Is NAD+ the Anti-aging Miracle Pill? Here’s What the Science Says

What is NAD+? Short for nicotinamide adenine dinucleotide, NAD+ is a coenzyme: a compound that certain enzymes need to work. It is crucial for the basic reactions in your cells that keep you alive.

It occurs in two forms: NAD+ and NADH (you can read about the differences in a minute when you dig into what they do). There’s a good chance you’ve heard of NAD+ and NADH when you had to memorize the Krebs cycle for your biology exam. The Krebs cycle is the process by which cells generate energy that your body uses to function.

Read on to find out what NAD+ and NADH do and how to boost your levels to keep your cells strong.

How NAD+ works

Here’s how to understand what NAD+ does, without having to relive high school bio.

Think of it as a waiter that picks up an electron from one table and drops it off at another. The oxidized form of NAD+ grabs an electron from one molecule. While it has a hold on that electron, it becomes NADH. NADH donates that electron to another molecule, and it becomes NAD+ again.

The simple act of shuffling electrons around helps your enzymes work, and those enzymes activate microscopic chemical reactions in your cells that keep them healthy and keep your whole body humming.

Why you need NAD+

Without NAD+, it all stops.

On a Bulletproof Radio podcast episode (iTunes), professor of biochemistry and director of the Obesity Initiative at the University of Iowa Dr. Charles Brenner, PhD, explains, “Conversion of our fuels, protein, fat and carbohydrate into energy requires NAD. Similarly, maintaining our blood glucose at night and generating ketones requires NADH. It’s actually reoxidized as NADH to NAD+. NADH is also re-oxidized to NAD+ when we make ATP from that fuel that we ate. This is required for all of our muscles to work, and for ideas to be transmitted along our nerves, and for us to hear.”

In a nutshell, we can’t function without it.

All the good food you’re eating won’t do a thing for you if your cells can’t extract energy from it. NAD+ picks up electrons, becomes NADH, and drops them off as part of the cycle that turns your food into energy that you use to move and think. On a microscopic level, your mitochondria, the battery packs of your cells, use that energy to do the things they need to do to stay alive and to repair themselves when there’s damage or stress.^[1]

On the flipside, when scientists created conditions in the lab that inhibited NAD+, cells died because they couldn’t make energy.^[2]

NAD+ also makes sure proteins are properly folded into the form they need to have to do their jobs.^[3] For example, if the insulin receptor protein is the wrong shape, your cells don’t get the signal to accept the delivery of fuel that’s coming from your bloodstream.

Benefits of NAD+

Supports healthy aging

Proteins that regulate biological pathways called sirtuin protect your cells from age-related decline.^[4] Your cells use NAD+ to make sirtuin proteins work. Sirtuins play a crucial role in maintaining the length of telomeres, DNA strand end caps that keep our chromosomes from unraveling.^[5] Scientists have linked long telomeres with longevity.

In a Bulletproof Radio podcast episode (iTunes), UCSF professor and co-author of New York Times bestseller “The Telomere Effect” Dr. Elissa Epel, PhD, explains, “When we measure telomeres in midlife, they’re a pretty reliable predictor of who gets disease early and, in some studies, who dies early. So, they do matter when we’re older.”

Because you want long telomeres and the longevity that goes along with them, you need plenty of NAD+ to keep them working efficiently.

Thing is, your NAD+ levels drop as you get older.^[6] One reason is that there’s a compound called CD-38 that destroys NAD+, which is a good thing in the right amounts. It keeps your NAD+ from getting too high and messing up your sleep-wake and hunger cycles. Rodent studies showed that with age came an increase in CD-38, which destroyed more and more NAD+.^[7] Eventually, the balance tips and you have too much CD-38, and not enough NAD+.

Makes cells resistant to stress and protects the brain

There’s plenty of research that shows that NAD+ protects cells from stress. When researchers measured NAD+ levels, they were able to predict cell survival when stressed.^[8] Sirtuins specifically protect against oxidative stress, and NAD+ helps sirtuins work properly.^[9]

In one study, researchers stressed rat brain cells by depriving them of oxygen, then they added NAD+ right to the cell culture. They found that cells treated with NAD+ were more resistant to stress and fewer cells died than in the cultures that did not get the extra shot of NAD+.^[10] Translation: healthy levels of NAD+ may help you stay strong and resilient, especially in the face of stress.

Glutamate, a chemical that brain cells use to talk to other cells, causes neurons to get excited, which releases free radicals and stresses them. Being in ketosis increases the NAD+ to NADH ratio, which protects brain cells from damaging free radicals.^[11]

Helps DNA repair

NAD+ is involved in the repair of DNA that has been damaged from normal day-to-day exposures and processes. It brings a negative charge to places where DNA is damaged, which facilitates repair.^[12] This process snaps up the NAD+ supply, which takes time and nutrients to restore.^[13] Studies show that replenishing NAD+ increases lifespan in animal models because it makes DNA repair more efficient.^[14]

Helps you sleep and eat at the right time

Scientists have identified the role of NAD+ in sleep cycles and hunger patterns. Circadian rhythm, your sleep-wake cycle, that depends largely on light and dark, determines when you feel awake, when you feel tired, when you feel hungry — in general terms, it determines the flow of your day.

A healthy circadian rhythm, sirtuins and NAD+ are all interconnected. Sirtuins depend on NAD+ to work properly. Circadian rhythm determines when NAD+ is available. If either sirtuins or NAD+ get disrupted, your circadian rhythm goes haywire. Researchers demonstrated this by disrupting the circadian rhythm in mice by suppressing a specific sirtuin, which depends on NAD+ to do its thing.^[15]

It goes the other way, too. When mice had too much NAD+, their activity and rest patterns went wonky due to a disruption in circadian rhythm.^[16]

Circadian rhythm also regulates the release of hunger hormones. in another rodent study, NAD+ showed an influence in regulating appetite,^[17] and, by extension, even body weight.

NAD+ supplements and how to increase NAD+ levels

You don’t have to put up with the problems that come with NAD+ drops from aging. Here are some ways to boost your levels naturally.

• Take NAD+ supplements: It comes in capsules and is easy to find.
• Follow a high-fat, low-carb keto diet: Being in ketosis, the state where your body uses fat instead of glucose for energy, increases the NAD+ to NADH ratio. You want higher NAD+, because it protects cells from oxidative stress — an imbalance between free radicals and antioxidants in your body that contributes to aging.^[18]
• Practice intermittent fasting: Restricting your eating increases NAD+ levels.^[19] Though calorie-restriction diets and periods of fasting will do it, those aren’t sustainable for the long term. Intermittent fasting is, if you do it right.
• Take oxaloacetate: A higher ratio of NAD+ to NADH helps you make more energy and makes your cells work better. Oxaloacetate activates the longevity pathway in a similar way that calorie restriction does. In roundworm studies, oxaloacetate converted to malate, which raised the NAD+ to NADH ratio.^[20] This makes more NAD+ available for your cells to use. Try KetoPrime, a highly bioavailable form of oxaloacetate.

Though the human race will never stop looking, there’s no one fountain of youth pill. NAD+ can give you an edge in the anti-aging game, but if you don’t have the diet and lifestyle basics down, it will only take you so far. The best way to slow down aging is to do something to better yourself, physically and mentally, every single day.