Key Takeaways
NAD+ supplements might help slow aging and improve brain health. NAD+ is important for energy, DNA repair, and lowering inflammation. Talk to a healthcare provider before taking NAD+ supplements to make sure they are safe for you.
Considering NAD+ supplements? Some research suggests they might help slow aging and improve cognitive function by supporting cellular processes, but the full extent of their benefits and risks is still under study. It's important to talk to your healthcare provider about whether they're right for you. Taking a supplement in the kitchen close up.
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Function of NAD+ in Your Body
NAD+ is a coenzyme vital for several body pathways, including:
Cellular energy DNA repair Hormone signaling Inflammation
NAD+ supports metabolism and the circadian rhythm, which is your body's 24-hour sleep cycle clock. Sirtuins, proteins that regulate aging and potentially extend lifespan, need NAD+.
NAD+'s role isn't fully understood, but decreased levels are linked to aging and conditions like:
Diabetes Inflammation Heart disease
Is NAD+ the Same as NADH?
NAD (nicotinamide adenine dinucleotide) comes in two forms:
NADH, "reduced" NAD, meaning it has an extra electron NAD+, "oxidized" NAD, meaning it lost an electron
NADH is different from NAD+.
Foods and Supplements to Boost NAD+
Some precursors (substances that form other substances) can boost NAD+ levels in your body. You can find them in supplements or foods, and they include:
Tryptophan Nicotinic acid (also known as niacin or vitamin B3) Niacinamide (another form of vitamin B3) Nicotinamide mononucleotide (NMN); the Food and Drug Administration (FDA) has considered NMN to be an investigational drug and not a supplement Nicotinamide riboside (NR)
Good food sources of tryptophan and niacin include the following:
Beef Chicken Fish Turkey
You can also get niacin from these vegetarian foods:
Dairy products Enriched grains Fruit Legumes Nuts Seeds Soy products Vegetables Whole grains
Benefits of NAD+ Supplements
Some studies, although limited, suggest NAD+ supplementation may provide the following benefits:
Support healthy aging: Because levels of NAD+ decrease with aging, it's theorized that supplements that boost NAD+ could slow the effects of aging and extend life span. Improve cognitive functioning: NAD+ may also protect against neurodegenerative diseases such as Alzheimer's or other forms of dementia. Improve cardiovascular health: NAD+ may decrease the risk of high blood pressure, arterial stiffness, and high cholesterol.
Preclinical Research
NAD+ and its precursors have been studied in preclinical trials (using cells in test tubes or animal models) for the following conditions:
Alzheimer's disease Amyotrophic lateral sclerosis (ALS) Huntington’s disease (HD) Parkinson’s disease (PD) Vascular dementia Cognitive decline Diabetes Obesity Heart protection Stroke Traumatic brain injury Fertility Glaucoma Ocular (eye) degeneration Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known as nonalcoholic fatty liver disease or NAFLD)
Keep in mind that results seen in animal or lab studies may or may not be replicated in humans. NAD+ is not currently recommended for any of these conditions.
Research in Humans
NAD, NMN, and NR have been studied in human clinical trials for the following conditions:
Parkinson's disease Prediabetes Addiction Inflammation
Many of these trials were very small and included 30 or fewer people. Large-scale studies are needed before these supplements can be recommended.
Dosage
Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian nutritionist (RD or RDN), pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.
There aren't many studies on the effects of NAD+ supplements in humans. So, it is unknown how to dose these supplements. Dosage will depend on your product and what you use it for.
Tryptophan, NMN, NR, and niacin or niacinamide food sources or supplements can increase NAD+.
Also, keep in mind that optimal dosing or duration of NAD+ supplements has not been established yet.
Clinical trials have used the following doses:
250 milligrams (mg) of NMN daily for metabolic benefits in females with prediabetes 1,000 mg of NR daily to improve body composition in people with obesity 1,000 mg of NR daily for Parkinson's disease
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. When choosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
Know These NAD+ Side Effects and Risks
Your provider may recommend you take an NAD+ supplement to slow the effects of aging or for another reason. However, consuming one of these supplements may have potential side effects that may be common or severe.
Some side effects associated with NAD+ supplements include the following:
Flushing Itching Elevated liver enzymes Liver toxicity Nausea Headache Low platelet levels Leg cramps
These side effects may vary depending on which NAD+ supplement you choose. NMN and NR might be better tolerated than other NADs, although fewer studies about their effects exist.
While not much is known about the severe side effects of these supplements, some animal studies have shown that NR, in particular, may cause tumors. However, whether this effect is the same in humans is unclear since results in animal studies don't always translate to those in humans.
Precautions
Since most of the evidence for NAD+ supplements comes from animal studies, not a lot is known about the effects of these supplements in humans.
Keep the following precautions in mind when using NAD:
Severe allergic reaction: Avoid using NAD+ supplements if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure. Pregnancy: NAD+ supplements are not recommended during pregnancy due to a lack of safety data in humans. Breastfeeding: Due to a lack of safety data in humans, NAD+ supplements are not recommended during breastfeeding. Children: Due to a lack of safety data in humans, NAD+ supplements are generally not recommended for children. That said, one long-term study concluded that nicotinamide (a form of B3) at a dose of 25 to 50 mg per kilogram (kg) of body weight (mg/kg) was safe for children. As a best practice, discuss the use of any supplements you're considering with your child's pediatrician. Other modifications: People with liver or kidney problems should be cautious when using NAD+ supplements due to possible side effects on these organs. And there's not enough evidence to know if NAD+ supplements are safe for people with cancer or inflammatory disorders like rheumatoid arthritis.
Interactions
NAD supplements may interact with the following medications:
Antidepressants: These medicines may lower the level of NAD in the body and make supplements less effective. Insulin: NAD+ supplements may increase or decrease insulin sensitivity, meaning you might need a different amount of insulin to get the same effect. Other supplements: More data are needed. However, other supplements that act on various pathways involved in the aging process may increase the effects of NAD+ supplements. A few examples of these supplements are curcumin, quercetin, and coenzyme Q10 (CoQ10).
It is essential to carefully read a supplement's ingredients list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.
23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Poljšak B, Kovač V, Milisav I. Current uncertainties and future challenges regarding NAD+ boosting strategies. Antioxidants (Basel). 2022;11(9):1637. doi:10.3390/antiox11091637
Imai S, Guarente L. NAD+ and sirtuins in aging and disease. Trends Cell Biol. 2014;24(8):464-471. doi:10.1016/j.tcb.2014.04.002
Mehmel M, Jovanović N, Spitz U. Nicotinamide riboside-The current state of research and therapeutic uses. Nutrients. 2020;12(6):1616. doi:10.3390/nu12061616
Makarov MV, Trammell SAJ, Migaud ME. The chemistry of the vitamin B3 metabolome. Biochem Soc Trans. 2019;47(1):131-147. doi:10.1042/BST20180420
Food and Drug Administration. Letter from FDA CFSAN to Inner Mongolia Kingdomway Pharmaceutical Limited regarding NDI 1259 - B-nicotinamide mononucleotide (NMN).
National Institute of Health Office of Dietary Supplements. Niacin.
MedlinePlus. Tryptophan.
Conlon NJ. The role of NAD+ in regenerative medicine. Plastic & Reconstructive Surgery. 2022;150:41S-48S. doi:10.1097/PRS.0000000000009673
Campbell JM. Supplementation with NAD+ and its precursors to prevent cognitive decline across disease contexts. Nutrients. 2022;14(15):3231. doi:10.3390/nu14153231
Zhang X, Zhang Y, Sun A, Ge J. The effects of nicotinamide adenine dinucleotide in cardiovascular diseases: Molecular mechanisms, roles and therapeutic potential. Genes & Diseases. 2022;9(4):959-972. doi:10.1016/j.gendis.2021.04.001
Abdellatif M, Sedej S, Kroemer G. NAD + metabolism in cardiac health, aging, and disease. Circulation. 2021;144(22):1795-1817. doi:10.1161/CIRCULATIONAHA.121.056589
Xie N, Zhang L, Gao W, et al. NAD+ metabolism: Pathophysiologic mechanisms and therapeutic potential. Signal Transduct Target Ther. 2020;5(1):227. doi:10.1038/s41392-020-00311-7
Wei Z, Chai H, Chen Y, et al. Nicotinamide mononucleotide: An emerging nutraceutical against cardiac aging?. Curr Opin Pharmacol. 2021;60:291-297. doi:10.1016/j.coph.2021.08.006
Nadeeshani H, Li J, Ying T, et al. Nicotinamide mononucleotide (NMN) as an anti-aging health product - Promises and safety concerns. J Adv Res. 2021;37:267-278. doi:10.1016/j.jare.2021.08.003
Brakedal B, Dölle C, Riemer F, et al. The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease. Cell Metab. 2022;34(3):396-407.e6. doi:10.1016/j.cmet.2022.02.001
Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021;372(6547):1224-1229. doi:10.1126/science.abe9985
Braidy N, Villalva MD, van Eeden S. Sobriety and satiety: Is NAD+ the answer?. Antioxidants (Basel). 2020;9(5):425. doi:10.3390/antiox9050425
Elhassan YS, Kluckova K, Fletcher RS, et al. Nicotinamide riboside augments the aged human skeletal muscle nad+ metabolome and induces transcriptomic and anti-inflammatory signatures. Cell Rep. 2019;28(7):1717-1728.e6. doi:10.1016/j.celrep.2019.07.043
Dall M, Hassing AS, Treebak JT. NAD+ and NAFLD - caution, causality and careful optimism. J Physiol. 2022;600(5):1135-1154. doi:10.1113/JP280908
Hwang ES, Song SB. Possible adverse effects of high-dose nicotinamide: Mechanisms and safety assessment. Biomolecules. 2020;10(5):687. doi:10.3390/biom10050687
Poljsak B, Kovač V, Milisav I. Healthy lifestyle recommendations: Do the beneficial effects originate from NAD+ amount at the cellular level?. Oxid Med Cell Longev. 2020;2020:8819627. doi:10.1155/2020/8819627
Sharma A, Chabloz S, Lapides RA, et al. Potential synergistic supplementation of NAD+ promoting compounds as a strategy for increasing healthspan. Nutrients. 2023;15(2):445. doi:10.3390/nu15020445
Viljoen M, Swanepoel A, Bipath P. Antidepressants may lead to a decrease in niacin and NAD in patients with poor dietary intake. Med Hypotheses. 2015;84(3):178-182. doi:10.1016/j.mehy.2014.12.017
By Megan Nunn, PharmD Nunn is a community pharmacist in Tennessee with 12 years of experience in medication counseling and immunization.
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