NAD+ is a coenzyme every cell uses to shuttle electrons in energy metabolism, most critically in mitochondrial ATP production. It's also a required substrate for sirtuins and PARP enzymes, which govern DNA repair and cellular aging pathways — the basis for its popularity in longevity medicine. NAD+ levels decline naturally with age, which is the premise behind most therapeutic and supplement marketing.

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• Compounding-clinic IV drips and injections, marketed for energy, cognitive clarity, and anti-aging support
• Oral precursor supplements: nicotinamide riboside (NR, GRAS/dietary-supplement status) and nicotinamide mononucleotide (NMN, in regulatory limbo since FDA excluded it from the dietary-supplement definition)
• Investigated as an adjunct in addiction-recovery/withdrawal protocols, though formal trial data remain sparse

• Unlike every other entry in this atlas, NAD+ is not a peptide or steroid — it's a naturally occurring coenzyme, chemically closer to a vitamin-derived cofactor than a hormone or amino-acid chain
• Included on the FDA's bulk drug substances list authorized for compounding, a notably more settled regulatory footing than most peptides in this collection
• In late 2024, the FDA issued warning letters to several compounding facilities over cGMP violations in bulk IV NAD+ preparation — a manufacturing-practice issue, not a ban on the compound itself