If you have been seeing NAD+ pop up in wellness conversations lately, you are not alone. Often called the molecule of youth, NAD+ plays a role in everything from energy production to cellular repair. To help us understand why it has become such a buzzword in longevity science, we turned to Dr. Shilpa, who breaks down what this powerhouse molecule really does and why supporting it matters for how you age, think, and feel.

What exactly is NAD+, and why do scientists call it the “fuel for life”?

NAD+ stands for nicotinamide adenine dinucleotide. It's a coenzyme found in every cell and is essential for the biochemical reactions that sustain life. NAD+ is a coenzyme for redox reactions, making it central to energy metabolism. It can directly and indirectly influence many key cellular functions, including metabolic pathways, DNA repair, chromatin remodeling, cellular senescence, and immune cell function. Hence, it’s apt that NAD+ is touted as the “fuel for life.” It powers every bodily process and keeps cells in good repair. Without NAD+, life as we know it couldn’t exist, as every system in the body needs NAD+ to function properly.

As we age, we experience a decline in NAD+. This decline is not only a hallmark of aging, but it also plays a role in the process of aging. Interventions that increase NAD+ may slow aspects of the aging trajectory and help us feel younger while improving overall health and wellness.

When people talk about anti-aging supplements, NAD+ always comes up. Why is it such a big deal compared to things like collagen, resveratrol, or CoQ10?

NAD+ operates at a more fundamental cellular level, thus impacting every organ and tissue compared to collagen or resveratrol. NAD+ works inside the cells, which means it tackles aging at its very root. Studies in animals with oral NAD+ (or precursor) supplementation have shown improvements in metabolism, endurance, and metabolic functions. Human trials are still at an early stage, with promising early evidence suggesting that NAD+ can improve markers of metabolic and cardiovascular health.

Supplements like collagen or CoQ10, while beneficial, target a narrower range of aging effects. In fact, resveratrol cannot work properly without NAD+, and CoQ10 depends on input from NADH for its antioxidant activity.

You’ve worked on advanced delivery systems. Why is absorption such a big deal when it comes to NAD+ precursors?

NAD+ has poor oral bioavailability as it degrades in our digestive tract. Hence, many supplements offer precursors like NMN, NR, or nicotinamide, which are smaller molecules that the body can absorb. However, as we age, the body’s ability to convert these into NAD(H) starts declining. I believe that we need a multi-targeted approach to replenish the body’s NAD stores where we attack the problem from all sides. Oral supplementation should include bioavailable NAD+ that is protected from the harsh stomach environment - consider liposomal technology! This should be combined with an NAD precursor and should also include ingredients that support NAD recycling pathways and inhibit the CD38 enzyme that breaks down NAD+. Every person is different, but this way you are giving the body several options and making it work.

NMN, NR, NADH - what’s the real difference, and is one form truly better for the body?

NMN and NR are precursors of NAD+, which means the body uses NMN or NR and converts them into NAD+, which is what is actually present in our cells. NMN and NR are smaller molecules, hence have a better chance for oral absorption. However, the body’s ability to convert NMN and NR to NAD+ may decline as we age.

NADH is the reduced form of nicotinamide adenine dinucleotide, whereas NAD+ is the oxidized form. The body cycles back and forth in a reversible process between the oxidized and reduced forms. So both forms are equally important.

How do liposomal formulations compare scientifically to IV drips or standard capsules?

Liposomal formulations offer better absorption than standard capsules. Since liposomes are similar in structure to the cell membrane, we anticipate better cellular uptake compared to capsules. NAD+ is also protected in the liposomal vesicle and remains stable for the body to use.

IV drips are faster (IV bypasses the regular digestive tract, hence is super fast). IV is considered 100% bioavailable. However, this requires a clinical setting and does not have the convenience of on-the-go supplementation.

Collagen makes skin plumper, magnesium helps with sleep - what’s the “everyday benefit” NAD+ users might actually feel?

I would say users might feel a spike in their energy. They may also experience more mental clarity. Effects vary widely depending on the product you take, age, lifestyle, etc. Some people express it as “they feel good” without really being able to pinpoint exactly what. Some people observe subtle benefits in recovery as well as skin after taking it for a couple of weeks.

What’s the biggest misconception you see in the supplement industry about NAD+?

The biggest misconception is that one can just take an NAD+ pill and this will boost their NAD+ levels. This is just a waste of money. The delivery system matters. You have to look for more bioavailable delivery formats - or take precursors if you’re using standard pills.

As a scientist, I also need to point out that human clinical studies on oral NAD+ supplements are still in their infancy, and NAD+ as a supplement is still a promising yet emerging science. This means don’t believe it if someone tells you that just taking NAD+ will make you “immortal” or forever young. Nothing is achievable without proper nutrition, daily exercise, and an intentional lifestyle.

If someone wanted to actually measure NAD+ status or effectiveness, which biomarkers or tests should they look at?

Biomarkers related to aging have been tested in clinical settings (metabolic markers like sirtuin activity, inflammatory biomarkers, and neurological markers). One may also see an improvement in lipid profile. However, less invasive and rapid methods are still new and may not provide accurate results. For now, one can test blood NAD+ levels. New promising tools and testing methods are on the way!

If you were building an “anti-aging stack,” where would NAD+ fit in, and what would you pair it with for maximum effect?

I would consider vitamin D3, glutathione, and omega-3s along with NAD+. Resveratrol and quercetin are beneficial antioxidants that may help with cellular senescence (meaning they help remove bad cells). My other personal favorites are magnesium and curcumin. Again, the most important aspect is to buy high-quality supplements that offer optimal absorption and are tested for safety and purity.