Is your favorite celebrity getting NAD+ therapy — and should you be too?
The answer: maybe, but more research is needed to know for sure.
NAD+, or nicotinamide adenine dinucleotide, naturally occurs in the body and plays a critical role in cellular metabolism and other processes linked to aging. Researchers believe aging can be modified in ways that speed it up or slow it down. Declines in NAD+ are associated with normal or accelerated aging, whereas increases in NAD+ may be associated with slowed aging — or anti-aging.
Although early studies suggest NAD+’s benefits, much of the research so far has been conducted on animals or in small-scale models. For those with the money and resources, however, the existing data is compelling enough to try NAD+ therapies.
NAD+ therapies can be taken in a synthetic form, as a dietary supplement or an injectable, and aim to boost the body’s overall NAD+ levels and, hopefully, offer anti-aging benefits to users.
[READ: Healthy Aging Tips]
What Is NAD+?
NAD+, or nicotinamide adenine dinucleotide, is essential for cellular metabolism and naturally occurs in every cell of the body. It’s vital for cellular health and energy production.
Charles Brenner, a leading expert on NAD+ and chief scientific advisor at Niagen Bioscience, a company that offers patented NAD+ precursor treatments, based in Los Angeles, explains that NAD+ has two essential functions: to create cellular energy and to provide cellular defense.
NAD+ creates cellular energy from food that we eat and provides cellular defense against metabolic stress, which can be caused by factors such as inflammation, infections and the aging process.
NAD+ is considered a coenzyme, which means it assists enzymes in carrying out functions in the body. It works with several enzymes that regulate stress responses to support their ability to repair DNA and defend against metabolic stress. Additionally, because NAD+ creates cellular energy, it is highly demanded by cells within high-functioning organs — like the heart and brain.
But when NAD+ is in short supply, it can struggle to carry out all of these duties. NAD+ supply can wane in conditions of high metabolic stress, such as those caused by infections or inflammation, or lifestyle habits, such as drinking alcohol, not getting enough sleep, living a sedentary lifestyle or excessive sun exposure, Brenner says.
NAD+ levels will also naturally decline with age. And concerningly, when NAD+ declines, inflammation and oxidative stress can rise.
“As we age, our NAD+ levels decline, which can compromise the body’s ability to repair damaged cells and maintain metabolic balance,” Brenner says. “This decline contributes to increased cellular stress and inflammation, which are major factors in aging and age-related diseases.”
[READ: 10 Tips to Live to 100]
What Is NAD+ Therapy?
NAD+ therapies are medical interventions intended to increase or replenish the NAD+ supply in your cells. These therapies are available as a dietary supplement, IV infusion or shot form. They contain synthetic versions of NAD+ or NAD+ precursors, which are substances that work with the body to help build NAD+.
NAD+ IV infusions, the most popular way to receive the supplement, have a price tag upwards of $1,000.
One NAD+ precursor that is utilized in modern treatments is nicotinamide riboside, or NR, which is a form of vitamin B3.
According to some animal and human studies, NR can help boost NAD+ levels in the body. While both substances are available as treatment, Brenner — whose company Niagen Bioscience offers a patented form of NR known as Niagen — recommends using NR because of its ability to “cross the cell membrane directly,” which he says NAD+ cannot do on its own.
“NR is the biggest piece of NAD+ that can get into cells,” Brenner says.
[See: Foods That Age You.]
What Are the Benefits of NAD+ Therapy?
Because NAD+ plays such an important role in the body, some people pursue treatments to increase their NAD+ levels. By boosting NAD+ levels, recipients aspire to prevent health issues that can arise when NAD+ levels are low and to slow down their aging process.
“Elevating NAD+ can support the body’s ability to manage oxidative stress, DNA repair and other functions vital for cellular resilience and health span,” Brenner says.
NAD+ therapy may lead to improvements in:
— Energy
— Brain function
— Sleep quality
— Inflammation
— Skin
— Workout recovery
“NAD+ therapy has reached mainstream popularity for good reason, as it can catalyze positive health results across an incredibly broad spectrum,” says Dr. Darshan Shah, founder and CEO of Next Health in Los Angeles and host of the EXTEND Podcast.
He adds that NAD+ appears to have mental health benefits too, such as helping patients overcome substance use disorders, anxiety and depression, and cognitive benefits, like fighting neurodegenerative diseases.
“One of the most remarkable and important clinical findings of NAD+ therapy is that it supports neuroplasticity — our brain’s ability to form and reorganize synaptic connections — which is essential for learning, memory and recovery from neurological injuries,” Shah says. “NAD+ can not only enhance brain function, but can also potentially slow the progression of neurodegenerative diseases.”
Preclinical models — research done in animals or lab settings before human trials — have shown that replenishing NAD+ through precursors like NR has “great potential” for targeting aging and age-based diseases, like Alzheimer’s disease. Researchers also suggest that NAD+ precursors have “exciting therapeutic potential” for aging, metabolic and neurodegenerative diseases. Further, studies on animal models suggest that NAD+ may help with a range of health conditions, including aiding postpartum weight loss and managing Type 2 diabetes.
Compared with animal studies, clinical trials on NAD+ and NAD+ precursors in humans are limited.
For instance, a very small 2020 study on exercise performance in found that NR supplementation increased levels of NADH and NAD(P)H — reduced forms related to NAD+ — in older men. Supplementation also decreased markers of oxidative stress and improved aspects of physical performance in older individuals. Interestingly, these benefits were not observed in younger study participants. The study included 12 young and 12 older male participants.
Who’s Getting NAD+ Therapy?
Celebrities like Hailey Bieber, Kendall Jenner and Joe Rogan have all talked about using NAD+ therapies — often as preventive health measures. Others are seeking the benefits too. But doctors have mixed reviews on whether or not the therapy is necessary.
“In places like Hollywood, people are getting NAD+ drips not because they’re sick — but simply to feel even better,” says Dr. Yoshua Quinones, a board-certified Internist with Medical Offices of Manhattan. “But here’s the catch: It’s not for everyone. If you’re already sleeping well, eating decently and moving your body, you’re likely doing just fine.”
Still, Quinones says that for people who are experiencing symptoms like “feeling constantly drained or recovering from something physically or emotionally, NAD+ might give you the extra boost you need.”
How Does NAD+ Therapy Work?
Your NAD+ therapy experience will vary based on the form of NAD+ you are receiving, such as if you are taking a supplement, receiving an infusion or a shot.
IV therapy, which has been popularized by celebrities, involves sitting or lying down while a medical professional hooks you up to a bag of synthetic NAD+ — or NR, depending on your treatment options. IV therapy can be a lengthy process — lasting up to a few hours — and may produce some sensations in the stomach.
“During the IV infusion, patients may experience temporary side effects like a warming sensation in their chest or abdomen, nausea or a feeling of pressure in the stomach or head,” Shah says, though he adds that some of these side effects can be mitigated by slowing down the speed of the IV drip.
Shah says that the side effects, or lack thereof, can vary based on a recipient’s tolerance level and are not related to how well NAD+ therapies work.
Shah utilizes NAD+ as part of his regular wellness routine, and he likes to bring a book, laptop or a podcast with him to keep his mind active during lengthy infusions.
Brenner adds that some people report gastric distress, such as nausea or diarrhea, following an NAD+ infusion, but may experience fewer side effects from an NR infusion.
Another option are NAD+ injections, which don’t take as long to administer. They are typically administered into the fatty tissue just under the skin into the back of the arm.
While NAD+ supplementation via IV or shots may be faster acting, NAD+ dietary supplements, available at your local pharmacy, offer fewer side effects and a far cheaper price tag.
Should You Take NAD+?
If you are interested in exploring NAD+ supplementation, you might want to talk to your doctor about trying it. Shah says that the treatment is generally very safe, but that more studies are needed to clarify its safety profile for certain groups, like people who are pregnant or breastfeeding. As with any treatment, it’s important to talk to your medical provider about any potential risks before beginning.
If your doctor says you are in the clear, however, Shah says IV infusions of NAD+ could be a good idea for you, even if you are not feeling under the weather.
“NAD+ can be an incredibly proactive therapy supporting brain health, detoxification and even mood in people who feel generally well to begin with,” Shah says. “But again, it’s not a silver bullet. It’s most effective with regular dosing paired with healthy lifestyle practices and thoughtful medical oversight.”
Quinones adds, “Take a moment to ask yourself why you want to try it: Are you treating burnout? Chasing a quick fix? Or are you genuinely invested in long-term wellness?”
“My number one tip: Treat NAD+ as a last resort, not a first step. Start with the basics — regular exercise, a balanced diet, quality sleep and B vitamins,” Quinones says. “If you’ve tried all that and still feel stuck, then NAD+ might be the extra support your body’s been asking for.”
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