How to Dose NAD+

The Body Pharm NAD+ 1000 pen is a prefilled, multi-dose subcutaneous pen holding 1000 mg of NAD+ in a 3 mL cartridge. There is no reconstitution and no bacteriostatic water: the pen dials the dose directly in 10 mg increments (the dial is marked 20/30/40/50 mg; 10 mg is dosable but unmarked), up to a maximum of 200 mg in any single day. Because you dose against the dial in milligrams, the internal concentration is a manufacturing detail, not a number you calculate against.

Two subcutaneous schedules are used in current UK research practice, and both are valid:

1. Intermittent schedule — 10–50 mg two-to-three times a week for the first four weeks, then 20–80 mg two-to-three times a week.
2. Daily schedule — 10–20 mg a day, five days a week, rising to 20–30 mg a day.

Do not exceed 200 mg in any single day on either schedule.

No peer-reviewed human pharmacokinetic curve for subcutaneous NAD+ has been published as of 2026. The schedules below are anchored to clinic standard operating procedures and mechanistic reasoning, not head-to-head trial data.

Key Takeaways

• The NAD+ 1000 pen is prefilled and dials directly in 10 mg increments (marked 20/30/40/50 mg), up to 200 mg/day — no reconstitution, no volume maths, no concentration to convert.
• Two research schedules are used: 10–50 mg two-to-three times a week (rising to 20–80 mg), or 10–20 mg a day five days a week (rising to 20–30 mg). Never exceed 200 mg in a day.
• Injection speed (30–60 seconds per dose) is the single most controllable variable for reducing flush severity.
• The NAD+ flush is a prostaglandin-mediated vasodilation response, not an allergic reaction, and resolves within 15–30 minutes.
• Rotate injection sites by at least 2 cm weekly to prevent lipohypertrophy and cumulative irritation.
• Flush severity scores and injection duration, recorded daily, are used to identify individual tolerance thresholds before escalating.

What Is NAD+ and Why Does Dosing Precision Matter?

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in every mammalian cell. It drives ATP production, sirtuin signalling, and PARP-mediated DNA repair. Tissue NAD+ concentrations decline measurably with age in preclinical and human samples, a pattern reviewed by Rajman et al. in Cell Metabolism (2018). This age-related decline is the mechanistic premise underpinning exogenous NAD+ research.

Subcutaneous delivery is used in research settings because oral NAD+ and its precursors (NMN, nicotinamide mononucleotide; NR, nicotinamide riboside) undergo extensive first-pass metabolism and gut-flora degradation, producing lower and more variable plasma exposure than parenteral administration in preclinical pharmacokinetic work. Direct human head-to-head bioavailability comparisons between oral precursors and subcutaneous NAD+ remain unpublished as of 2026. Researchers select the route on mechanistic grounds rather than confirmed pharmacokinetic superiority.

Precision matters because the dose-response margin between a tolerable flush (severity score 0–2) and a disruptive one (3–4) is narrow, and the flush scales with both dose and injection speed. That is why both schedules build up gradually rather than opening at the top of the range. The NAD+ 1000 pen covered here is treated strictly as a research compound. Readers applying subcutaneous injection technique and site rotation from adjacent peptide protocols should still start at the lowest dose in whichever schedule they follow.

NAD+ Subcutaneous Schedules at a Glance

Two schedules are in common use. Pick one and stay on it rather than mixing the two.

Intermittent schedule (10–80 mg, two-to-three times weekly)

Start at the low end (10–20 mg) to gauge the flush and hold until it stays at or below Grade 2, then build within the band. The dial's 10 mg increments let a researcher who flushes hard drop back a step or two and rebuild.

Daily schedule (10–30 mg once daily, five days a week)

Hold the induction dose for at least a week and confirm the flush stays at or below Grade 2 before moving to the maintenance band.

Neither schedule exceeds 200 mg in a single day — that is the ceiling on the pen. Titrate upward only when the previous step's flush score sits at or below Grade 2.

Operating parameters common to both schedules:

1. Administer at a consistent daily (or session) window so the flush-severity score is comparable step to step.
2. Rotate sites per the subcutaneous injection technique and site rotation protocol; never re-use a puncture point within seven days.
3. Hold the current step until the flush settles at or below Grade 2 before escalating.
4. Set the dose on the pen dial in 10 mg increments (marked 20/30/40/50 mg) — there is nothing to reconstitute or draw up.
5. Never exceed 200 mg in a single day.

Understanding the NAD+ Flush Response

The NAD+ flush is a prostaglandin-mediated cutaneous vasodilation response, not an allergic reaction. It resolves spontaneously within 15–30 minutes of subcutaneous administration. Rapidly rising circulating NAD+ and its metabolites trigger release of prostaglandin D2 and E2 from skin Langerhans cells and keratinocytes, producing the same vasodilatory cascade described for niacin flush by Benyo et al. in the Journal of Clinical Investigation (2005). That 2005 mechanism paper remains the foundational reference. No 2020–2026 work has overturned the prostaglandin model for nicotinamide-class flush reactions.

Onset is typically 5–10 minutes post-injection. The flush peaks around the 10–15 minute mark and dissipates by 30 minutes. Expected symptoms are warmth across the face, neck and upper chest, diffuse pink-to-red erythema, tingling, and mild itching. What separates a pharmacodynamic flush from a hypersensitivity reaction is the absence of urticaria (raised hives), wheeze, lip or tongue swelling, and any systemic symptom, dizziness, tachycardia beyond mild awareness, or nausea persisting past the flush window. Persistent or systemic symptoms warrant discontinuation and clinical review, not titration.

Flush severity scales with dose and injection speed. This is precisely why both schedules hold each step until the flush settles and escalate the dial in defined increments rather than jumping straight to the top of the range.

Body Pharm UK Flush-Severity Scale (researcher self-assessment)

Protocols score the most intense moment of the flush, not the average, within 20 minutes of administration:

1. Grade 0, no perceptible warmth, no erythema, no tingling.
2. Grade 1, mild facial or upper-chest warmth; no visible redness; no behavioural change.
3. Grade 2, visible erythema across face/neck plus tingling or mild itch; tolerable while seated.
4. Grade 3, significant discomfort, marked erythema, pronounced itch or burning. Protocols describe pausing mid-administration and delivering the remainder more slowly, or holding the next dose at the current step.
5. Grade 4, any systemic feature (urticaria, wheeze, swelling, presyncope). Protocols call for stopping and seeking medical assessment; this is not a flush.

The score is recorded in a dosing log alongside time-to-onset and injection duration, using the same abdominal site discipline described in the subcutaneous injection technique and site rotation guide.

How Injection Speed Reduces NAD+ Flush Severity

Injection speed is the single most controllable variable for reducing flush severity at any given NAD+ dose. Slowing plunger depression to 30–60 seconds for the full dose blunts the rate of local tissue uptake, flattening the systemic NAD+ rise and reducing the prostaglandin D2-mediated cutaneous vasodilation responsible for the flush.

The mechanism is pharmacokinetic, not pharmacological. A rapid sub-10-second bolus drives a sharper peak concentration (Cmax) from the abdominal depot. A 30–60 second delivery spreads absorption across a wider window and lowers the peak. No dedicated randomised controlled trial has quantified injection speed versus flush severity for subcutaneous NAD+ as of 2026. Published rate-dependent flush data exist only for IV infusions. The subcutaneous speed-flush relationship is mechanistically reasoned and practice-observed rather than trial-confirmed.

In Body Pharm UK protocol review notes, researchers self-reporting on the flush-severity scale consistently logged lower grades when injection duration exceeded 30 seconds, and higher grades when the same dose was delivered in a sub-10-second push. The effect becomes meaningful at the higher doses on either schedule, where the absolute prostaglandin load is larger.

Reported slow-administration parameters

Protocols for any larger subcutaneous NAD+ dose describe the following sequence, using a 30–31G, 4–6 mm pen needle into an abdominal site rotated per the subcutaneous injection technique and site rotation guide:

1. Pen warming. The pen is typically warmed in the hand for 30 seconds beforehand; cold solution is reported to sting more and to prompt faster plunger depression.
2. Skin fold. A 2–3 cm skinfold is pinched at least 5 cm lateral to the umbilicus to lift subcutaneous tissue away from muscle.
3. Needle angle. A 45° insertion through the pinched fold to the hub is described; a 90° angle is reported as acceptable with a 4 mm needle in adequate adipose tissue.
4. Administration rate. The plunger is depressed over 30–60 seconds, with seconds counted aloud or timed. Protocols note that if a Grade 2+ flush begins mid-administration, pausing for 10 seconds before resuming more slowly is used.
5. Withdrawal. The needle is held in place for 5 seconds after the dose finishes, then withdrawn at the insertion angle, with dry pressure applied without rubbing.

Logging injection duration alongside the flush score, paired over each step, is reported to reveal each researcher's individual speed threshold.

Titrating the NAD+ 1000 Pen

Whichever schedule you choose, titrate to let each researcher map their personal flush threshold before reaching the top of the range. The pen dials in 10 mg increments (marked 20/30/40/50 mg), so steps can be as fine as the schedule needs, up to a 200 mg/day ceiling.

Daily schedule

Start at 10–20 mg once daily (five days a week) and hold for at least a week. If the flush stays at or below Grade 2, move up toward the 20–30 mg maintenance band in 10 mg steps, holding each new step for several days before the next. If a step produces a Grade 3 flush, drop back one increment and extend that step before trying again.

Intermittent schedule

Start at 10–50 mg two-to-three times a week for the first four weeks. Hold until the flush at that dose is reliably at or below Grade 2, then step up toward the 20–80 mg band as tolerance allows. Keep injection duration at the slow end (45–60 seconds) and rotate sites strictly. Never exceed 200 mg in a single day.

Skipping steps on either schedule compresses the prostaglandin adaptation window and reliably raises flush severity at the next dose.

Handling and Storing the NAD+ 1000 Pen

The NAD+ 1000 pen ships prefilled and ready to dial — there is no powder to reconstitute and no diluent to add. Store the pen unopened at 2–8 °C, protected from light. Unopened shelf life is 24 months. Once the pen is first pierced (first use), use it within 12 months. If refrigeration isn't available the pen stays stable at room temperature (up to 30 °C) for up to 30 days.

NAD+ oxidises readily. The solution should be pale straw to clear. Discard any pen whose solution has turned yellow-brown, cloudy, or developed particulate. Bring the pen to roughly 20–22 °C in the hand for 60–90 seconds before administration, reducing sting and supporting the slow-plunger cadence covered in the subcutaneous injection technique and site rotation guide. Do not shake the pen.

Storage summary

Injection Site Selection and Rotation

The three subcutaneous sites with the most pinchable fat and lowest reported irritation in current subcutaneous NAD+ practice are the abdomen (2–5 cm lateral to the navel), the outer thigh, and the flank (love-handle region) [1][8]. All three accommodate a 29–31G pen needle at a 45–90° angle depending on subcutaneous depth. Shorter 4–6 mm pen needles are reserved for leaner research subjects [1][7].

Rotate sites on a fixed weekly cycle rather than ad hoc. A workable rotation for a three-injection week is: Monday left abdomen, Wednesday right flank, Friday outer thigh, then mirror the following week. Never re-use the exact puncture point within seven days. Offset each new injection by at least 2 cm from the last mark to limit lipohypertrophy and cumulative histamine-related irritation [1].

Mild localised erythema, a 2–4 cm pink halo, and transient warmth at the bleb are typical with NAD+ and usually resolve within 60–120 minutes [1][8]. Persistent induration beyond 24 hours, spreading redness, or a palpable nodule warrants pausing that site and reviewing technique.

Needle and site quick-reference

• Gauge: 29–31G pen needle [1][7].
• Length: 8–12 mm for abdominal/flank subcutaneous; 4–6 mm for thigh in lean subjects [1].
• Angle: 45° pinched fold (8 mm), 90° (4–6 mm).
• Rotation: minimum 2 cm offset; never same site on consecutive days.
• Avoid: scar tissue, stretch marks, visible vasculature, and the 2 cm zone around the navel.

The same rotation logic applies across the wider protocol covered in the subcutaneous injection technique and site rotation guide.

NAD+ Dosing FAQs for Researchers

Do I need to reconstitute the NAD+ 1000 pen? No. The pen is prefilled and dials the dose directly in 10 mg increments (marked 20/30/40/50 mg). There is no powder, no bacteriostatic water, and no volume to draw up.

Which schedule should a researcher use? Both the daily schedule (10–30 mg once daily, five days a week) and the intermittent schedule (10–80 mg two-to-three times a week) are valid. Pick one and stay on it rather than mixing the two, so the flush-tolerance log stays interpretable.

What if the flush is severe at the starting dose? Drop back one or two 10 mg increments on the dial, extend that step by several days, and re-titrate upward only once flush severity settles. Pushing through severe discomfort offers no documented pharmacokinetic benefit and increases the risk of vasovagal symptoms reported in IV NAD+ practice literature [1][8].

Is there a maximum subcutaneous dose? The ceiling is 200 mg in any single day, on either schedule. Higher single doses appear only in IV infusion contexts [2][4][8] and do not inform subcutaneous pen ceilings.

How long should a research cycle last? Published clinic protocols run 4–12 weeks, typically with a 2–4 week washout before re-cycling [2][8]. Cycles beyond 12 weeks of continuous subcutaneous NAD+ are poorly characterised in the 2020–2026 literature.

Can NAD+ be stacked with other peptides? Stacking is outside this protocol's scope. The broader longevity peptide category covers compatible compounds. The subcutaneous injection technique and site rotation guide applies the same administration method. The NAD+ 1000 pen remains the reference product for the doses above.

Research Disclaimer and Safe Handling

All Body Pharm UK products, including the NAD+ 1000 pen, are supplied strictly for research and analytical purposes and are not for human consumption. This guide summarises dosing patterns reported in clinical practice literature [3][5][8] and does not constitute medical advice. Researchers should:

1. Comply with current MHRA (Medicines and Healthcare products Regulatory Agency) guidance on unlicensed medicines and any applicable Home Office regulations governing peptide research procurement and handling [1][2].
2. Follow the subcutaneous injection technique and site rotation standards when planning bench protocols.
3. Consult the full peptide guides index for adjacent research protocols.

Next Steps

Choose one of the two schedules and begin at its lowest dose, recording flush severity score and injection duration daily in a dedicated log. Hold each step until the flush settles at or below Grade 2 before escalating on the dial. This approach is reported to identify an individual's personal tolerance threshold before reaching the top of whichever range is being used. Where flush severity exceeds Grade 2, or systemic symptoms occur, pause escalation, review administration technique against the slow-administration parameters above, and consult the FAQs section before proceeding.

References

1. Clinic and compounding-pharmacy subcutaneous NAD+ protocols and IV NAD+ practice literature; MHRA/Home Office unlicensed-medicines guidance. Practitioner and regulatory context, not a peer-reviewed pharmacokinetic study. [unverified — no linkable source]
2. Practitioner guidance on NAD+ dosing frequency and research-cycle length; no published head-to-head human trial. [unverified — no linkable source]
3. Clinical-practice content (2023–2024) describing subcutaneous NAD+ maintenance ranges. [unverified — no linkable source]
4. Clinic loading/maintenance schedule references. Clinic protocol, not a trial. [unverified — no linkable source]
5. Clinic standard operating procedures and handling conventions. [unverified — no linkable source]
6. Product specification for the NAD+ 1000 prefilled pen (1000 mg, 10 mg dial increments marked 20/30/40/50 mg, 200 mg/day maximum). [bodypharm.co.uk]
7. Needle-gauge and site-selection conventions for subcutaneous NAD+ administration. [unverified — no linkable source]
8. IV NAD+ practice literature and site-reaction/irritation observations. [unverified — no linkable source]