What did @xoashh.s2 actually say?
The creator documented a subcutaneous NAD+ injection on TikTok, warning viewers that it burns intensely and that newcomers should start with a different peptide first. She described injecting slowly, mentioned trying clove to reduce the sting, and said a friend had a similar reaction. Her bottom line: "NAD just burns" and the payoff was "the best workout" and a mood shift afterward.
To her credit, she was not making medical claims or citing a protocol. This was experiential, personal, and framed as a caution to beginners. She also pushed back on the idea of rushing the injection, which is actually reasonable advice. But there are a few things worth unpacking, including whether what she is injecting qualifies as NAD+, why it burns, and whether the workout and mood effects are plausible or just placebo.
Does the science back this up?
The burning sensation is real and well-documented. It is not fully explained by pH alone, though that is a contributing factor. Studies do support NAD+ administration affecting energy metabolism and mood-adjacent pathways.
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in cellular energy production and sirtuins signaling. IV NAD+ administration has been studied more rigorously than subcutaneous injection. Birkmayer et al. (1996, Acta Neurologica Scandinavica Supplementum) and later work by Conze et al. (2019, Scientific Reports) on NAD+ precursors like NMN and NR demonstrated that systemic NAD+ levels can be raised through supplementation, with effects on energy metabolism. The burning during IV infusion is well-reported in clinical settings and linked to the rate of administration and concentration, not just pH. Slowing the injection, as the creator recommends, is consistent with clinical practice for reducing discomfort. However, subcutaneous NAD+ injection is not a standardized medical protocol, and absorption data for this route is limited compared to IV.
What did they get wrong (or right)?
She got the burn warning right. She got the slow-injection advice right. Where things get shakier is the attribution of a specific workout boost and mood lift to NAD+ specifically.
Crediting NAD+ for "the best workout" after a single subcutaneous dose is plausible in theory but very difficult to verify. NAD+ precursors have shown performance-adjacent effects in longer supplementation studies. Yoshino et al. (2021, Science) found that NMN supplementation improved muscle insulin sensitivity in postmenopausal women over 10 weeks. A single injection is a different scenario entirely. The acute mood shift she describes is harder to attribute. Adrenaline from the injection experience itself, confirmation bias, or the simple act of doing something intentional for your health can produce a temporary mood lift. The creator does not claim NAD+ cures anything, which keeps her out of the most dangerous misinformation territory. But presenting anecdotal workout and mood effects as a reliable outcome is misleading without that context.
Her mention of "backwater" likely refers to bacteriostatic water used for reconstitution. Using the wrong diluent does affect pH and discomfort, so that detail matters more than she gave it credit for.
What should you actually know?
NAD+ injections are not FDA-approved for the uses described here. Compounded NAD+ products vary significantly in purity and concentration, and subcutaneous administration lacks robust clinical evidence compared to IV delivery.
The burning sensation is real and has been documented in IV contexts at rates above clinical tolerance thresholds. If you are experiencing significant burning during a subcutaneous injection, that is a signal worth taking seriously, not just pushing through. The quality of the bacteriostatic water and the concentration of the compound both affect tolerability. Anyone considering NAD+ therapy should do so under medical supervision, with a licensed prescriber who can assess whether it is appropriate, source compounded products from an FDA-registered pharmacy, and monitor response. The creator's personal experience is not a protocol. Her results, positive or otherwise, cannot be generalized. And the "clove" mentioned as a burn-mitigation strategy has no clinical evidence behind it in this context.