A monthly NAD+ protocol means taking a set dose on a fixed rhythm, usually 50mg every other day after a three-day start, rather than an occasional injection or drip. Your cells use and recycle NAD+ all the time, so one dose is a short top-up. The studies that measured a rise in NAD+ all used repeated dosing over weeks.
This article is for anyone deciding between buying a single dose or session now and then, and committing to a regular routine. It covers why consistency matters, what the research does and does not tell us, what a month on the standard protocol looks like, how the costs compare in the UK, and when a one-off purchase is still the sensible choice.
Educational content, not medical advice. NAD+ is not intended to diagnose, treat, cure or prevent any disease. Speak to a licensed prescriber before starting any injectable protocol, especially if you are pregnant or breastfeeding, have active or historic cancer, atrial fibrillation, are immunosuppressed or have had a transplant, or take regular medication. NAD+ is for adults only.
Why consistency matters with NAD+
NAD+ is not a vitamin you stock up on. It is a working coenzyme that every cell spends and rebuilds continuously. It carries electrons in the reactions that make ATP, and it is the fuel that sirtuins and PARP enzymes burn when they repair DNA and manage stress. Each time those enzymes act, they break a molecule of NAD+ down, and the cell recycles the pieces through what is called the salvage pathway.
A 2021 review in Nature Reviews Molecular Cell Biology describes that turnover in detail: the NAD+ pool is constantly being consumed and remade, and with age the consuming side, driven partly by the enzyme CD38, tends to outpace the rebuilding side. That gap does not close after one top-up. It reopens the next day, and the day after.
Think of it as keeping a reservoir topped up against a steady outflow, not as filling a tank once. That is the basic case for a routine over a one-off.
What a single dose can and cannot do
A single 50mg injection delivers NAD+ itself, under the skin, where it is absorbed into the bloodstream. Some people notice a mild lift in energy or a warm flush within hours; others notice nothing at all on day one. Both are normal.
What a single dose cannot do is tell you much. A 2019 pilot study in Frontiers in Aging Neuroscience followed plasma NAD+ during and after a six-hour IV infusion and found that the body takes infused NAD+ up and processes it rather than holding it in the blood. In other words, the molecule goes to work and is used. That is what you want, but it also means the effect of any one dose is temporary.
There is also a practical point. Whatever you feel after one dose is mixed up with that day's sleep, caffeine, training and stress. You cannot judge whether NAD+ suits you from a single injection, in the same way you cannot judge a new training plan from a single session.
What the research shows, and what it does not
No published trial has compared a monthly injection protocol directly with occasional doses, so it would be wrong to claim one has been proven better. What we can say is how the human studies that did measure NAD+ were designed.
| Study | What was taken | Duration | Main NAD+ finding |
|---|---|---|---|
| Airhart et al., PLoS ONE, 2017 | Oral NR, rising doses, twice daily | 9 days | Blood NAD+ rose during repeated dosing |
| Martens et al., Nature Communications, 2018 | Oral NR, daily | 6 weeks | Blood NAD+ raised by around 60% versus placebo |
| Yoshino et al., Science, 2021 | Oral NMN, daily | 10 weeks | NAD+ metabolites raised in blood and muscle |
| Grant et al., Frontiers in Aging Neuroscience, 2019 | IV NAD+, single infusion | 6 hours | Infused NAD+ was taken up and metabolised, not simply stored |
Two things stand out. First, every study that reported a sustained rise in NAD+ used repeated dosing over days or weeks. Second, most of the evidence is for oral precursors, NR and NMN, not for injected NAD+. We cover that difference in our complete guide to NAD+ injections in the UK. The sensible reading is that NAD+ behaves like something you maintain, and that a protocol should be judged over weeks, not hours.
What the research does not show is that NAD+ of any kind slows ageing or extends life in people. We do not make that claim, and you should be wary of anyone who does.
What a month on the standard protocol looks like
The reference protocol is 50mg per injection. On the pen with a 500mg cartridge, that is 0.3ml, or 30 clicks. With a 1000mg vial and a U-100 syringe, it is 0.25ml, or 25 units. If you prefer a gentler start, the first few doses can be 25mg, which is 0.15ml or 15 clicks on the pen.
| Period | Rhythm | Doses | NAD+ per week |
|---|---|---|---|
| Days 1 to 3 | Once a day | 3 | 150mg in the first three days |
| Rest of month one | Every other day | 3 to 4 a week | 150 to 200mg |
| Month two onwards, if it suits you | Twice a week | 2 a week | 100mg |
| Without a prescriber, never exceed | 100mg per injection | 500mg | |
Across the first month that comes to roughly 16 or 17 doses, a little over 800mg. A 500mg cartridge holds ten doses, so two cartridges cover the first month with a few doses to spare. On maintenance, two cartridges last around ten weeks. The dosage calculator works out the clicks or units for you, and our dosage guide explains each step of the protocol.
Most people find the first two weeks are when they learn the routine: the best time of day, whether to eat first, how to rotate injection sites. By week three or four it takes under a minute. That is also the point at which it becomes fair to ask whether it is helping.
The cost: one-off doses versus a monthly routine
Buying NAD+ occasionally almost always costs more per dose. The table compares current UK prices for the same 50mg dose.
| Option | Price | 50mg doses | Cost per dose |
|---|---|---|---|
| IV drip at a clinic, single session | £300 to £800 | One session of 250 to 500mg | Not comparable; a half-day visit |
| Trial Kit, 500mg, with pen | £175 | 10 | £17.50 |
| Discovery Kit, 2 × 500mg, with pen | £279 | 20 | £13.95 |
| Pen Refill Kit, 1 month | £285 | 20 | £14.25 |
| Pen Refill Kit, 2 months | £519 | 40 | £12.98 |
| Pen Refill Kit, 3 months | £739 | 60 | £12.32 |
| Injection Kit, 2 × 1000mg vials | £279 | 40 | £6.98 |
The Trial Kit and Discovery Kit include the reusable pen, so part of their price is a one-time cost you do not pay again. Once you own the pen, the refill kits are the running cost, and the longer the plan, the lower the cost per dose. The vial kit is the lowest per dose but uses a syringe rather than the pen. Our comparison of 500mg and 1000mg kits sets the formats side by side.
There is a hidden cost in occasional use too. A cartridge should be finished within four weeks of its first dose. If you inject now and then, you are likely to throw away doses that are left in an opened cartridge. A steady routine uses every dose well inside that window.
How a subscription fits around real life
The usual objection to a monthly plan is commitment. A subscription for refills is designed to remove that worry rather than add to it:
- It arrives before you run out. Two cartridges cover the first month, so a monthly delivery keeps you on rhythm without reordering.
- You can pause it. Travelling, unwell or simply taking a break: pause the next delivery and restart when you are ready.
- You can cancel any time. There is no minimum term.
- Delivery is free across the UK, and every order includes fresh 32G, 6mm micro-needles and wipes.
When a one-off purchase still makes sense
A routine is not right for everyone from day one. A single kit is the better choice if:
- You have never injected before and want to check you are comfortable with the pen and how you tolerate NAD+ before committing. The Trial Kit gives you ten doses, roughly three weeks on the standard rhythm, which is long enough to learn the routine.
- Your prescriber wants to review how you respond after a first block before agreeing a longer plan.
- You are planning a defined block, for example around a demanding month at work or a training cycle, and will stop afterwards.
Even then, treat that kit as a short protocol rather than a single dose. Ten doses on a rhythm tells you far more than one dose taken on a whim.
Which kit to start a monthly protocol with
- Starting out and planning to continue: the Discovery Kit gives you the pen and two 500mg cartridges, enough for the first month.
- Already own the pen: the Pen Refill Kit comes in one, two or three month plans, and a subscription can be paused or cancelled at any time.
- Comfortable with a syringe: the Injection Kit with two 1000mg vials covers around two months on the standard protocol.
Every product is pre-mixed and third-party tested to 99.5% purity. The full range is in the NAD+ collection, and if you are unsure which plan suits you, get in touch.
Frequently asked questions
Is it better to take NAD+ regularly or only when I feel tired?
Regularly. Your cells use and recycle NAD+ continuously, so a single dose is a short-term top-up. The human studies that measured a rise in NAD+ all used repeated dosing over days or weeks. Occasional doses also make it hard to judge whether NAD+ is helping.
How long should I follow a protocol before deciding if it works?
Give it about four weeks. The first two weeks are mostly about learning the routine. By the end of the first month you have taken around 16 doses and can judge it fairly, ideally alongside notes on sleep, energy and recovery.
How much NAD+ do I need for one month?
On the standard 50mg protocol, the first month uses roughly 16 or 17 doses, a little over 800mg. Two 500mg cartridges cover it. On twice-weekly maintenance, the same two cartridges last around ten weeks.
Is a monthly NAD+ protocol cheaper than IV drips?
Yes, by a wide margin. A single IV session at a UK clinic typically costs £300 to £800. A month of home injections on the standard protocol, around £280 for two 500mg cartridges, costs less than one session, and each dose takes under a minute.
Can I pause my NAD+ subscription?
Yes. Refill subscriptions can be paused or cancelled at any time, with no minimum term. Pausing is useful around travel or illness, and you can restart on the maintenance rhythm when you return.
Sources
- Covarrubias AJ et al. NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology, 2021.
- Airhart SE et al. An open-label, non-randomized study of the pharmacokinetics of the nutritional supplement nicotinamide riboside (NR) and its effects on blood NAD+ levels in healthy volunteers. PLoS ONE, 2017.
- Martens CR et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications, 2018.
- Yoshino M et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science, 2021.
- Grant R et al. A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD+. Frontiers in Aging Neuroscience, 2019.
