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The Peptide Atlas

NAD+

A coenzyme (not a peptide) that every cell uses to turn food into energy, made in the body from vitamin B3.

Class
Coenzyme (nicotinamide adenine dinucleotide), not a peptide
Evidence
Human-tested
Status
Available as a compounded prescription (injection or nasal spray); oral precursors (NR, NMN) are sold as supplements.
Forms
Subcutaneous injection, nasal spray, IV infusion; oral precursors

What people use it for

Energy that fades by mid-afternoon, slower recovery, and the cellular wear of aging.

The signal

NAD+ carries electrons through the reactions that make ATP, and it's the fuel for the sirtuin and PARP enzymes that maintain and repair DNA [1]. Levels fall with age: human skin samples show NAD+ dropping and oxidative damage rising across adult decades [2], and the NAD+ metabolome in blood plasma shifts measurably in normal aging [3].

How it works

Cells make NAD+ from vitamin B3 and recycle it constantly. With age, the enzymes that consume it get busier and the machinery that makes it slows, so the pool shrinks. Restoring it supplies the energy-making chain and the repair enzymes with what they run on. Injected or infused NAD+ enters the bloodstream directly; oral precursors have to be converted first.

What the research shows

The biology is well established: a 2021 review in Nature Reviews Molecular Cell Biology describes NAD+ as central to energy metabolism and an essential cofactor for the sirtuins [1]. The age-related decline is documented in human tissue [2] and plasma [3]. A pilot study of intravenous NAD+ in healthy adults showed plasma NAD+ rising during the infusion, with the molecule reaching circulation and being metabolized over several hours [4]. Trials tying NAD+ restoration to how people feel day to day are still small, and most human supplement trials used oral precursors (NR, NMN) rather than NAD+ itself.

What people get wrong

That it's a peptide. NAD+ is a coenzyme, a small molecule derived from vitamin B3, and it appears in peptide conversations only because the same clinics and protocols offer it. And that NMN or NR pills are the same thing: they are precursors the body has to convert, and the amount that becomes NAD+ inside cells is a different question from taking NAD+ directly.

Pepvio prescribes this through licensed U.S. physicians and pharmacies. Pepvio's NAD+ protocol

References

  1. Covarrubias AJ et al., Nat Rev Mol Cell Biol (2021). NAD+ metabolism and its roles in cellular processes during ageing. PubMed
  2. Massudi H et al., PLoS One (2012). Age-associated changes in oxidative stress and NAD+ metabolism in human tissue. PubMed
  3. Clement J et al., Rejuvenation Res (2019). The Plasma NAD+ Metabolome Is Dysregulated in "Normal" Aging. PubMed
  4. Grant R et al., Front Aging Neurosci (2019). A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+. PubMed

Last reviewed 2026-09-29. Every reference is verified against the primary literature at review time. How the Atlas grades evidence