NAD+ Therapy: Separating Signal From Hype

What NAD+ Actually Is

Nicotinamide adenine dinucleotide — NAD+ — is a coenzyme present in every living cell. It sits at the center of energy metabolism, helping cells convert nutrients into the fuel that runs them. It also participates in DNA repair pathways and in the activity of enzymes involved in cellular maintenance. This is not fringe biology. NAD+ is textbook biochemistry, taught in every medical curriculum.

NAD+ levels are understood to decline with age and to be affected by metabolic stress. That decline is the kernel of truth the wellness market builds on. The reasoning runs: less NAD+ with age, supplement NAD+, restore function. The molecule is real and the decline is real. Whether infusing or injecting NAD+ reliably reverses age-related decline in a way that produces the outcomes people are sold is where the evidence thins.

What the Evidence Supports — and What It Doesn't

NAD+ and its precursors are an active area of research. The laboratory and animal work is genuinely interesting. The human clinical evidence is earlier and more limited than the marketing implies, and much of what circulates online is extrapolated from cell studies, animal models, or small trials rather than large outcome studies in people.

The responsible position is restraint. NAD+ therapy is not an FDA-approved treatment for aging, cognitive decline, addiction recovery, athletic performance, or any specific disease, and it should not be presented as one. Claims that it "reverses aging," "repairs your DNA," or "detoxifies" the body compress real but partial science into promises the data does not yet carry. Some patients report feeling more clear or energized after a course; that experience is valid and worth respecting, and it is also not the same as a proven clinical effect. A physician's job is to hold both of those truths at once.

How It's Delivered, and Why the Route Matters

NAD+ is given intravenously or intramuscularly. The IV route is the more common protocol and is typically administered as a slow infusion. Speed matters: NAD+ infused too quickly is associated with sensations such as flushing, chest tightness, nausea, or cramping during the drip. These are generally transient and managed by slowing the rate, which is one reason NAD+ infusions are unhurried by design rather than quick.

Delivery in a medical setting is not a formality. Dosing, infusion rate, hydration, and patient monitoring are clinical decisions. At FORMA, every NAD+ consultation and every treatment is performed by Dr. Trentin personally — an internal-medicine and aesthetic-medicine trained physician, not a delegated injector. That matters most for a therapy where the right answer is often "this isn't indicated for you" rather than "yes."

Who It Is and Isn't For

NAD+ is not a screening-free, anyone-can-walk-in service. A proper consultation reviews your medical history, current medications, and what you are actually trying to address. Some goals are reasonable to discuss; others are better served by sleep, nutrition, addressing an underlying condition, or a treatment with a stronger evidence base. NAD+ is one tool, and it is not always the right one.

Patients with significant cardiovascular, hepatic, or renal conditions, those who are pregnant or breastfeeding, and those on certain medications warrant particular caution, and candidacy is decided case by case. The conservative practice is to treat NAD+ as adjunctive and individualized, never as a substitute for medical evaluation of a real symptom. If something feels off in your body, that is a reason to be examined, not a reason to book an infusion.

The useful next step is a direct conversation. If you are curious whether NAD+ fits your goals — and willing to hear an honest answer if it doesn't — Dr. Trentin will give you the unmarketed version at consultation.