Benefits, Side Effects, and Efficacy

It’s a typical weekday morning. Before the hustle and bustle of the day begins, you sip your collagen coffee while scrolling your social feeds. One after the other, almost every swipe is a post about the next best anti-aging elixir, compound, exercise, or food. Then, NAD pops up—a supplement touted by the likes of Hailey Bieber and Kendall Jenner as an anti-aging goldmine worthy of using for a lifetime. But is it really, though?

NAD—short for nicotinamide adenine dinucleotide—is a cellular coenzyme responsible for turning the food you eat into usable energy. It also plays a major role in DNA repair, cellular processes, and immune system function. Even though the body produces NAD naturally, its production of NAD declines as you age.

That means the older you get, the harder it is for your body to keep you healthy and process nutrients into energy. That’s why you feel more sluggish, and your risk of illness or injury increases. It’s also why people became interested in NAD supplementation.

The idea is that supplementing with NAD could equate to more energy, better health, and maybe even a longer, healthier life. But before you hit the submit button on your virtual shopping cart, let’s uncover what happens to your body when you take NAD supplements.

Understanding NAD

NAD acts as a coenzyme within the body to help several metabolic processes happen. Essentially, coenzymes assist other molecules in whatever job they’re designed to do. Without this metabolic pathway, you would not function.

Then there’s DNA, which is easily damaged via life stressors, UV radiation, and alkylating and oxidative molecules. Fortunately, your body is quite good at maintaining DNA integrity by sending in NAD to get the job done. Without getting into the complex nature of DNA repair pathways, NAD calls in molecules to quickly nourish and rejuvenate the damaged DNA cells.

As mentioned earlier, NAD acts as an assistant or middleman, so to speak, making things happen and maximizing communication between cells throughout the body. Without enough NAD, simple processes in the body may take longer, partly because of poor communication. This might look like a compromised immune system (AKA you get sick more often), poor stress response, and an increased risk for obesity, type 2 diabetes, metabolic syndrome, cancer, and other degenerative diseases.

Potential Effects of NAD Supplementation

With the inevitable decline in NAD as you age, your energy production and cellular repair also decline. This reduction leads to energy loss, mental fatigue, wrinkles, and frequent sickness. Though there’s no way to stop this from happening, you can fill in the gaps with NAD supplementation.

Boosted Cellular Energy

When you eat food, it’s broken down into molecules to produce energy in the form of ATP. During this process, NAD acts as an enzyme facilitating the conversion of NADH to ATP. Without enough NAD, the body has a difficult time producing ATP in a timely manner, which can lead to feeling sluggish and tired. Supplementing with NAD could increase cellular energy production by boosting ATP levels, potentially improving metabolism and reducing fatigue.

Research on people with chronic fatigue syndrome evaluated the safety and effectiveness of NAD supplementation on fatigue, quality of life, and sleep quality. The overall consensus is that supplementing with NAD has a positive effect on quality of life and improves health parameters like anxiety, energy, and immune system response.

Enhanced Cellular Repair

Because NAD is involved in mechanisms of DNA repair that help protect cells from damage caused by stress, oxidative damage, and aging, higher levels (as a result of supplementation) may promote a more efficient process.

For instance, one study investigated the role of NAD supplementation on DNA repair. Researchers found that supplementation decreased the accumulation of endogenous DNA damage and improved DNA repair capacity. Ultimately, supplementing with NAD may positively impact DNA repair in the context of aging and in neurodegenerative diseases like Alzheimer’s disease.

Improved Cellular Communication

Cellular communication is essential for overall health, well-being, and longevity. If cells cannot get messages to each other promptly, aging will advance.

Because NAD acts like an assistant, its job is to ensure that things happen quickly and efficiently. Restoring NAD to youthful levels means your body’s checking things off its daily to-do list fast. In doing so, it restores cell-signaling function and reduces stress.

Current Research

While there is existing research on NAD supplementation in humans, it is not complete or conclusive. There is always room for ongoing studies and findings.

That said, there are some promising benefits to using a NAD supplement for conditions like age-related cognitive decline, neurodegenerative diseases (Alzheimer’s, Parkinson’s), and cardiovascular health. Here’s what research has shown so far.

• Age-related cognitive decline: Research on using NAD supplements for cognitive decline is promising. However, the majority of the findings were in animal studies. Despite this, a recent review found that NAD supplementation may preserve cognitive health across a variety of age-related diseases, including Alzheimer’s disease and dementia.
• Neurodegenerative diseases: Healthy brain aging is extremely important especially in the prevention of neurodegenerative diseases like Alzheimer’s, Parkinson’s, and Huntington diseases. During normal brain aging, NAD levels decline. Over time this leads to cellular damage, improper cellular waste disposal, impaired stress response, DNA repair delay, stem cell exhaustion, and inflammation. Supplementing with NAD may return NAD to healthy levels and prevent further damage to brain cells. Though promising, more research in humans is needed.
• Cardiovascular health: Cardiovascular diseases often involve metabolic disorders (abnormal lipid and glucose metabolism), oxidative stress (cell damage), and inflammation (poor cell signaling). These stress markers make it difficult for the heart to function properly and contribute to cardiovascular disease. Even within the heart, NAD homeostasis is important. One review found that boosting levels of NAD with supplements has favorable effects on heart health and may have a profound influence on cardiovascular disease.

Dosage and Delivery Methods

The two most common delivery methods for NAD are oral tablets and IV injections. NAD tablets are available online, usually as an NAD precursor nicotinamide riboside (NR) and/or niacin (NADH). These precursor supplements strongly influence positive NAD levels.

NAD+ IV injections are available at local clinics and are generally not covered by insurance. These intravenous injections use a more immediate source of NAD. However, it must be dripped over the course of at least two hours to prevent adverse events like rapid heartbeat, nausea, and anxiousness.

The best dosage and delivery method of NAD is still under investigation. However, most reported side effects occur only in doses higher than those used clinically or for those used for daily supplementation. Therefore, take the dosage recommended by a healthcare provider and avoid exceeding this to prevent side effects and potential health risks.

Natural Ways to Boost NAD

If you’re not ready to take the NAD supplement leap, there are ways to boost NAD naturally with simple lifestyle changes. Here’s what you need to know.

• Exercise: Regular aerobic and resistance training exercise has a regenerative effect on NAD levels and can even return them to young adult levels. A 2019 study found that aerobic and resistance training increase NAMPT, the precursor to NAD.
• Circadian Rhythm & Sleep: Your circadian rhythm (AKA internal 24-hour clock) and sleep patterns directly correlate with NAD+ production. Getting enough sleep is key for maintaining adequate levels—sleep deprivation and disrupted sleep patterns are associated with decreased NAD+ synthesis.
• Environmental Stress (Heat/Cold): Cold plunge pools and saunas may help boost NAD. Exposure to extreme hot and cold temperatures may place extra stress on the body, triggering the production of NAD+.
• Certain foods: A balanced diet can provide all the NAD you need, especially if you include foods rich in vitamin B3 (niacin) and leafy green vegetables. Vitamin B3 (aka niacin) can easily be found in meat, fish, dairy products, avocado, and whole grains and is the precursor to NAD. Niacin converts to NAD for use in cellular metabolism. Tryptophan, a precursor for NAD, is found in turkey, chicken, fish, nuts, and soy. Leafy green vegetables, including broccoli, colored cabbages, and green onions, also contain compounds that positively influence NAD levels.

Bottom Line

While NAD is promising as an anti-aging powerhouse, there are still many unknowns regarding NAD supplementation. Before making any changes to your healthcare routine and supplement lineup, talk to a healthcare provider, such as a registered dietitian to ensure you’re making the right choice for you. In the meantime, fueling your body with nourishing foods and living a healthy lifestyle free from tobacco and other stressors is the cornerstone for promoting cellular health and overall well-being.