Nicotinamide Adenine Dinucleotide · NADH · NAD
The master coenzyme of cellular energy — levels drop 50% by age 50.
FDA
Approved
WADA
Not Listed
HALF-LIFE
~2.5 hours oral; longer via IV
ROUTE
Oral / IV infusion
SCHEDULE
Daily (oral) or monthly (IV)
In Plain English
The master coenzyme of cellular energy — levels drop 50% by age 50.
Status & Legality
What do these mean?NAD+ restoration
Mitochondrial energy
DNA repair
Sirtuin activation
NAD+ is a coenzyme central to over 500 enzymatic reactions — energy metabolism, DNA repair, circadian regulation, and sirtuin activation. Intracellular levels decline 40–60% between ages 20 and 60. Direct oral NAD+ has limited bioavailability; precursors NMN and NR are more efficiently converted. IV infusion bypasses gut absorption for rapid repletion and is increasingly used in longevity clinics.
Flushing at high IV doses
Nausea at very high oral doses
Mild headache initially
Generally well tolerated at standard doses
Buying direct NAD+ supplements expecting high oral bioavailability — gut absorption of direct NAD+ is poor; NMN and NR precursors convert far more efficiently
Not pairing with a sirtuin activator (resveratrol, pterostilbene) — elevated NAD+ substrate is underutilized without sirtuin activation
IV infusions without medical oversight — rapid infusions cause flushing and nausea; must be diluted and administered slowly over 60+ minutes
Resveratrol and pterostilbene — synergistic sirtuin activation; resveratrol requires NAD+ as substrate to function
PARP inhibitors (cancer medications) — PARP enzymes consume NAD+; combination may compete for NAD+ substrate
Metformin — affects mitochondrial complex I, which is NAD-dependent; combined use requires monitoring
Direct NAD+ supplements have poor oral bioavailability — you're largely wasting money taking them as capsules. Use NMN or NR precursors instead. IV NAD+ infusions at longevity clinics deliver faster results but at significant cost. Regardless of the route, always pair with resveratrol or pterostilbene — NAD+ raises the fuel but sirtuins need to be activated to use it.
RESVERATROL
The sirtuin activator from red wine — synergizes with NAD+ for longevity signaling.
EPITHALON
Telomere extension peptide — the longevity compound.
COQ10
Essential for ATP production — depleted by statins, age, and high training loads.
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Stats
Sources & Studies
Chini EN. et al., Nat Rev Mol Cell Biol, 2021