The Science of NAD+

Review the role of NAD+ in cellular energy production, redox reactions, mitochondrial function, sirtuin activity, DNA repair, cellular signaling, and age-related changes in NAD+ metabolism.

Current Research and Clinical Applications

The course examines available research on NAD+ and its precursors, reviewing areas of clinical interest such as fatigue, cognitive health, metabolic function, substance-use recovery, mood, post-viral symptoms, and healthy aging. Preliminary findings are not presented as established treatment outcomes.

Patient Screening and Selection

Participants will learn to review medical history, medications, treatment goals, contraindications, hydration status, vascular access, and factors that may increase the risk of adverse responses.

IV NAD+ Administration

A structured intravenous NAD+ workflow is presented, encompassing supplies, preparation, dosing considerations, infusion rates, patient positioning, monitoring, documentation, and post-infusion instructions.

Subcutaneous NAD+ Administration

Instruction is provided on preparation, injection technique, site selection and rotation, dosing schedules, storage, patient education, and monitoring for subcutaneous NAD+ therapy.

Infusion Rates and Patient Tolerance

The course addresses the impact of infusion rate on patient tolerance and reviews common infusion-related responses, including nausea, abdominal discomfort, chest pressure, headache, flushing, lightheadedness, and fatigue.

Guidance is provided on when to slow, pause, modify, or discontinue an infusion, as well as when further patient evaluation is warranted.

Safety and Risk Management

The course reviews sterile preparation, pharmacy sourcing, product quality, infection control, emergency procedures, adverse-event documentation, and staff responsibilities.

The FDA has received reports of severe chills, shaking, vomiting, and fatigue following administration of compounded injectable NAD+ products. Some reports were consistent with excessive endotoxin exposure, highlighting pharmacy selection and product quality as key safety concerns.

NAD+ Products and Routes of Administration

Compare IV, subcutaneous, intramuscular, oral, and nasal approaches. Review differences in administration, patient experience, clinical workflow, cost, and the limitations of comparing one delivery method with another.

Consent and Documentation

Instruction is provided on explaining off-label use, uncertain benefits, treatment alternatives, potential side effects, compounded-product considerations, costs, and follow-up requirements.

The course includes an attorney-reviewed consent form and clinical documentation templates.

Pricing and Practice Implementation

Participants will learn to develop pricing structures for intravenous infusions, subcutaneous injections, intramuscular boosters, treatment packages, and follow-up services.

The course reviews startup expenses, staff time, pharmacy costs, supplies, appointment duration, patient education, scheduling, and ethical marketing practices.

NAD+ Marketing and Patient Education

Instruction is provided on describing NAD+ therapy without making claims regarding disease treatment or guaranteed anti-aging outcomes. The course includes patient education materials and customizable social media content for clinical practice use.