What it is
NAD+ — nicotinamide adenine dinucleotide — is a coenzyme present in every cell, central to energy metabolism, DNA repair, and the activity of sirtuin enzymes. NAD+ levels decline with age, and that decline has driven interest in supplementation through precursors (NMN, NR) and direct administration.
Injectable NAD+ at Esvie is administered subcutaneously or intramuscularly. It is not an FDA-approved pharmaceutical — it is compounded for off-label use under physician supervision. Clinical evidence for direct NAD+ administration is evolving, and Dr. Brown will be transparent about what the data does and does not support before recommending a protocol.
A practical note: NAD+ injections sting. That is the nature of the molecule, not a reflection of preparation or technique. Patients who tolerate it well typically settle into a manageable rhythm; others find it intolerable and stop.
How Dr. Brown approaches it
Wellness injections at Esvie begin with a clinical consultation, not a phone order. Dr. Brown reviews your history, the symptoms or goals motivating the request, and any underlying medical issues that need workup before NAD+ is prescribed.
Persistent fatigue, brain fog, or low energy can be symptoms of conditions that deserve evaluation — thyroid, sleep apnea, anemia, depression, nutrient deficiencies. NAD+ is not a substitute for that workup. If the workup is clean and a NAD+ protocol is appropriate, a written plan — dose, route, frequency, and monitoring — is provided.
What to expect
Consultation: An in-person visit with Dr. Brown. Medical history, review of any prior workup, baseline labs as indicated, and a discussion of realistic outcomes.
Treatment visit: Subcutaneous or intramuscular injection administered in office. The injection itself takes only minutes; expect mild stinging or warmth at the site that fades within a short period.
Cadence: Weekly to monthly depending on the protocol. Patients who tolerate self-administration may transition to home injections after instruction.
Monitoring: Check-ins at intervals. Adjustments made based on response, tolerance, and any new symptoms.
Candidacy
Good candidates have completed appropriate medical workup, have realistic expectations, and tolerate the injection.
Not a candidate if you are pregnant or nursing. Not a candidate with active untreated malignancy. Not a candidate seeking NAD+ as a substitute for evaluation of an underlying condition. Not a candidate if injection-site reactions are persistently intolerable.
If NAD+ is not the right fit, Dr. Brown will say so and discuss alternatives — including the workup that should happen first.