NAD: what is it, who’s it for, does it work?

As you start getting older, you may notice changes in your metabolism, energy levels, and overall health. If you’re looking to slow down the changes seen in aging, an anti-aging supplement like NAD+ may be able to help. Researchers are finding that this supplement may be able to reverse or slow down some of the signs of aging. 

Keep reading to learn more about what NAD is, its benefits, and who it’s for. 

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Nicotinamide adenine dinucleotide (NAD) is a coenzyme, which means it helps initiate enzymatic activity in the body and supports enzymes in doing what they’re supposed to do. 

NAD exists primarily in one of two forms in the body—NAD+ or NADH. It switches between these forms as a result of a redox reaction, which is when an electron transfers between two different molecules. 

NAD+ is the oxidized form of NAD, meaning that it’s missing an electron and is able to accept one from another molecule. NADH is the reduced form of NAD and carries an electron that can be donated to another part of a reaction. 

The body uses NAD to support mitochondrial function (mitochondria are your cells’ powerhouses), repair DNA, prevent oxidation, and improve cellular function, among other things. Here are a few examples of how the body uses NAD (Mehmel, 2020):

• Plays a role in producing energy and breaking down glucose to create adenosine triphosphate (ATP), an essential compound in the body 

• Activates proteins called sirtuins, like SIRT1, which support DNA repair, glucose metabolism, and insulin secretion, and protect nerve cells and blood vessels

• Used for repairing cells from damage

• Supports genome expression (turning genes on and off), as well as repairing and protecting DNA

NAD+ levels naturally start to decrease during aging. Researchers are finding that low NAD+ levels may be associated with the development of some age-related health conditions, like heart disease, diabetes, Alzheimer’s disease, and Parkinson’s disease (Mehmel, 2020). 

The body has intelligent ways of creating new NAD when it needs it, but as we get older, we may need to help it along a bit. We can help the body create more NAD by ingesting certain nutrients (in the form of food or supplements) (Mehmel, 2020).

NAD therapy uses oral supplements or intravenous (IV) medications to stimulate cell regeneration and increase NAD levels. The medication or supplements to boost NAD levels don’t actually contain NAD+. Instead, they provide your body with the precursors to NAD+. 

You can get these precursors through your diet, but clinical trials show supplements are a good way to boost NAD+ levels. Common precursors used in NAD+ supplements include (Mehmel, 2020):

• Nicotinamide riboside (NR)

• Nicotinamide mononucleotide (NMN)

• Nicotinic acid (NA)

• Nicotinamide (NAM)

• Tryptophan (TRP)

• Nicotinamide phosphoribosyltransferase (NAMPT)

NAD therapy may help stimulate NAD+ synthesis, slow down age-related health changes, and improve energy levels (Mehmel, 2020). 

Here are some of the potential benefits of NAD supplements:

• Boost memory and concentration: Both human clinical trials and animal studies show that increasing NAD+ levels helps improve memory and cognitive function throughout a healthy lifespan (Johnson, 2018). 

• Increase energy levels: NAD+ helps support energy production throughout the body, including in muscles during workouts. Without adequate NAD+, you may feel fatigued more quickly during workouts and have lower energy levels in general (Mehmel, 2020). 

• Lower blood pressure: Research shows that NAD+ helps to support a healthy heart by lowering blood pressure, reducing inflammation, and reducing stiffness in arteries (Mehmel, 2020). 

• Lower cholesterol: NAD+ helps activate sirtuins, which facilitate lipid metabolism. Research suggests that taking NR or NMN supplements may help lower cholesterol and lipid levels (Mehmel, 2020). 

• Healthy weight maintenance: Animal studies show that mice taking NAD+ supplements didn’t gain as much weight as those without the supplement when following a high-fat diet (Dellinger, 2017). A 2021 study found that NAD+ biosynthesis was associated with improving metabolic health in people with obesity (Francyzk, 2021).

• May help slow the progression of neurodegenerative conditions: Preventing low NAD+ levels appears to help protect nerve cells and prevent DNA damage. This may help prevent increased symptoms of neurodegenerative conditions like Alzheimer’s and Parkinson’s disease (Mehmel, 2020). 

• May help protect against heart disease, diabetes, and liver disease: NAD+ is important for lipid and glucose metabolism. Healthy energy metabolism is essential for preventing conditions like diabetes, atherosclerosis, and fatty liver disease (Mehmel, 2020).

Because of the wide range of potential health benefits and preventative uses of NAD+, many people could benefit from it. There is no age limit for its use, and no established recommendation has been created. 

More research is needed to fully understand who NAD supplements are best suited for. Talk with your doctor if you’re curious about starting an NAD+ supplement. 

Here are some examples of people who may benefit from NAD+ supplements (with the caveat that these benefits are not all proven in humans yet):

• People with neurological or cognitive changes

• People who want to increase energy levels and reduce fatigue

• People experiencing changes to their metabolism or weight

• People who are looking for an anti-aging supplement in an attempt to slow down the aging process and prevent age-related health conditions

Most people experience minimal to no known side effects when taking NAD supplements. Still, more research is needed to fully understand the effects of NAD. 

Early research suggests NAD therapy helps increase circulating NAD+ levels and has some health benefits (Mehmel, 2020). Clinical studies have examined a range of doses and different precursors for NAD. However, there is no established dose, and the best option may vary based on the goal of treatment. Talk with your healthcare provider about which option may be the best fit for you. 

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

December 10, 2021

Written by

Ashley Braun, RD, MPH

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.