Is NAD the longevity molecule or just a fad?

NAD (nicotinamide adenine dinucleotide) is a key molecule found in every cell in the body. It helps produce energy, is involved in DNA repair , and regulates important cellular processes such as cell-to-cell communication and calcium balance. It also activates proteins called sirtuins, which are linked to healthy aging .

With age, NAD levels naturally decline, which has been linked to mitochondrial dysfunction, metabolic decline, neurodegeneration, and chronic inflammation.

What does the evidence say ?

Preclinical studies in animal models have shown promising benefits of increased NAD : improved cognitive function, increased insulin sensitivity, increased resistance to oxidative stress, and a potential cardioprotective effect. For example, Mills et al. (2016) demonstrated that administration of NMN to aged mice improved energy metabolism and insulin sensitivity.

In humans, studies are still limited and mostly preliminary. A clinical trial published in Nature Communications (Martens et al., 2018) showed that NR supplementation for six weeks in older adults was safe and increased blood NAD levels, although no clinically significant changes were observed in that short period.

Can NAD be stimulated through nutrition?

Yes. Endogenous NAD synthesis can be enhanced with a proper diet. Foods rich in niacin (vitamin B3), such as chicken, tuna, liver, avocado, and whole grains, provide natural precursors. Additionally, practices such as regular exercise and intermittent fasting have been shown to promote NAD biosynthesis by activating the NAMPT enzyme.

Currently, NAD itself is not approved as a direct supplement by the FDA or the EMA. Its precursors, NR and NMN, are marketed as dietary supplements , which implies less regulation. Intravenous administration of NAD is not supported by official clinical guidelines, and its use is considered experimental.

There are also no standardized clinical tests for measuring intracellular NAD levels in the office setting. It can be assessed indirectly with mass spectrometry in research settings, but it is not available for outpatient practice.

NAD does not accumulate. It has a short half-life and is rapidly utilized in metabolic processes. The amount infused intravenously is not maintained for long, and its cellular uptake is limited. Its sustained clinical effects have not been demonstrated. Therefore, some functional centers recommend repetitive protocols, although without robust support.

The evidence does not support the widespread use of NAD supplements or intravenous therapies as an anti-aging intervention. Their use should be reserved for specific clinical settings, under professional supervision, and with clear understanding of their experimental nature.

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