The Signal-Capacity Problem

Healing peptides are signaling molecules. They provide instructions. They tell cells what to do.

BPC-157 tells the body to build new blood vessels and repair damaged tissue. It accelerates wound healing and promotes the growth of blood supply into injured areas.

TB-500 tells cells to move. It helps cells migrate into damaged areas and organize themselves for repair—like calling workers to a construction site.

GHK-Cu tells the body to remodel tissue structure. It increases collagen production and helps shift scar tissue toward functional, organized architecture.

KPV tells the immune system to calm down. It reduces overactive inflammatory responses and supports recovery in barrier tissues like gut and skin.

These are instructions. They assume cells can execute.

Execution requires energy. Cell migration is energy-intensive—cells have to physically move, reorganize their internal structure, push through tissue. Building new blood vessels requires sustained power output—cells multiplying, forming tubes, stabilizing connections. Collagen production is one of the most energy-demanding processes in the body—assembling complex protein structures from scratch. Even calming inflammation requires energy—immune cells clearing debris and transitioning into repair mode.

When NAD⁺ is depleted, cells cannot produce the energy these processes require. The signal arrives. Cells attempt to respond. Mitochondria cannot deliver. The result is partial execution—gains that are incomplete, fragile, slow to consolidate.

Why Healing Stacks Hit Ceilings

Clinicians using peptide combinations for healing see a pattern: initial response, then plateau.

BPC-157 kicks off blood vessel formation. New vessels start forming. Then progress slows before the area is fully supplied with blood flow. TB-500 initiates cell migration. Repair cells move toward the injury site. Then the wave stalls before the area is fully populated. GHK-Cu begins tissue remodeling. Collagen organization improves. Then the tissue remains less organized than expected.

Multiple explanations exist—inadequate dosing, individual variation, the nature of the specific injury. But one common factor: the energy supply.

These peptides increase metabolic demand on healing tissue. They are telling cells to work harder, move faster, build more. If the cells receiving those signals are already running on thin NAD⁺ reserves—which is likely in anyone over 40, anyone with chronic inflammation, anyone healing from significant injury—the demand exceeds capacity.

The peptides did their job. The infrastructure to execute was missing.

The Capacity Layer

NAD⁺ is not a healing peptide. It does not signal repair. It does not direct cell behavior.

It ensures cells can respond to the signals they receive.

When NAD⁺ is adequate, mitochondria produce clean energy. Cells have the power to migrate when TB-500 tells them to migrate. Cells have the output to multiply and form blood vessels when BPC-157 activates that program. Cells have the capacity to produce collagen when GHK-Cu turns on tissue remodeling.

NAD⁺ support does not replace peptide signaling. It removes a common bottleneck that prevents peptide signals from fully executing.

Practical Application

Who benefits: Anyone using BPC-157/TB-500 combinations for healing—especially if over 40 (baseline NAD⁺ already depleted), if healing has been slow in the past, if there is chronic inflammation or post-viral history. These populations start from a lower capacity baseline.

Timing: Start NAD⁺ support when you start the peptide protocol, not after you notice stalling. The goal is to ensure capacity is adequate while demand increases, not to rescue after a ceiling is hit.

Route and dose:

• Oral precursors (NR/NMN 300-500mg daily) as foundation for minor injuries and maintenance
• Subcutaneous/intramuscular NAD⁺ (100-250mg, 2-3x weekly) during active healing phases for significant injuries, surgical recovery, or known depletion

Duration: Continue NAD⁺ support through the healing period. Tissue remodeling continues for weeks to months after acute healing completes. Sustained capacity matters.

What to Expect

NAD⁺ support does not make peptides work faster in a dramatic way. The benefit is:

• More complete execution of peptide signals
• Fewer stalls and plateaus mid-healing
• Better consolidation of initial gains
• Less fragility in healed tissue

The subjective experience is often "healing that finishes" rather than "healing that starts strong then stalls." Not more dramatic—more complete.

Limitations

Human data specifically on NAD⁺ combined with healing peptides does not exist. The logic is mechanistic: peptides increase energy demand, NAD⁺ supports energy production, therefore NAD⁺ should support peptide efficacy. This is plausible and coherent, not proven by controlled trials.

Individual response varies. Some people notice clear differences with NAD⁺ support; others notice little. Baseline depletion, injury type, and genetics all matter.

NAD⁺ support does not fix poor peptide sourcing, inadequate dosing, or inappropriate protocols. It is one variable—the capacity layer—not the whole picture.

Cancer considerations apply. NAD⁺ supports cellular metabolism broadly. Active cancer is a contraindication. Cancer history warrants discussion with an oncologist before any NAD⁺ supplementation protocol.

References

• Cantó C, et al. NAD+ metabolism and the control of energy homeostasis. Cell Metabolism 2015.
• Yoshino J, et al. NAD+ Intermediates: The Biology and Therapeutic Potential. Cell Metabolism 2021.
• Sims CA, et al. Nicotinamide mononucleotide preserves mitochondrial function and increases survival in hemorrhagic shock. JCI Insight 2018.