Weeks 1–4 execution — the daily reset rhythm

Injection schedule, dose math, what you'll feel by day 10.

The first four weeks aren't about pushing the mitochondria. They're about unblocking the electron transport chain so it can carry the load you're about to add. Run too hot here and you'll feel like garbage by day 5 — paradoxical fatigue is the signature of an unprepared substrate getting flooded with cofactor before its plumbing is ready. The Phase 1 rhythm is deliberately conservative: stabilize, load, then move.

What's actually happening in your cells

When NAD+ levels collapse — and by 50 they've collapsed, often by 50–80% from peak — the limiting step isn't NAD+ availability per se. It's electron flow through Complexes I–IV. Half-broken complexes leak electrons, generate reactive oxygen species, and the ROS feedback-loops back to damage cardiolipin, which sits in the inner mitochondrial membrane holding the supercomplexes in alignment. You can pour all the NAD+ you want into a cell whose ETC is leaking; you'll feel the flush, you won't feel the lift.

Methylene Blue at sub-milligram dosing solves this by acting as an alternative electron carrier — it accepts electrons upstream of the broken complex and donates them downstream, bypassing the bottleneck while the membrane lipids remodel. The pharmaceutical dose is 0.5 to 1 mg. Not 10. Not 15. The online forums that quote 20–60 mg are conflating Lieurance's pulsed-mood-disorder protocol with the daily mitochondrial-priming dose, and the difference is the difference between a metabolic enhancer and a pro-oxidant that crashes you. Practitioner consensus on the mitochondrial application is clear: the low dose, daily, with cycling.

Once the ETC is stabilized (you need a week minimum, two is better), NAD+ injections do what they're supposed to do — restore Complex I substrate availability, fuel sirtuin-1 and PARP-1, and walk the NADH:NAD+ ratio back toward a young-cell setpoint. Subcutaneous administration is the at-home delivery that the practitioner corpus describes as practical: slower absorption than IV, dramatically less flush, no clinic chair. The B-vitamin cofactor stack (B1, B2, B6) runs underneath to keep the salvage pathway turning — without them, supplemented NAD+ degrades before it gets recycled.

The Weeks 1–4 stack

Dose math — reconstituting a 100 mg NAD+ vial

The formula: Units on insulin syringe = (Dose ÷ Concentration) × 100

Reconstitute a 100 mg NAD+ vial with 2 mL bacteriostatic water. Concentration = 50 mg/mL = 50,000 mcg/mL.

• For a 50 mg dose: (50 ÷ 50) × 100 = 100 units (full 1 mL insulin syringe)
• For a 75 mg dose: (75 ÷ 50) × 100 = 150 units (1.5 mL — use a 1 mL syringe twice, or step up to a 3 mL)
• For a 100 mg dose: (100 ÷ 50) × 100 = 200 units (2 mL)

If 200 units in one shot is painful (it often is at this volume), split into two 100-unit injections on opposite sides of the abdomen.

Injection site rotation — the 4-week map

Lower abdomen, two inches from the navel, clockwise rotation. Twelve sites mapped like a clock face gives you a full month of rotation before re-using a site — which is exactly the window connective tissue needs to fully recover from a SubQ insertion.

• Week 1: Positions 12, 3, 6, 9 (cardinal points), Mon/Wed/Fri/Sat — but you're not injecting NAD+ yet, this is just MB titration. Skip to Week 2.
• Week 2: NAD+ starts. Mon = 12 o'clock, Wed = 4 o'clock, Fri = 8 o'clock.
• Week 3: Mon = 1, Wed = 5, Fri = 9.
• Week 4: Mon = 2, Wed = 6, Fri = 10.

One syringe per injection. Never mix NAD+ with anything else in the syringe. If you develop a hard lump that doesn't resolve in 48 hours, that site is out of rotation for two weeks — it's early-stage lipodystrophy from poor rotation or repeat trauma.

What you should feel

• Days 1–4 (MB-only): Subtle — slightly cleaner mental clarity by day 3, mildly improved morning energy. If you feel nothing, dose is correct. If you feel wired or anxious, drop to 0.5 mg.
• Days 5–10 (MB + first NAD+ injections): First injection will produce a flush — chest tightness, mild pressure, sometimes a brief "I need to use the bathroom" sensation. This is normal and resolves in 5–15 minutes. By injection three (end of Week 2), the flush is dramatically reduced.
• Days 10–14: Sleep depth improves — most users report waking less at night and remembering more dreams (NAD+-driven sirtuin activity in circadian neurons). Morning cortisol response normalizes; the 3 PM crash starts to soften.
• Days 14–21: Exercise recovery shortens. Heart rate variability climbs 5–15%. Skin appearance subtly improves — surface vasculature looking less inflamed.
• Days 21–28: Sustained baseline energy lift. Not the "wired" of stimulants — the "I forgot I used to feel tired all the time" of restored ATP production capacity.

What's NOT happening yet

• Telomere extension. That's a Phase 2 question and requires Epitalon, which we won't introduce until Week 5. Don't add it now.
• Significant body composition change. NAD+ optimizes the engine. It doesn't burn fat. If you came in expecting visible recomposition by day 21, recalibrate — that's the Phase 2 stack with MOTS-c.
• Cognitive transformation. You'll feel sharper. You will not feel like a different person. Heroic cognitive shifts in the first month are usually placebo or the lift from finally sleeping well, not direct neurogenesis.
• Permanent NAD+ baseline elevation. Stop the protocol cold at week 4 and you regress in 10–14 days. Phase 1 is loading; the maintenance schedule (Module 10) is what holds it.
• MB "high dose" effects. At 0.5–1 mg you will not feel a "trip," a "lift," or any psychoactive shift. If you do, you're dosed wrong.

Track sleep, morning energy 1–10, and injection-site response daily for 28 days — the data is the protocol.