If you keep up with the latest health trends, chances are you’ve heard of NAD. A wellness buzzword that’s currently holding the spotlight, NAD (which stands for nicotinamide adenine dinucleotide) is an energy-generating co-enzyme that’s found in every cell in the body.
Rewind to episode five of Keeping Up With The Kardashians and you may recall the moment when best friends Kendall Jenner and Hailey Bieber meet up to undergo NAD+ IV therapy. “I’m going to do NAD for the rest of my life, and I’m never going to age,” Bieber told the cameras. Hot in the US, the NAD market was valued at $535.53 million in 2022, and is only expected to grow.
Now making waves in the UK, NAD+ (the ‘raw’ form of NAD and the most widely used term when referring to it) is taking over the wellness sphere. Since covid, UK consumers have learned the value of investing in preventative health strategies and there has been a huge increase in people actively seeking out evidence-based solutions like NAD+.
With several reported health benefits (from boosting energy to promoting healthy skin), it’s easy to see why NAD+ plays an important role to keep our bodies functioning and generating energy.
But also, it is much more than that. NAD+ is involved in many processes that take place in our cells. As we age, our bodies use more NAD+, but our capacity for making it diminishes. NAD+ decline is a major factor in the progression of many age-related diseases, such as inflammation, neurodegenerative disorders, cardiovascular problems or cancer.
What Is NAD+?
NAD+ and NADH — discovered in 1906 by William John Young and Sir Arthur Harden — are two sides of the same coenzyme critical to every cell and many metabolic processes in our bodies. Although both are similar, they're still different.
NAD+ is a crucial coenzyme found in our cells. It plays a major role in regulating cellular functions, neuroprotection, DNA repair and anti-ageing. “If you have high levels of NAD+, it means you will have lots of cellular energy, your cells will function optimally, and you will feel more energetic and alert. It also means your body can repair itself quicker, which helps keep your organs, including your skin, in good health.
The problem is that as we age, we see a gradual decline in cellular NAD⁺ levels. This decline in NAD⁺ is linked to numerous age-associated diseases, including cognitive decline, cancer, metabolic disease, sarcopenia (age-related loss of muscle mass and strength), and fragility. Many of these diseases can be slowed down or even reversed by restoring NAD⁺ levels.
So, what exactly is NAD⁺, how is it made, and how is it used by our cells? Answering these questions will help us understand the roles of NAD⁺ in maintaining healthy ageing and how NAD⁺ deficiencies can be treated.
Unlock How The Process Works
NAD+ enters the cell or organelle (like mitochondria), accepts electrons in the form of hydrogen atoms from NADH (remember it has some extra electrons to donate), and becomes NADH.3 Meanwhile, the NADH that donated electrons becomes NAD+, and the process repeats itself.
NAD+ and NADH are simply different forms of NAD, one with extra electrons and one without, and they pass these electrons back and forth between themselves as a catalytic chain reaction.
This coupled reaction explains why, when NAD+ levels fall, the entire chain reaction starts to fail. Similarly, replenishing NAD+ levels via IV infusion helps restore these reactions to optimum levels.
What Is It Used For In The Body
NAD+ is an enabler, or a fuel, for other molecules which help the body to perform at its best. When levels decrease, the activities of any NAD (H) dependant enzymes in oxidative phosphorylation, TCA cycle, and glycolysis are hindered, with a possible inactivation of certain downstream molecular pathways which play a role in the repair of DNA.
In other words, without it our body does not function as well as it could, is less effective at repairing itself and leads to a slower metabolic rate. Without NAD+ acting as an important little taxi, your cells will generate less of the energy the body needs to survive and carry out its functions.
The importance of NAD+, therefore, stems not from any magical ingredient, but its ability to help other beneficial molecules do their jobs. If we were looking at the body as a football team for example, NAD+ would be the central midfielder, making the tackles and providing the possession which helps the strikers put the ball in the net.
It’s not flashy, it’s not showy but without it, the entire operation falls apart. Those molecules are crucial to repairing cells, improving our metabolism and regulating biological functions. It helps maintain cardiovascular health and regulate normal blood sugars. It controls calcium signalling, metabolic pathways, critical processes in the nervous system and brain, and immune function.
It regulates sirtuin protein functions. The sirtuin, a group of seven proteins in our cells, directs metabolism and cellular aging processes. Without NAD+ we can experience a number of health implications.
How Can I Improve My NAD+ Levels?
While we can’t stop the natural decline of NAD+, we can help slow down the rate at which our bodies use up important NAD+ stores. Avoid things that are known to deplete NAD+ such as a poor diet, excess alcohol, smoking and sunburn. Seek out foods that are made up of amino acids that are also precursors to NAD+, such as broccoli and cabbage as well as some fruits.
In addition, exercise, especially resistance training and HIIT, has been found to ignite the body’s NAD+ production pathway. A recent study examined metabolites in the muscle tissue from younger and older adults, finding that adults who exercised rigorously had NAD+ levels similar to those of young adults. However, over-exercising can actually have the opposite effect.
Healthy habits aside, research suggests that supplementing NAD+ may top up our levels. “NAD+ boosting in cells and animals has yielded some impressive results so now the focus has shifted to human clinical trials, where notable results so far include improvements in cardiovascular function, reduced inflammation, improved cellular energy production, and reversal of biomarkers of ageing.
While the body produces it naturally, levels of NAD decline as we age – which is where supplementation comes into play. However, It is also easy to make further simple lifestyle changes in order to help your body to maintain NAD+ levels for longer.
Calorie restriction has been shown among other benefits, to help with lowering oxidative stress, a major component of ageing. High oxidative stress leads to high NAD+ consumption. Fasting has also been shown to improve NAD+ levels in the body. We are not talking here about dieting, we are talking about avoiding overindulgence, and eating more food than our bodies need, so just eat sensibly and eat what you really need.
If you spend much time in the sun, you may be prematurely depleting your own supply of NAD+. Direct sunlight on the skin forces your body to use increased amounts of NAD+ to repair cell damage caused by the sun’s ultraviolet (UV) rays. When you’re outside, why not limit your time in the sun and think about covering exposed skin with loose-fitting, lightweight clothing to prevent skin damage.
Although time in the direct sunlight isn’t good for your overall health or NAD+ levels, spending time in natural or artificial heat can boost those levels. Heat sources, like hot tubs, saunas, and heated pools, cause your heart to pump faster, requiring more energy from your body to keep cool. This triggers the increased production of NAD+ to supply needed energy.
Raw foods that contain vitamin B, like avocados, steamed fish, and peanuts, should be part of your daily diet. You can also boost NAD+ levels by drinking two to three glasses of cow’s milk every day.
While you add in these healthy food choices, you should also limit how much bread, rice, and other white flour products you consume. Instead, look for less-processed whole grains that maintain higher amounts of B vitamins.
Another option to consider adding to your diet are fermented foods and drinks, like sauerkraut and kombucha, which contain NAD+. These foods are also good at easing persistent bloating and chronic joint pain.
Do We Need To Supplement Our Levels?
As we age, our NAD+ levels decline – halving every 20 years from birth. And as our NAD+ levels decline, energy production and cellular repair decrease, leading to many of the common complaints associated with ageing such as wrinkles, loss of energy and brain fog.
Scientists have demonstrated that boosting NAD+ back to youthful levels can rejuvenate old cells back to a state of youth, leading to multiple beneficial effects against ageing and age-related disease. Supplements and IV therapy can boost NAD+ levels, and certain lifestyle changes may help slow down the decline of NAD+.
Oral NAD vs. IV NAD
The details above demonstrate the importance of maintaining optimum levels of NAD+ in the body. Taking NAD via oral supplements and IV does increase NAD+ levels, but not equally. Here’s why.
When you take oral NAD supplements, the NAD must pass through your gut and find its way to your bloodstream and then to the cells that need it. Along the way, a significant amount of NAD is lost due to issues like gut absorption, gut emptying rate, cardiovascular health, and others.
On the other hand, receiving a NAD IV infusion bypasses all these hurdles, delivering NAD to your bloodstream, an expressway to your cells that guarantees 100% absorption
Do NAD+ Supplements Actually Work?
Although there are no large-scale clinical trials on humans yet, there is promising research that suggests NAD+ supplementation may have several health benefits. Below, we outline the key ones:
Increased alertness and energy: “One of the most notable benefits of boosting NAD+ is an improvement in both physical and mental energy. Meaning increased endurance, better cognitive function and reduced brain fog.
Improved sleep: Sleep can also improve as NAD+ can help regulate your circadian rhythm which ensures you get quality restorative sleep. One 2022 study found that after 12-weeks of supplementing NMN (one of the precursors of NAD), fatigue improved in older adults.
Enhanced recovery: As well as improving physical energy, boosting NAD+ reserves has been found to aid muscle recovery after exercise. Which is why several athletes are reported to have regular NAD+ IV therapy.
Hair and nail growth: Some supplement users have seen an improvement in the health of their hair and nails. This is because when your cellular health improves, the body invests more resources into these less important areas of our biology.
Collagen regeneration: If you want to boost skin health, then you need to improve your cellular health. This is exactly what NAD+ does. For example, collagen loss leads to wrinkles, so for years people have focused on ways to replace collagen with the best collagen supplements and creams. But we now know that the best way to increase collagen is to protect the health of our collagen producing cells (fibroblasts) – something which boosting NAD+ has been shown to do.
What Are The Drawbacks?
So far, there are no reported adverse side effects of taking NAD+ supplements. But the safety of long-term use and high-dose supplementation is still under study. NAD+ IV therapy is usually done very slowly to minimise a sensation of muscle cramping or nausea – that tends to pass in about 10 minutes.
A single NAD+ IV infusion can set you back £490 and the drip will take approximately 90-minutes to infuse. For a speedier solution that’s more affordable,try looking for a NAD+ boosting supplement that will help restore the body’s own natural NAD+ production pathways – like Nuchido TIME+.
It's important to note that you cannot ingest ‘pure NAD+’. NAD+ is an unstable molecule that is broken down in the digestive system before it can reach the bloodstream, let alone the cells where it's actually needed. Hence why, most powders and pills contain its precursors, nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN). These precursors are converted into NAD+ inside the cells.
Recently NMN can no longer be sold as a supplement in the US. This is because it is now under investigation as a potential new drug which will require extensive testing in humans. NMN supplements are, however, still available to shop here in the UK – though we'd recommend speaking to your doctor before adding them into your wellness regime.
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