Vitamin A, collagen, CBD…. Not a month goes by when we hear about a new ‘wonder’ ingredient that is going to blitz our ailments and hold back the years.
The latest contender is NAD (pronounced ‘N.A.D.’), an energy-generating molecule that’s found in every cell in the body. In supplement form, it may improve our health (and, by extension, our skin) in a myriad of ways, from giving us more energy to reducing cravings to protecting against cell damage, and much more. It’s touted by some as ‘the ultimate anti-ageing pill’ for its ability to keep youthful energy levels topped up. Fans include biohacker Davinia Taylor, who says “It helps me get rid of brain fog and boosts my confidence; it makes me feel like a 20-year-old.” The supplement’s ability to support menopause is another reason why women biohackers have embraced it.
According to molecular biologist and UK supplement entrepreneur Dr Nichola Conlon. Americans have moved beyond asking what NAD+ (the ‘activated’ form of NAD and the term that’s most widely used for this energy-generating co-enzyme) is and “only want to know what the bestNAD+ supplement is.” In the UK, she says, “consumers have really embraced the idea of long-term preventative healthcare much more than they did before, and they’re looking for solutions like NAD+ that really hold water.”
Doctors we spoke to were cautious but open-minded. Cosmetic physician Dr David Jack says: “I’ve seen numerous studies showing benefits of NAD supplementation in modulating inflammation, metabolic decline and cellular and DNA repair.” The chance of side effects, he says, is low, so “although the evidence is in its early stages, NAD+ may be a very useful supplement for patients either suffering from neurodegenerative conditions or as part of an anti-ageing supplement routine.”
The buzz around NAD+ has spawned a growing market for NAD+ IV therapy as well as for supplements that help our body make its own NAD+: so-called NAD+ precursors (or ‘boosters’). The latest cutting-edge capsules to crowd the wellness shelves, you’ll spot them primarily as NMN, Niagen or NAD+ supplements.
For our pick of the best NAD+ boosters and to find out whether NAD+ IV therapy is worth it, read on.
What is NAD+?
NAD+ (nicotinamide adenine dinucleotide) is a natural chemical found in every single cell in the body. It plays a major role in generating cellular energy, as well as in maintenance and repair of your cells, and you will also see it referred to as NAD or NADH. All in all, it is thought to be involved in more than 500 different reactions that keep cells in good health.
How does NAD+ work to help fight ageing?
If we have high levels of NAD+, it means we have lots of cellular energy, meaning our cells function optimally and we feel more energetic and alert. It also means the body can repair itself quicker, which helps keep our organs, including our skin, in pristine working order. But just like collagen, our levels of NAD+ decline with age. It’s thought they halve every 20 years, from the day you’re born. With age, the body becomes less able to generate it, plus older, naturally more damaged cells use up NAD+ stores at a higher rate. A downwards spiral of NAD+ correlates with the onset of many of the complaints associated with ageing including wrinkles, memory loss, heart problems, dementia, Parkinson’s, vision loss, and more. “NAD+ decline is seen as one of the nine main hallmarks of ageing,” says Conlon.
How do you increase your levels of NAD+?
You cannot stop the decline of your body’s ability to produce NAD+, but you can slow down the rate at which the body uses it up. Basically, the healthier you are and the less damage your body’s cells sustain (from things like disease, stress, unhealthy lifestyle choices and an unhealthy environment), the more NAD+ you have available for keeping your organs in ‘homeostasis’, or strong, healthy and ‘young’ for their age.
In other words, a good old healthy lifestyle with the right nutrition and lots of stress management is, as per usual, the best way to keep this important energy molecule ticking over. In terms of diet, foods rich in vitamin B3 should be top of your list. “It’s a precursor for NAD, meaning it's one of the building blocks that the body uses to make NAD,” says Conlon. The richest source of B3 , or niacin, is liver, followed by chicken, turkey and salmon. But it’s also found in rice, legumes and fruits such as bananas.
Healthy lifestyle habits such as HIIT exercise and intermittent fasting are, says Conlon, actually due to them igniting the body’s NAD+ production: “the temporary cell stress they create switches on our internal maintenance and repair mechanism,” she says.
But it’s increasingly thought supplementing NAD+ can off-set its natural decline as well, as evidenced by multiple studies. One suggests that NAD+ supplementation may activate the protection and stabilisation of telomeres, which help prevent cell death and therefore the risk of long-term diseases setting in. Ultimately, says Conlon, “while I would stop short of saying NAD+ supplementation helps you live longer, it is clear it improves health-span, which is the proportion of your life you spend in good health.”
But there is a caveat. There are thousands of papers on NAD+ supplementation in animals, and, says Conlon, about 20 human studies. But at present, there is no conclusive, long-term proof that it can reverse or delay ageing. It’s also important to keep in mind that we are talking about a nutritional supplement here, not medication. Of course, that doesn’t stop people from taking their chances in the pursuit of a longer, healthier life.
What are the benefits of NAD+ supplements?
Reported benefits of NAD+ supplementation are wide-ranging:
- Improving sports performance: Due to its energy-boosting abilities (increases in energy, resilience and recovery are reported) and positive impact on muscle function, NAD+ is popular with athletes and sports performance coaches. It is also used (in the US at least) to help treat chronic fatigue syndrome.
- Sleep issues and hangovers: In one study, it was shown NAD+ seems to re-set our internal ‘body clock’, causing some to supplement NAD+ to treat jet lag and insomnia. “I know people use it to support mitochondria (our ‘cell batteries’) to combat fatigue,” says nutritional therapist Daniel O’Shaughnessy. And because it fortifies cells’ defence systems, it is used by others as a ‘hangover cure’ to help protect the liver from the damage alcohol does. “It’s used in addiction treatment to support the withdrawal from alcohol and some drugs,” says O’Shaughnessy. “It’s also being researched for long-Covid support.”
- Collagen regeneration: The world of aesthetics and ‘tweakments’ is keeping a beady eye on NAD+ as well. No wonder, as high levels of cellular energy mean that the body can more effectively prevent and clear up signs of skin ageing such as brown spots and fine lines. “Not only that, but the basic principle of ‘tweakments’ is that a level of controlled damage is inflicted on the skin, which then sets off a repairing, collagen-boosting mechanism in the skin,” says Conlon. “However, if the body is low on cellular energy, it has trouble performing this tissue repair and it won’t generate much additional collagen, leading to disappointing or even negative results. Boosting NAD+ reserves is thought to shore up this collagen supply and can therefore be the essential missing ‘prep’ step in skin rejuvenation procedures.”
- Improving symptoms of menopause: The booming menopause market is also ready to pounce. “We are super interested in the implications for menopause relief, and are chasing scientific data for this,” says Dr Conlon. “Menopause causes a huge increase in cellular ageing in a short space of time, turning off the energy and repair mechanisms that you so desperately need right at this time of life.”
NAD+ is effective at mopping up DNA damage and oxidative stress, so may help off-set this lack of repair. “It may also support memory and cognition, which means it could help with the dreaded ‘brain fog’,” says Conlon. Cosmetic physician Dr Sophie Shotter recommends NAD supplements to patients who struggle with hormone-related energy levels.
- Suppressing food cravings: Apart from the aforementioned protective effect on the liver and delivering much-needed energy when you’ve been burning the candle at both ends, “NAD+ can help suppress the cravings that plague addicts of any plumage,” says Conlon. The theory is that having enough NAD+ in your system stops the body ‘running on empty’ from substance abuse. As a result, it craves fewer ‘fresh hits’ of more stimulants.
Former party girl and recovering alcoholic turned biohacker Davinia Taylor noticed this after having a NAD+ IV drip. “It gets rid of any cravings - sugar, shopping…. I didn’t even fancy the chips I was trying to treat myself with,” she says. “NAD+ shuts down the body’s need for a dopamine rush. It makes me feel not wired like you would from Red Bull - but chipper. It’s like a healthy alternative to hair of the dog, and an antidote to the fact that hangovers get worse with age. It’s an awake, clean energy that helps you deal with any stress better. It’s the ultimate energy shortcut for me - no dietary changes, no meditation.”
What are the side effects of taking NAD+ supplements?
From the research so far (which comprises only those few human studies), very few contra-indications have been flagged for taking supplements with NAD+ precursors (see below for more on these). In the human studies, 1000-2000mg of nicotinamide riboside (one popular precursor) a day had no harmful effects – and most supplements contain 250-300mg a day. However, long-term effects in humans are still relatively unknown.
Can you take NAD+ supplements when pregnant?
NAD+ is vital for normal organ development in babies but the advice is to, out of caution, hold off on taking NAD+ supplements in pregnancy. An Australian 2020 studyon animals concluded that supplementing with precursor NMN improved the quality of ovarian cells in adult mammals but it’s not known what effect it had their unborn young.
What is the best way to supplement NAD+?
The jury is out on the best way to take your NAD+ supplementation, but NAD+ IV therapy and supplements containing NAD+ boosters or precursors are the most popular options.
- NAD+ IV therapy: Having a NAD+ IV drip delivers NAD+ directly into your veins, which biohacking fans claim increases bioavailability and is therefore is the fastest way to get a major clarity-of-mind boost in preparation for a major event or to aid recovery from injury or illness.
Beware, though: apart from a substantial financial investment, having these drips is also an investment in time, as they typically take three hours to infuse. Unless you take the ‘speedy’ half-hour option which, according to people we’ve spoken to, has an unpleasant side effect in the shape of temporary stomach and brain pressure as the active works its way into your system.
Taylor gets her drips from Dr Enayat at London biohacking health clinic Hum2n (https://hum2n.com/), who offers a ‘substance detox programme’ of five IV drips in one week, starting at £2795, and a three-drip anti-ageing protocol, with extras such as glutathione and B vitamins, from £1295. A single drip costs £350.·
- Topical NAD+ supplementation: The first topical NAD+ cream has just been launched in the shape of Intuisse Active NAD+ Face Serum, £250 for 20ml. Using ‘ground breaking liposomal technology’, the brand says NAD+ is delivered deep into the skin “to brighten, tighten, smooth and intensely hydrate to extend your ‘skin span’”. It’s an intriguing premise, but there are currently no independent clinical trials to prove that this type of dermal delivery can work for NAD+ (as we know, it’s a very large molecule, which makes it tough to penetrate the skin barrier) or for NAD+ precursors.
- Oral NAD+ supplements in the shape of NAD+ boosters or NAD+ precursors: According to Conlon, getting pure NAD+ into the bloodstream via NAD+ injections or NAD+ drips doesn’t mean the enzyme actually gets into the body’s cells. “Right now, there’s very little proof that it can, apart from some indication that it can permeate some neuronal [brain and nervous system] cells,” she says.
This is why most oral NAD+ supplements provide not NAD+, but NAD+ precursors (or ‘boosters’), which the body converts into NAD+ to provide a slow and steady supply of cellular energy. The names you’re looking for are:
- A form of vitamin B3 called nicotinamide riboside or niagen (related to famed multi-functional skincare ingredient niacinamide)
- nicotinamide mononucleotide (NMN), which the body converts into NAD+.