You'll find big claims about NAD+ online. Here's what the published research does and doesn't show, in plain words, with links to the studies so you can read them yourself.
The short answer
NAD+ is essential to how every cell makes energy and repairs itself. Levels go down with age. In animal studies, raising NAD+ has improved several measures of health. Studies in people are earlier and smaller, and researchers are still working out what raising NAD+ does for human health. Anyone who promises you specific results is getting ahead of the science.
What NAD+ does in your body
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell. It has two main jobs:
- Energy. It helps your cells turn food into usable energy, much of it in the mitochondria, the cell's power plants. [1, 2]
- Maintenance. It's used by enzymes that help repair DNA and regulate how cells respond to stress, including the sirtuin family of enzymes. [1, 3]
Because cells use NAD+ up as they do this work, they constantly need to make more. [4]
NAD+ levels decline with age
Researchers have found that NAD+ levels fall in many tissues as we get older. [1, 3] One reason they've identified is an enzyme called CD38, which breaks down NAD+ and becomes more active with age. Aging "senescent" cells appear to switch it on in nearby cells. [5, 6]
This decline is one of the main reasons scientists are interested in whether restoring NAD+ could support healthy aging.
What animal studies have found
Most of the strongest findings so far come from studies in mice and rats:
- In older mice, restoring NAD+ improved how mitochondria and stem cells worked and modestly extended lifespan. [7]
- A review of the animal research found that raising NAD+ in old or diseased animals can promote health across several organ systems. [8]
- In a rat model of reduced blood flow to the brain, NAD+ improved memory measures and reduced inflammation. [9]
- Researchers are also studying NAD+ in heart health and age-related disease. [10, 11]
Results in animals don't always carry over to people, which is why human studies matter.
What we know in people
Human research is newer. Most of it has used oral NAD+ "precursors" such as nicotinamide riboside (NR), which the body converts into NAD+. [12] These studies have generally been short and small. They are mainly about whether NAD+ levels go up and whether it's well tolerated, with health outcomes still under study. [4, 12]
The biology is also complicated. One review points out that NAD+ and aging cells interact in ways that could make "anti-aging" treatments harder to get right than they first look. [13] That's a good reason to use NAD+ with a physician involved, not on your own.
What this means for you
- NAD+ is a natural part of how your body works, and its decline with age is well documented.
- Raising NAD+ is a promising, active area of research, but it's not a proven treatment for any disease.
- People report different experiences, and results vary.
- A licensed physician reviews your health history before you start, and we check in with you every month.
If you have questions about whether NAD+ makes sense for you, your physician can talk you through what's known.
The studies
- Covarrubias AJ et al. NAD+ metabolism and its roles in cellular processes during aging. Nature Reviews Molecular Cell Biology, 2021. Read
- Cantó C, Menzies KJ, Auwerx J. NAD+ metabolism and the control of energy homeostasis. Cell Metabolism, 2015. Read
- Chini CCS et al. NAD and the aging process: Role in life, death and everything in between. Molecular and Cellular Endocrinology, 2017. Read
- Zapata-Pérez R et al. NAD+ homeostasis in human health and disease. EMBO Molecular Medicine, 2021. Read
- Chini C et al. The NADase CD38 is induced by factors secreted from senescent cells. Biochemical and Biophysical Research Communications, 2019. Read
- Covarrubias AJ et al. Senescent cells promote tissue NAD+ decline during ageing via the activation of CD38+ macrophages. Nature Metabolism, 2020. Read
- Zhang H et al. NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science, 2016. Read
- Rajman L, Chwalek K, Sinclair DA. Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metabolism, 2018. Read
- NAD+ improves cognitive function and reduces neuroinflammation… in chronic cerebral hypoperfusion models. Journal of Neuroinflammation, 2021. Read
- Abdellatif M et al. NAD+ metabolism in cardiac health, aging, and disease. Circulation, 2021. Read
- Braidy N et al. Role of nicotinamide adenine dinucleotide and related precursors as therapeutic targets for age-related degenerative diseases. Antioxidants & Redox Signaling, 2019. Read
- Mehmel M, Jovanović N, Spitz U. Nicotinamide riboside: the current state of research and therapeutic uses. Nutrients, 2020. Read
- Mendelsohn AR, Larrick JW. Interacting NAD+ and cell senescence pathways complicate antiaging therapies. Rejuvenation Research, 2019. Read
This article is for general education and isn't medical advice. Compounded medications are not FDA-approved. Prescription required; a licensed physician determines eligibility.