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Writer's pictureAshton Prescott

NAD+: Benefits, Side Effects, and Supplementation



Nicotinamide adenine dinucleotide (NAD+) is an essential molecule that plays a pivotal role in countless biological processes, including energy metabolism, DNA repair, and cell longevity. Over the past few decades, NAD+ has garnered attention in the fields of health, anti-aging, and wellness as a promising compound that may extend lifespan and support healthier aging. But beyond the buzz, what does the science actually say about NAD+? Is it really a miracle molecule? In this blog post, we’ll explore what NAD+ is, its benefits, side effects, and the different ways to boost its levels through precursors, diet, and supplements.


What exactly is NAD+?


NAD+ stands for nicotinamide adenine dinucleotide, a coenzyme found in all living cells. Coenzymes are small molecules that assist enzymes in facilitating biochemical reactions in the body. NAD+ plays a critical role in redox reactions—processes that involve the transfer of electrons from one molecule to another, which are central to energy production in cells.


NAD+ exists in two forms:


1. NAD+ (oxidized form) which accepts electrons during metabolic reactions.

2. NADH (reduced form) which donates electrons, completing the energy transfer cycle.


The conversion between NAD+ and NADH is fundamental to processes like glycolysis, the Krebs cycle (or citric acid cycle), and oxidative phosphorylation, all of which are part of how our cells convert nutrients into ATP, the energy currency of the cell.


The Importance of NAD+ in Cellular Functions

NAD+ is more than just a molecule involved in energy metabolism. It plays a pivotal role in several critical functions:



1. Mitochondrial Health: NAD+ is essential for the proper functioning of mitochondria, the cell's powerhouse. Mitochondria rely on NAD+ to produce ATP, which fuels cellular activities. A decline in NAD+ levels is associated with mitochondrial dysfunction, which has been linked to aging and age-related diseases. I can not stress enough how important mitochondrial support is and I will follow up with a blog supporting this topic!

2. DNA Repair: NAD+ helps activate certain enzymes involved in repairing damaged DNA. DNA damage occurs regularly due to environmental stressors like UV radiation, pollution, and normal cellular processes. When NAD+ levels decline, the efficiency of DNA repair mechanisms also decreases, potentially contributing to aging and disease. For me, this was my motivation for taking this supplement in particular.


3. Sirtuins Activation: NAD+ is a critical activator of sirtuins, a family of proteins that regulate cellular health, aging, and metabolism. Sirtuins are sometimes referred to as the "longevity genes" due to their role in promoting cellular survival and longevity. NAD+ depletion impairs sirtuin activity, which can accelerate aging processes.


4. NAD+: Also plays a role in regulating circadian rhythms—the internal body clock that governs sleep-wake cycles and other physiological processes. Sirtuins, which depend on NAD+, interact with the circadian clock to help maintain metabolic and immune homeostasis.


5. Inflammation Control: NAD+ is involved in regulating inflammatory responses by inhibiting certain enzymes that contribute to inflammation. Chronic inflammation is a hallmark of many age-related conditions, including heart disease, neurodegenerative disorders, and autoimmune diseases.


Benefits of NAD+ Supplementation

Given its critical role in so many physiological processes, NAD+ has become a key target for supplementation to improve health and combat aging. Let’s dive into the evidence-supported benefits of boosting NAD+ levels.


1. Enhanced Energy Metabolism


Since NAD+ is central to the production of ATP, increasing NAD+ levels can help improve overall energy metabolism. People who take NAD+ precursors or supplements often report increased physical energy and mental clarity. This is especially beneficial for aging individuals whose natural NAD+ levels have declined.


For example, a 2020 study published in *Cell Metabolism* found that boosting NAD+ levels in older mice improved mitochondrial function, leading to increased physical endurance and strength. These findings suggest that NAD+ supplementation could potentially help combat age-related fatigue and energy loss in humans.



2. Anti-Aging Effects and Longevity


Perhaps the most exciting potential benefit of NAD+ supplementation is its ability to slow down the aging process. This is largely due to its activation of sirtuins, which are involved in DNA repair, inflammation control, and mitochondrial function—all processes that decline with age. Sirtuins are also believed to play a role in extending lifespan in various organisms.


Research has shown that boosting NAD+ levels can extend the lifespan of animals. For example, a 2013 study found that increasing NAD+ levels in mice through supplementation extended their lifespan and improved their overall health. While human studies are still in the early stages, these findings have raised hopes that NAD+ could be a key player in promoting healthy aging.


3. Improved Cognitive Function and Neuroprotection


The brain is a highly energy-demanding organ, and its cells rely heavily on NAD+ to maintain proper function. As we age, cognitive decline becomes more common, in part due to reduced mitochondrial function and increased oxidative stress. NAD+ is thought to offer neuroprotective benefits by enhancing mitochondrial function and supporting the repair of damaged neurons.


Preclinical studies suggest that increasing NAD+ levels can improve cognitive function and protect against neurodegenerative diseases like Alzheimer’s and Parkinson’s disease. In one study, mice with Alzheimer’s-like symptoms experienced improvements in memory and cognitive function after being treated with NAD+ precursors. Though human research is still in its infancy, NAD+ supplementation shows promise in delaying the onset of cognitive decline and neurodegeneration.


4. Enhanced Muscle Function and Recovery

NAD+ also plays a crucial role in muscle health, particularly as we age. Older adults often experience a decline in muscle mass and strength, a condition known as sarcopenia. This decline is partly due to reduced mitochondrial function and an increase in oxidative stress.


By boosting NAD+ levels, we may be able to improve muscle function and promote faster recovery from exercise. Studies in older mice have shown that increasing NAD+ levels can lead to improved muscle strength and endurance, as well as faster recovery from injury. Some athletes have started using NAD+ precursors to enhance their performance and recovery, although more research is needed in humans to confirm these effects.


  1. Metabolic Health and Weight Management


NAD+ plays a significant role in regulating metabolism. Studies suggest that increasing NAD+ levels can improve metabolic health by enhancing insulin sensitivity, reducing fat accumulation, and promoting weight loss. In a study published in *Nature Medicine*, researchers found that NAD+ supplementation improved glucose metabolism and reduced body fat in mice.


Additionally, NAD+ is involved in regulating brown fat, a type of fat that burns calories to generate heat. By boosting NAD+ levels, it may be possible to activate brown fat and promote weight loss, particularly in people struggling with metabolic disorders like obesity or type 2 diabetes.


6. Cardiovascular Health

The cardiovascular system, including the heart and blood vessels, also relies heavily on NAD+ for optimal function. Studies have shown that NAD+ supplementation can improve vascular function and reduce the risk of heart disease.


One of the key mechanisms by which NAD+ supports cardiovascular health is by improving endothelial function—the ability of blood vessels to dilate and constrict properly. Endothelial dysfunction is a major contributor to hypertension (high blood pressure) and atherosclerosis (hardening of the arteries), both of which increase the risk of heart disease.


In animal studies, boosting NAD+ levels has been shown to reduce blood pressure, improve arterial health, and enhance overall heart function. Although more research is needed in humans, these findings suggest that NAD+ supplementation could be a promising strategy for promoting cardiovascular health, particularly in older adults.



Direct supplementation with NAD+ is challenging because it is not well-absorbed when taken orally. Instead, the most effective way to increase NAD+ levels is by taking precursors—molecules that the body can convert into NAD+. Several NAD+ precursors are available as supplements, each with its own advantages and disadvantages.


1.Nicotinamide Riboside (NR)

Nicotinamide riboside (NR) is one of the most well-known and studied NAD+ precursors. It is a form of vitamin B3 (niacin) and is readily converted into NAD+ in the body. NR has gained popularity due to its ability to raise NAD+ levels effectively and safely.


Several studies have shown that NR supplementation can increase NAD+ levels in both animals and humans. For example, a 2016 study found that taking NR supplements increased NAD+ levels by 60% in healthy adults after eight weeks of supplementation. NR has also been shown to improve mitochondrial function, cognitive health, and muscle endurance in preclinical studies.


NR is widely available as a dietary supplement, and it is generally well-tolerated with few reported side effects. However, like all supplements, it’s important to use it as directed and consult with a healthcare provider before starting any new regimen.


2. Nicotinamide Mononucleotide (NMN)

Nicotinamide mononucleotide (NMN) is another NAD+ precursor that has garnered significant attention in recent years. NMN is found naturally in small amounts in foods like broccoli, avocados, and edamame, but these dietary sources are insufficient to significantly raise NAD+ levels.


Like NR, NMN is efficiently converted into NAD+ in the body. Studies in animals have shown that NMN supplementation can increase NAD+ levels, improve mitochondrial function, and enhance endurance and cognitive performance. Early human studies have also reported positive results, with NMN supplementation being shown to increase NAD+ levels and improve vascular health in older adults.

NMN is considered to be safe and well-tolerated, although long-term studies are still needed to fully understand its effects

in humans. NMN supplements are becoming increasingly popular, particularly among those looking to boost their NAD+ levels for anti-aging purposes.


3. Nicotinamide (NAM)

Nicotinamide (NAM), also known as niacinamide, is another form of vitamin B3 that can be converted into NAD+. Unlike NR and NMN, however, NAM has a more limited ability to raise NAD+ levels, and high doses of NAM may actually inhibit certain beneficial NAD+-dependent processes, such as sirtuin activation.


While NAM is commonly used in skin care products for its anti-inflammatory and anti-aging properties, it is generally not recommended as the first choice for NAD+ supplementation due to its potential inhibitory effects on longevity pathways.



4. Niacin (Nicotinic Acid:

Niacin, or nicotinic acid, is another form of vitamin B3 that can be converted into NAD+. Niacin is well-known for its ability to lower cholesterol levels, and it has been used for decades as a treatment for cardiovascular diseases.


However, niacin supplementation is associated with several side effects, including flushing, itching, and gastrointestinal discomfort. While niacin can raise NAD+ levels, its side effects and the availability of more effective NAD+ precursors like NR and NMN make it a less popular choice for those seeking to boost NAD+ levels specifically for anti-aging or cognitive health purposes.



While NAD+ itself is not available in significant amounts through diet, some NAD+ precursors are found in various foods. However, the levels of these precursors in foods are generally too low to significantly impact NAD+ levels.


Foods that contain small amounts of NAD+ precursors:


Broccoli: Contains small amounts of NMN.

Avocados: Provide both NR and NMN, although in very low quantities.

Milk: Contains NR and NAM.

Fish (e.g., sardines, tuna, salmon): Rich in niacin and other B vitamins.

Mushrooms: Contain nicotinic acid (niacin).

While these foods can contribute to overall B vitamin intake, supplementation with NAD+ precursors like NR or NMN is usually required to achieve significant increases in NAD+ levels.


The optimal dosage of NAD+ precursors depends on the specific supplement being used and the individual’s health status. Here are some general guidelines:


Nicotinamide Riboside (NR): Most studies have used doses of 250-500 mg per day. Some supplements contain higher doses, but it's generally recommended to start with a lower dose and gradually increase if needed.

Nicotinamide Mononucleotide (NMN): Typical doses range from 250 to 500 mg per day, although some studies have used doses as high as 1,000 mg. As with NR, it's advisable to start with a lower dose and adjust based on individual response.


Nicotinamide (NAM): Doses of 500-1,000 mg per day are commonly used in studies, although NAM is not the preferred choice for raising NAD+ levels due to its potential inhibitory effects on sirtuins.


Niacin: Doses for raising NAD+ levels typically range from 250-500 mg per day, but higher doses (up to 2,000 mg) have been used for cholesterol-lowering effects. However, niacin is associated with flushing and other side effects.


Side Effects of NAD+ Supplementation:


Ok, no I will say something that I am ethically and legally required to say... NAD+ supplementation, particularly in the form of NR and NMN, is generally considered safe and well-tolerated. However, like all supplements, there are potential side effects to be aware of and you should ALWAYS consult your doctor or healthcare provider before starting any and all supplements and alternative treatments... With that being said, I personally have had amazing feedback from my clients and patients that I have consulted on with the exception of slight flushing; but again, the overall results far out-weighed this.




Common Side Effects


Digestive Discomfort: Some individuals may experience mild digestive issues, such as nausea, bloating, or diarrhea, especially when taking high doses of NAD+ precursors. Since I am prone to stomach issues, I take it at night and have found that any side effects I may have, I sleep through. I also eat a little something so my stomach is not completely empty

Flushing: Niacin, in particular, is known to cause a flushing reaction, characterized by redness, warmth, and itching of the skin. This effect is generally harmless but can be uncomfortable. This is usually pretty mild in most cases.


Headache: Some users of NAD+ supplements report headaches, particularly when starting supplementation or increasing the dose. I personally have never heard this complaint and is generally a side effect of either taking too much or increasing too quickly.


Long-Term Safety:

While short-term studies suggest that NAD+ precursors are safe, there is still limited data on the long-term effects of NAD+ supplementation. More research is needed to determine whether chronic use of NAD+ boosters has any adverse effects or interactions with other medications.


Comparable Supplements to NAD+ Precursors:

In addition to NR, NMN, and niacin, several other supplements and compounds have been studied for their potential to enhance cellular health and longevity. While they don’t directly increase NAD+ levels, they may work synergistically with NAD+ to support mitochondrial function and reduce oxidative stress.


1. Coenzyme Q10 (CoQ10)

Coenzyme Q10 is a powerful antioxidant that supports mitochondrial function and energy production. Like NAD+, CoQ10 levels decline with age, contributing to reduced energy metabolism and increased oxidative stress. Supplementing with CoQ10 may help support cellular energy production and protect against age-related mitochondrial decline.


2. Resveratrol

Resveratrol is a natural polyphenol found in red wine, grapes, and berries. It is known for its antioxidant properties and its ability to activate sirtuins—much like NAD+. Some research suggests that resveratrol may enhance the effects of NAD+ boosters by further activating sirtuins and promoting longevity.


3. Pterostilbene

Pterostilbene is a compound closely related to resveratrol but with better bioavailability. It has similar antioxidant and anti-aging properties and may work synergistically with NAD+ to enhance cellular health and longevity.


4. Alpha-Lipoic Acid (ALA)

Alpha-lipoic acid is another antioxidant that supports mitochondrial health and helps regenerate other antioxidants in the body. ALA may work alongside NAD+ to support energy metabolism and protect against oxidative stress.


NAD+ as a Promising Molecule for Health and Longevity

NAD+ plays a critical role in many aspects of cellular health, from energy production to DNA repair and mitochondrial function. As we age, NAD+ levels naturally decline, contributing to the aging process and the onset of age-related diseases. By boosting NAD+ levels through supplementation with precursors like nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN), we may be able to slow down the aging process, improve cognitive function, enhance muscle health, and support cardiovascular health.


While NAD+ supplementation holds great promise, it's important to approach it with caution. More research is needed to fully understand the long-term effects of NAD+ boosters, and individuals should always consult with a healthcare provider before starting any new supplement regimen.

In the quest for better health and longevity, NAD+ stands out as a molecule with tremendous potential! Truly. Whether you are looking to enhance your energy levels, improve cognitive function, or promote healthy aging, boosting NAD+ levels could be an important step toward achieving your health goals. Below are some suggestions of NAD+ products that are great. No, these are not affiliate links but products that I have used, recommended or I carry in the medicinary on my website. I do not recommend companies that I have not vetted or use personally and my choices will always include pharmaceutical grade supplements at multiple price points, whenever possible!


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