Mechanism

NAD+

Emerging evidence

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme essential for energy metabolism and DNA repair. Its levels fall with age, which is why NAD+ precursors are a popular longevity intervention — though human longevity benefits remain unproven.

Also known as: NAD, NAD+, nicotinamide adenine dinucleotide, NAD precursors, NMN, nicotinamide mononucleotide, nicotinamide riboside, NR

What NAD+ is

Nicotinamide adenine dinucleotide (NAD+) is a coenzyme found in every living cell. It shuttles electrons in energy metabolism and is a required co-substrate for enzymes involved in DNA repair and stress responses (PARPs and sirtuins).

Why it matters for longevity

Tissue NAD+ levels decline with age in animals and humans, and low NAD+ is linked to mitochondrial and metabolic dysfunction. This has made raising NAD+ — typically with precursors such as nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN), or via NAD+ infusions — one of the most marketed longevity interventions.

What the evidence shows

Oral NR and NMN reliably raise blood NAD+ markers in human trials, so target engagement is real. What is *not* yet established is a meaningful effect on ageing, healthspan or disease outcomes: most randomised trials are small, short and use surrogate endpoints. We therefore rate the longevity claim Emerging. Intravenous NAD+ in particular has little controlled outcome evidence and is not a proven anti-ageing treatment.

What to ask a clinic

Ask what outcome — beyond raising a lab value — is expected, the dose and infusion time (rapid IV infusion can cause discomfort), and how you will be monitored.

Sources & references

  1. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology. 2021. doi:10.1038/s41580-020-00313-x
  2. Effects of nicotinamide riboside on NAD+ levels, cognition, and symptom recovery in long-COVID: a randomised controlled trial. eClinicalMedicine. 2025.

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Educational information, not medical advice. Evidence ratings follow our methodology.