NAD+ is a small molecule rather than a peptide. SS-31 is a peptide that works inside your mitochondria.
They are aimed at different things: NAD+ at energy & aging; SS-31 at mitochondrial energy.
| Comparison | NAD+ NAD · nicotinamide adenine dinucleotide | SS-31 (Elamipretide) elamipretide · Forzinity |
|---|---|---|
| How it works | How it works NAD+ is a coenzyme, not a peptide. Every cell uses it constantly to turn food into energy, and levels fall substantially with age. | How it works SS-31 targets one specific molecule inside your mitochondria: cardiolipin, a fat that makes up part of the inner wall where energy is actually produced. |
| What it is | A cellular fuel taken for energy, focus, and anti-aging. | A mitochondrial peptide, approved in 2025 for the rare genetic disease Barth syndrome. |
| Status | In clinical useCompounded | FDA approvedFDA-approved (accelerated) |
| Typical dose | 50–100 mg per dose | 40 mg per day |
| How often | 2-3x/week | Daily |
| Stays active | Not established | ~2-3 hours |
| Dose comes from | Community practice | FDA drug label |
| Cycled? | Commonly given as a course of infusions, then occasional top-ups Community practice | Not cycled FDA drug label |
| What it does | ||
| Drug class | Coenzyme (not a peptide) | Mitochondrial peptide |
| Used for | A cellular fuel people take to fight fatigue and brain fog, sharpen focus, and support anti-aging. | A shot that targets your cells' energy factories to fight fatigue and support aging muscle, heart, and eyes. It is in real clinical trials for mitochondrial disease. |
| Receptors hit | — | — |
| Numbers | ||
| Full dose line | 50 up to 100 mg per dose (start low, increase slowly) | 40 mg per day |
| Why that cycle | Clinics typically run a block of sessions and then space them out. The structure is a clinic convention rather than something a trial arrived at. | Taken continuously for as long as it is working. Neither the label nor clinical practice describes an on/off schedule. |
| Weight / effect | Not measured in a trial | Not measured in a trial |
| Chain length | Not disclosed | Not disclosed |
| Common vial | 500 mg | 50 mg |
| Before you start | ||
| Route | Under the skin, into muscle, or into a vein | Under the skin (subcutaneous) |
| Do not use if | Pregnancy No established contraindications, because it has not been formally studied for them | No formal contraindications were established at approval Pregnancy, where it has not been studied |
What separates them
Proof behind the dose. SS-31 has a dose taken straight off an FDA drug label. NAD+ has a range that comes from community practice, with no published human study behind it.
Staying on it. SS-31 is taken continuously. NAD+ is normally run in blocks with breaks, though for this one the block length is convention rather than a tested schedule.
What doesn't differ: Neither has a measured effect size from a published trial, so there is no number to rank them on.
What people actually report
NAD+
- The plain (unbuffered) form stings sharply on injection; the buffered form is adjusted to sting far less.
- Flushing and nausea increase with higher doses and faster injection.
- Chest tightness or difficulty breathing during an infusion
- Signs of an allergic reaction
SS-31 (Elamipretide)
- Mostly injection-site reactions.
- It is not yet approved.
- Signs of a serious allergic reaction such as trouble breathing, swelling, or a severe rash, which has required permanent discontinuation in rare cases
Side effects are what users and trials report most often, not a complete list. Anything sudden, spreading, or breathing-related is an emergency regardless of which compound caused it.
People also compare
This comparison does not cover cost, long-term safety, or how you personally will respond. Effect figures come from separate trials in different populations and are not always directly comparable to each other. Nothing here is medical advice or a recommendation to use any of these. Talk to a clinician about your own situation.