NAD+ (Nicotinamide Adenine Dinucleotide)

NAD⁺ (Nicotinamide Adenine Dinucleotide) – Cellular Energy & Mitochondrial Support

NAD⁺ plays a central role in ATP creation and cellular repair. As levels decline with age, optimising NAD⁺ has become a key focus in longevity science. Learn how NAD⁺ functions within the body and its relevance in IV therapy.

What the ingredient is

NAD⁺ (Nicotinamide Adenine Dinucleotide) is a coenzyme present in all living cells. It exists in oxidised (NAD⁺) and reduced (NADH) forms and is essential for transferring electrons in metabolic reactions. It regulates cellular energy, mitochondrial efficiency, and DNA repair processes.

Mechanism of action

NAD⁺ acts as:

  • An electron carrier in oxidative phosphorylation and ATP production

  • A substrate for sirtuins (SIRT1–7), enzymes linked to metabolic regulation and ageing

  • A cofactor in PARP enzymes responsible for DNA repair

  • A regulator of cell survival, inflammation, and metabolic signalling

IV administration can rapidly elevate systemic levels more effectively than oral supplementation, due to poor oral bioavailability.

Physiological roles

Vitamin B12 is required for:

  • Supports mitochondrial energy production
  • Essential for ATP synthesis
  • Regulates cellular repair and DNA maintenance
  • Supports healthy ageing processes
  • Contributes to neurotransmitter function and cognitive health
  • Helps manage oxidative stress and cellular resilience

Evidence summary

Research highlights NAD⁺ decline with age, metabolic stress, and lifestyle factors. Studies show that increasing NAD⁺ precursors may support mitochondrial performance, metabolic health, and longevity pathways.
Evidence for IV NAD⁺ is growing, but varies depending on clinical context. Most strong data is from mechanistic, metabolic, and ageing research, not disease treatment.

Potential benefits

Supports energy levels and reduces cellular fatigue

Promotes mental clarity and cognitive function

Helps maintain metabolic health

Supports cellular repair and resilience

Contributes to healthy ageing mechanisms

Safety profile

  • Generally safe when administered under clinical supervision
  • Slower infusion rates can improve comfort
  • Caution in individuals with severe cardiovascular disease or hypersensitivity

Interactions

Interacts with niacin-based supplements (precursor pathways)

May affect medications influencing mitochondrial metabolism

Alcohol and chronic stress significantly reduce NAD⁺ levels

Evidence rating

Moderate – strong mechanistic evidence in cellular and ageing research; emerging but limited clinical trial data for IV NAD⁺ in wellness contexts.

References

  • Verdin E. NAD⁺ in ageing and disease. Science.
  • Trammell SA, Brenner C. NAD⁺ metabolism and therapeutics.
  • National Institutes of Health (NIH) – NAD⁺ metabolic pathways.
  • PubMed clinical literature on sirtuins, mitochondria, and NAD⁺ decline.