NAD+

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell. It plays essential roles in energy metabolism, DNA repair, and cellular signalling. Without NAD+, your cells couldnt convert food into usable energy. It's that fundamental to life.

The "+" indicates the oxidised form, which accepts electrons during metabolic reactions. NAD+ shuttles electrons between molecules, enabling the chemical reactions that power cellular function. It also serves as a substrate for enzymes called sirtuins, which regulate ageing-related processes.

Why NAD+ levels matter

NAD+ levels decline significantly with age - some estimates suggest a 50% reduction between ages 40 and 60. This decline correlates with reduced energy production, impaired DNA repair, and increased vulnerability to age-related conditions. Researchers have proposed that falling NAD+ contributes directly to ageing processes.

Various stressors accelerate NAD+ depletion: alcohol consumption, overeating, inflammation, and chronic disease all drain NAD+ reserves faster than normal. This creates a potential negative spiral where stress depletes NAD+, impairing the cellular processes needed to cope with stress.

Sirtuins and longevity

Sirtuins are a family of enzymes that require NAD+ to function. They regulate numerous processes linked to ageing: DNA repair, inflammation, metabolism, and stress resistance. When NAD+ runs low, sirtuin activity decreases correspondingly.

Much longevity research focuses on maintaining sirtuin function through NAD+ support. Animal studies show promising results with NAD+ precursor supplementation, including extended lifespan in some models. Human translation remains an active area of investigation.

Supplement approaches

Direct NAD+ supplementation faces challenges. The molecule is large and doesn't absorb well orally. This has led to focus on precursors - smaller molecules that your body converts to NAD+. The main options include:

NMN (nicotinamide mononucleotide) converts to NAD+ in one enzymatic step. NR (nicotinamide riboside) requires two steps. Both raise NAD+ levels effectively in studies. Plain niacin (vitamin B3) also increases NAD+ but causes uncomfortable flushing at effective doses.

IV and injection routes

Intravenous NAD+ therapy delivers the coenzyme directly into the bloodstream, bypassing digestive absorption issues. IV infusions typically take 2-4 hours due to potential side effects from rapid administration. Some clinics use intramuscular injections for faster protocols.

Subcutaneous NAD+ injections offer another option. These are quicker than IV but still bypass the digestive system. The compound absorbs from the injection site over hours. Some users report significant effects, though controlled studies comparing delivery methods remain limited.

Acute effects and sensations

People receiving IV NAD+ commonly report intense sensations during infusion: chest tightness, abdominal discomfort, nausea, and anxiety-like feelings. These subside when the infusion rate slows. The sensations aren't dangerous but can be unpleasant.

Post-treatment, many report improved energy, mental clarity, and sense of wellbeing. Whether these effects result from NAD+ itself or placebo response remains debated. Controlled studies show biological effects on NAD+ levels, but subjective improvement is harder to quantify objectively.

Research applications

Addiction recovery programs have adopted NAD+ therapy, theorizing that it helps restore neurotransmitter balance disrupted by substance abuse. Some clinics report reduced withdrawal symptoms and cravings. Scientific evidence is promising but not yet definitive.

Neurological conditions, chronic fatigue, and general "anti-ageing" applications are also explored. The broad role of NAD+ in cellular function makes it relevant to virtually any condition involving cellular energy or repair processes.

Dosage considerations

Oral precursor supplements typically range from 250mg to 1000mg daily for NMN or NR. IV therapy doses vary widely between providers, commonly 250mg to 1000mg per session. Injectable subcutaneous doses are typically smaller, often 50-100mg.

Higher isn't necessarily better. Some research suggests moderate, consistent supplementation works better than occasional high doses. The body has limited capacity to utilise NAD+ at any given time.

Quality matters

NAD+ and its precursors should be stored properly - typically refrigerated or frozen for the raw compound. Sublingual formulations may offer better absorption than standard capsules for oral use.

Check for third-party testing and purity verification. The supplement industry has variable quality control, and you want certainty about what you're actually getting.