What is NAD+, and why you should take it?

What Is NAD⁺ and What Is the Best Way to Supplement It ?

Nicotinamide Adenine Dinucleotide (NAD⁺) is an essential coenzyme found in every living cell. It participates in over 300 cellular reactions and plays a central role in:

• Energy production (ATP synthesis)

• DNA repair and cellular regeneration

• Mitochondrial function

• Sirtuin activation (anti-aging pathways)

• Redox reactions and antioxidant defense

NAD⁺ functions as a key electron carrier during oxidative phosphorylation in the mitochondria. Without sufficient NAD⁺, cells cannot efficiently convert nutrients into ATP—the body’s primary “energy currency.”

Why NAD⁺ Declines With Age

NAD⁺ levels naturally decrease by 40–60% between ages 40 and 60 due to:

• Increased inflammation (activating CD38, a major NAD-consuming enzyme)

• Oxidative stress

• Mitochondrial dysfunction

• Greater demand for DNA repair

• Decreased endogenous synthesis

This decline is strongly associated with metabolic dysfunction, fatigue, decreased cognitive performance, and accelerated aging.

Potential Health Benefits of Optimizing NAD⁺

Research—both human and translational—suggests that maintaining optimal NAD⁺ levels may support:

1. Brain & Cognitive Health

• Enhances neuronal energy metabolism

• Slows age-related cognitive decline

• Supports neuroprotection (via SIRT1 and SIRT3)

Key evidence: NR increased NAD⁺ in the brain and improved cognitive markers in older adults (Brady et al., 2022).

2. Chronic Fatigue & Mitochondrial Support

Higher NAD⁺ availability improves mitochondrial ATP production and may reduce fatigue seen in:

• Chronic fatigue states

• Long COVID

• Age-related energy decline

Key evidence: IV NAD⁺ increased energy and mitochondrial function markers in small clinical trials.

3. Metabolic and Cardiovascular Health

NAD⁺ precursors show benefits for:

• Insulin sensitivity

• Fat oxidation

• Lowering triglycerides

• Improving endothelial function

Key evidence: NR improved lipid parameters and reduced inflammatory cytokines (Martens et al., 2018).

4. Anti-Aging & Cellular Repair

NAD⁺ activates sirtuins, PARPs, and other longevity-associated enzymes:

• DNA repair

• Reduced oxidative damage

• Improved autophagy and mitophagy

• Maintenance of telomere integrity

5. Inflammation & Immune Modulation

Acts as a cofactor for enzymes involved in cellular defense and immune regulation.

Key evidence: NAD⁺ repletion showed anti-inflammatory effects in human macrophages and in vivo models.

Clinical Uses of NAD⁺ in Functional & Regenerative Medicine

Common NAD⁺-related clinical applications include:

• Anti-aging protocols

• Chronic fatigue and mitochondrial dysfunction

• Cognitive decline / neuroprotection

• Metabolic optimization (insulin resistance, obesity)

• Alcohol or drug detox support (under physician supervision)

• Adjunct therapy for neurodegenerative conditions (Alzheimer’s, Parkinson’s—experimental)

Age-X Clinics often use a combined strategy: IV NAD⁺ for rapid restoration + oral precursors for maintenance.

What Is the Best Way to Supplement NAD⁺?

There is no single “best” option—each has specific benefits. The most studied NAD⁺ precursors are:

1. NMN (Nicotinamide Mononucleotide)

Pros:

Direct precursor to NAD⁺

• Strong evidence in metabolic health and cellular aging

• Good oral bioavailability

• Rapid conversion into NAD⁺

Evidence:

NMN improved muscle insulin sensitivity in postmenopausal women (Yoshino et al., 2021).

Best for: anti-aging, metabolic support, mitochondrial health

2. NR (Nicotinamide Riboside)

Pros:

• FDA-recognized as GRAS

• Well-studied in humans

• Improves NAD⁺ in blood and tissues

• Potential cognitive benefits

Limitations: conversion to NMN required before reaching NAD⁺.

Evidence:

NR improved blood pressure and arterial health in older adults (Martens et al., 2018).

3. NAD⁺ IV Therapy

Pros:

• Immediate elevation of systemic NAD⁺

• Can achieve higher levels than oral supplements

• Useful in clinical settings: fatigue, detox, neuro support

Limitations:

• Must be administered by trained clinicians

• Time-intensive (60–180 minutes)

Best for: patients seeking rapid NAD⁺ restoration.

4. Niacin (Vitamin B3)

Effective but limited by flushing and GI side effects.

So Which Is the Best? (Clinically)

For longevity and metabolic optimization, most practitioners—including many in regenerative medicine—prefer:

→ Daily NMN or NR (for long-term maintenance)

→ Periodic IV NAD⁺ (for rapid elevation or therapeutic use)

Age-X Protocol Example:

• IV NAD⁺ 250–500 mg monthly or as needed

• NMN 300–500 mg/day (or NR 300–600 mg/day) for maintenance

• Combine with sirtuin-activating lifestyle factors: exercise, fasting, red/infrared light therapy

At Age-X clinics we will help you to restores your NAD+levels and boost your energy and metabolism to increase your lifespan and most importantly your healspan, call us at

813-751-3570 for the Apollo Beach office

940-303-4120 for the Bradenton office,

References (Clinically Relevant & High-Quality)

1. Martens CR et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD⁺ in healthy middle-aged and older adults. Nat Comm. 2018.

2. Yoshino M et al. NMN increases muscle insulin sensitivity in prediabetic women. Science. 2021.

3. Brady NN et al. Nicotinamide riboside increases brain NAD⁺ and improves neurodegeneration biomarkers. Aging Cell. 2022.

4. Rajman L, Chwalek K, Sinclair DA. Therapeutic potential of NAD⁺ boosting strategies in aging and disease. Nat Rev Drug Disc. 2018.

5. Verdin E. NAD⁺ in aging, metabolism, and neurodegeneration. Science. 2015.

6. Poddar SK et al. NAD⁺ and mitochondria: implications in aging and disease. Cell Metabolism.

7. CD38 and NAD depletion research: Chini CC et al. Trends Mol Med. 2018.