Protocols & Performance
What to Expect with NAD+ at Moonshot
Your complete protocol guide: first visit, loading phase, maintenance dosing, what the injection feels like, timeline of results, stacking with other therapies, and pricing. Everything you need to know before starting NAD+ at Moonshot Medical.
Medically reviewed by Missy Zammichieli, DNP, APRN, FNP-BC · April 1, 2026
YOUR FIRST VISIT
No referral is needed. Your first visit begins with a brief consultation where your provider reviews your health history, current medications, and specific goals. If you are stacking NAD+ alongside hormone optimization or peptide therapy, your provider maps out how NAD+ fits into the broader picture.
If you are a good candidate, same-day injection is possible. Most patients walk in, consult, get their first shot, and are out the door within 30 minutes. No downtime. Return to normal activity immediately.
Who is not a good candidate: Your provider screens for contraindications during the consultation. NAD+ may not be appropriate for patients with certain active cancers, severe liver disease, or specific medication interactions. The consultation takes a few minutes and ensures NAD+ is both safe and effective for your situation.
LOADING PHASE PROTOCOL (WEEKS 1-4)
The loading phase is designed to rapidly restore depleted NAD+ pools to functional levels. By the time most patients walk into our clinic, their cellular NAD+ has been declining for years or decades. A single injection raises circulating NAD+ temporarily, but the cellular machinery that uses NAD+ — sirtuins, PARPs, mitochondrial enzymes — needs sustained, repeated exposure to upregulate. That is what the loading phase accomplishes.
Frequency
2 injections per week for the first 2 to 4 weeks. Your provider determines the exact duration based on your age, baseline health, symptom severity, and how you respond. Some patients complete the loading phase in 2 weeks. Others benefit from the full 4.
Dose
Typically 100 to 250mg per injection, delivered subcutaneously. Your provider adjusts the dose based on your body weight, tolerance, and response. Starting at the lower end and titrating up is common for patients who are new to NAD+ therapy.
Purpose
Rapidly saturate NAD+-dependent enzyme systems. This means filling the substrate pool that mitochondria, sirtuins, and PARP enzymes draw from. Think of it as filling a reservoir that has been slowly draining for years. You need sustained input to bring the level back up before maintenance can hold it there.
What to Expect During Loading
Mild warmth or flushing at the injection site is normal and resolves within minutes. Most patients begin noticing energy improvements within the first 1 to 2 weeks — reduced afternoon crashes are typically the first thing reported. Improved exercise recovery and sleep quality follow shortly after.
Investment: The loading phase typically involves 8 injections over 4 weeks at $60 per injection, totaling approximately $480. This is the phase where patients invest the most time and money. It is also the phase that builds the foundation for everything that follows.
MAINTENANCE PHASE
Once the loading phase restores your NAD+ pools, the goal shifts to maintaining those levels. NAD+ is continuously consumed by enzymatic processes — PARP-mediated DNA repair, sirtuin activity, CD38 signaling — so without ongoing support, levels decline again. Your provider recommends a schedule based on your goals, lifestyle, and how you responded during loading.
Weekly Maintenance
Best for: Athletes with high training volumes, high-demand professionals, and patients who want to maintain peak levels. Cost: $240/month.
Weekly dosing keeps NAD+ pools consistently elevated. For patients training hard or stacking NAD+ with hormone therapy and peptides, this frequency produces the most consistent results.
Biweekly Maintenance
Best for: Most patients. The most common maintenance frequency at Moonshot Medical — balances effectiveness with cost and convenience. Cost: $120/month.
Every two weeks keeps NAD+ levels above the threshold where most patients maintain the energy, recovery, and cognitive benefits they gained during loading.
Monthly Maintenance
Best for: Patients on hormone optimization plans (1 injection/month included), those who want minimum effective maintenance, or patients with milder baseline depletion. Cost: $60/month or included with membership.
Monthly is the minimum effective frequency. It slows the rate of NAD+ decline and provides a monthly cellular reset. For hormone optimization members, this comes at no additional cost.
Adjusting over time: Maintenance frequency is not locked in. Some patients start with weekly, find their results are stable, and step down to biweekly. Others start monthly and move to biweekly after noticing benefits fade between injections. Your provider will check in periodically and adjust based on how you are responding.
WHAT THE INJECTION FEELS LIKE
If you have never had a subcutaneous injection before, it is natural to wonder what you are in for. The short answer: it is fast, minimally uncomfortable, and you are back to your day immediately.
The Needle
NAD+ at Moonshot is delivered via subcutaneous (SubQ) injection. This means a small, thin needle is inserted into the fatty tissue just below the skin, typically in the abdomen or upper arm. The needle is smaller than what you would see for a blood draw or intramuscular injection. Most patients describe it as a brief pinch. Some barely feel it at all.
Duration
The entire process takes about 5 minutes from prep to completion. The injection itself is under a minute. The rest is prep, site selection, and a quick check-in with your provider.
During the Injection
You may feel mild warmth or a flushing sensation as NAD+ enters your system. This is a normal vasodilatory effect — NAD+ causes temporary widening of blood vessels. Some patients notice a warm feeling that spreads from the injection site. It is not painful. It resolves within a few minutes without intervention.
After the Injection
There is no downtime. You return to normal activity immediately. No restrictions on exercise, driving, or work. Some patients report feeling slightly energized or mentally sharper within hours of their injection. Others notice a more gradual effect over the first few days. Occasional mild soreness at the injection site is normal and resolves on its own.
Compared to IV NAD+: Some clinics offer NAD+ via intravenous infusion (30-60 minutes, more intense flushing). At Moonshot, we use SubQ delivery because it is faster, well-tolerated, and still delivers NAD+ directly to the bloodstream. A 5-minute visit is easier to maintain consistently than a 60-minute infusion, and consistency is what drives results.
TIMELINE OF RESULTS
NAD+ is not a stimulant. The effects are metabolic — driven by improved mitochondrial output and increased sirtuin activity at the cellular level. Results build over time. Here is what most patients report, though individual responses vary:
Week 1-2: Energy Baseline Shifts
The most common early report is improved energy, particularly a reduction in afternoon crashes. Patients who were dragging through the 2-4 PM window notice they can sustain focus and productivity later into the day. This is the mitochondrial effect — better ATP production means more available energy for every cell in your body.
Week 2-3: Recovery and Sleep
Exercise recovery improves noticeably. Soreness duration decreases. Patients report handling higher training volumes without the same recovery cost. Sleep quality often improves as well, given NAD+'s role in circadian rhythm regulation through SIRT1.
Week 3-4: Cognitive Clarity
Many patients report improved cognitive clarity and sustained mental focus. The brain consumes roughly 20% of the body's energy, making it one of the organs most sensitive to NAD+ status. Patients describe clearer thinking, better word recall, and easier focus on demanding tasks.
Month 2-3: Cumulative Benefits
Compounding effects become apparent. Patients on maintenance report improvements in skin quality, mood stability, and workout performance. These are downstream effects of sustained mitochondrial optimization and enhanced sirtuin activity working over weeks and months.
An honest note: Individual results vary. NAD+ works best as part of a comprehensive optimization approach — not in isolation. Patients who are also addressing nutritional deficiencies, optimizing hormones, training consistently, and managing sleep tend to see the most pronounced results. NAD+ amplifies the foundation you build through those other interventions.
Ready to start your NAD+ protocol? Book your first visit and get started the same day.
Book Your First VisitSTACKING NAD+ WITH OTHER THERAPIES
NAD+ does not compete with other therapies — it supports them. Most interventions we offer activate cellular pathways that require NAD+ as a cofactor. When NAD+ is depleted, those therapies may not reach their full potential.
TRT + NAD+
Testosterone replacement therapy activates anabolic and metabolic pathways — protein synthesis, mitochondrial biogenesis, fat oxidation. These pathways are energy-intensive and rely on NAD+ as a direct cofactor. Think of testosterone as the signal telling your body to build and repair. NAD+ is the energy that powers the construction crew. Without adequate NAD+, the signal goes out but the work gets done inefficiently.
BPC-157 / TB-500 + NAD+
BPC-157 and TB-500 are tissue repair peptides that accelerate healing of tendons, ligaments, muscles, and gut tissue. The cellular repair processes they trigger — angiogenesis, fibroblast proliferation, collagen synthesis — are all energy-dependent. NAD+ fuels the mitochondrial machinery that these repair processes draw from. The combination tends to produce faster, more complete recovery than either intervention alone.
GLP-1 + NAD+
GLP-1 receptor agonists drive metabolic changes that stress mitochondrial function — increased fatty acid oxidation, altered glucose metabolism, and the energetic demands of active weight loss. NAD+ supports mitochondrial efficiency during these shifts. Patients on GLP-1 who also receive NAD+ tend to report better energy levels during weight loss, which is a common complaint with GLP-1 therapy alone.
Sermorelin + NAD+
Sermorelin stimulates growth hormone release, which drives tissue repair, fat metabolism, and recovery via IGF-1 signaling. These are energy-intensive processes. Combining growth hormone stimulation with NAD+ creates a synergy: the growth signal is amplified by adequate cellular energy. Patients using both typically report accelerated recovery and improved body composition changes.
Protocol coordination: Your provider coordinates NAD+ scheduling with your other treatments to maximize synergy. This is the advantage of receiving all therapies at a single clinic rather than piecing together protocols from multiple providers.
LAB MARKERS TO TRACK
There is no commercially available direct NAD+ blood test. What we can do is track surrogate markers and objective measurements that correlate with the cellular improvements NAD+ drives.
Inflammatory Markers
High-sensitivity C-reactive protein (hsCRP) is the primary marker. NAD+ supports sirtuin-mediated anti-inflammatory pathways, which can reduce systemic inflammation over time. A downward trend in hsCRP is a positive signal.
Metabolic Panel
Fasting glucose, insulin, HbA1c, and lipid panel. Improvements in metabolic markers — particularly fasting insulin and triglycerides — can reflect enhanced cellular metabolism driven by restored NAD+ levels.
Hormone Levels
For patients on hormone optimization, tracking testosterone, free T, SHBG, thyroid panel, and cortisol alongside NAD+ helps identify whether the metabolic support is translating into improved hormonal function.
DEXA Body Composition
DEXA scans provide precise measurements of lean mass, fat mass, and bone density. For patients stacking NAD+ with TRT, peptides, or GLP-1 therapy, serial DEXA scans are the gold standard for tracking body composition changes.
Subjective tracking matters too: Keep a simple log of energy levels, recovery times, sleep quality, and cognitive function. Many patients notice improvements in how they feel before lab markers shift — functional benefits of restored cellular energy precede measurable changes in blood chemistry.
PRICING AND PLANS
Transparent pricing. No hidden fees, no required memberships, no upsell packages.
Per Injection
$60 per SubQ injection. No membership required. Walk in, get your shot, walk out.
Loading Phase (Weeks 1-4)
8 injections over 4 weeks at 2x/week. Total cost: approximately $480. This is the upfront investment that builds the foundation for maintenance.
Monthly Maintenance
$60 to $120 per month depending on whether you are on monthly ($60), biweekly ($120), or weekly ($240) maintenance. Most patients land at biweekly.
Hormone Optimization Members
Patients on a hormone optimization plan at Moonshot receive 1 NAD+ injection per month included in their membership at no additional cost. Additional injections beyond the included one are $60 each.
No insurance, by design: NAD+ therapy is not covered by insurance (industry-wide, not Moonshot-specific). The upside: no diagnosis codes or referrals needed. If your provider confirms it is appropriate, you can start the same day.
COMMON QUESTIONS
How quickly will I feel results from NAD+ injections?
Most patients notice improved energy and reduced afternoon crashes within the first 1 to 2 weeks of the loading phase. Deeper benefits like improved exercise recovery, sleep quality, and cognitive clarity typically emerge by weeks 2 to 4. NAD+ works at the cellular level, so results are cumulative rather than immediate. The loading phase is designed to build a critical mass of NAD+ that your body can sustain with maintenance dosing.
Do I need a referral or prior labs to start NAD+ injections?
No referral is needed. Your first visit includes a brief consultation where your provider reviews your health history, current medications, and goals to determine if NAD+ is appropriate for you. Same-day injection is possible if you are a good candidate. Baseline labs are recommended as part of a comprehensive optimization approach but are not required to begin NAD+ therapy.
Can I combine NAD+ with testosterone therapy or peptides?
Yes, and this is one of the most effective approaches. NAD+ is a cofactor for the metabolic pathways that testosterone activates, so replenishing NAD+ helps hormones do their job more effectively. Peptides like BPC-157 and TB-500 activate tissue repair processes that require cellular energy from NAD+. Your provider at Moonshot coordinates timing and dosing across all your therapies to maximize synergy.
Is the loading phase necessary, or can I just do monthly injections?
The loading phase is recommended because it rapidly restores depleted NAD+ pools to functional levels. Starting with monthly injections alone is slower and may not produce noticeable results for several months. Most patients who complete the loading phase report a clear difference in energy and recovery that makes the upfront investment worthwhile. That said, your provider will work with you to find a protocol that fits your budget and schedule.
What does an NAD+ injection cost at Moonshot?
NAD+ injections are $60 per shot with no membership required. A full loading phase (8 injections over 4 weeks) runs approximately $480. Maintenance ranges from $60 to $120 per month depending on frequency. Hormone optimization members receive 1 injection per month included in their plan at no additional cost. There are no hidden fees, contracts, or required packages.
NAD+ INJECTIONS IN PARK RIDGE & CHICAGO'S NORTHWEST SUBURBS
Moonshot Medical and Performance
542 Busse Hwy
Park Ridge, IL 60068
- No referral needed — book directly online
- Same-day injection — consult and first shot in one visit
- Minutes from O'Hare — right off the Kennedy Expressway
- Co-located with Moonshot CrossFit — integrated recovery
Serving the Northwest Suburbs
Patients come to Moonshot for NAD+ therapy from across the northwest Chicago suburbs:
- Des Plaines, Niles, Edison Park
- Morton Grove, Glenview, Skokie
- Chicago and surrounding communities
Easily accessible from all NW suburbs. Free parking on-site.
READY TO START YOUR NAD+ PROTOCOL?
Book your consultation, review your health history with a provider, and get your first injection the same day. No referral needed. No commitment required. Just a straightforward path to cellular optimization.
Book Consultation