NAD+ Supplementation Dosing: No Established Medical Guideline Exists
I cannot provide a medical recommendation for daily NAD+ supplementation dosing because there are no FDA-approved indications, drug labels, or clinical practice guidelines establishing therapeutic doses for nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN) in humans.
Critical Context: These Are Not FDA-Approved Medications
The evidence provided consists entirely of:
- Unrelated clinical guidelines for antibiotics, anticonvulsants, and other prescription medications 1, 2, 3, 4
- Basic science and animal research on NAD+ precursors 5, 6, 7, 8, 9
None of these sources provide clinical dosing recommendations for NAD+ supplementation in humans for any medical condition.
What the Research Actually Shows
Safety Concerns from Animal Studies
- NMN at 300 mg/kg and NR at 230 mg/kg worsened atherosclerosis in mice despite improving lipid profiles and fatty liver 5
- The study concluded that doses around 100 mg/kg had minimal harmful effects on atherosclerosis in this animal model 5
- These findings emphasize the need for establishing safe dosages before widespread clinical use 5
Mechanistic Understanding Only
- NR and NMN are NAD+ precursors that can elevate cellular NAD+ levels 6, 7, 8, 9
- Mammalian cells require conversion of extracellular NMN to NR for cellular uptake and NAD+ synthesis 8
- NRK1 enzyme is necessary and rate-limiting for using exogenous NR and NMN for NAD+ synthesis 8
No Human Dosing Data
- The research discusses potential therapeutic applications but provides no established human dosing protocols 7, 9
- Studies mention that NR and NMN are "safe and well-tolerated" but do not specify validated therapeutic doses 9
Why This Question Cannot Be Answered Medically
NAD+ precursors (NR and NMN) are currently sold as dietary supplements, not prescription medications. They lack:
- FDA approval for any medical indication
- Established therapeutic dose ranges
- Clinical practice guidelines
- Drug interaction profiles
- Long-term safety data in humans
The question asks about "NAD plus 1000mg" but does not specify:
- Which NAD+ precursor (NR vs NMN)
- What the "1000mg" refers to
- What medical condition is being treated
- Patient-specific factors (age, weight, comorbidities)
Clinical Recommendation
If you are considering NAD+ supplementation for a medical purpose, consult with a physician who can evaluate your specific clinical situation. The absence of clinical guidelines means any dosing would be empirical and potentially unsafe, particularly given the animal data showing harm at higher doses 5.
For general health supplementation (not medical treatment), follow manufacturer recommendations on commercially available products, recognizing these are not medically validated doses.