NAD+ IV Therapy for Brain Health in St. Marys, GA
NAD+ IV therapy restores the coenzyme your brain needs to produce energy at the cellular level. NAD+ levels drop steadily with age, and at The Neurogenesis Project in St. Marys, Georgia, neurologist Dr. Sean Orr uses intravenous NAD+ as part of a diagnostic-driven protocol to restore cellular metabolism, support DNA repair, and protect neurons from age-related decline.
Available at our St. Marys, Georgia clinic.
What NAD+ Does in the Brain
Nicotinamide adenine dinucleotide, abbreviated NAD+, is a coenzyme found in every living cell. It functions as an electron carrier in the mitochondrial electron transport chain, the process by which cells convert nutrients into adenosine triphosphate (ATP). Without adequate NAD+, mitochondria cannot produce energy efficiently, and cells begin to falter.
The brain is the most energy-demanding organ in the body. It accounts for roughly 2% of total body weight but consumes about 20% of the body’s resting energy output. Neurons require a constant supply of ATP to maintain ion gradients across their membranes, synthesize neurotransmitters, and support synaptic transmission. When NAD+ levels fall, the supply chain behind all of this activity begins to break down.
NAD+ also participates in DNA repair through its role as a substrate for enzymes called PARPs (poly ADP-ribose polymerases), which detect and repair single-strand DNA breaks. It activates sirtuins, a family of proteins that regulate cellular stress responses, mitochondrial biogenesis, and inflammatory signaling. Research published in Cell Metabolism (Imai and Guarente, 2014) demonstrated that sirtuin activity depends directly on NAD+ availability, and that declining NAD+ levels contribute to age-related metabolic dysfunction across tissues, including the brain.
The decline is measurable. Studies suggest that NAD+ levels in human tissue drop by approximately 50% between the ages of 40 and 60. Massudi et al. (2012, PLoS ONE, n=36) documented an age-dependent decrease in NAD+ concentrations in human skin tissue that correlated with increased oxidative DNA damage. In brain tissue, similar declines have been observed in animal models, where reduced NAD+ was associated with impaired mitochondrial function, increased neuroinflammation, and accelerated neuronal loss.
The symptoms that patients notice—slower recall, difficulty concentrating, mental fatigue that worsens through the day, reduced capacity for sustained attention—are downstream consequences of this metabolic shortfall. The neurons are still there, but they lack the fuel to perform at their previous capacity.
Dr. Orr walks through the research, the side effects and the open questions in more depth in What Is NAD+ IV Therapy? A Neurologist Explains How It Works.
Why IV Delivery Matters
NAD+ is available as an oral supplement, and precursors like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are widely sold for daily use. These oral forms have value for long-term maintenance, and Action Potential Supplements offers formulations designed to support NAD+ metabolism as part of an ongoing brain health regimen. We also offer NR intravenously as Niagen IV, which runs in about an hour. But oral bioavailability is limited. NAD+ is a large molecule that is partially degraded in the gut, and the amount that reaches systemic circulation is a fraction of the ingested dose.
Intravenous delivery bypasses the digestive system entirely. The full dose enters the bloodstream directly, producing a rapid and measurable increase in plasma NAD+ concentrations. Grant et al. (2019, Antioxidants & Redox Signaling, n=8) measured a roughly 400% increase in blood NAD+ levels following a single IV infusion, with levels remaining elevated for several hours post-infusion. Oral NR supplementation in the same study produced a smaller and more gradual rise.
At The Neurogenesis Project, NAD+ infusions are administered over two to four hours. The slow drip rate is deliberate. Rapid infusion can cause chest tightness, nausea, and flushing, so Dr. Orr titrates the rate based on each patient’s tolerance. Patients sit comfortably in a clinical infusion suite at our St. Marys, Georgia clinic, and the nursing staff monitors vitals throughout the session.
For patients enrolled in the Intensive Brain Health Program, NAD+ infusions typically run daily over a three-to-five-day treatment block. This approach builds NAD+ stores more effectively than a single session and allows the clinical team to adjust dosing in real time based on patient response.
NAD+ IV Therapy Cost
NAD+ is priced by the milligram, at $1 per mg, with no membership or package required. Dr. Orr confirms the dose at your first visit.
Direct-care pricing, paid at the time of service. We provide a superbill for HSA or FSA reimbursement. IV infusions are available Mondays, Thursdays and Fridays at our St. Marys office, a short drive from Kingsland, Yulee, Fernandina Beach and Brunswick. Short on time? Niagen IV raises NAD+ in about an hour, from $450.
Who Benefits from NAD+ IV Therapy
NAD+ depletion is a factor in a range of neurological conditions and age-related cognitive changes. The following groups represent the patients who most commonly receive NAD+ infusions as part of their treatment at our clinic.
Age-Related Cognitive Decline
As NAD+ levels fall with age, mitochondrial efficiency drops and neurons lose metabolic capacity. Patients in their 40s through 70s who notice slower processing speed, difficulty with word retrieval, or persistent mental fatigue often have measurably reduced NAD+ availability. Restoring those levels through IV infusion gives neurons the substrate they need to produce energy and maintain repair mechanisms.
Post-Concussive & Traumatic Brain Injury
TBI creates a metabolic crisis in the brain. Injured neurons demand more energy while the mitochondria that supply it are themselves damaged. NAD+ infusions address this mismatch by replenishing the coenzyme pool that mitochondria rely on. For patients recovering from concussion or more severe brain injuries, NAD+ is typically paired with other treatments described on our traumatic brain injury page.
Cognitive Recovery After Substance Use
Chronic substance use depletes NAD+ stores and damages mitochondrial function throughout the brain, particularly in the prefrontal cortex and reward circuitry. People who have stopped using often live with fatigue, brain fog, and difficulty with executive function. NAD+ infusions help restore the metabolic baseline these circuits need to begin functioning again. Dr. Orr works with patients in the Rescue from Rehab track to address these cognitive deficits alongside other neurological care.
Executive Optimization
Not every patient who comes for NAD+ therapy has a diagnosis. Some are executives, physicians, attorneys, and other professionals whose work demands sustained high-level cognitive output. They may have no measurable pathology, but they notice that their mental stamina and processing speed have declined from where they were five or ten years ago. NAD+ infusions, combined with the broader metabolic optimization protocol, help restore the cellular energy economy that underpins peak cognitive function.
Dr. Orr’s Clinical Approach
Many patients come to us for NAD+ on its own, and we often provide infusions to walk-in patients after a physician screening. You do not need to enroll in a program to book one.
NAD+ is often more effective, though, when it is part of comprehensive care. A full workup with advanced brain imaging, blood-based biomarker panels and neurocognitive testing tells Dr. Orr whether mitochondrial dysfunction, NAD+ depletion or a related metabolic deficit is contributing to your symptoms. Those results shape the dose, the schedule and what the infusions are paired with.
In a comprehensive plan, NAD+ is one of several treatments. The plan might also include exosome therapy, mesenchymal stem cells, other IV therapies or targeted nutritional interventions, depending on what the imaging and lab work reveal. A patient with significant neuroinflammation and low NAD+ markers will receive a different protocol than a patient with intact inflammatory markers but reduced mitochondrial complex I activity. Dr. Orr treats the underlying neurology; NAD+ is a tool in that treatment, not the treatment itself.
After the initial treatment block, follow-up testing measures objective changes. Repeat neurocognitive assessments, updated biomarker panels, and in some cases follow-up imaging allow Dr. Orr to track whether the intervention produced measurable improvement and to adjust the protocol accordingly. Patients in the Intensive Brain Health Program receive this follow-up as a standard part of their care.
Related Treatments
Niagen IV Therapy
Intravenous nicotinamide riboside, the NAD+ precursor, infused in about an hour. The alternative for patients who find the NAD+ drip hard to tolerate.
Exosome Therapy
Cell-derived vesicles that carry repair signals across the blood-brain barrier. Used alongside NAD+ to target neuroinflammation and promote neural recovery.
Stem Cell Therapy
Mesenchymal stem cells for sustained neural repair and immunomodulation. Often combined with NAD+ infusions in the Intensive Brain Health Program.
What to Expect
Initial consultation and neurological assessment
Estimated time: 30 minutes
Dr. Orr reviews your medical history, current symptoms, medications, and treatment goals. He may order baseline laboratory tests including NAD+ metabolite levels and mitochondrial function markers to determine whether IV NAD+ is appropriate for your clinical situation.
Customized IV protocol formulation
Estimated time: 15 minutes
Based on assessment findings, Dr. Orr determines the NAD+ dosage (typically 250 to 1000 mg per session), infusion rate, and whether additional cofactors such as B vitamins or magnesium should be included. The protocol accounts for your body weight, tolerance history, and specific neurological targets.
IV placement and comfort setup
Estimated time: 10 minutes
A nurse places a peripheral IV line, usually in the forearm or hand. You settle into a reclining chair in a private infusion suite. Vital signs are recorded at baseline. The clinic provides blankets, Wi-Fi, and a quiet environment for the duration of the infusion.
Slow intravenous infusion with clinical monitoring
Estimated time: 3 hours
Pharmaceutical-grade NAD+ is administered as a slow IV drip over two to four hours. The infusion rate is adjusted based on how you respond; some patients experience mild chest tightness or nausea at higher drip rates, and slowing the infusion resolves this. A clinician checks vital signs and symptoms at regular intervals throughout.
Post-infusion assessment and follow-up plan
Estimated time: 15 minutes
After the infusion is complete, you rest briefly while the team confirms stable vital signs. Dr. Orr discusses what you may notice in the hours and days following treatment, reviews any maintenance infusion schedule, and schedules follow-up testing if your NAD+ therapy is part of a broader Intensive Brain Health Program protocol.
Frequently Asked Questions
What is NAD+ and why does the brain need it?+
NAD+ is a molecule every cell needs to produce energy and repair DNA. The brain uses a disproportionate share of it, so when levels drop, thinking and memory suffer first.
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NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in every cell in the body. It is required for mitochondrial energy production, DNA repair, and the regulation of cellular stress responses. The brain consumes roughly 20% of the body’s total energy output despite accounting for only about 2% of body weight, making it especially dependent on a steady NAD+ supply. When NAD+ levels decline, neurons lose the ability to produce adequate ATP, and repair mechanisms slow down.
How is NAD+ administered at The Neurogenesis Project?+
NAD+ is given through a slow IV drip over two to four hours at our clinic in St. Marys, Georgia. Dr. Orr adjusts the rate based on your tolerance.
Read the full answer
NAD+ is delivered through a slow intravenous drip over the course of two to four hours per session. The IV route bypasses the digestive system entirely, allowing the coenzyme to reach systemic circulation at full concentration. Patients are monitored throughout the infusion at our clinic in St. Marys, Georgia. Dr. Orr adjusts the infusion rate and dosing based on each patient’s tolerance, body weight, and treatment goals.
Who is a candidate for NAD+ IV therapy?+
Patients with cognitive decline, brain injury, concussion recovery, cognitive recovery after substance use, and those seeking to maintain brain performance as they age. Dr. Orr evaluates candidacy through examination, labs, and imaging.
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Candidates include patients experiencing age-related cognitive decline, individuals recovering from traumatic brain injury or concussion, people recovering cognitive function after substance use whose brain chemistry has been disrupted by prolonged substance use, and people seeking to maintain or improve cognitive performance as they age. Dr. Orr evaluates candidacy through neurological assessment, laboratory testing, and advanced imaging before recommending NAD+ infusions.
How many NAD+ sessions are typically needed?+
Most patients receive infusions over three to five consecutive days during the initial program, with optional maintenance sessions every four to eight weeks afterward.
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The number of sessions depends on the patient’s condition and treatment goals. Most patients in the Intensive Brain Health Program receive NAD+ infusions over the course of three to five consecutive days during their initial protocol. Some patients return for periodic maintenance infusions, typically once every four to eight weeks. Dr. Orr adjusts the frequency based on follow-up testing and clinical response.
What does NAD+ IV therapy cost?+
NAD+ alone starts at $250 for 250 mg ($1 per milligram). Our Anti-Aging package with glutathione and B vitamins is $675. Insurance does not cover it, but HSA and FSA funds can be used.
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NAD+ Alone is priced at $1 per milligram: $250 for 250 mg, $500 for 500 mg, and $900 for 1,000 mg. Our Anti-Aging package, which combines NAD+ with glutathione and B vitamins, is $675. Patients who want a shorter visit can choose Niagen IV, an intravenous nicotinamide riboside infusion that runs in about an hour and is priced from $450. Payment is collected at the time of service and we provide a superbill for HSA or FSA reimbursement; insurance does not typically cover NAD+ infusions.
Should I choose NAD+ IV or Niagen IV?+
NAD+ IV delivers the finished molecule but takes two to four hours because faster rates cause side effects. Niagen IV delivers a precursor that infuses in about an hour with fewer side effects. Dr. Orr will recommend one based on your situation.
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Both raise NAD+. NAD+ IV delivers the finished coenzyme and has to run over 2 to 4 hours because faster rates cause chest tightness and nausea. Niagen IV delivers nicotinamide riboside, the precursor your cells convert to NAD+, and is tolerated at a much faster rate, so the visit takes about an hour. Patients who have had trouble sitting through an NAD+ drip, or who cannot spare an afternoon, usually prefer Niagen. Dr. Orr will recommend one or the other based on your history and goals.
Is NAD+ IV therapy FDA-approved?+
No. NAD+ is not FDA-approved for any specific disease. It is administered as a compounded IV preparation under physician supervision using pharmaceutical-grade product.
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NAD+ is classified as a dietary supplement ingredient and is not FDA-approved as a drug for the treatment of any specific disease. The IV administration of NAD+ is performed as a clinical service under physician supervision. At The Neurogenesis Project, Dr. Orr uses pharmaceutical-grade NAD+ sourced from licensed compounding pharmacies that comply with USP 797 sterile compounding standards, and he discusses the evidence base and regulatory status with every patient before treatment.
How long does an NAD+ infusion session take?+
Two to four hours per session, depending on the dose. Higher doses require a slower drip rate.
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NAD+ infusions take two to four hours depending on the dose. Higher doses require slower infusion rates. The rate is adjusted based on patient tolerance. If side effects such as nausea or flushing occur, we slow the rate until they resolve.
What side effects can I expect during or after an NAD+ infusion?+
The most common are nausea, flushing, and a pressure sensation in the chest or head. These improve when the drip is slowed. Eating before the session and staying hydrated helps.
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The most common side effects are nausea, abdominal cramping, flushing, and a sensation of chest or head pressure. These are rate-dependent and improve when the infusion is slowed. Some patients report fatigue or mild headache in the hours following, which resolves by the next day. Eating a light meal before the session and staying hydrated reduces the likelihood.
Can I take oral NAD+ supplements instead of IV therapy?+
Oral NAD+ has poor absorption. Oral precursors like nicotinamide riboside can raise NAD+ levels but less dramatically than IV. Many patients use oral supplements for maintenance between IV sessions.
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Oral NAD+ itself has very poor bioavailability. NAD+ precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are absorbed orally and can raise blood NAD+ levels. However, IV administration achieves substantially higher and more immediate plasma concentrations. The choice between oral precursors for maintenance and IV therapy for acute repletion depends on the clinical scenario and severity of NAD+ depletion.
Restore Your Brain’s Energy Supply
NAD+ is the molecule your mitochondria depend on to keep neurons firing. If age, injury, or years of metabolic stress have depleted your reserves, a diagnostic workup with Dr. Orr can determine whether IV NAD+ therapy belongs in your treatment plan.