What did @insideout_aesthetics actually say?
The creator recommended a NAD+ subcutaneous injection protocol based on personal experience and a pharmacist's suggestion. In their words, they do "40 units four times a week" and find that dose is "where I feel best." They also described a ramp-up approach: starting at 20 units, progressing through 30 and 40, before reaching 50 units three times a week, which the pharmacist recommended. They credited this protocol with helping them "recover from injuries quicker" and feel "a little bit more energy."
To be clear about what this is: one person sharing their personal dosing experience at a medspa, framed as general guidance. No patient population is specified. No underlying condition is mentioned. No adverse effects are discussed. That framing matters, because 122,000 people watched this video, and some of them are likely taking notes.
Does the science back this up?
The honest answer is: partially, but with serious caveats. The evidence for NAD+ precursor therapy is real but mostly comes from oral or IV nicotinamide riboside (NR) and NMR studies, not subcutaneous NAD+ injections specifically. The subcutaneous route is used clinically, but it is not well-studied in controlled trials.
Human research on NAD+ supplementation does show increases in blood NAD+ levels. Elhassan et al. (2019, Cell Reports) demonstrated that oral NR raised whole blood NAD+ in older adults. Dollerup et al. (2018, Nature Communications) found similar results with NR in a randomized controlled trial. However, these studies looked at precursors, not direct NAD+ injection. The mechanistic assumption that more circulating NAD+ translates to better energy and faster recovery is biologically plausible, given NAD+'s role in mitochondrial function and DNA repair, but the clinical evidence for those specific outcomes in healthy adults remains thin. Martens et al. (2023, Nature Aging) showed some cardiovascular benefits with NMN in older adults, but that is a different compound and a different population.
What did they get wrong (or right)?
Credit where it is due: the ramp-up approach they describe is actually reasonable. Starting at a lower dose and titrating upward is standard clinical practice for compounds that can cause side effects like flushing, nausea, and injection site reactions. That part is not controversial.
What is more problematic is the confident causal language. Saying the protocol helps "recover from injuries quicker" implies a therapeutic outcome. NAD+ is not FDA-approved for injury recovery. Subcutaneous NAD+ is a compounded preparation, and compounded drugs are not equivalent to any approved formulation. The creator does not mention this. They also do not mention that "units" is an unusual way to measure NAD+ doses. NAD+ is typically dosed in milligrams, not units. Units is a measurement used for insulin and a handful of other biologics. Using that terminology without clarification creates confusion about what is actually being injected and at what concentration.
The claim that 300mg IV NAD+ infusions exist is accurate, those are offered at some clinics, but the video does not address the significant side effect profile of IV NAD+, which includes chest tightness, nausea, and cardiovascular stress at higher infusion rates.
What should you actually know?
NAD+ therapy is a legitimate area of clinical and research interest. The biology is real. The commercial hype, however, has run well ahead of the evidence, and videos like this one can blur that line quickly.
A few things worth knowing before you follow any protocol you saw on TikTok. First, subcutaneous NAD+ injections involve a compounded drug. Compounded drugs vary in concentration, sterility, and quality across pharmacies, which matters a lot when you are injecting something. Second, the "units" framing in this video should prompt you to ask your prescriber exactly what concentration you are receiving. Third, the energy and recovery benefits described here are anecdotal. That does not mean they are false, but it does mean they are not proven in your body, for your goals, at this dose. Fourth, any protocol involving injections requires medical supervision, bloodwork, and a prescriber who knows your full history. A TikTok video cannot substitute for that.
If you are interested in NAD+ therapy, that conversation belongs in a clinical setting, not in a comments section.