provider. Compounded by a 503B pharmacy. Delivered monthly — if approved.
Not a supplement.
A coenzyme your cells
are already running on.
Subcutaneous delivery.
Bypasses GI degradation.
Prescribed, not purchased.
The same molecule behind
sirtuin activation, ATP production,
and cellular repair — restored.
A single, precisely formulated compound — compounded by a licensed 503B pharmacy and prescribed by a board-certified provider after clinical review.
Prescription issued subject to provider judgment. Results vary. Not a guarantee of outcomes. Compounded NAD+ is not an FDA-approved drug product.
NAD+ is essential to the electron transport chain — the process your mitochondria use to produce ATP. When NAD+ levels are depleted, energy production efficiency declines at the cellular level, well before you feel it as fatigue. Subcutaneous NAD+ therapy restores the substrate your cells need to generate energy as they did earlier in life. Results vary by individual; provider-guided dosing targets optimal restoration.
NAD+ is a required cofactor for sirtuins — a class of proteins directly involved in DNA repair, gene expression regulation, and cellular stress response. Sirtuin activation is one of the most studied longevity mechanisms in current research. By restoring NAD+ availability, the protocol supports the cellular machinery responsible for maintaining genomic integrity — a function that declines measurably with age.
NAD+ supports neurological function through multiple pathways: mitochondrial energy production in neurons, neuroprotection via sirtuin-mediated mechanisms, and maintenance of neuronal NAD+ pools that decline with age. Patients on provider-guided NAD+ protocols often report improvements in mental clarity, sustained focus, and cognitive stamina — particularly notable in those managing high cognitive demands. Individual results vary.
Oxidative stress — cellular damage from reactive oxygen species — accumulates with physical demand, metabolic activity, and aging. NAD+ supports the enzymatic systems responsible for managing oxidative stress and facilitating cellular repair. Adults on NAD+ protocols frequently report improved recovery, though individual response varies and outcomes are not guaranteed.
You're sleeping adequately, maintaining an active lifestyle, and eating well — and still hitting an energy ceiling that shouldn't be there. When fatigue persists despite sound fundamentals, cellular energy production is worth examining. NAD+ protocols are provider-evaluated based on your full clinical picture; outcomes vary.
NAD+ decline begins in the mid-thirties and accelerates through the forties and fifties. If your energy, recovery, or cognitive performance has noticeably shifted over the past several years without a clear cause, age-related NAD+ depletion is a clinically supported explanation — not just a lifestyle problem.
NAD+ protocols are frequently prescribed alongside GLP-1 or Tesamorelin protocols for patients pursuing comprehensive clinical and longevity optimization. Your provider evaluates all active treatments during intake to determine compatibility and appropriate sequencing. Stacking is case-by-case, not automatic.
You view health through a clinical and longevity lens. NAD+ supports the cellular energy systems that sustain daily function and the repair mechanisms associated with long-term cellular health. A provider-guided protocol ensures dosing is appropriate for your biology — not a generic supplement dose.
Your intake screens for all contraindications. Every candidate is evaluated by a licensed physician before any prescription is issued. If your clinical picture requires additional review, your provider will advise you directly — no prescription is issued without clearance.
A structured medical questionnaire covering your health history, current medications, energy and wellness concerns, and contraindication screening. Under five minutes. No video call required. Completed entirely on your schedule.
A board-certified physician reviews your intake within 48 hours. They evaluate your candidacy, assess contraindications, and issue your prescription if approved. If not approved, you receive clinical reasoning and are not charged. No guesswork.
Your NAD+ is compounded by a licensed 503B outsourcing facility under cGMP standards and shipped temperature-controlled, directly to your door. Injection supplies are included. No pharmacy visit. No insurance required.
Monthly provider check-ins and dosing adjustments based on your response. Direct messaging access to your care team throughout the protocol. Your dosing evolves as your clinical picture does — active management, not auto-pilot.
I'm on my feet 12 hours at a stretch. NAD+ was the first thing in years that actually changed my energy floor — not just gave me a spike. The difference is sustained and it showed up during shifts, not just on my days off.
Eight weeks in. Sleep quality improved first. Then focus. Then I started hitting PRs in the gym again. I wasn't expecting all three. My expectation was marginal improvement in one area — what I got was a measurable shift across everything I track.
My recovery between training blocks was becoming a problem. Three months on NAD+ and I'm stacking workouts I couldn't have tolerated before. I'm not recovering faster by doing less — the volume has gone up and the recovery has kept pace.
Individual results vary and are not typical. Testimonials reflect patient-reported outcomes and are used for illustrative purposes only. Results are not guaranteed. All patients are under licensed physician supervision. Outcomes are not representative of the typical patient experience.
The training is there. The discipline is there. The biology may not be keeping up. Provider-guided NAD+ therapy addresses the cellular energy deficit that effort alone cannot overcome.
Start Assessment →Subscriptions renew monthly. Cancel anytime before your renewal date — no fees, no calls required. Provider review is required before any prescription is issued. All treatments require physician approval. Results vary. FSA/HSA eligibility depends on your individual plan. Compounded NAD+ is not an FDA-approved drug product.
Oral NAD+ precursors — NMN, NR, and nicotinamide — must survive the gastrointestinal tract and be converted to NAD+ through enzymatic pathways before becoming bioavailable to cells. Research suggests this process results in significant degradation, and the amount of NAD+ that reaches systemic circulation from oral supplementation is substantially lower than what you take. Subcutaneous injection delivers the compound directly into tissue, bypassing GI degradation entirely. The result is meaningfully higher bioavailability — which is why the injectable form is prescribed and managed by a physician rather than sold over the counter. The dose and delivery method make the difference.
Response timelines vary by individual and are not guaranteed. Many patients report early changes in energy quality and sleep — often within the first two to four weeks. Cognitive improvements and recovery changes tend to emerge over four to eight weeks as NAD+ levels are progressively restored. The most measurable changes are typically reported at the eight-to-twelve week mark. This is not a stimulant — it doesn't produce an acute effect. It works by restoring cellular substrate over time. Your provider will check in monthly and adjust dosing if your response is not progressing as expected.
NAD+ is commonly prescribed alongside GLP-1 and Tesamorelin protocols for patients pursuing comprehensive longevity and metabolic health — the mechanisms are distinct and generally complementary. Your physician reviews all active medications, supplements, and protocols at intake and evaluates compatibility on a case-by-case basis. Stacking is not automatic — it requires clinical clearance. If you are currently on a GLP-1 or hormone protocol, disclose this during your intake assessment so your provider can design the appropriate sequence and ensure there are no interactions with your current treatment plan.
Lab work is not universally required to start NAD+ therapy, but your provider may request baseline labs depending on your health history and intake responses. If you have underlying conditions — particularly kidney or liver disease — your provider will require a clinical review of relevant labs before issuing a prescription. If you have recent bloodwork, noting your results during intake can be helpful context. Your physician makes the determination about what additional screening is needed based on your individual clinical picture. There is no standard lab panel required for NAD+ across all patients.
NAD+ is administered as a subcutaneous injection — the same technique used for insulin and GLP-1 medications. Your first shipment includes detailed injection instructions and all necessary supplies: pre-filled or multi-dose vials, syringes, and alcohol prep pads. Subcutaneous injection involves introducing a small needle just under the skin — typically in the abdomen or thigh — at a shallow angle. Most patients are comfortable with the process within the first one to two self-administrations. If you have any questions or concerns after receiving your supplies, your care team is reachable via direct message and will walk you through the technique.
Dosing is determined by your prescribing physician based on your individual health history, goals, body weight, and clinical presentation — it is not a fixed protocol applied uniformly. NAD+ subcutaneous doses are typically initiated at a lower level and adjusted based on your tolerance and response. Your provider may titrate your dose upward over the first few months as your clinical picture develops. Because this is a physician-prescribed compound, dosing is tailored — not standardized. You will receive your specific dose information with your prescription documentation and can discuss adjustments with your care team at any monthly check-in.
Your intake takes five minutes. Provider review within 48 hours. No waiting room. No contracts. No guesswork. Prescription issued if approved — compounded and delivered monthly.
