How Useful Is NAD⁺, Really?

It’s Q&A Day at 10almonds!

Have a question or a request? We love to hear from you!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

No question/request too big or small 😎

❝I was recommended NAD+ as an anti-aging supplement, what is the science on it? It seems expesnive, so I don’t want to waste my money but it’s whether it’s an investment in my health. Would appreciate any info.❞

Hi! This is an interesting one, as the answer is generally:

• Yes, it is very important
• No, it doesn’t help much

These aren’t either/or, by the way, both statements are true, according to best current science, anyway.

First, what it actually is:

• Nicotinamide adenine dinucleotide, or “NAD” to its friends, is a coenzyme produced in the human body (amongst other places), and it is critical for cellular energy metabolism.
• NAD^⁺ is the version of it where the + indicates the positive formal charge of one of its nitrogen atoms. We won’t get too much into the chemistry of this, but we will mention that it’s a cofactor with NADH, with the former accepting electrons and the latter donating electrons.

While both cofactors are important, NAD^⁺ is the one that gets depleted with aging (note: not with chronological age, but rather with biological aging).

So it’s the one that there’s most focus on replenishing.

And yes, it’s important, because its depletion is then a causal factor for many age-related diseases:

❝Remarkably, ageing is accompanied by a gradual decline in tissue and cellular NAD⁺ levels in multiple model organisms, including rodents and humans.

This decline in NAD⁺ levels is linked causally to numerous ageing-associated diseases, including cognitive decline, cancer, metabolic disease, sarcopenia and frailty.

Many of these ageing-associated diseases can be slowed down and even reversed by restoring NAD⁺ levels.❞

~ Dr. Rosalba Perrone et al.

Read in full: NAD⁺ metabolism and its roles in cellular processes during ageing

The supplement most commonly taken to boost NAD^⁺ levels is nicotinamide riboside (NR), because NAD^⁺ itself cannot be usefully supplemented directly at all.

It works, insofar as it succeeds in boosting NAD^⁺ levels, but does not significantly help, for example, in a recent study,

❝A 12‑week randomized, placebo‑controlled trial of nicotinamide riboside (NR) was conducted in older adults with amnestic mild cognitive impairment (MCI). NR supplementation doubled blood nicotinamide adenine dinucleotide (NAD⁺) levels compared with placebo. Primary and secondary endpoints of cognition, whole brain blood flow, and cardiovascular function did not significantly improve over 12 weeks.❞

Source: A phase-II randomized controlled pilot study of nicotinamide riboside supplementation in older adults with amnestic mild cognitive impairment

But the good news is…

Supplements are not the only way

There’s an enzyme nicotinamide phosphoribosyltransferase (“NAMPT”, to its friends) involved in the synthesis of NADᐩ, and exercise boosts levels by 127% (i.e., it more than doubles the levels), based on a modest three-week exercise bike regimen:

Skeletal muscle NAMPT is induced by exercise in humans

And to underline that point, another study found that resistance training (so, a different kind of exercise from that of the previous study) boosts levels of NADᐩ itself by the same 127%:

Resistance training increases muscle NAD⁺ and NADH concentrations as well as NAMPT protein levels and global sirtuin activity in middle-aged, overweight, untrained individuals

We wrote about that here: Dr. Greger’s Anti-Aging Eight ← you should definitely check out the other 7, too!

One way to get more out of NADᐩ

We’ll get straight to the point: it works very well paired with a senolytic agent, i.e. something that kills aging cells so that they get recycled sooner:

NAD+, Senolytics, or Pyruvate for Healthy Aging?

To read more about senolytics, check out:

Fisetin: The Anti-Aging Assassin

Want to try some?

While we can’t strongly recommend NADᐩ-boosting supplements as especially well-evidenced for supporting health, you’re welcome to try, so…

We don’t sell it, but here for your convenience is an example product on Amazon 😎

Enjoy!