What Is NAD? A Plain-Language Guide to NAD+

NAD has gone from a textbook term to a wellness buzzword in just a few years. You will see it on supplement bottles, in podcasts about longevity and on IV menus. Before deciding whether any of it is for you, it helps to understand what NAD actually is and what it does.

Short answer: NAD stands for nicotinamide adenine dinucleotide, a coenzyme found in every living cell. Its two forms, NAD+ and NADH, shuttle electrons in the chemical reactions that turn food into energy. NAD+ is also used by enzymes involved in DNA repair and cell signalling. Levels fall in some tissues with age, which is why NAD+ has attracted interest, but proven benefits of boosting it in people are still limited.

NAD, NAD+ and NADH

“NAD” is the family name. It exists in two main forms that convert back and forth:

• NAD+ is the oxidized form, ready to accept electrons.
• NADH is the reduced form, carrying electrons to the mitochondria, where they help produce ATP, the cell’s energy currency.

Think of NAD+ as an empty delivery truck and NADH as the same truck loaded with cargo. For more detail, see NAD+ versus NADH.

What NAD+ does

Energy metabolism

NAD+ is essential to the pathways that break down carbohydrates, fats and protein. Without it, cells cannot produce energy efficiently.

DNA repair

Enzymes called PARPs use NAD+ to help repair damaged DNA.

Sirtuins

Sirtuins are a family of enzymes that depend on NAD+ and help regulate how cells respond to stress, inflammation and metabolism. They are a major reason NAD+ is linked with ageing research.

Cell signalling

NAD+ is also involved in calcium signalling and the body’s daily circadian rhythms.

Where NAD+ comes from

Your body builds NAD+ from several sources:

• Tryptophan, an amino acid found in protein foods
• Niacin and nicotinamide, forms of vitamin B3
• Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), precursors found in small amounts in food and sold as supplements

It also recycles NAD+ constantly through a salvage pathway. Learn about the differences between precursors in NMN versus NR versus NAD+.

Why levels change

Studies in animals and some human tissues show NAD+ levels decline with age. Inflammation, metabolic stress and heavy alcohol use may also increase NAD+ consumption. Whether falling NAD+ causes age-related decline, or is one marker of it, is still being studied.

Ways people try to raise NAD+

• Lifestyle: exercise, sleep and diet all influence NAD+ metabolism. See natural ways to support NAD+.
• Oral precursors: NR and NMN supplements, which raise blood NAD+ levels in human studies.
• Injections: smaller doses given into the skin or muscle. Compare them in NAD+ injections versus IV.
• IV infusion: NAD+ delivered directly into a vein, slowly, over a longer appointment.

What we know and what we do not

NAD+ is essential to life; that is not in question. What remains unproven is whether raising NAD+ above your usual levels improves energy, slows ageing or prevents disease in people. Small human studies show precursors are generally safe and raise blood NAD+, while effects on health outcomes have been modest or mixed. Our article on NAD+ benefits and research summarizes the evidence in more depth.

NAD+ at AuraWell

We offer NAD+ infusions at 250 mg or 500 mg, given slowly with a registered nurse adjusting the rate for comfort. Every first visit starts with a health screen, and your practitioner will tell you honestly whether NAD+ makes sense for your goals. Read our NAD+ IV therapy guide for what to expect.

Can you measure your NAD+ level?

NAD+ can be measured in blood and tissue samples, but these tests are mostly used in research. They are not part of routine blood work in Ontario, and there is no agreed “normal range” that a clinician can use to say your level is low. Results can also shift with the sample type, the lab method and the time of day.

This matters because it means NAD+ therapy is usually chosen on the basis of how you feel and your goals, not a test result. If fatigue is the reason you are curious, standard tests such as iron, vitamin B12, thyroid function and blood sugar are more useful first steps. Our guide to causes of fatigue to check before IV vitamins walks through them.

Who might consider NAD+, and who should not

People who often ask about it

• Healthy adults interested in healthy ageing who already have the basics of sleep, food and activity in place
• People who have read about NAD+ precursors and want to understand their options
• Adults who want to try an infusion with clinical screening rather than buying products online

People who need a different first step or extra review

• Anyone who is pregnant or breastfeeding, as safety data are lacking
• People with active cancer or a history of cancer, because the role of NAD+ in cell growth is still being studied
• Those with significant heart, liver or kidney conditions
• Anyone with unexplained symptoms such as weight loss, ongoing exhaustion or shortness of breath, which need a medical assessment first

Questions to ask before trying NAD+ in any form

• What do I hope to notice, and how will I know if it is working?
• Is a supplement, a lifestyle change or an infusion a sensible place to start for me?
• What dose is being suggested, and why? Our article on 250 mg versus 500 mg NAD+ explains how dose is chosen.
• Who reviews my health history, and who will be with me during an infusion?
• How will my other medications and supplements be checked?

At AuraWell, our Nurse Practitioner screens every NAD+ request, and a nurse administers and monitors each infusion in the clinic. If you would like a broader wellness plan, our naturopathic doctor can look at nutrition, sleep and supplements alongside it. When you are ready, our guide on preparing for a first NAD+ infusion covers the day itself.

A short history of NAD+

NAD+ was first identified in the early 1900s, when researchers studying how yeast ferments sugar noticed that a small heat-stable “helper” molecule was needed for the reaction to work. Over the following decades, scientists worked out its structure and its role in energy production, and later linked it to vitamin B3 and to pellagra, a deficiency disease once common in North America. Interest in NAD+ and ageing is far more recent, growing mainly over the last twenty years.

Curious about NAD+? Learn more about NAD+ IV therapy in Woodbridge or call 905-207-7000 to book a screening visit at AuraWell Health, 4600 Hwy 7, Unit 105, Woodbridge, ON L4L 4Y7, serving Vaughan and Richmond Hill.