protocols
Retatrutide + NAD: Beginner Protocol
Who This Is For
First-time peptide users who want:
- Clear structure with minimal complexity
- Predictable weight loss without energy collapse
- A foundation for more advanced protocols later
The goal is not aggressive weight loss at the expense of overall health. It is metabolic recalibration—restoring the body's ability to burn stored fuel without the fatigue, cravings, and rebounds that accompany GLP-1 monotherapy.
Why These Two Together
Retatrutide creates the conditions for fat loss through three receptor pathways:
| Receptor | What it does | Retatrutide (vs. Native) |
|---|---|---|
| GLP-1R | Appetite suppression, gastric slowing | 0.5× |
| GIPR | Insulin sensitivity, nutrient partitioning | 2.0× |
| GCGR | Hepatic oxidation, prevents metabolic slowdown | 0.2× |
Retatrutide's moderate GLP-1 (0.5×) provides appetite control without the intense nausea of full GLP-1 agonists like semaglutide. The strong GIP signal (2×) drives insulin efficiency and fat metabolism. The attenuated glucagon (0.2×) maintains hepatic fat oxidation without hyperglycemic effects.
The result is a deficit that feels natural rather than forced. Hunger quiets. Metabolic rate holds.
But mobilized fat still needs to be burned. That's where NAD+ becomes essential.
In a deficit, cells lean heavily on β-oxidation—the pathway that converts fat to ATP. This pathway is NAD+-hungry. When NAD+ runs short, fat is mobilized but not efficiently converted to energy. Fatigue sets in. Cravings return. Progress stalls.
Maintaining NAD+ keeps the fat-burn → ATP chain moving. Energy stays stable while the deficit does its work.
Dosing Protocol
| Parameter | Retatrutide | NAD+ |
|---|---|---|
| Dose | 0.5–4 mg total weekly | 100–200 mg |
| Frequency | Weekly or every 3 days | 5× per week |
| Timing | Any time | Morning |
| Route | SubQ | IM or SubQ |
| Note | Allow 4+ weeks before increasing | Inject slowly |
Weekly Schedule (Example)
| Compound | Mon | Tue | Wed | Thu | Fri | Sat | Sun |
|---|---|---|---|---|---|---|---|
| Retatrutide | — | — | 1–4 mg | — | — | — | — |
| NAD+ | 100–200 mg | 100–200 mg | 100–200 mg | 100–200 mg | 100–200 mg | Rest | Rest |
Adjust to your chosen retatrutide frequency. Consistency matters more than the specific schedule.
Timeline: What to Expect
Weeks 1–4
| Adaptation | Appetite suppression begins within 48–72 hours |
| Early signals | Reduced snacking, flatter glucose curves, 2–4 lb loss (some water/glycogen) |
| Side effects | Mild nausea possible; smaller protein-first meals help |
| Energy | May fluctuate initially; NAD+ smooths this out |
Weeks 5–8
| Steady progress | Fat loss stabilizes at 1–2 lb/week |
| Appetite | Becomes mechanical rather than emotional |
| Energy | Often better than baseline with consistent NAD+ |
| Challenge | May need reminders to eat enough protein |
Weeks 9–12
| Consolidation | Scale progress may slow; body composition keeps improving |
| Measurements | Waist circumference drops, clothes fit differently |
| Metabolic state | Hunger control effortless, energy stable |
| Decision point | Continue, maintain, or advance to Intermediate |
Lifestyle Foundation
This protocol works on top of, not instead of, basic metabolic hygiene.
| Component | Target |
|---|---|
| Protein | 1.0 g/lb body weight daily |
| Training | 2–4 resistance sessions/week |
| Movement | Walking on non-lift days (7–10k steps) |
| Cardio | Zone 2 (conversational pace) while adapting |
| Sleep | 7–9 hours; NAD+ often improves sleep via calmer glucose |
| Hydration | 3+ liters daily; retatrutide can blunt thirst signals |
When Progress Stalls
| Step | Action |
|---|---|
| 1 | Re-check protein, steps, and hydration. Ensure you're not under-eating to the point of rebound cravings. |
| 2 | If nausea is minimal and you've held 4+ weeks at current level, raise retatrutide by +0.5 mg/week. |
| 3 | Move NAD+ to 200 mg per dose or add one additional NAD+ day. |
| 4 | Keep new settings for 4+ weeks before any further changes. |
Managing Side Effects
| Issue | Primary Mitigation | Secondary Options |
|---|---|---|
| Nausea | Hold dose; smaller protein-first meals | Ginger tea; move injection away from largest meal |
| Constipation | Fiber + fluids | Magnesium citrate at bedtime |
| Headache | Hydration | Add electrolytes |
| NAD+ injection sting | Buffered NAD+, slower push | Split volume; IM instead of SC |
| Fatigue | Increase NAD+ to 200 mg or add extra day | Check protein and sleep |
Monitoring
| Timepoint | What to Track |
|---|---|
| Baseline | Fasting glucose, fasting insulin, HbA1c, lipid panel, blood pressure |
| Weekly | Weight (same conditions), waist measurement, energy (1–10), hunger (1–10) |
| Bi-weekly | Progress photos (front/side/back), clothing fit |
| Week 8–12 | Repeat baseline labs; expect improved glucose, TG/HDL ratio, blood pressure |
What Comes Next
After 12 weeks, two paths:
Maintenance: Reduce retatrutide to 1–2 mg/week. NAD+ at 100 mg on training or high-stress days. Continue lifestyle foundation.
Progress to Intermediate: Add L-Carnitine and MOTS-c to increase fat oxidation capacity and preserve lean mass during deeper recomposition. See Retatrutide Recomp Protocol.
Contraindications
- Personal or family history of medullary thyroid carcinoma or MEN2 syndrome
- Active pancreatitis
- Pregnancy or breastfeeding
- Severe GI motility disorders
Discuss with a physician if you have a history of gallbladder disease, diabetic retinopathy, or are on glucose-lowering medications that may need adjustment.
Related Guides
- GLP-1 Results — trial data on weight loss and body composition
- Retatrutide Guide — complete retatrutide overview
- NAD+ Guide — why NAD+ matters for metabolic function
- Retatrutide Recomp Protocol — advanced dual-axis protocol
References
- Jastreboff AM, et al. Triple-Hormone-Receptor Agonist Retatrutide for Obesity. NEJM 2023. https://doi.org/10.1056/NEJMoa2301972
- Yoshino J, et al. NAD+ Intermediates: The Biology and Therapeutic Potential. Cell Metabolism 2021. https://doi.org/10.1016/j.cmet.2020.11.007
- Covarrubias AJ, et al. Senescent cells promote tissue NAD+ decline during ageing. Nature Metabolism 2020. https://www.nature.com/articles/s42255-020-00305-3
Medical Disclaimer
The content in this protocol guide is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before beginning any new protocol, supplement, or medication.