NAD+: Promising Molecule for Longevity and Disease Prevention Awaits Further Research

A coenzyme essential for cellular survival is gaining attention for its potential anti-aging properties, though scientists caution more research is needed before drawing definitive conclusions. Nicotinamide adenine dinucleotide (NAD+), sometimes called the “fountain of youth,” naturally declines with age but has become increasingly popular as a supplement in recent years.

Last month, researchers from the University of Oslo published a comprehensive review in Nature Aging examining the connection between NAD+ and aging. Their analysis of both preclinical and clinical studies concluded that restoring NAD+ levels could promote healthier aging and potentially slow or treat neurodegenerative diseases.

NAD+ exists in every cell of the human body and plays what researchers describe as a “critical role” in functions essential to survival. Previous studies have revealed notably low NAD+ levels in patients with Alzheimer’s disease, consistent with the natural decline of this molecule as people age.

“NAD+ may hold the key to healthier aging and could protect us against diseases like Alzheimer’s disease and Parkinson’s disease,” said Evandro Fei Fang-Stavem, an associate professor at the University of Oslo. “However, we need further research on how to effectively utilize NAD+ in patient treatment.”

Cellular Benefits and Therapeutic Potential

According to Dr. Amanda Kahn, a board-certified internist and longevity expert in New York City, research shows that boosting NAD+ offers multiple cellular benefits, including improved mitochondrial and stem cell function, enhanced energy metabolism, better focus and mood, and support for tissue repair.

“From a longevity standpoint, NAD+ is one of the most central molecules in maintaining youthful cellular function,” Kahn explained. “It activates longevity pathways that protect against DNA damage and inflammation.”

Additionally, higher NAD+ levels may offer neuroprotection against Alzheimer’s and Parkinson’s diseases, enhance insulin sensitivity, reduce inflammation, repair skin, boost immune defense, and improve symptoms in long COVID patients.

Dr. Halland Chen, a double board-certified physician specializing in longevity, emphasized that studies in both animals and early human models demonstrate that maintaining healthy NAD+ levels improves energy metabolism, cognitive function, and overall vitality.

“Restoring NAD+ is ultimately about cellular repair and mitochondrial optimization, not just an energy boost,” Chen said. “Clinical experience shows that NAD+ therapy enhances energy, focus and endurance, while supporting detoxification and reducing oxidative stress from daily life, travel or poor sleep.”

NAD+ activates sirtuins, proteins related to longevity that regulate DNA repair, cellular stress responses, and gene expression. Chen noted, however, that larger human studies are still needed to confirm these effects.

Administration Methods and Effectiveness

Since NAD+ molecules are too large to cross directly into cells, most therapies use “precursors” that enter cells and then create NAD+. The most common precursors include nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), typically taken in pill, capsule, or powder form.

“Oral NAD precursors can modestly raise NAD+ levels and are convenient for daily maintenance,” Kahn explained. “In contrast, injections or IV infusions bypass the gut and deliver NAD+ directly into circulation, leading to more rapid and noticeable effects on energy, focus and recovery.”

For patients who can’t tolerate needles, Kahn sometimes prescribes NAD+ nasal sprays, though she notes the benefits are usually less pronounced. “In general, I find that combining daily oral precursors with weekly NAD+ injections offers the most comprehensive support for both intracellular and extracellular NAD stores,” she advised.

Chen added that while oral supplements work well for maintenance, IV therapy provides a “rapid cellular reboot” that’s particularly useful after travel or for enhanced performance. “Sessions typically last two to four hours and are administered as a series of three infusions within seven to 10 days, followed by monthly maintenance.”

NAD+ therapy appears to benefit those managing fatigue, metabolic dysfunction, or neurological decline most significantly. However, Chen notes that healthy adults typically experience modest benefits unless the therapy is combined with optimized nutrition, exercise, and sleep habits.

Potential Risks and Expert Guidance

Though generally considered safe under medical supervision, NAD+ therapy can cause mild side effects. Chen reports that headache, nausea, or chest tightness may occur, especially during faster IV infusions, but typically resolve when the infusion rate is slowed.

He recommends caution for individuals with active liver or kidney disease, those with a personal or family history of cancer, and women who are pregnant or breastfeeding.

Kahn notes that injection site reactions like mild redness, itching, or tenderness are common but harmless and quickly dissipate. “Some patients notice a transient rush, lasting no more than 10 minutes, after taking an NAD+ injection due to a brief release of adrenaline and mitochondrial ATP,” she explained. “While not dangerous, it can feel uncomfortable if not anticipated.”

When selecting NAD+ products, experts emphasize that quality matters more than quantity. “Patients should look for clinically validated, third-party-tested formulations and start with lower doses to gauge tolerance,” Chen advised.

Importantly, NAD+ therapy isn’t a standalone solution for health and longevity. “If the core pillars—sleep, movement, nutrition, metabolic balance and stress regulation—are not in place, NAD+ therapy won’t deliver its full potential,” Chen cautioned. “It’s like pouring premium fuel into an engine that hasn’t been maintained—the energy source is there, but the system isn’t optimized to use it.”

Medical experts strongly recommend consulting a physician before starting any NAD+ regimen. “Your doctor needs to know about all supplements you plan to take, including NAD+, because it has strong biological effects,” Chen emphasized. “Your doctor will evaluate your personal health risks and check your medications for potential interactions with NAD+ supplements.”

As research continues, NAD+ remains a promising but still developing area of anti-aging medicine that requires careful individual consideration and professional guidance.