NAD+ is one of those things people hear about long before anyone explains it properly. It gets described as an energy drip, an anti-ageing infusion, a hangover cure. None of those are quite right, and the vagueness does the treatment no favours — because what it actually does is more specific, and more interesting, than the marketing around it.
Here is the clinical version, without the hype.
What NAD+ actually is
NAD+ stands for nicotinamide adenine dinucleotide. It is a coenzyme, which means it is a helper molecule that other reactions cannot proceed without. It sits inside every cell in your body, and it is central to two jobs in particular.
The first is energy. Your mitochondria use NAD+ to convert what you eat into usable cellular fuel. Without enough of it, that conversion becomes less efficient — which is felt not as a dramatic symptom but as a general flatness.
The second is repair. NAD+ is required by the enzymes that carry out DNA repair and by the sirtuins, a family of proteins involved in how cells handle stress and ageing. These are not optional background processes. They run constantly.
NAD+ levels decline with age. They also fall under sustained physical stress, poor sleep, illness, and heavy alcohol use. That decline is normal, and it is gradual, and it is part of why recovery takes longer at fifty than it did at twenty-five.
Why intravenous, and not a capsule
This is the question worth asking about any supplement, and in this case the answer is genuinely about chemistry rather than preference.
NAD+ is a large, unstable molecule. Taken by mouth, it does not survive the trip. Stomach acid and gut enzymes break it apart before it is absorbed, and what does get through the gut wall is processed by the liver before reaching general circulation. Precursor supplements such as NMN and NR are designed to get around this by giving the body smaller building blocks to reassemble, and they do raise NAD+ to a degree — but the dose that reaches your cells is a fraction of what the label suggests.
An intravenous infusion bypasses digestion entirely. The coenzyme enters the bloodstream directly. That is the whole argument for the IV route: not that it is more fashionable, but that it is the delivery method the molecule actually tolerates.
What an infusion is like
Slower than people expect, and that is deliberate.
A session typically runs between sixty and one hundred and twenty minutes depending on dose. The rate matters: pushed too quickly, NAD+ commonly causes chest tightness, flushing, a wave of nausea, or a cramping sensation. These are not allergic reactions and they are not dangerous — they are a direct response to infusion speed, and they resolve within a minute or two of slowing the drip. Part of the clinician's job during the session is reading those signals and adjusting.
Most people read, work, or sleep through it. Most return to normal activity the same day, though some notice mild tiredness or muscle soreness in the hours afterward.
Who tends to benefit
The honest answer is that NAD+ is not a treatment for a specific diagnosis, and anyone presenting it that way is overreaching. What it supports is cellular capacity, and the people who notice it most tend to fall into recognisable groups.
People in sustained recovery — from illness, from surgery, from a period of genuine overwork. People whose energy has flattened in a way that bloodwork does not fully explain. Athletes and physically demanding workers managing recovery load. People already pursuing hormone optimization or a structured weight management plan, where NAD+ is one component of a broader picture rather than a standalone fix.
It is also reasonable to be sceptical. If your fatigue has an identifiable and treatable cause — low iron, an underactive thyroid, a hormone shift, poor sleep, undiagnosed sleep apnoea — then the right first step is finding that cause, not infusing around it. This is the practical advantage of having infusions supervised by someone who can also order and interpret the labs: the question "should you be doing this at all?" gets asked properly.
What it will not do
It will not reverse ageing. It will not substitute for sleep. It will not outrun a nutritional deficiency or an untreated condition. And a single infusion is rarely where people notice a meaningful change — protocols are usually built as a short series followed by maintenance, with the spacing set by how you respond rather than by a fixed schedule.
Realistic framing matters here, because the gap between what NAD+ is marketed as and what it does is where disappointment lives.
How it works at Juvenescence
Every infusion is administered personally by Stephanie Eschak, Nurse Practitioner — not delegated to nursing staff. That matters for a treatment where the rate has to be adjusted in response to how you are tolerating it, and where the sensible first question is often whether an infusion is the right answer for your situation at all.
NAD+ IV therapy starts at $220. Every new patient begins with a clinical intake so that dose and frequency are planned around your history rather than a standard menu. Patients travel from across the Cowichan Valley, Duncan, Nanaimo, Victoria and Ladysmith.
If you are weighing it up, book a consultation and ask the blunt questions. A treatment worth having is one that holds up to them.
Written by Stephanie Eschak, Nurse Practitioner, at Juvenescence Wellness in Lake Cowichan, BC. This article is general information, not medical advice for your individual situation. Book a consultation or call 250·932·6171.