Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Head-to-head comparison of NAD+ and SS-31 — mechanism, dosing, side effects, legal status, and pricing.
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme present in all living cells, not a peptide. It is classified here alongside peptides for user convenience in the anti-aging / metabolic category. NAD+ plays a central role in cellular energy metabolism and redox reactions and is studied for its involvement in mitochondrial function, DNA-damage signaling via sirtuins and PARPs, and age-associated metabolic decline. IV NAD+ is not FDA-approved for any clinical indication; it is administered off-label through compounding pharmacies and functional-medicine clinics with limited rigorous outcome data.
SS-31 (elamipretide) is a mitochondria-targeted tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) developed by Hazel Szeto (Cornell) and clinically advanced by Stealth BioTherapeutics. It concentrates in the inner mitochondrial membrane by binding cardiolipin. In September 2025, the FDA granted accelerated approval to elamipretide (brand name FORZINITY) as the first therapy for Barth syndrome — the first FDA-approved mitochondria-targeted drug. It remains investigational for other indications.
NAD+
SS-31
Category
Legal Status
Mechanism
Dose Range
Route
COA-verified vendors · trust score ≥70 required · single-vial price — bulk/bundle deals may be lower
NAD+
SS-31
COA corpus from Disclosed Labs — independently tested batches only.
NAD+
146
COAs
99.4%
Avg purity
15
Labs
SS-31
65
COAs
99.8%
Avg purity
12
Labs
The strongest human evidence for raising circulating NAD+ comes from oral-precursor trials. A randomized, double-blind, placebo-controlled study of nicotinamide riboside combined with pterostilbene (NRPT) showed sustained dose-dependent increases in whole-blood NAD+ over 8 weeks in healthy adults (Dellinger et al., npj Aging and Mechanisms of Disease, 2017). A Yoshino/Baur/Imai review summarizes the biology and emerging therapeutic potential of NR and NMN, including preclinical healthspan data in aged mice (Cell Metabolism, 2018). Direct IV NAD+ has only small pilot pharmacokinetic data: Grant et al. infused 750 mg over 6 hours in 8 healthy men and documented altered plasma and urine NAD+ metabolome without clinical-outcome endpoints (Frontiers in Aging Neuroscience, 2019). No adequately powered RCTs support IV or SubQ NAD+ for anti-aging, cognition, addiction, or Parkinson's disease; clinic marketing claims outrun the published outcome evidence.
Key references
The original SS-peptide class was described by Zhao, Szeto and colleagues (J Biol Chem 2004, PMID 15178689), showing ~1000-fold concentration at the inner mitochondrial membrane and protection against oxidative cell death. Szeto's 2014 review (Br J Pharmacol, PMID 24117165) reframed the mechanism as cardiolipin-binding rather than antioxidant scavenging. The TAZPOWER trial (NCT03098797) in Barth syndrome, with its 168-week open-label extension (Thompson et al., Genet Med 2024, PMID 38602181), supported FDA accelerated approval of FORZINITY in September 2025 at 40 mg SubQ daily. The Phase 3 MMPOWER-3 trial in primary mitochondrial myopathy (Karaa et al., Neurology 2023, PMID 37268435) FAILED co-primary endpoints of 6-minute walk test and fatigue score, though a post-hoc nuclear-DNA subgroup showed improvement. Phase 2 ReCLAIM-2 in geographic atrophy missed primary endpoints but reduced ellipsoid-zone attenuation; a Phase 3 trial is ongoing. Earlier heart failure trials (PROGRESS-HF) showed only modest signals.
NAD+ (Metabolic) and SS-31 (Recovery) are in different categories and target different biological pathways. This is a common pattern in multi-compound research protocols. Researchers should monitor the biomarkers from both profiles and watch for interactions listed in each compound’s contraindications. Consult a licensed healthcare provider before combining any research compounds.
This platform provides informational tools only, not medical advice. This comparison is for educational purposes only. Consult a licensed provider.
Frequency
Dosing Notes
Half-life
Side Effects
Contraindications
Lab Testing
Key references
Disclosed Labs