A Beginner's Guide To NAD+

In this article, we’ll focus on NAD+, one of the key forms of NAD (Nicotinamide Adenine Dinucleotide), 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.

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 decline.

• 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. 

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.

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• 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.

NAD+, short for nicotinamide adenine dinucleotide, was first discovered in 1906 by Sir Arthur Harden and has been studied ever since for its vital role in metabolism and energy production. Below is a timeline showing the key discoveries that helped scientists understand this essential molecule and how it supports life at a cellular level.

In his 1930 Nobel Prize lecture, Hans von Euler-Chelpin referred to NAD+ as “cozymase”, highlighting its vital role in life processes. He described it as one of the most important activators within the plant and animal world, recognising its importance long before its functions were fully understood.

Otto Heinrich Warburg, known for describing the “Warburg effect”, built on this knowledge in the 1930s by showing how NAD+ participates in metabolic reactions. Around the same time, public health expert Dr Joseph Goldberger identified that pellagra was caused by something missing in the diet. His research laid the groundwork for the later discovery of nicotinic acid and influenced international nutrition policies to improve public health.

As scientific tools improved in the decades that followed, researchers began to see just how essential NAD+ is at a cellular level. It became clear that this coenzyme is not only central to energy production but also crucial for DNA repair and overall metabolic health. Ongoing research continues to explore NAD+ and its potential in supporting healthy ageing and cell function.

Our understanding of NAD+ and why it matters really started to develop in the 1960s. During this time, French scientist Pierre Chambon discovered a process called poly ADP-ribosylation using extracts from hen liver. In this process, NAD+ is split into two parts. One part, nicotinamide, is recycled, while the other, ADP-ribose, attaches to a protein. This discovery laid the foundation for research into PARPs, or poly ADP-ribose polymerases. These proteins rely on NAD+ to carry out key cellular functions. They are also similar to another group of proteins known as sirtuins, as both only work when NAD+ is present.

Scientists have identified two main protein groups that depend on NAD+: PARPs and sirtuins. The table below highlights their main features.

Sirtuins are often called the “guardians of the genome” because they help maintain cellular stability and health. These proteins were first identified in the 1970s, but their connection to NAD+ wasn’t discovered until the 1990s. Leonard Guarente, a biologist at MIT, found that a sirtuin in yeast called SIR2 could extend the yeast’s lifespan, but only when activated by NAD+.

This discovery created a strong link between sirtuins and metabolism. It showed that metabolism is closely connected to other biological processes, helping scientists understand how the body’s systems work together. It also encouraged new research into how NAD+ supports health and ageing.

How do humans get NAD+?

Humans naturally produce NAD+ through the foods they eat. Many foods contain amino acids that act as precursors, meaning the body can use them to make NAD+. However, one particular precursor known as NR (nicotinamide riboside) has been found to be especially effective at increasing NAD+ levels. Think of NAD+ precursors as different routes to the same destination — and NR as the most direct and efficient route.

Comparing NAD+ sources

The table below shows the main ways we get NAD+ and how each source supports its production.

Because of this efficiency, scientists began exploring ways to access NAD+ beyond diet. This led to the development of better NAD+ supplements. With NR showing promise as an effective option, it raised an important question: we know what NAD+ does, but what is the best way to increase it?

Due to NAD+ levels declining with age it can affect how well the body produces energy and carries out key processes that keep cells healthy.

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.

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.

NAD+ (nicotinamide adenine dinucleotide) is essential for turning food into energy and keeping cells healthy. As discussed, as we get older, NAD+ levels decline, but there are proven ways to help support and restore them safely.

The most effective and clinically supported way to increase NAD+ is by taking specific precursors. Two of the most studied are nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). Research shows both can significantly raise NAD+ levels in the blood without harmful side effects.

Both supplements were found to be safe and effective, but NAD+ levels returned to normal after stopping them, suggesting that consistent supplementation may be needed to maintain the benefits.

Regular exercise also helps support NAD+ levels. A study published in Nature Aging showed that active adults had muscle NAD+ levels similar to much younger people. While this research focused on muscle tissue, it suggests exercise may help maintain NAD+ throughout the body.

Some foods naturally contain NAD+ precursors, but only in very small amounts. While a healthy diet supports cell function, it’s unlikely to raise NAD+ significantly through food alone.

These foods contribute to healthy cell function, but their NAD+ content is too low to replace what’s lost with age. That’s why supplements and lifestyle changes are often recommended to support healthy NAD+ levels over time.

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

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. 

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.

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. 

NAD+ supplementation, using products like the Vivere NAD+ 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.

Are you considering a NAD+ injection? If you answered 'yes', our beginner's guide to NAD injections is the perfect starting place for people interested in learning how a shot of NAD can boost your energy levels, enhance your focus and optimise your longevity.

"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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