If you keep up with the latest health trends, chances are you’ve heard of NAD. Beyond being a wellness buzzword that’s currently holding the spotlight, NAD (which stands for nicotinamide adenine dinucleotide) is an energy-generating co-enzyme that’s found in every cell in the body. And while the body produces it naturally, levels of NAD decline as we age – which is where supplementation comes into play.
Rewind to episode five of Keeping Up With The Kardashians and you may recall the moment when best friends Kendall Jenner and Hailey Bieber meet up to undergo NAD+ intravenous (IV) therapy. “I’m going to do NAD for the rest of my life, and I’m never going to age,” Bieber told the cameras. Hot in the US, the NAD market was valued at $535.53 million in 2022, and is growing fast.
Now making waves in the UK, NAD+ (the ‘raw’ form of NAD and the most widely used term when referring to it) is taking over the self-care sphere. “Since the pandemic, UK consumers have learned the value of investing in preventative health strategies and there has been a huge increase in people actively seeking out evidence-based solutions like NAD+,” notes Dr Nichola Conlon, molecular biologist and expert in healthy ageing.
With several reported health benefits (from boosting energy to promoting healthy skin), it’s easy to see why supplementing NAD+ sounds appealing. But can it really turn back the clock? Ahead, experts answer the key questions around NAD+ and whether you’d benefit from adding NAD+ supplements (taken orally or via IV) into your wellness regime.
What is NAD+?
NAD+ is a crucial coenzyme found in our cells. It plays a major role in regulating cellular functions, neuroprotection, DNA repair and anti-ageing. “If you have high levels of NAD+, it means you will have lots of cellular energy, your cells will function optimally, and you will feel more energetic and alert,” says Conlon. It also means your body can repair itself quicker, which helps keep your organs, including your skin, in good health.
Do we need to supplement our NAD+ levels?
As we age, our NAD+ levels decline – halving every 20 years from birth. And as they do so energy production and cellular repair decrease, “leading to many of the common complaints associated with ageing such as wrinkles, loss of energy and brain fog,” says Conlon.
“Scientists have demonstrated that boosting NAD+ back to youthful levels can rejuvenate old cells back to a state of youth, leading to multiple beneficial effects against ageing and age-related disease,” she continues. Supplements, including IV therapy, can boost NAD+ levels, and certain lifestyle changes may help slow down the decline of NAD+.
How can we increase our levels of NAD+?
While we can’t stop the natural decline of NAD+, we can help slow down the rate at which our bodies use up important NAD+ stores. “Avoid things that are known to deplete NAD+ such as a poor diet, excess alcohol, smoking and sunburn,” advises Conlon. Seek out foods that are made up of amino acids that are also precursors to NAD+, “such as broccoli and cabbage as well as some fruits,” adds Dr Melanie Angelova, medical practitioner at Optimise Health.
In addition, exercise – especially resistance training and HIIT – has been found to ignite the body’s NAD+ production pathway. “A recent study examined metabolites in the muscle tissue from younger and older adults, finding that adults who exercised rigorously had NAD+ levels similar to those of young adults,” says Angelova.
Healthy habits aside, research suggests that supplementing NAD+ may successfully top up our levels. “NAD+ boosting in cells and animals has yielded some impressive results so now the focus has shifted to human clinical trials,” says Conlon, who adds that “notable results so far include improvements in cardiovascular function, reduced inflammation, improved cellular energy production, and reversal of biomarkers of ageing”.
Do NAD+ supplements actually work?
Although there are no large-scale clinical trials on humans yet, there is promising research that suggests NAD+ supplementation may have several health benefits. Below, we outline the key ones:
- Increased alertness and energy: “One of the most notable benefits of boosting NAD+ is an improvement in both physical and mental energy,” says Conlon. “Meaning increased endurance, better cognitive function and reduced brain fog.”
- Improved sleep: Sleep also improves as, according to Conlon, NAD+ can help regulate your circadian rhythm which ensures you get quality restorative sleep. One 2022 study found that after 12-weeks of supplementing NMN (one of the precursors of NAD), fatigue improved in older adults.
- Enhanced recovery: As well as improving physical energy, boosting NAD+ reserves has been found to aid muscle recovery after exercise. Which is why several athletes are reported to have regular NAD+ IV therapy.
- Hair and nail growth: Some supplement users have seen an improvement in the health of their hair and nails. “This is because when your cellular health improves, the body invests more resources into these less important areas of our biology,” explains Conlon.
- Collagen regeneration: If you want to boost skin health, then you need to improve your cellular health. “And this is exactly what NAD+ does,” says Conlon. “For example, collagen loss leads to wrinkles, so for years people have focused on ways to replace collagen with the best collagen supplements and creams. But we now know that the best way to increase collagen is to protect the health of our collagen producing cells (fibroblasts) – something which boosting NAD+ has been shown to do.”
But while the benefits appear manifold, what of any drawbacks?
So far, there are no reported adverse side effects of taking NAD+ supplements. But the safety of long-term use and high-dose supplementation is still under study. “NAD+ IV therapy is usually done very slowly to minimise a sensation of muscle cramping or nausea – that tends to pass in about 10 minutes,” says Angelova.
What’s the most effective way to supplement NAD+?
NAD+ supplementation comes in various forms – IV, injection, orally in pill or liquid form. The most popular options are NAD+ IV therapy and supplements containing NAD+ precursors. According to Angelova, “the safest way to increase NAD+ levels, as proven in clinical studies, is through intravenous (IV) administration directly with NAD+”.
Available at home via wellness providers Optimise Health, a single NAD+ IV infusion will set you back £490 and the drip will take approximately 90-minutes to infuse. At the NADclinic in London, an expert can advise you on the right IV infusion programme for you, whether it's a single IV (from £180), extended infusion programme or bespoke protocol – before safely taking you on your NAD+ treatment journey.
For a speedier solution that’s more affordable, Conlon recommends looking for a NAD+ boosting supplement that will help restore the body’s own natural NAD+ production pathways – like her very own supplement, Nuchido TIME+.
It's important to note that you cannot ingest ‘pure NAD+’, says Conlon. “NAD+ is an unstable molecule that is broken down in the digestive system before it can reach the bloodstream, let alone the cells where it's actually needed.” Hence why, most powders and pills contain its precursors, nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN). These precursors are converted into NAD+ inside the cells.
But since the beginning of this year, NMN can no longer be sold as a supplement in the US. This is because it is now under investigation as a potential new drug which will require extensive testing in humans. NMN supplements are, however, still available to shop here in the UK – though we'd recommend speaking to your doctor before adding them into your wellness regime.
Does NAD+-based skincare actually work?
Alongside the wellness boom in NAD+ supplementation comes a beauty boom in skincare containing it. "The rationale behind increasing available NAD+ levels in the skin make so much sense," dermatologist Dr Sam Bunting tells Bazaar, "NAD+ is an integral molecule driving everything from fixing damage in our DNA to repairing our skin barrier". But can it have these effects when applied topically? "Experts think NAD+ is able to penetrate when correctly formulated, but it is quickly converted into niacinamide," she explains – something which is already widely used in skincare.
With NAD+ in skincare, it's best to look outside the box, she feels. "The part that is critical to consider is the recycling of NAD+," she explains – "it gets less efficient as we age and becomes the rate limiting step to having enough NAD+ available for all the cell’s 'housework'". Think of it as the cell’s battery going flat, the expert offers.
Ergo, Dr Bunting formulated her new Flawless Moisturiser Intense with the innovatibe ingredient Sunflower Shoot Extract (SSE), which has the ability to boost NAD+ levels. "In our independent study, SSE outperformed niacinamide by acting very quickly (within just 24 hours) and resulting in 34 per cent less damage to the cell batteries when exposed to damaging UVA," she says. That’s not to say niacinamide doesn’t perform too; it just highlights a different way of working.
The other thing she notes as exciting about boosting NAD+ levels via skincare is how much better all your products with actives ingredients (such as retinoids and vitamin C) can perform when your skin cells are fully charged. "I firmly believe this is a new frontier in skin well-ageing," she concludes.