NAD+ in Medicine: The Future of Anti-Aging Treatments?

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- Updated by Jody Mullis MS, RD, Nutritionist

Key Takeaways

  • NAD+ is important for DNA repair and energy production, and scientists are studying its potential for treating diseases.
  • NAD+ and NADH need to be balanced for proper cellular function.
  • Ways to boost NAD+ levels include diet, supplements, exercise, stress management, and sleep.
  • The salvage pathway for NAD+ biosynthesis is important for maintaining NAD+ levels, and scientists are exploring new treatments using this pathway.

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NAD+ is a critical molecule in cellular metabolism with significant implications in medicine. As scientists strive to unravel the complexities of human biology, understanding the role of NAD+ in medicine has become increasingly crucial. This molecule is involved in DNA repair and energy production and has been studied for its potential therapeutic applications for a wide range of medical conditions. In this article, we will explore the structure and function of NAD+ and the salvage pathway involved in its biosynthesis. We will also examine the various roles NAD+ plays in biological processes, its potential uses in medicine, and why this molecule is so essential.

NAD+ and its importance in cellular metabolism

Nicotinamide adenine dinucleotide (NAD+) is a coenzyme that plays a vital role in cellular metabolism.  NAD+ exists in two forms: NAD+ and NADH, with the former being the oxidized form and the latter being the reduced form. The balance between these two forms is essential for proper cellular function.

One of the most crucial functions of NAD+ is its direct and indirect influence on cellular metabolism. By playing a role in metabolic pathways, NAD+ affects a variety of important cellular functions that are vital for promoting healthy aging, maintaining tissue and metabolic homeostasis, as well as DNA repair and immune cell function. Additionally, it also plays a role in chromatin remodeling and cellular senescence.

Overall, the importance of NAD+ in relation to cellular metabolism cannot be overstated - this molecule is essential for maintaining the proper functioning of many key biological processes that keep us healthy and functioning at our best.

Dr Rhonda Patrick explores NAD+ in aging and the precursors NMN and NR

What is Cellular Energy?

Cellular energy refers to the process of producing energy within a living cell. It is essential for the proper functioning of different cellular activities, such as metabolism and growth. One critical component involved in cellular energy production is NAD+.

Cellular energy is also produced by the mitochondria, which are found inside cells and belong to a group called eukaryotic cells. The mitochondria are responsible for producing energy for the cell. The mitochondria are responsible for a wide range of activities, including energy production, respiration, and the synthesis of proteins. Mitochondrial function is based on the process of oxidative phosphorylation, which uses oxygen and molecules such as NADH and FADH2 to generate energy in the form of ATP. This energy is then used to power various metabolic processes that occur within the cell, such as protein and lipid synthesis. In addition, cellular energy can also be produced by glycolysis, a process that involves the breakdown of glucose to produce energy without using oxygen.

Understanding the role of NAD+ in medicine

NAD+ plays a critical role in cellular metabolism [1], energy production [2], DNA repair [3], and cell signaling [4]. It exists in two forms - NAD+ and NADH - with the balance between them being essential for proper cellular function. Understanding the structure and function of NAD+ is crucial for understanding cellular metabolism and its impact on human health.

What is NAD+ Restoration?

NAD+ restoration involves increasing the levels of this coenzyme in the body, often with the help of supplements like NMN powder or intravenous infusions. By doing so, it may be possible to restore optimal bodily functions and reverse some age-related decline.

Research studies have shown promising results for NAD+ restoration therapy such as improved cognitive function and heart health along with its potential anti-aging effects. However, more studies are needed to fully understand its long-term safety and effectiveness for medical use.

What are the key factors in successful NAD+ restoration?

Firstly, it's important to understand that there are different methods of restoring NAD+, such as through NMN supplements and IV therapy. Choosing the right method and dosage is crucial for effectiveness and safety.

Secondly, lifestyle habits also play a critical role in maintaining optimal NAD+ levels. Consuming a healthy diet rich in nutrients like niacin and tryptophan, reducing alcohol consumption, getting enough sleep and regular exercise can help to support NAD+ production and preservation.

Lastly, addressing any underlying health issues may be necessary for effective NAD+ restoration. Conditions such as chronic stress or inflammation can deplete NAD+ levels over time. By identifying and treating these underlying issues, one can facilitate better results when trying to restore optimal levels of NAD+.

What is the Future of Age Prevention?

This has far-reaching implications for our attitude and approach toward aging, presenting the opportunity to enter a new era of cellular regenerative medicine to not only manage the external signs of aging but also to develop therapies that support the body to repair and restore itself back to a state of internal well-being.

The future of age prevention is bright, with many new technologies and research being conducted in the field of regenerative medicine. This includes stem cell therapies, gene therapies, and other treatments that have shown promise in reversing the aging process. Pharmaceutical and biotech companies are investing heavily in the development of anti-aging treatments and therapies, which could potentially revolutionize the way we age and prevent age-related diseases. Additionally, lifestyle changes such as dietary modifications increased physical activity, and stress management are being studied and implemented as potential age management strategies. As more research is conducted and new technologies emerge, the future of age prevention looks incredibly promising.

What are the benefits of cellular regenerative medicine?

Cellular regenerative medicine is a highly promising field that offers many benefits. In this area, damaged or diseased tissues are regenerated with the help of stem cells or other regenerative cells, which have the potential to develop into various types of healthy cells.

One significant benefit of cellular regenerative medicine is that it has the potential to repair tissues that were previously considered irreparable. For instance, patients suffering from spinal cord injuries or heart disease may gain new hope through this innovative approach.

Another advantage of this field is that it can minimize the need for invasive surgeries. Instead of cutting into a patient's body and removing or transplanting an organ, doctors may be able to use cellular therapies to regenerate damaged tissues.

Cellular regenerative medicine also has the potential to accelerate healing time and reduce recovery periods for patients. Compared to traditional treatments, which may take days or weeks for a patient to recover from, cellular therapy could offer rapid results with minimal downtime.

Finally, this approach may help individuals who suffer from chronic pain due to injuries or illnesses. By repairing damaged tissues at the cellular level, physicians may effectively relieve pain in ways that were previously not possible with conventional treatments.

The Salvage Pathway for NAD+ Biosynthesis

The salvage pathway for NAD+ biosynthesis is a critical process in maintaining adequate levels of NAD+ in cells [7]. This pathway involves the conversion of nicotinamide into nicotinamide mononucleotide (NMN), which is then converted into NAD+. NAD+ deficiency has been linked to several health conditions, making it essential to maintain adequate levels of this coenzyme.

Key enzymes involved in this pathway include nicotinamide phosphoribosyltransferase (NAMPT) and nicotinamide mononucleotide adenylyltransferase (NMNAT).

NAMPT catalyzes the conversion of nicotinamide into NMN, which is then converted into NAD+ by NMNAT. These enzymes play a crucial role in maintaining adequate levels of NAD+ in cells, preventing health conditions associated with its deficiency.

Furthermore, research on drugs targeting these enzymes has gained attention as potential therapeutic applications for treating age-related diseases. Inhibition of PARP-1, a rate-limiting enzyme involved in NAD+ consumption, has also been explored as a potential therapeutic target.

Understanding the key enzymes involved in the salvage pathway and their key roles is crucial for developing new therapeutic applications aimed at improving human health outcomes. Further research on these enzymes' potential targets could lead to significant advancements in medicine and novel treatments for various health conditions linked to NAD+ deficiency.

How to Boost Cellular Energy with NAD+

As discussed already, NAD+ is a crucial molecule for cellular energy production, and its levels naturally decline with age. However, there are several ways to boost NAD+ levels in the body. One method is through diet and supplementation with NAD+ precursors such as NR or NMN. These precursors are converted into NAD+ in the body, helping to increase energy levels and improve overall cell function.

Another way to boost NAD+ levels is through exercise. Studies have shown that regular physical activity can increase NAD+ levels in the body, leading to improved energy production and cellular health. In addition, getting enough sleep and managing stress levels can also help maintain healthy NAD+ levels.

Finally, there are several lifestyle changes that can help boost NAD+ levels. These include avoiding alcohol and nicotine, which can deplete NAD+ levels in the body, as well as avoiding processed foods and excess sugar. By making these changes, individuals can support their body's natural NAD+ production and maintain healthy energy levels for optimal cellular function.

Niacin and NAD+

Niacin, also known as vitamin B3, is a key component in the NAD+ coenzyme pathway. When ingested, niacin is converted into nicotinamide adenine dinucleotide (NAD+) and plays a vital role in many cellular processes. It helps to convert nutrients from food into energy, assists with DNA repair and cell differentiation, and regulates circadian rhythm.

Niacin is also essential for the production of cholesterol and other fatty acids important for proper functioning of cells. It helps maintain the health of the cardiovascular system, skin, and other organs. Niacin deficiency can lead to anemia, skin and mouth lesions, digestive disturbances, and mental health issues. 

Comparing Niacin to NMN

There are some key differences to consider when comparing niacin to NMN. Niacin has been used for decades as a dietary supplement to boost NAD+ levels [8]. It has been shown to improve cardiovascular health and lower cholesterol levels. However, taking high doses of niacin can cause uncomfortable side effects like flushing and gastrointestinal distress.

On the other hand, NMN is a newer player in the game of NAD+ precursors. Recent studies have shown that NMN is a more effective precursor molecule than niacin, with better absorption rates and faster conversion to NAD+. Additionally, unlike niacin, NMN does not seem to cause significant side effects, even at high doses.

While both niacin and NMN can be effective in boosting NAD+ levels in the body, it's worth considering one's individual needs and preferences when deciding which precursor molecule to use. In general though, it seems that NMN may offer some unique advantages over niacin as a way to increase our body's supply of this vital coenzyme.


In conclusion, NAD+ plays a critical role in cellular metabolism, energy production, DNA repair, and cell signaling. The balance between the oxidized form, NAD+, and the reduced form, NADH, is essential for proper cellular function. NAD+ deficiency has been linked to several health conditions, including age-related diseases, metabolic disorders, and neurodegenerative diseases. Therefore, understanding the structure and function of NAD+ is crucial for developing new therapeutic applications in medicine.

The salvage pathway for NAD+ biosynthesis plays a vital role in maintaining cellular function and preventing health conditions associated with NAD+ deficiency. Key enzymes involved in this pathway, including nicotinamide phosphoribosyltransferase (NAMPT) and nicotinamide mononucleotide adenylyltransferase (NMNAT), are responsible for converting precursors into NAD+. Research on drugs targeting these enzymes has gained attention as potential treatments for various health conditions linked to NAD+ deficiency.

Boosting NAD+ levels through diet and supplementation, regular exercise, adequate sleep, and stress management can improve overall cellular function and maintain healthy energy levels. Niacin, also known as vitamin B3, is a crucial component in the NAD+ coenzyme pathway, and supplementing with NAD+ precursors such as niacin, NMN and NR can potentially promote longevity and mitigate the effects of aging. However, more research is needed to determine the safety and effectiveness of using NAD+ supplementation for therapeutic purposes, and it is always best to consult with a healthcare provider before starting any new supplement regimen.

[1] - NAD+ metabolism and its roles in cellular processes during ageing

[2] - NAD+ Metabolism and the Control of Energy Homeostasis: A Balancing Act between Mitochondria and the Nucleus

[3] - Fueling genome maintenance: On the versatile roles of NAD+ in preserving DNA integrity

[4] - Role of NAD+ in regulating cellular and metabolic signaling pathways

[5] - Age-related NAD+ decline

[6] - NAD+ in Brain Aging and Neurodegenerative Disorders,al.%2C%202014%2C%202016a%3B

[7] - NAD+ metabolism: pathophysiologic mechanisms and therapeutic potential

[8] - Niacin Cures Systemic NAD+ Deficiency and Improves Muscle Performance in Adult-Onset Mitochondrial Myopathy