Does Taking an NAD Supplement Really Have Anti-Aging Effects?

Find out what role nicotinamide adenine dinucleotide plays in your body and how to choose the best NAD supplement.

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Season one of The Kardashians saw Kendall Jenner and Hailey Bieber getting NAD (aka nicotinamide adenine dinucleotide) IV drips together, bags of yellow fluid hooked up to their arms. If you were intrigued by the scene but hate needles (or expensive treatments) you might be curious about NAD supplements: pills, powders, and gels that wellness-minded individuals have been turning to in the name of boosting their energy levels and cognition and generally remaining healthy as they age. For the full story on NAD supplementation, including whether it's safe and beneficial, read on.

What Is NAD?

First, some background on nicotinamide adenine dinucleotide, a compound naturally found in your cells that is referred to as NAD. The simplified explanation is that NAD plays a part in the process that your body uses to generate energy from food, according to Joshua Rabinowitz, M.D., Ph.D., professor of chemistry and the Lewis-Sigler Institute for Integrative Genomics at Princeton University. "In order to generate energy from food, you first turn NAD into NADH [the reduced form of NAD; the H stands for hydrogen], and then you use the NADH to drive the production of ATP [adenosine triphosphate], which is the most common usable form of energy in the cells of your body," says Dr. Rabinowitz. 

"On top of that, [NAD] has multiple signaling functions that help regulate the proper function of the body," says Dr. Rabinowitz. For example, "[NAD] activates enzymes called sirtuins, which have many different effects on the body, including decreasing inflammation, and there're some theories that it may help the body" by increasing longevity, says Neil Paulvin, D.O., a physician specializing in functional medicine and integrative sports medicine. However, "it is still being studied" to better understand the potential benefits, he says. NAD exists in two forms, NAD+ and NADH, and the molecule switches back and forth between the two forms when performing its functions in your body, says Joseph Baur, Ph.D., professor of physiology at the Perelman School of Medicine at the University of Pennsylvania.

What Are the Benefits of NAD?

"Preclinical data shows that taking NAD can offer health benefits such as improving muscle strength and performance, boosting energy and metabolism, and aiding cognition, as well as preventing certain diseases of aging," says Anant Vinjamoori, M.D., chief medical officer at Modern Age. "In addition to these overall health benefits, many disease states, such as chronic fatigue, inflammatory disorders, and metabolic disorders, involve issues with depleting NAD."

At this point, more studies are needed to back up that the benefits of NAD supplements apply to humans. "It's clear that [taking NAD-boosting supplements has a benefit] in rodents," says Baur. In humans, there have been both positive and negative studies, and they've generally been small and of "shorter duration than [researchers] would ultimately like to see," he says.

NAD levels decrease with age as NAD gets destroyed by a specific enzyme that increases with age, but the drop may not be all that dramatic, says Baur. "Typically, it's maybe [a] 30 percent decrease between a really old and a young person," he says. "And so this is the huge question in the field right now. Is that [decrease] enough to matter?"

What's the Deal with NAD Supplements?

While you may have heard someone say they take "NAD supplements," they aren't technically taking NAD itself. Instead of taking NAD, you take compounds that your body can convert into NAD. "When you take an oral NAD supplement, you are actually taking an NAD precursor, which is a building block for NAD," says Dr. Vinjamoori. "NAD is a complete molecule [which] actually cannot be absorbed in the GI tract."

When shopping for these supplements, you'll either see nicotinamide mononucleotide (NMN) or nicotinamide riboside (NR) — two NAD precursors — on the label. NMN is a compound that your body can convert to NAD and NR is a compound that your body can convert to NMN. For ease, this article will collectively refer to those precursor supplements as "NAD supplements," since that's how they're typically known.

Are There Better Ways to Boost NAD Levels Than NAD Supplements?

Oral NMN or NR supplements aren't the only routes that may boost your body's NAD level. "There's some evidence that calorie restriction can also boost NAD levels in some tissues," says Baur. (Of course, working with a doctor or dietitian to get a sense of your individual caloric needs is key.)

"Exercise [also] clearly boosts NAD, at least in skeletal muscle," says Baur. "And getting regular exercise is probably the strongest recommendation [anyone] can make. If you're not optimizing your exercise levels, then you're definitely not doing something that would really, really benefit you."

NAD-boosting IV drips are another option, as Jenner and Bieber can attest. "From a research perspective, there aren't currently any comprehensive studies comparing IV NAD to oral NAD precursors, but oral NAD precursors are definitely more well-studied," says Dr. Vinjamoori. "However, in my [experience], IV NAD tends to have a more profound and noticeable effect on patients than oral NAD." (Editor's note: Modern Age offers NAD IV drips as a service.)

"I think there are more likely ways to boost NAD than taking the supplement," says Dr. Rabinowitz. "I think if you want to increase NAD in your tissues, there's a greater chance of an effect if you were to take something such as NR or NMN intravenously." On the other hand, "there's also less known about the safety of taking these supplements intravenously than orally," he says. An NAD IV drip may be more beneficial, but it may also be riskier.

What Else You Should Know Before Trying NAD Supplements

Keep in mind that while NAD supplements are available OTC, they could still carry risks. "These supplements are similar to niacin and when used in pharmaceutical doses, niacin can cause serious muscle or liver problems in some people, so these supplements may not be benign," says Dr. Rabinowitz. (ICYDK, niacin is a B vitamin and another NAD precursor.) "...and I would recommend against taking them during pregnancy or breastfeeding."

Additionally, the supplement industry is largely unregulated, unlike drugs that are regulated by the Food and Drug Administration, so it's essential to speak with your doctor and do your research before starting an NAD supplement. "There really are a lot of companies that fly by night," says Baur. "And when people do analysis on the pills that are available, they often find that a lot of them contain a mixture, for instance, of nicotinamide and riboside, and they're not even bonded together. They're not the actual molecule." 

Pro tip: To find a quality supplement, NAD or otherwise, consider going for an option that's being used for research. "You can look at," says Baur. "There's a website that lists all the trials going on and [you can] look for clinical trials going on with these molecules...That's certainly what I would look for if I was going to take something, knowing that they've handed it to scientists who have the capability and have done verification on what they're being handed."

Bottom line, the jury is still out on just how safe and effective NAD supplements are. If you're sold, make sure to do your homework before adding one of the supplements to your daily routine.

This piece was fact-checked by Emily Peterson.

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