A new client in Palm Beach Gardens — call him Steve, 54, arrived via a longevity podcast — opened his first consultation with a question our nurses hear weekly, delivered with the confidence of a man who has done exactly one evening of research: "I want the thousand. The podcast guy does a thousand." The nurse's reply has since entered our internal hall of fame: "The podcast guy also does his in a clinic with a lunch break. Let's talk about what the number actually buys you."
What the milligrams actually change
Three things scale with dose, and only one of them is the reason you're booking:
- Session length — linearly. NAD⁺ must infuse slowly for comfort (the flush is rate-dependent), so the milligrams set the clock: 250mg fits in under an hour, 500mg runs 60–90 minutes, 1000mg can stretch toward two and a half hours or more. This is the most underrated dosing factor in the category, because the best protocol is one you'll actually repeat.
- Sensation likelihood. More molecule, more infusion time near your flush threshold. Manageable at any dose with a good nurse on the clamp — but first-timers who start at 1000 are choosing the deep end for their first swim.
- Cost — and here's where menu economics live. NAD⁺ is genuinely expensive to source at pharmaceutical grade, so price scales with dose legitimately. What's not always legitimate is the implication that benefit scales the same way.
Milligrams scale the clock, the cost, and the flush. The benefit curve is the one that flattens.
The honest benefit curve
Here's the part the bigger-number menus skip: member-reported outcomes — the steadier afternoons, cheaper workouts, the volume-knob-on-tired effect — cluster at the working doses and don't reliably double when the dose does. The pattern across our thousands of sessions: 250mg is a real introduction (genuine effects, gentlest session — the right first date for the cautious); 500mg is the working standard where the serious-protocol benefits live at a bookable session length — it's why our formulas run it; 1000mg+ belongs to specific intensive protocols, typically clinic-based multi-day programs, where the long sessions are the point. For general performance and longevity use, the extra 500 mostly buys you an extra hour in the chair and a rounder invoice. Ask any provider pushing four figures of milligrams the killer question: what is the extra dose for, in my case? Silence is an answer.
Choosing your number
The decision tree we actually use: curious and cautious? Start at 250 or with Niagen — feel the category gently. Ready to run the real experiment? 500mg — ideally inside The Surge, where it works alongside the hydration and B vitamins its own pathways spend — then judge by the following two weeks, not the session itself. Considering 1000+? Have a specific reason and a provider who can articulate it, and block the afternoon. And whatever the number: rhythm beats size — a sustainable 500 monthly outperforms a heroic 1000 you never repeat.
The 500 standard
NAD+ $749
Our formulas run a full 500mg — the working dose serious protocols are built on.
IV Fluids · B-Complex · + 3 IM Shots: B12 · D3 · CoQ10
Steve's revision
Steve ran 500 monthly for a quarter and reported the outcome that settles most dosing debates: "Turns out the number that matters isn't the milligrams. It's how many months in a row you show up." The podcast guy, for what it's worth, would agree — it's usually in the episode after the one everyone stops listening to.
This article is for general education and is not medical advice. IV therapy at SurgIV is administered by registered nurses under physician-written protocols, with a health screening before your first visit. Talk to your doctor about what is right for you.
