Does boosting NAD+ support healthy aging?

Nicotinamide adenine dinucleotide (NAD+) is one of the most important molecules in your cells. It acts as a coenzyme, meaning it helps enzymes do their jobs. At its core, NAD+ is essential for:

• Energy metabolism: NAD+ shuttles electrons during redox reactions, which is how your cells convert food into ATP, the body’s usable energy.
• DNA repair: Specialized enzymes use NAD+ to fix breaks in DNA, protecting against mutations that can drive cancer and aging.
• Cell signaling: NAD+ powers proteins such as sirtuins (enzymes that regulate stress resistance, inflammation, and longevity pathways) and PARPs (poly ADP-ribose polymerases, enzymes that repair DNA but also consume a lot of NAD+ in the process)

Why NAD+ Declines With Age

Research consistently shows that NAD+ levels fall as we get older. This is not just a lab finding: in humans, lower NAD+ has been associated with neurodegenerative disease, insulin resistance, heart failure, and even increased cancer risk (Verdin, 2015; Covarrubias et al., 2020; Abdellatif et al., 2021).

One reason is increased activity of enzymes that use up NAD+:

• CD38: An enzyme on immune cells that breaks down NAD+. Its activity rises with chronic inflammation, which tends to increase with age.
• PARPs: DNA repair enzymes that consume NAD+ when they respond to accumulated DNA damage. Over time, they may deplete NAD+ faster than the body can make it.

The combination of reduced NAD+ production and increased consumption leads to lower cellular energy, weaker DNA repair, and less resilience to stress.

Can We Restore NAD+?

Animal studies suggest that replenishing NAD+ through dietary precursors such as nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN) improves muscle strength, metabolism, and even cognitive performance. Lifestyle strategies like exercise and caloric restriction also raise NAD+.

Early human trials have found that NR and NMN supplementation can increase blood NAD+ levels and appear safe, but results on actual health outcomes are still preliminary. A 2023 review in The Journals of Gerontology highlighted the need for longer, well-controlled trials to determine whether NAD+ boosters truly improve aging-related outcomes in people (Freeberg et al., 2023).

How do I test for NAD+ levels

Currently, NAD+ is not part of routine blood panels but specialized labs have developed assays that measure NAD⁺ and related molecules (like NADH and NADPH) from a blood sample.