NAD+ IV Therapy Ann Arbor | Energy and Longevity Treatment

Key takeaways

• NAD+ is a molecule every cell uses to make energy and repair DNA, and levels fall with age.
• Supply falls because the body makes less, burns more, and carries a heavier daily load.
• IV delivery skips digestion, so it is used when oral precursors are not enough.
• Arbour offers IV, under-the-skin and oral routes, chosen to fit your goal and schedule.
• The evidence is promising but early. NAD+ is not a cure for any disease, and we screen first.

A few months ago, a patient came into our Ann Arbor clinic with a feeling she could not name. She was not sick. Her labs were normal and her exam was clear. But she felt as if her internal battery had slowly drained over the years. Her mental sharpness had dulled. Her stamina had dropped. Recovery from exercise took longer. She wanted to feel like herself again.

I see this pattern often in my practice. It often points to something happening inside the cells: a fall in NAD+ (a molecule every cell needs to make energy and repair DNA; levels fall with age).

What Is NAD+ and Why Does It Matter for Longevity?

NAD+ stands for nicotinamide adenine dinucleotide. It is a coenzyme (a helper molecule for enzymes) found in every cell of your body. It helps turn the food you eat into usable energy. It supports DNA repair. It helps set your body clock. And it keeps your mitochondria (the tiny power plants inside your cells) healthy.

NAD+ levels fall with age, often by a large margin by middle age (Cell Metabolism, 2018; Nature Reviews Molecular Cell Biology, 2021). This decline is linked to many of the hallmarks of aging.

• Less energy.
• A slower metabolism.
• Changes in memory and focus.
• Cells that cope less well with stress.

Why Does NAD+ Fall With Age, and What Does That Do?

NAD+ does not crash overnight. It slips lower over years, and several things drive it at once (Nature Reviews Molecular Cell Biology, 2021; DOI: 10.1038/s41580-020-00313-x).

• Your body makes less. The salvage pathway that recycles nicotinamide back into NAD+ slows down with age.
• Your body burns more. NAD-consuming enzymes such as CD38 get more active as low-grade inflammation (the body's alarm response) rises with age.
• Daily load adds up. Poor sleep, heavy alcohol use, chronic stress and metabolic disease all draw on the same pool.

When the supply falls, three systems feel it first.

• Mitochondria. They need NAD+ to make ATP, the fuel your cells run on. With less NAD+, they work less well. You feel it as fatigue and slower recovery. In a 2026 study, the transporter that carries NAD into mitochondria fell with age in human and mouse fat tissue. Deleting it in mice caused obesity, poor glucose control and insulin resistance, and restoring it protected against them (Aging Cell, 2026; DOI: 10.1111/acel.70509). The treatment half of that work was done in mice, not people, and that matters.
• DNA repair. Your DNA takes thousands of hits a day from normal metabolism, UV light and environmental toxins. NAD+ fuels the PARP enzymes that find and fix DNA breaks. With less NAD+, damage is thought to build up faster than it is cleared.
• Sirtuins. These seven enzymes are sometimes called "longevity genes". They help control inflammation, stress response and metabolism. All seven need NAD+ to work. When NAD+ is low, sirtuin activity drops.

The brain is unusually exposed. Neurons use a lot of energy and cannot easily be replaced. NAD+ supports their upkeep and stress resistance, and NAD-dependent pathways are disturbed in neurodegenerative disease (Cell Metabolism, 2019; DOI: 10.1016/j.cmet.2019.09.001). That is mechanism and disease-model work. Nobody has shown that raising NAD+ prevents dementia.

What is known about raising it back up is narrower than most articles suggest. Oral precursors do raise blood NAD+, as covered below. Whether that slows human aging or reverses any disease has not been shown. For the deep dive, read our guides to what the human evidence does and does not show and the benefits of NAD+ IV therapy. If tiredness in your forties or fifties brought you here, see our guide to fatigue after 40.

How Does NAD+ IV Therapy Work?

NAD+ precursors can be taken by mouth. The main ones are nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). NAD+ IV therapy (an infusion of NAD+ straight into a vein) skips the gut entirely. More of the dose reaches your blood, and it gets to your cells faster.

During an infusion, cells across the body take up the NAD+. There it supports the mitochondria, feeds the sirtuin and PARP enzymes involved in DNA repair, and helps regulate metabolism.

Most patients report effects within hours to days.

• Clearer thinking and better focus.
• Steadier energy that lasts.
• In some cases, better mood and sleep.

It is not a stimulant. It works by restoring the chemistry your cells need to run well.

Which NAD+ Delivery Method Fits You: IV, Subcutaneous or Oral?

At Arbour Longevity we offer three routes, each with its own strengths.

IV NAD+ Therapy

IV delivery puts NAD+ straight into the bloodstream, so the whole dose is available at once. This is the most intensive form. Patients choose it for the biggest cellular top-up in the shortest time, for sharper thinking, or for recovery from chronic fatigue and post-viral illness.

A typical session takes 2 to 4 hours. We infuse the dose slowly to limit side effects. We offer 250mg ($395), 500mg ($550) and 1000mg ($995).

Subcutaneous NAD+ Injections

Subcutaneous (under the skin) injections are a practical maintenance option. After instruction, you can give them yourself at home. They suit upkeep between IV sessions, or people whose schedules cannot fit a long infusion.

Oral NAD+ Precursors (NMN and NR)

Oral precursors are the easiest form of support. Research confirms they raise NAD+ levels, though less than direct delivery. They work best alongside IV or injections rather than instead of them. We cover the differences in our guide to NMN vs NR and which precursor actually reaches your cells.

What Does the Evidence Actually Show?

Honesty matters here, because this field is full of overstated claims. Here is the fair read.

The strongest evidence is for oral boosters. NR and NMN are safe at the doses studied and reliably raise blood NAD+ in people (Antioxidants & Redox Signaling, 2023; DOI: 10.1089/ars.2023.0354). The effect on outcomes has been smaller than the lab work predicted, partly because gut bacteria change how precursors are processed. There is moderate evidence in specific groups: better insulin sensitivity in some women with prediabetes, and better walking distance in peripheral artery disease.

For IV NAD+ itself, large randomized trials are still sparse. What we have is a sound mechanism, good precursor data, decades of clinical use, and steady patient reports of better energy, focus and recovery, especially after a short series.

So the honest picture is promising and biologically reasonable, but not yet proven by large trials. Any clinic telling you otherwise is selling rather than practicing.

Not sure NAD+ is your problem?
Your $35 first visit in Ann Arbor starts with your history and the labs your symptoms call for, and the fee is applied toward your plan.
Book your $35 first visit Call (734) 436-3357

What Conditions Can NAD+ IV Therapy Support?

NAD+ is not a cure for any disease. It can support a range of health goals, each covered in depth in our NAD+ benefits guide.

• Cellular energy. Patients often report steadier daily energy, not the jittery spike of a stimulant. This matters most for fatigue that rest does not fix, post-illness depletion, age-related metabolic slowdown, and athletes who want faster recovery.
• Brain performance. NAD+ supports neuron health and helps manage inflammation in the brain. Many patients describe brain fog lifting and thinking speed improving.
• Cellular repair. Restoring NAD+ supports PARP-driven DNA repair, sirtuin activity, fewer worn-out "senescent" cells, and the growth of new, healthier mitochondria.
• Burnout recovery. Burnout is a physical state, not just mental exhaustion. Chronic stress drains NAD+ and disrupts the nervous system in measurable ways. NAD+ IV is a common protocol for recovery from long high-stress periods and post-illness fatigue.
• Metabolic health. NAD+ plays a role in glucose and fat metabolism. That can support weight management and insulin sensitivity, often alongside hormone optimization or medical weight loss where labs point that way.

Is NAD+ IV Therapy Safe?

NAD+ occurs naturally in your body. IV delivery is generally well tolerated in a clinical setting with trained staff. Most patients have few side effects. Some report mild flushing, nausea or cramping during the drip. These usually settle when we slow the rate.

We monitor every patient throughout and tailor speed and dose to your tolerance.

Who Should Not Get NAD+ IV Therapy?

NAD+ IV is not right for everyone, which is why we screen first. Without specialist clearance, we do not treat people who:

• Are pregnant or breastfeeding.
• Are in active cancer treatment.
• Have severe heart, kidney or liver disease.
• Have uncontrolled high blood pressure.
• Have a known sensitivity to nicotinamide.

This is not a complete list. We decide together at your consultation, based on your full history.

How Is NAD+ IV Therapy Given at Arbour Longevity?

At our Ann Arbor clinic, infusions take place in a comfortable, private setting. They usually run two to four hours, depending on dose and tolerance. Many patients relax, read or work remotely.

We often recommend a loading series first: two to four infusions over a few weeks. After that, maintenance every four to eight weeks, depending on your response and goals. For patients on a steady protocol, IV therapy memberships start at $199 per month on the Silver tier. That includes a monthly Myers' Cocktail or glutathione IV. Many patients combine NAD+ with peptide therapy, hormone optimization, or other IV nutrient protocols.

Because NAD+ works at the cellular level, benefits tend to build over time. It is a foundation, not a quick fix.

What Should You Expect During and After Treatment?

You sit comfortably with an IV line in your arm. We start the drip slowly and adjust to how you feel. Some patients notice a warm feeling or mild stomach tightness. We manage that by slowing the rate.

Afterwards, most patients feel clear-headed and energized within a few hours. Some sleep better that night. Others notice effects that build over days and weeks: more energy, better focus, better mood.

Good hydration, good food and enough sleep all help you get more from the treatment.

Frequently Asked Questions About NAD+ IV Therapy

How often should I get NAD+ IV therapy?

Most patients begin with a loading phase of two to four infusions, about a week apart. Then maintenance every four to eight weeks. Frequency depends on your goals, baseline health and response. We build a tailored plan at your consultation.

How long does the energy effect last?

After one infusion, many patients notice a lift lasting several days to a couple of weeks. After a short loading series the effect tends to last longer. That is why we usually suggest a series rather than a one-off.

Can I take NAD+ supplements instead of getting IV therapy?

Oral precursors like NR and NMN help, and they are often part of a longevity supplement plan. IV puts NAD+ into the blood at levels oral doses cannot match. Many patients find that more effective for acute fatigue or brain fog. Often the right answer is both.

Can I get my NAD+ level tested?

Not in a way that is clinically useful yet. Blood NAD+ tests exist and are used in research. But there is no validated range that tells one person whether their level is "low" or what to do about it. We work from symptoms, history and standard labs instead.

Does everyone's NAD+ decline at the same rate?

No. Inflammation, metabolic health, sleep, alcohol intake and physical activity all shape the curve. That is why two people the same age can look quite different metabolically.

What is the difference between NAD+ and NADH?

They are two forms of the same molecule. NAD+ is the oxidised form that accepts electrons. NADH is the reduced form that carries them. The ratio between them, not just the total, is part of what signals the state of a cell.

Can lifestyle alone support NAD+?

Exercise, enough sleep, avoiding excess alcohol, and keeping inflammation and blood sugar in a healthy range all ease the load on NAD+. That is unglamorous, free, and better evidenced than anything you can buy.

Does raising NAD+ reverse aging?

No, and anyone claiming otherwise is ahead of the evidence. Restoring NAD+ in older animals improves several measures of function. That has not been shown to slow aging in humans, and it is not what we promise here.

Will NAD+ IV help me lose weight?

Not on its own. NAD+ supports glucose and fat metabolism, and it can help with the energy and drive that make lifestyle change stick. But it is not a weight loss treatment. If weight is your main goal, a metabolic and hormone workup is the more honest starting point.

Can I combine NAD+ with hormone therapy or peptides?

Yes, and many patients do. NAD+ works on cellular energy production. Hormone optimization and peptide protocols work on different pathways. Because the same clinician manages all three here, they are coordinated rather than stacked blindly.

Can NAD+ therapy help with addiction recovery?

NAD+ has been studied in substance use recovery because of its role in cellular repair and brain signalling. Some programs use it as an add-on. It is not a standalone treatment for addiction and should sit within a broader clinical program.

Do I need labs before my first NAD+ IV?

We review your health history at consultation and order labs where your history or symptoms warrant it. If persistent fatigue is your main complaint, we first rule out thyroid dysfunction, anemia, low testosterone and sleep apnea. Only then do we assume NAD+ is the answer.

Is NAD+ IV therapy covered by insurance?

NAD+ IV therapy is an elective wellness treatment and is not usually covered. We are clear about pricing up front, and HSA and FSA cards are accepted.

Ready to Take the Next Step in Ann Arbor?

If you want to address fatigue, brain fog or the effects of aging at the cellular level, NAD+ IV therapy may be a useful tool. At Arbour Longevity we pair regenerative therapies with tailored medical care. Your clinician is Gandhi Bhattarai, FNP-BC, PMHNP-BC, a triple board certified nurse practitioner.

If persistent fatigue is what brought you here, the useful first step is a workup, not a drip. Your first visit is $35, and that fee is applied toward any treatment you choose. Book your $35 first visit online, or call or text (734) 436-3357. We are at 2217 Packard St #15, Ann Arbor, MI 48104, open Thursday through Monday, 10am to 7pm. We serve Ypsilanti, Saline, Dexter, Chelsea and the wider Washtenaw County area.

References

1. Rajman L, Chwalek K, Sinclair DA. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metab. 2018;27(3):529-547. PMID 29514064. DOI: 10.1016/j.cmet.2018.02.011
2. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22(2):119-141. PMID 33353981. DOI: 10.1038/s41580-020-00313-x
3. Lautrup S, Sinclair DA, Mattson MP, Fang EF. NAD+ in brain aging and neurodegenerative disorders. Cell Metab. 2019;30(4):630-655. PMID 31577933. DOI: 10.1016/j.cmet.2019.09.001
4. Yaku K, Nakagawa T. NAD+ precursors in human health and disease: current status and future prospects. Antioxid Redox Signal. 2023;39(16-18):1133-1149. PMID 37335049. DOI: 10.1089/ars.2023.0354
5. Kojima D, Yaku K, Kosugi S, et al. The mitochondrial NAD transporter SLC25A51 in adipocytes regulates adipose tissue mitochondrial function and systemic metabolism during aging. Aging Cell. 2026;25(5):e70509. PMID 42015379. DOI: 10.1111/acel.70509

This content is for educational purposes and does not constitute medical advice or a promise of any particular result. NAD+ IV therapy requires clinical evaluation and is not appropriate for everyone. Individual results vary. Arbour Longevity, 2217 Packard St #15, Ann Arbor MI 48104, (734) 436-3357.