Nicotinamide adenine dinucleotide, or NAD+ for short, is a molecule that is found inside all of our cells. NAD+ controls many key processes in the body, including energy metabolism, cell survival. [1, 2] 

Some of the key roles of NAD+ include:

Levels of NAD+ production rise and fall depending on food intake, exercise, and the time of day. 

NAD+ is vital to our survival; however, the amount of NAD+ doesn’t remain the same throughout our lives. As we get older, NAD+ levels fall, which is, in part, a process responsible for why we age. [3] 

NAD+ decline with age is the result of decreased production and increased usage of NAD+ mainly due to the accumulation of DNA damage with age requiring more NAD+ [4].

NAD+ decline results in increased disease susceptibility, especially to age-associated chronic diseases like heart disease, diabetes, neurodegenerative diseases, and mental disorders. [5-8]

Therefore, the maintenance of sufficient NAD + production is vital for cell survival and function.

In this article, I talk about how NAD+ can support your health and well-being and how to increase NAD+ levels also when aging.

NAD+ Production

NAD+ may be produced from the amino acids tryptophan or aspartic acid. [9, 10] but this process does not occur in all tissues, so most cells to rely on a pathway called the salvage pathway for producing NAD+ from nutrients available from our food [11], especially vitamin B3, which enters this salvage pathway and acts as an NAD+ precursor.

The Benefits of NAD+

Animal studies show that raising NAD+ levels in the body may lower the risk of heart disease, diabetes and mental decline and partly reverse the signs of aging. 

Raising NAD+ levels has been shown to improve vascular function in aged mice. [12]

A 2013 study has found that raising NAD+ levels can partly restore cognition to Alzheimer’s mouse models. [13, 14, 15]

Another research on mice has shown that the loss of NAD+ can lead to the degeneration of skeletal muscles. [16]

In 2017, scientists proved that, after injecting mice with vitamin B3, an  NAD+ precursor, the repair of damaged DNA got significantly faster.

Studies have also observed that NAD+ decline is also associated with non-alcoholic fatty liver disease, insulin resistance and metabolic syndrome [17]

Depressive-like behaviors are also associated with NAD+ decline [18].

How to Increase NAD+ Levels

Due to all of the previously mentioned benefits of sufficient NAD+ levels in our cells, maintaining levels with aging is crucial for health.

Oral supplementation of vitamin B3 – niacin, in the form of nicotinic acid or nicotinamide (NAM), the regular forms of vitamin B3 found in most B complex supplements, is an option. These forms of vitamin B3 enter the NAD+ salvage pathway and have been shown to increase NAD+ levels in cells. But this method is not usually adopted because of the side effect of a painful flushing sensation at high doses of these forms of vitamin B3. [19, 20]. 

But do not lose hope. There are more suitable forms of vitamin B3 that increase NAD+. 

These vitamin B3 forms include nicotinamide mononucleotide (NMR) and nicotinamide riboside (NR). These two vitamin B3 forms increase the levels of NAD+, but without any side effects. 

All of these four versions of the vitamin B3 are structurally different, and the body processes them differently.

The last two mentioned forms of vitamin B3 – nicotinamide mononucleotide and nicotinamide riboside –  have also been shown to improve multiple physiological functions in animal models when supplemented [21,22, 23, 24]

These two forms of vitamin B3 are also found in foods like whey protein, and brewer’s yeast, which you may increase consumption with aging. 

But, of these two most beneficial forms of vitamin B3, nicotinamide riboside is especially beneficial. It is even well-tolerated at the therapeutic dose of 1000 mg per day, with no serious adverse events occurring. [25]

Even a single dose of nicotinamide riboside stimulates NAD+ production in healthy humans. [26, 27] 

We also see an increase in other energy producing molecules such as adenosine and ATP,  with nicotinamide riboside supplementation, which increases energy in the body.

Dietary supplementation of nicotinamide riboside also significantly improves NAD+ levels in the brain, reducing brain function decline that occurs with aging. [28]

To Conclude:

All in all, NAD+ is a crucial molecule for the body, and its effects on health and aging are more than evident. When consuming foods such as Brewer’s yeast and whey protein, or supplementing with the most potent anti-aging form of vitamin B3, nicotinamide riboside, which I definitely recommend after the age of 50, then NAD+ levels rise to help us feel more alert, relaxed, energized, and more youthful even as we age.

Feel free to comment below and let me know what you liked best about this article.

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Dr. Galit Goldfarb

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