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NAD+, or nicotinamide adenine dinucleotide, is a coenzyme found in every living cell and plays a crucial role in numerous cellular processes, including energy production, DNA repair, and cell signalling (Canto et al., 2015). Aging and various age-related diseases have been associated with declining NAD+ levels, thus sparking interest in NAD+ therapy as a potential treatment to counteract these effects (Braidy et al., 2019).

This article will provide an in-depth analysis of NAD+ therapy, exploring its benefits, potential risks, and future directions.

 Understanding NAD+ and Its Functions

NAD+ is a coenzyme involved in several fundamental biological processes. It plays a critical role in metabolism, acting as a redox agent that helps convert nutrients into energy (Ying, 2008). In redox reactions, NAD+ serves as an electron carrier, facilitating the transfer of electrons during cellular respiration and energy production (Chini et al., 2018). Additionally, NAD+ is involved in DNA repair and cell signalling, contributing to the maintenance of genomic stability and overall cellular health (Canto et al., 2015).

The Science Behind NAD+ Therapy

NAD+ therapy aims to boost the levels of NAD+ in the body through various methods, including oral supplementation, intravenous infusions, and injections (Braidy et al., 2019). Common oral supplements include nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR), which are NAD+ precursors that can be converted into NAD+ in the body (Trammell et al., 2016). Intravenous infusions and injections deliver NAD+ directly into the bloodstream, bypassing the digestive system for rapid absorption (Braidy et al., 2019).

Research and evidence supporting IV NAD+ therapy are still emerging, but initial studies show promising results. Animal studies have demonstrated that increasing NAD+ levels can improve mitochondrial function, reduce inflammation, and extend lifespan (Zhang et al., 2016). Although human studies are limited, preliminary evidence suggests that NAD+ therapy may help improve cognitive function, reduce fatigue, and enhance stress resistance (Martens et al., 2018).

Health Benefits of NAD+ Therapy

Increased energy levels and mitochondrial function

NAD+ therapy has been shown to improve energy levels and mitochondrial function by promoting efficient cellular respiration and ATP production (Chini et al., 2018). This can result in increased physical endurance, reduced fatigue, and overall enhanced vitality (Martens et al., 2018).

Improved cognitive function

NAD+ therapy has been linked to improved cognitive function, possibly due to its role in DNA repair, neuroprotection, and energy metabolism (Lautrup et al., 2019). In a pilot study, older adults taking NR supplements demonstrated improved cognitive performance and brain plasticity (Martens et al., 2018).

Enhanced cellular repair and stress resistance

NAD+ therapy may improve cellular repair mechanisms and increase resistance to cellular stress (Verdin, 2015). This is particularly important in the context of aging, as age-related declines in NAD+ levels can contribute to increased susceptibility to DNA damage and inflammation (Braidy et al., 2019).

 Anti-ageing effects and potential lifespan extension

Animal studies have shown that boosting NAD+ levels can extend lifespan and delay the onset of age-related diseases (Zhang et al., 2016). Although more research is needed to determine if these effects translate to humans, NAD+ therapy holds promise as a potential anti-ageing intervention.

Reduction of age-related diseases risk

By promoting cellular repair and improving mitochondrial function, NAD+ therapy may reduce the risk of developing age-related diseases such as Alzheimer’s, Parkinson’s, and cardiovascular diseases (Lautrup et al., 2019).

Potential Side Effects and Risks

Common side effects of NAD+ therapy

Some individuals may experience mild side effects from NAD+ therapy, including headaches, nausea, and skin flushing (Conze et al., 2019). However, these side effects are generally transient and subside as the body adjusts to the treatment.

Long-term safety concerns

As NAD+ therapy is still a relatively new field, long-term safety data is limited. More research is needed to understand the potential long-term risks associated with sustained NAD+ supplementation or treatment.

Contraindications and interactions

NAD+ therapy may not be suitable for everyone, and individuals with certain medical conditions or taking specific medications should consult their healthcare provider before initiating NAD+ therapy (Conze et al., 2019).

NAD+ Therapy as a Complementary Approach

The importance of a holistic health approach

While NAD+ therapy offers potential benefits, it is essential to adopt a holistic health approach that encompasses a balanced diet, regular exercise, and stress management to fully optimize health and wellness.

Combining NAD+ therapy with a healthy lifestyle

Incorporating NAD+ therapy alongside other healthy lifestyle habits, such as proper nutrition, exercise, and sleep hygiene, can maximize the potential benefits of treatment and promote overall well-being (Braidy et al., 2019).

Other anti-ageing strategies and interventions

NAD+ therapy can be complemented with other anti-ageing strategies, such as caloric restriction, intermittent fasting, and using antioxidants or anti-inflammatory supplements (Longo et al., 2015).

Current Limitations and Future Directions

Limitations of current research

While the benefits of NAD+ therapy are promising, current research is limited by small sample sizes, short-term studies, and a lack of human trials. More extensive, long-term, and well-controlled studies are needed to fully understand the potential benefits and risks of NAD+ therapy.

Ongoing studies and clinical trials

Several ongoing clinical trials are investigating the effects of NAD+ therapy on various health outcomes, including cognitive function, metabolic health, and cardiovascular disease risk. The results of these trials will provide valuable insights into the efficacy and safety of NAD+ therapy in humans (ClinicalTrials.gov, 2021).

Potential future advancements in NAD+ therapy

As our understanding of NAD+ biology and its therapeutic potential continues to evolve, we can expect advancements in NAD+ therapy, such as the development of more effective delivery methods, personalized treatment plans, and the identification of novel therapeutic targets.


The benefits of NAD+ therapy, including increased energy levels, improved cognitive function, and potential anti-ageing effects, hold promise for promoting health and wellness. However, more research is needed to fully understand the long-term effects and safety of NAD+ therapy. As we continue to explore the potential of NAD+ therapy, it is essential to adopt a holistic health approach and consider incorporating this treatment alongside other healthy lifestyle habits to maximize its potential benefits.



Braidy, N., Berg, J., Clement, J., Khorshidi, F., Poljak, A., Jayasena, T., … & Grant, R. (2019). Role of NAD+ and related precursors as therapeutic targets for age-related degenerative diseases: Rationale, biochemistry, pharmacokinetics, and outcomes. Antioxidants & Redox Signaling, 30(2), 251-294.

Canto, C., Menzies, K. J., & Auwerx, J. (2015). NAD+ metabolism and the control of energy homeostasis: a balancing act between mitochondria and the nucleus. Cell Metabolism, 22(1), 31-53.

Chini, C. C. S., Tarragó, M. G., & Chini, E. N. (2018). NAD and the aging process: Role in life, death, and everything in between. Molecular and Cellular Endocrinology, 455, 62-74.

ClinicalTrials.gov (2021). Search of: NAD. Retrieved from https://clinicaltrials.gov/ct2/results?cond=&term=NAD&cntry=&state=&city=&dist=

Conze, D., Brenner, C., & Kruger, C. L. (2019). Safety and metabolism of long-term administration of NIAGEN (nicotinamide riboside chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults. Scientific Reports, 9(1), 1-12.

Lautrup, S., Sinclair, D. A., Mattson, M. P., & Fang, E. F. (2019). NAD+ in brain aging and neurodegenerative disorders. Cell Metabolism, 30(4), 630-655.

Longo, V. D., Antebi, A., Bartke, A., Barzilai, N., Brown-Borg, H. M., Caruso, C., … & Fontana, L. (2015). Interventions to slow aging in humans: are we ready? Aging Cell, 14(4), 497-510.

Martens, C. R., Denman, B. A., Mazzo, M. R., Armstrong, M. L., Reisdorph, N., McQueen, M. B., … & Seals, D. R. (2018). Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications, 9(1), 1-11.

Trammell, S. A., Schmidt, M. S., Weidemann, B. J., Redpath, P., Jaksch, F., Dellinger, R. W., … & Brenner, C. (2016). Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nature Communications, 7(1), 1-14.

Verdin, E. (2015). NAD+ in aging, metabolism, and neurodegeneration. Science, 350(6265), 1208-1213.

Ying, W. (2008). NAD+/NADH and NADP+/NADPH in cellular functions and cell death: regulation and biological consequences. Antioxidants & Redox Signaling, 10(2), 179-206.

Zhang, H., Ryu, D., Wu, Y., Gariani, K., Wang, X., Luan, P., … & Auwerx, J. (2016). NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science, 352(6292), 1436-1443.