NAD+ Explained: Precursors, Supplements, IV Therapy and What Actually Works
How NAD boosters and infusions really affect your cellular metabolism – and what remains purely theoretical
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Summary
The episode at a glance
This summary was generated automatically by AI from the episode transcript and translated into English. It may contain errors or omissions and does not replace medical advice.
In this episode, Mario and Max explain the importance of NAD+ (nicotinamide adenine dinucleotide) for the human body, particularly for energy metabolism and DNA repair. They discuss why NAD+ levels decline with age, the roles of factors such as exercise, chronic inflammation, and lifestyle, and assess various methods for increasing levels—from diet and exercise to supplements such as NR and NMN and controversial NAD+ infusions.
Key Takeaways
- 01NAD+ is a crucial molecule (coenzyme) for energy metabolism in the mitochondria and for the function of DNA repair enzymes (sirtuins and PARPs).
- 02NAD+ levels decline substantially with age, more so in men than in women. Exercise can help keep levels high for longer.
- 03Chronic inflammation (inflammaging) and increased demand for DNA repair are major reasons for the age-related decline in NAD+ levels.
- 04Various precursors can be used to increase NAD+ levels. Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are more effective than vitamin B3 (niacin).
- 05There is very little scientific evidence supporting the effectiveness of NAD+ infusions for increasing intracellular NAD+ levels over the long term, and their effectiveness is questionable, particularly compared with taking precursors orally.
- 06Measuring your NAD+ levels, for example through dried blood spot tests, is recommended before supplementation to clarify your individual needs and check whether the measures are working.
- 07NADH is the reduced form of NAD+ and part of the same cycle, but taking NADH supplements does not increase NAD+ levels.
In detail
Mario and Max begin by explaining the difference between NAD+ and NADH. Both are forms of the same molecule and are constantly converted into one another during cellular energy metabolism through redox reactions. NAD+, however, is the limiting factor. NAD+ also serves as an important coenzyme for sirtuins and PARPs, which are crucial for DNA repair and longevity. These functions specifically require NAD+, not NADH.
NAD+ levels decline significantly with age—in men, by about half between the ages of 20 and 40. The main reasons are reduced production by the body, increased consumption due to chronic inflammation (inflammaging, via the CD38 signaling pathway), and greater demand for DNA repair.
Regular exercise, especially endurance training, can help maintain NAD+ levels. Fasting, such as intermittent fasting, or a ketogenic diet can also raise levels in the short term. A consistent sleep-wake cycle is beneficial as well, since NAD+ follows a circadian rhythm.
Vitamin B3 (niacin, nicotinamide) is a precursor, but it raises levels only modestly. The more direct precursors nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are considerably more effective. While NR is approved as a dietary supplement in the EU, NMN is currently still classified as a chemical. NADH supplements do not increase NAD+ levels.
Mario and Max express skepticism about NAD+ infusions. The scientific evidence is very limited. Measurements show that oral supplements increase intracellular NAD+ levels more effectively and with longer-lasting results than infusions. Since NAD+ is a large molecule that cells cannot readily take up directly, the benefits of these expensive infusions are questionable.
Because individual needs vary considerably, the hosts recommend measuring your NAD+ levels before starting an intervention. This can be done through specialized laboratories or at-home dried blood spot tests. Testing can establish whether you have a deficiency and whether your chosen measures, such as supplementation, are actually working.
What you can actually do
- Measure your NAD+ levels before considering supplementation to determine your needs.
- If you have a deficiency or want to optimize your levels, consider taking NAD+ precursors such as NR or NMN.
- Exercise regularly, especially endurance exercise, to support your body's own NAD+ production.
- Maintain a healthy sleep-wake cycle, as this influences NAD+ levels.
- Consider the scientific evidence when choosing a method, and be skeptical of expensive infusions with limited supporting evidence compared with oral supplements.
Mentioned in this episode
- NAD+ (nicotinamide adenine dinucleotide)
- A key coenzyme in cellular metabolism, essential for energy production and DNA repair.
- NR (nicotinamide riboside)
- An effective NAD+ precursor approved as a dietary supplement in the EU.
- NMN (nicotinamide mononucleotide)
- Another well-known and effective NAD+ precursor, which is legally classified as a chemical rather than a dietary supplement in the EU.
- Sirtuins & PARPs
- Families of enzymes involved in DNA repair that require NAD+ as 'fuel'.
- CD38
- An enzyme whose activity increases during inflammation and that is a major consumer of NAD+ in the body.
- Pellagra
- A classic vitamin B3 deficiency disease that is essentially a severe form of NAD+ deficiency.
What this episode is about
What does NAD+ really do? We compare NAD+ and NADH, oral precursors and IV infusions, testing, sex differences and lifestyle strategies that may influence cellular NAD levels.