A Beginner's Guide To NAD+

NAD+

05 September 2025

A clinician holding up a vial of NAD+

In this article, we’ll explore what NAD+ is and why it plays a vital role in your body. We’ll explain the differences between NAD, NADH and NAD+, as well as how your NAD+ levels naturally decline as you age. We’ll also look at the factors that can affect your body’s ability to maintain NAD+ and why keeping these levels steady could be important for overall health. As well as this, we’ll answer some common questions about NAD+ to help you understand how it works and what you can do to support healthy levels.

Key Takeaways

Here are the 5 biggest takeaways from this article about NAD+:

  • NAD+ is vital for energy production and cellular function. It exists in two forms, NAD+ (oxidised) and NADH (reduced).

  • NAD+ levels naturally decline with age and are linked to a number of age-related health conditions like muscle loss and cognitive issues.

  • Lifestyle factors like your diet, exercise levels and calorie consumption can influence your NAD+ levels.

  • NAD+ supports healthy ageing and helps with energy production, DNA repair and inflammation control. 

  • NAD+ supplementation is generally considered to be safe and effective for the majority of people. 

Understanding NAD (Nicotinamide Adenine Dinucleotide)

NAD (Nicotinamide Adenine Dinucleotide) is a vital coenzyme that exists in every living cell. It plays a key role in energy production, helping to convert nutrients into the fuel that powers essential biological processes. NAD is derived from vitamin B3 and is crucial for maintaining overall health.

NAD exists in two forms, oxidise (known as NAD+) and reduced (known as NADH). These forms work together in metabolic reactions that generate ATP, the main energy source for cells. Without enough NAD, the body’s ability to produce energy and carry out important functions can be affected.

The importance of maintaining NAD+ levels as you age

Having healthy NAD+ levels as you age is important for overall well-being, as it supports essential cellular functions such as metabolism, DNA repair and immune response. NAD+ levels naturally decline over time which can affect the body's ability to produce energy and repair damage. This contributes to signs of ageing and increased health risks.

Lower NAD+ levels have been linked to age-related conditions such as cognitive decline, muscle loss, metabolic disorders and general frailty. Some research suggests that boosting NAD+ levels may help support cellular function and slow down certain ageing processes. By maintaining adequate NAD+ levels, the body can continue to generate energy efficiently, repair damaged cells and regulate key biological processes in later life.

NAD, NADH & NAD+ Explained

NAD, which stands for National Adenine Dinucleotide is a coenzyme that plays a role in cellular energy production and metabolism. As mentioned, NAD exists in two different forms, NAD+ (oxidise) and NADH (reduced). 

NAD+ is the active form of NAD that helps enzymes carry out reactions, including energy production and DNA repair. NAD+ accepts electrons from other molecules which allows it to work on biochemical processes.

NADH is the reduced form of NAD. Once NAD+ has accepted electrons it is converted into NADH. NADH carries these electrons to mitochondria where they are used to produce ATP which, as mentioned, is the main energy source for cells.

To put it simply, NAD+ accepts electrons whilst NADH donates them to help create energy. Constant conversion between NAD+ and NADH is essential for keeping cells functioning properly. As NAD+ levels decline with age, energy production and other processes may be affected.

What can impact your body's NAD+ levels?

Several factors can influence NAD+ levels in the body which could influence energy production and overall health. Some lifestyle choices and biological processes can help boost NAD+ levels, while others contribute to their decline.

Factors that contribute to an increase in NAD+ levels include:

  • The amount of vitamin B3 you consume.

  • Reducing your calorie intake and fasting activates enzymes that enhance NAD+ production.

  • Regular physical activity which increases the body’s demand for ATP.

  • Low glucose levels activate pathways that recycle and maintain NAD+ levels.

  • Exposure to heat through saunas, steam rooms and hot baths.

Factors that contribute to reduced NAD+ levels include:

  • Ageing, as NAD levels decline with age.

  • Chronic stress and inflammation.

  • Eating a poor diet with low levels of vitamin B3.

Frequently Asked Questions

Below are some of the most frequently asked questions about NAD (Nicotinamide Adenine Dinucleotide).

How is cellular metabolism affected by NAD?

NAD plays a crucial role in cellular metabolism which is the process of cells converting nutrients into energy. Without sufficient NAD levels, energy production and other vital biological processes can be disrupted.

One of NAD’s main functions is to support ATP production, the primary energy source for cells. ATP is involved in several key metabolic pathways and helps ensure that cells have the energy they need to perform essential functions.

As NAD+ levels decline with age, the body’s ability to produce energy can be affected. This can lead to slower metabolism, increased fatigue and a higher risk of metabolic disorders such as obesity, type 2 diabetes and cardiovascular disease. 

Does NAD+ promote healthy ageing?

NAD+ plays a key role in healthy ageing by supporting essential cellular functions such as energy production, DNA repair and inflammation control. NAD+ levels naturally decline with age which may contribute to common age-related health issues. When NAD+ levels drop, cells struggle to generate energy efficiently, which can lead to fatigue, muscle weakness and metabolic decline.

NAD+ is also essential for DNA repair. Over time, DNA becomes damaged due to natural environmental factors and ageing processes. NAD+ helps repair damaged DNA and maintain genetic stability. By doing this, NAD+ may help protect against age-related diseases such as cancer and neurodegenerative conditions.

NAD+ also plays a role in reducing inflammation, which could help prevent many age-related diseases. Chronic inflammation is linked to conditions such as cardiovascular disease, arthritis and issues with cognition.

Does NAD+ affect everyone in the same way and at the same rate?

NAD+ does not affect everyone in the same way or decline at the same rate. Several factors, including age, genetics, lifestyle and overall health, influence how NAD+ levels change over time and how they impact the body.

One of the biggest factors is age. While NAD+ levels naturally decline as people get older, the rate of decline can vary from person to person. Some people may experience a quicker decrease that causes noticeable effects on energy levels, metabolism and overall health. Genetics also play a role in how the body produces and utilises NAD+, as does diet, exercise and the amount of sleep you get.

Underlying health conditions can also impact NAD+ levels. Obesity, diabetes and chronic inflammation can lead to increased NAD+ consumption, reducing its availability for important bodily functions. 

How safe is NAD+ supplementation?

NAD+ supplementation, using products like the Vivere NAD+ Vi-Pen, is generally considered safe for most people when taken as directed. NAD+ injections are well-tolerated, with few mild side effects such as nausea, headaches, or digestive upset, which are rare and usually temporary. It’s important to consult with a professional healthcare provider before starting a NAD supplement, especially if you have existing health conditions or are taking other medications. Pregnant or breastfeeding individuals should also seek professional medical advice before use.

Final Thoughts from Yusra

NAD+ is a crucial coenzyme that supports essential biological functions, including energy production, DNA repair and metabolism. As we age, NAD+ levels naturally decline, which can lead to a variety of age-related health issues such as fatigue, cognitive decline and metabolic disorders. By understanding the factors that influence NAD+ levels such as diet, exercise and lifestyle choices it's possible to support healthy NAD+ levels and potentially slow the ageing process. Maintaining adequate levels can help promote overall health and well-being. As with any supplement, it's important to consult a healthcare provider before starting NAD+ supplementation to ensure safety and suitability for individual needs.

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Further Reading

NAD+ metabolism and its roles in cellular processes during ageing - PMC

The Role of NAD+ in Regenerative Medicine - PMC

Role of NAD+ in regulating cellular and metabolic signalling pathways - PMC

Healthy Lifestyle Recommendations: Do the Beneficial Effects Originate from NAD+ Amount at the Cellular Level? - Poljsak - 2020

NAD+-Increasing Strategies to Improve Cardiometabolic Health? - PMC

PARP Inhibitors: An Innovative Approach to the Treatment of Inflammation and Metabolic Disorders in Sepsis - PMC

Healthy Lifestyle Recommendations: Do the Beneficial Effects Originate from NAD+ Amount at the Cellular Level?

Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review - PubMed

Current Uncertainties and Future Challenges Regarding NAD+ Boosting Strategies - PMC

Author
Yusra Serdaroglu Aydin - Head of Nutrition & Registered Dietitian at Vivere

Yusra Serdaroglu Aydin, MSc RD

Head of Nutrition and Registered Dietitian

Yusra is a registered dietitian with a multidisciplinary background in nutrition, food engineering, and culinary arts.

During her education, her curiosity about all aspects of food led her to earn an Associate Degree in Culinary Arts and an MSc in Food Engineering. She explored the kitchen side to create recipes that are both healthy and delicious, while gaining a deep understanding of the technologies, regulations, and strategies behind the food we eat in the modern world.

She has over five years of experience helping people modulate their gut microbiome, improve gastrointestinal health, optimize blood parameters, manage food intolerances, and achieve sustainable weight management. She has worked with thousands of patients, helping them transform their long-term eating habits, and is deeply passionate about improving nutrition knowledge and habits in those she supports.

At Vivere, Yusra leads the development and continuous improvement of nutrition-focused products and services. Her work involves aligning scientific research with product strategy, enhancing user experience, and supporting cross-functional collaboration. With experience in business development and training, she brings a practical, science-based approach to creating effective, health-oriented solutions.

Outside of work, Yusra loves to cook for loved ones, enjoy good food, travel to explore new cuisines, and seek out local dishes to bring fresh flavors to the table.

Education:
Health Science University -  BSc Nutrition and Dietetics, 2020
Anadolu University -  Associate Degree in Culinary Arts, 2019
Istanbul Technical University - MSc Food Engineering, 2024

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Medical Reviewer
Sarah Godden - Nutritionist - Affiliate BDA Member

Sarah Godden, BSc (Hons) Nutrition Consultant

Nutritionist

Sarah Godden is a highly experienced Nutrition Consultant and an affiliate member of the BDA with over 30 years of expertise in nutrition, health promotion, and wellbeing. She has worked across the UK and Middle East, supporting people to improve their health through evidence-based, personalised nutrition advice.

Her career spans schools, residential care, corporate settings, and public health initiatives. She has also consulted for government departments, charities, and private companies, delivering specialist nutrition services tailored to their needs. During her time in the UAE, Sarah was a trusted nutrition expert for the press and the go-to person for professional media commentary.

Sarah has developed and delivered weight management programmes, reviewed and improved meal provision for organisations, and trained care staff, kitchen teams, and fellow nutritionists to raise standards.

Specialising in weight loss, gut health, food sensitivities, and women’s health, she combines science with a down-to-earth approach that makes nutrition easy to understand and apply. She is passionate about translating complex nutrition research into simple, practical steps that empower people to make lasting changes.

Alongside her consultancy, Sarah has supported individuals and small groups to reach their health goals with clarity and confidence. Her approach is always compassionate, practical, and focused on long-term wellbeing rather than quick fixes.

Education:
University of North London - BSc (Hons) Nutrition with Biology, 1992

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