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 and DNA repair. 

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

Would you prefer to watch the key information from our article as a video instead? Check out our beginner's guide video to NAD+ below:

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell that helps convert food into cellular energy, supports DNA repair and drives hundreds of enzyme reactions. It is the active, oxidised form of NAD and works alongside its reduced partner, NADH. Your body makes NAD+ from vitamin B3 precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), and levels tend to fall with age.

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.

Learn more about NAD+ with Yusra including what it is, why it matters, and how it affects your energy, focus, and recovery. below:

If you're short on time, take a look at Yusra's 40 second overview of NAD+ below:

• NAD, which stands for Nicotinamide Adenine Dinucleotide is a coenzyme that plays a role in cellular energy production. 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 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 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 health. Ongoing research continues to explore NAD+ and its potential in supporting healthy ageing and cell function.

The future of NAD+

By looking back at the history of NAD+ and the discoveries made over time, researchers now have a clearer picture of its importance in the body’s natural processes. This growing knowledge is helping the scientific community explore new ways to use NAD+ to improve how we age, recover and stay healthy. The true potential of NAD+ is only beginning to unfold, and the future research around it is one of the most promising areas in modern science.

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+.

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.

NAD+ (nicotinamide adenine dinucleotide) is an essential molecule that helps your body create energy, repair DNA, and support healthy ageing. Your body can produce NAD+ naturally, but levels tend to drop as you get older. To maintain or boost NAD+, you can get it through your diet or from supplements known as precursors.

Precursors are nutrients that your body converts into NAD+. Several have been shown to increase NAD+ levels (Poljšak et al, 2022):

Many everyday foods supply the niacin and tryptophan your body uses to make NAD+. According to the NIH Office of Dietary Supplements, animal foods such as poultry, beef and fish provide around 5 to 10 mg of niacin per serving, mostly as the highly bioavailable coenzymes NAD and NADP. Plant foods such as nuts, legumes and grains provide around 2 to 5 mg per serving, mainly as nicotinic acid.

Examples include (National Institute of Health Office of Dietary Supplements):

The table below compares natural and supplemental NAD+ sources and how each supports the body’s NAD+ production.

Because NR has shown such strong results, researchers began exploring new ways to increase NAD+ beyond diet alone. This led to the development of advanced supplementation methods such as NAD+ injections, oral supplements and IV drips. These offer more direct and measurable support for people looking to improve energy, recovery, and long-term wellbeing.

Research into NAD+ supplements is still developing, but some studies suggest potential health benefits. These findings are early and more human research is needed before clear conclusions can be made.

These potential benefits are based on early research, and NAD+ supplements are not yet proven to prevent or treat any medical condition.

Most NAD+ research so far comes from laboratory and animal studies rather than people. These early findings show where NAD+ and its precursors might help, but results in cells and animals often do not carry over to humans. The conditions below have been studied preclinically only, and NAD+ is not a treatment for any of them.

It’s important to note that results from preclinical studies may not reflect how NAD+ works in humans. At present, NAD+ is not recommended for treating or preventing any of these conditions.

Human trials on NAD+, NMN and NR are still small and early. The studies below tested NAD+ precursors in people, but most involved fewer than 30 participants and specific groups, so the findings are preliminary. They do not show that NAD+ supplements treat or prevent these conditions.

Many of these human trials involved fewer than 30 participants, meaning larger and longer studies are needed to understand how NAD+ supplements may affect health. Until then, these products should not be used as a replacement for medical treatment or professional care.

Always speak to a healthcare professional before starting any new supplement, especially if you have an existing health condition or take prescribed medicines.

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 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, 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.

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

You can support NAD+ levels naturally through diet, exercise, calorie control and NAD+ precursor supplements such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). Precursors have the strongest evidence for raising blood NAD+, while regular exercise, fasting and a vitamin B3-rich diet help your body produce and recycle NAD+ more efficiently.

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.

Because NAD+ levels fall over time, many people consider oral supplements that provide NAD+ precursors such as NR and NMN. This section covers how safe those oral supplements are and what to keep in mind. Injectable NAD+, including pen devices, is a prescription-only medicine and is covered separately below.

Oral NAD+ supplements that provide precursors such as NR and NMN are generally considered safe for most healthy adults when taken as directed, with side effects that are usually mild and short-lived. Human research is still limited, so speak to your GP or pharmacist first if you take medicines, have a health condition, or are pregnant or breastfeeding.

When taken as directed, NAD+ supplementation is generally considered safe for most healthy adults. Reported side effects are rare and tend to be mild, such as short-term nausea, headaches, or mild digestive upset. These usually clear up quickly on their own.

Everyone’s health is unique, so it’s best to speak with a qualified healthcare professional before using any NAD+ product. This is particularly important if you take prescription medicines or have an existing health condition.

In the UK, oral NAD+ precursors are regulated as food supplements under food law rather than as medicines, and the MHRA does not authorise them as treatments for any condition. Learn how the MHRA classifies a product as a medicine.

Nicotinamide riboside (NR) is authorised as a novel food at a maximum of 300 mg per day for general adults, and 230 mg per day for pregnant and breastfeeding women. Nicotinamide mononucleotide (NMN) is not currently authorised as a novel food in Great Britain or the European Union and remains under assessment by the Food Standards Agency, although it is still sold in the UK during that process. For nicotinamide itself, the UK Expert Group on Vitamins and Minerals sets a guidance level of 500 mg per day for adults. Higher-dose nicotinic acid is a separate, prescription-only medicine, and NICE does not recommend nicotinic acid (niacin) for preventing cardiovascular disease. Always follow the dose on the label and speak to your GP or pharmacist before starting.

Most people tolerate NAD+ well, but mild side effects can happen. The table below summarises the most common effects and how long they typically last.

Some evidence suggests that NAD+ precursors such as NMN (nicotinamide mononucleotide) and NR (nicotinamide riboside) may be easier for some people to tolerate. However, further studies are still needed to confirm their safety in the long term.

Human research on NAD+ supplements is still limited, so certain groups should use caution or avoid them altogether. Always seek medical advice before starting any supplement if you are unsure.

Like many supplements, NAD+ may interact with some medications or other health products. The table below outlines potential interactions to be aware of.

If you’re considering trying NAD+ therapy for the first time, start by speaking with your healthcare provider. They can help you decide whether NAD+ supplementation is right for you and guide you on safe use alongside any current medication or treatment.

Injectable NAD+ is not the same as an oral supplement. In the UK it is an unlicensed medicine, which means it is not authorised by the Medicines and Healthcare products Regulatory Agency (MHRA) as a licensed product and should only be supplied and administered under the care of a a suitable prescriber. Do not treat injectable NAD+ as interchangeable with the oral precursors described above. If you are considering it, that decision should be made with a qualified healthcare professional.

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

NAD+ supports healthy ageing by powering the cellular processes that tend to slow down as we get older, including energy production in the mitochondria and DNA repair. Levels of NAD+ fall with age, and lower levels are linked to fatigue, muscle loss and cognitive decline, though NAD+ is not a proven treatment for any age-related disease.

NAD+ plays a key role in healthy ageing by supporting essential cellular functions such as energy production and DNA repair. 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 and muscle weakness.

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 neurodegenerative conditions.

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 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 and diabetes can lead to increased NAD+ consumption, reducing its availability for important bodily functions. 

When taken as directed, oral NAD+ precursor supplements such as NR and NMN are generally well tolerated by most healthy adults. Reported side effects are usually mild and short-lived, such as nausea, headache or mild digestive upset. Because human research is still limited, speak to your GP or pharmacist before starting, particularly if you take prescription medicines, have a health condition, or are pregnant or breastfeeding.

Injectable NAD+ is a different matter and is covered in the section on NAD+ injections above.

No, NAD+ is not a peptide. NAD+ (nicotinamide adenine dinucleotide) is a coenzyme made of two nucleotides, whereas a peptide is a short chain of amino acids. The term "NAD+ peptide" is sometimes used loosely in the longevity and injectable market, but chemically NAD+ is a dinucleotide. Your body builds it from precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN).

"NAD+ is a crucial coenzyme that supports essential biological functions, including energy production and DNA repair. As we age, NAD+ levels naturally decline, which can lead to a variety of age-related health issues such as fatigue and cognitive decline.

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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The Role of NAD+ in Regenerative Medicine - PMC

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

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