NAD+ supplements deliver precursors of nicotinamide adenine dinucleotide (NAD+), a critical coenzyme that the cells in your body use to generate energy.
NAD+ levels decline with age, and this decline is associated with many of the problems of aging: cognitive decline, oxidative damage to the body, cardiovascular disease, metabolic dysfunction, and more.
NAD+ supplements seem to mimic some of the more advanced anti-aging strategies currently only used in scientific research, like long-term caloric restriction, and hold an incredible amount of promise as an anti-aging supplement. Check out some of their potential benefits below.
Research
NAD+ benefits
1. NAD+ supplements are very effective at boosting levels of NAD+ in your blood
One of the most important precursors for NAD+ is nicotinamide riboside, a molecule that is related to (but not identical to) vitamin B3.
This molecule achieved its high level of importance thanks to research that makes a strong case for its ability to quickly and effectively boost levels of NAD+ in the body. A scientific paper published by researchers at the University of Iowa was able to demonstrate that nicotinamide riboside, taken as a supplement, leads to large increases in NAD+ in both mice and humans (1).
A single dose of nicotinamide riboside was able to boost levels of NAD+ by 170% compared to normal levels over the course of just 12 hours. The study results also suggest that massive doses of nicotinamide riboside aren’t necessary: 100, 300, and 1000 mg doses performed equally well when it came to boosting NAD+ in the blood. This is encouraging, because it suggests that you aren’t losing out if you go with a more modest dose of nicotinamide riboside.
2. NAD+ can mimic the anti-aging benefits of caloric restriction
One of the proposed mechanisms for why life extension and anti-aging diet strategies like caloric restriction and intermittent fasting work has to do with their ability to modify NAD+ metabolism.
This means you can get the benefits of caloric restriction without going on an aggressive calorie-restricted diet.
3. Nicotinamide riboside is the best way to boost NAD+
It can be hard to keep all the niacin derivatives and relatives straight, since their names are so similar, but the bottom line is that nicotinamide riboside, or NR, is the most effective of the various NAD+ precursors.
The same 2016 paper referenced above also compared nicotinamide riboside to these two other NAD+ precursors, sometimes referred to as Nam and NA, and found that NR is the best at boosting NAD+ levels.
More surprisingly, the researchers also found that Nam and NA seem to be processed through different biochemical pathways than NR.
This is surprising because they are all precursors to the same compound. However, these findings could suggest that certain NAD+ precursors are more effective at some specific applications than others—for example, in this study, only NR led to increased NAD+ concentration in the heart, as opposed to other NAD+ precursors which did not lead to increases in NAD+ in heart tissue.
4. NAD+ supplements could help prevent some of the harmful effects of obesity
Since NAD+ plays a pivotal role in cellular metabolism, one obvious potential area of application is in obesity. One of the primary negative health effects of obesity is the metabolic abnormalities, like type 2 diabetes, that can result from having excess body fat.
Some research suggests that supplements that boost NAD+ levels could help protect you from some of these negative metabolic effects. One such paper was published in 2012 in the journal Cell Metabolism (2). In the paper, mice fed a nicotinamide riboside supplement were largely able to resist the negative metabolic effects of being fed a high-fat diet.
The researchers interpreted their results to mean that boosting NAD+ levels in the body could help both with negative health effects from obesity, and negative health effects from aging (since both of these conditions lead to abnormalities in cellular metabolism).
5. Maintaining high levels of NAD+ might help protect you from cognitive decline
Research in rats consistently shows that NAD+ levels in the brain drop precipitously with age. One paper published in 2013 demonstrated that NAD+ declines go hand-in-hand with an increase in oxidative damage in the central nervous system (3).
The researchers hypothesized that the accumulation of this oxidative damage—brought on by decreases in the body’s ability to slow down and prevent oxidation—are behind the cognitive decline that is seen in brain function with increasing age.
Other research in a mouse model of Alzheimer’s disease showed how mitochondrial dysfunction is a hallmark effect of degenerative diseases of the central nervous system, like Alzheimer’s and dementia (4).
By using NMN (nicotinamide mononucleotide, an NAD+ precursor found in NAD+ supplements) to augment the levels of NAD+ in the mice, the researchers were able to reverse the negative changes in mitochondrial function in their mouse model of Alzheimer’s.
As with many of the exciting frontiers of NAD+ supplementation, this research is still in the early stages, but these preliminary animal studies show a lot of promise for helping to treat or perhaps even prevent or slow down the progress of neurodegenerative diseases in humans.
More research, including clinical trials, will be needed to confirm these results, but the initial signs from animal studies such as these are nevertheless very exciting.
6. Boosting NAD+ levels could improve heart function and sustain heart health as you get older
One area of your body that has an extremely high concentration of mitochondria, and hence an extremely high demand for NAD+, is your heart tissue.
Several studies suggest that boosting NAD+ levels could have positive effects on heart function, since heart damage and heart failure are associated with decreased levels of NAD+. One study, published in the Journal of Cellular Physiology in 2017 by Pankaj Chaturvedi and Suresh Tyagi, cites research showing that NAD+ supplementation can improve heart function in animal models of heart failure (5).
The connection between NAD+ function and heart health also seems to be linked to stem cells in heart muscle: as you get older, your stem cells cease to function as well, and eventually die off.
However, NAD+ supplementation could help sustain your muscle stem cells as you get older, which translates into better heart health (your heart being a muscle, of course). NAD+ supplementation in animals has even been able to prevent damage from ischemia and reperfusion, two sources of serious heart damage in heart disease (6).
7. NAD+ could improve your muscle function and even extend your lifespan
One of the biggest turning points in interest in NAD+ wasa 2016 publication in the prestigious journal Science that reported on a wide range of experiments on using the NAD+ precursor nicotinamide riboside (the primary ingredient in many top NAD+ supplements) to boost NAD+ levels in aging mice (7).
With several detailed studies on the muscle physiology of the aged mice, both with and without the NAD+ supplement, the researchers were able to demonstrate significant improvements in muscle function after NAD+ supplementation. In addition, the mice given NAD+ had significantly longer lifespans than the control mice not given the NAD+ supplement.
The researchers chalked this up in part to an increase in the protection provided to stem cells: by sustaining the body’s ability to repair itself, the inevitable decline of aging was staved off for longer in the mice with higher NAD+ levels.
As more research in humans comes out, we’ll learn more about whether these effects translate to people, but NAD+ supplements, particularly those based on nicotinamide riboside, appear to have a very bright future.
NAD+ side effects
Some NAD+ supplements can cause flushing and tingling in your skin. Depending on the specific NAD+ supplement you are taking, the side effect profile may vary. The best-known side effects of NAD+ supplements include “flushing,” a redness and tingling in your skin (often your face or fingers) that you feel soon after taking the supplement.
Not all NAD+ precursors cause flushing. Flushing is associated with nicotinic acid, or NA, which is a form of vitamin B3. Other NAD+ precursors do not cause flushing. According to a paper by researchers in Slovenia, while there is scarce large-scale research in humans for most NAD+ precursors, extrapolating from animal data suggests that they are likely safe at the doses used in humans (8).
Very high doses of some NAD+ precursors are not advised. The only notable exception is for high doses of nicotinamide and nicotinic acid. Very high doses of these NAD+ precursors (over 500 to 900 mg per day) are not recommended, as they can lead to elevated levels of liver enzymes, abdominal pain, itchy skin, flushing, and vomiting.
NAD+ dosage
The right dosage of an NAD+ supplement is going to depend on the specific NAD+ precursor that you are taking.
NR: aim for 100-300 mg per day. If you are using nicotinamide riboside, doses in the range of 100 to 300 mg per day all appear to be equally effective.
NMN has been studied at 100-5000 mg per day. Research using NMN (nicotinamide mononucleotide) has explored doses of 100-500 mg per day, though only for safety, not to determine which dosage level is most effective (9).
Keep nicotinamide and nicotinic acid intake to under 500 mg per day. Nicotinamide and nicotinic acid should be limited to less than 500 mg per day, for the aforementioned issues with flushing, itching, and other side effects.
NAD+ benefits FAQ
Q: Can you get NAD+ from food?
A: While NAD+ content in food can’t be incorporated into your body, you can make use of NAD+ precursors like tryptophan, nicotinamide riboside, and nicotinic acid (vitamin B3). Good sources for these NAD+ precursors include cow’s milk, turkey, fish, mushrooms, and nutritional yeast.
If you aren’t getting enough NAD+ precursors in your diet, or if you want direct control over the dosage of these precursors, consider taking an NAD+ supplement alongside these foods. If you are using a supplement for NAD+ and are eating a diet that’s high in NAD+ precursors, make sure you don’t exceed the recommended upper limit of 500 mg per day of nicotinamide (vitamin B3).
Higher levels of other NAD+ precursors appear safe, but too much vitamin B3 can cause skin itching and flushing. If you aren’t taking a supplement that contains high levels of vitamin B3, though, you should be fine.
Q: What is the difference between NADH and NA+?
A: NADH and NAD+ are two forms of the same molecule. NADH is the “reduced” form, and NAD+ is the “oxidized” form. When used in biological processes, NAD+ reverts back and forth between its reduced and oxidized forms, functioning as a cog in the cellular equipment that produces and regenerates energy for your body.
In terms of supplementation, the terminology isn’t important: neither NAD+ nor NADH can be absorbed directly. Instead, you need to eat foods or take supplements that provide precursor molecules that your body can synthesize into NAD+.
Q: Can you boost your NAD+ levels with niacin?
A: Yes, niacin (one of the forms of vitamin B3) can lead to increased levels of NAD+ in your blood, but it’s far from the best way to boost your NAD+ levels. Niacin and other direct forms of B3 can be harmful at higher doses, and don’t seem to be as effective as other NAD+ precursors at actually boosting levels of NAD+ in your body.
While vitamin B3 is certainly important, if you are specifically targeting your NAD+ levels, it’s better to opt for a supplement that uses nicotinamide mononucleotide or nicotinamide riboside. These are the NAD+ boosters that have shown the most promise in preliminary research, and appear to have a better safety profile than niacin.
Q: Can NAD+ supplements help with Alzheimer’s?
A: While there aren’t any solid clinical trials supporting the use of NAD+ supplements to improve symptoms of Alzheimer’s disease, there is some circumstantial evidence from biochemistry studies and animal models that suggest that boosting NAD+ levels with a supplement could help.
For example, a scientific paper published in 2018 in the journal Current Opinion in Psychiatry cites numerous studies showing that aging and deteriorating brain cells have lower levels of NAD+ (9).
While the utility of NAD+ supplements in terms of improving actual symptoms is still theoretical, it’s nevertheless a very exciting opportunity, and several studies are underway.
Q: How do NAD+ supplements increase NAD+ levels?
A: NAD+ supplements work by providing your body with precursors to synthesize NAD+. Most adults have normal levels of NAD+, thanks to a synthesis pathway that involves the amino acid tryptophan or the B-vitamin niacin. However, some research suggests that boosting NAD+ levels beyond the normal range could lead to protective effects for older adults.
Related: Our best NAD+ picks
Summary
NAD+ is a powerful source of energy for your body, and NAD+ supplements provide you with the precursors you need to synthesize more of it in your cells.
Scientific evidence suggests that boosting NAD+ levels could help with a wide range of health conditions that occur as a consequence of aging, like cognitive decline, cardiovascular disease, and low energy levels.
For these reasons, NAD+ supplements are one of the most exciting frontiers in anti-aging nutrition research.
