What Is NAD+ And Can It Really 'Reverse' Aging?

There’s been chatter on TikTok about a “miracle drug” called NAD+ that can allegedly reverse or “cure” aging. But the reality is a lot more complex than TikTok has made it to be.

NAD+, or nicotinamide adenine dinucleotide, is an essential coenzyme in regulating metabolism, longevity, DNA repair, and the immune system. A deregulation of NAD+ levels is associated with signs of aging, metabolic diseases, neurodegeneration, and cancer.

Preliminary studies in mouse models have shown that increasing supplements of NAD+ precursors—including nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR)—may result in health benefits and delayed signs of aging.

Human bodies are like electric cars in the sense that they run on high-energy electrons, and these electrons need a way to travel through the body, according to Charles Brenner, PhD, the researcher who identified NR as an unanticipated vitamin precursor of NAD+.

“In cars and other devices, the electrons flow on copper wires. In our bodies, high-energy electrons are carried by NAD coenzymes. NAD is vital to cellular function and allows us to convert our food to energy and to build and repair our bodies,” Brenner told Verywell.

NAD+ is neither a drug nor a miracle, he explained. But it has become a big area of focus in the healthy aging space because it declines with age and exposure to certain stressors, such as sedentary lifestyles, high fat/sugar diets, excessive alcohol intake, and immune challenges. This decline in NAD+ has been observed in people with aging-related diseases.

Current research suggests that NAD+ levels can be raised by taking NAD+ precursors or boosters, Brenner added. NR, which was discovered by Brenner, is currently one of the most well-researched and efficient precursors of NAD+. NR is being studied in clinical trials that include research on heart disease, Alzheimer’s disease, kidney injuries, aging, and chemotherapy.

“Multiple conditions of metabolic stress including overweight, alcohol use, DNA damage, sunlight exposure, infection, inflammation, and postpartum disturb the NAD system,” Brenner said. “When the NAD system comes under attack, NR is powerfully protective of tissue functions and metabolism.”

What Has NAD+ Research Found So Far?

In animal models, studies have shown that stimulating NAD+ with NMN or NR can extend healthspan—defined as years lived in good health—and reduce premature aging, according to Renae Thomas, MD, MPH, a physician certified in family medicine, public health, and general preventive medicine.

Human trials so far have shown that NAD+ supplementation may improve exercise performance in older adults, increase insulin sensitivity, and provide anti-inflammatory effects, Thomas added.

“Because NAD+ plays a vital role in many of the biological processes in humans associated with aging and DNA repair, it is definitely a very interesting area of research. We just need more data to support the claims and hype around it at this time,” she said.

It’s important to note that taking supplements is not the only strategy to increase NAD+ levels, Thomas added. Many healthy human lifestyle behaviors, such as exercise, quality sleep, and not eating excessive calories, are also associated with increased levels of NAD+ and likely the associated health benefits.

However, NMN is currently not allowed to be marketed in the U.S. because the FDA in 2022 said this ingredient no longer met its definition as a dietary supplement. While these NAD+ supplements may provide some benefits, Thomas said it’s best to speak with your physician before trying them.

Correction - July 20, 2023: This article was updated to include more information about the legal status of NMN in the U.S.