Table of ContentsView AllTable of ContentsWhat Is NAD+?NAD+ vs. NADHFoods With NAD+UsesDosageFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is NAD+?
NAD+ vs. NADH
Foods With NAD+
Uses
Dosage
Frequently Asked Questions
Oxidized nicotinamide adenine dinucleotide(NAD+) is crucial to over 500 enzyme reactions in your body. NAD+ can be derived from tryptophan.
Levels of NAD+ are reduced withagingand conditions like the following:
This article covers the latest evidence for using NAD+ supplements and some safety concerns to be aware of if you decide to use them.
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NAD+ is a coenzyme that is important for many pathways in the body, including the following:
It also helps maintain metabolism andcircadian rhythm(the 24-hour internal clock regulating sleep cycles).
Significantly, signaling proteins calledsirtuinsrequire NAD+ to regulate age-related changes and extend life span.
Is NAD+ the Same as NADH?
Nicotinamide adenine dinucleotide, or NAD, can come in two forms, as follows:
NADH is different from NAD+.
Do Foods Contain NAD+?
Severalprecursors(a substance that can form other substances) can increase NAD+ levels in the body. You can get these precursors through supplements or foods. Precursors that increase NAD+ levels include the following:
Good food sources of tryptophan and niacin include the following:
You can also find some niacin in the following vegetarian foods:
Because levels of NAD+ decrease with aging, it’s theorized that supplements that boost NAD+ could slow the effects of aging and extend life span.
NAD+ and its precursors have been studied in preclinical trials (using cells in test tubes or animal models) for the following conditions:
Results seen in animal or lab studies may or may not be replicated in humans. NAD+ is not currently recommended for any of these conditions.
NAD, NMN, and NR have been studied in human clinical trials for the following conditions:
Many of these trials were very small and included 30 or fewer people. Large-scale studies are needed before these supplements can be recommended.
Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.
There aren’t many studies on the effects of NAD+ supplements in humans. So, it is unknown how to dose these supplements. Dosage will depend on your product and what you use it for.
Tryptophan, NMN, NR, and niacin or niacinamide food sources or supplements can increase NAD+.
And keep in mind that optimal dosing or duration of NAD+ supplements have not been established yet.
Clinical trials have used the following doses:
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
Side Effects
Your provider may recommend you take an NAD+ supplement to slow the effects of aging or for another reason. However, consuming one of these supplements may have potential side effects that may be common or severe.
Some side effects associated with NAD+ supplements include the following:
These side effects may vary depending on which NAD+ supplement you choose. NMN and NR might be better tolerated than other NADs, although fewer studies about their effects exist.
While not much is known about the severe side effects of these supplements, some animal studies have shown that NR, in particular, may cause tumors.However, whether this effect is the same in humans is unclear since results in animal studies don’t always translate to those in humans.
Precautions
Since most of the evidence for NAD+ supplements comes from animal studies, not a lot is known about the effects of these supplements in humans.
Do keep the following precautions in mind when using NAD:
Interactions
NAD supplements may interact with the following medications:
It is essential to carefully read a supplement’s ingredients list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.
Summary
NAD+ is essential for regulating metabolism and circadian rhythm. As we age, levels of NAD+ decline. Reduced levels of NAD+ are associated with conditions like mental decline, diabetes, and heart disease.
Niacin, niacinamide, NMN, and NR can all boost levels of NAD+ in the body. In theory, these supplements could slow the effects of aging and combat diseases, but more research is needed.
Without strong clinical trials in humans, informed decisions cannot be made about the risks versus benefits of various NAD+ supplements.
Frequently Asked QuestionsNAD+ supplements are popular remedies promoted as “antiaging” supplements. Some people take them for conditions like dementia and diabetes.Keep in mind, though, that there’s very little evidence that these supplements are effective in humans.It is not known. Despite some effectiveness in animal models, strong clinical trials are needed before NAD+ supplements can be recommended.There are risks associated with the use of any supplement.Side effects of NAD+ supplements can include flushing, headache, and liver toxicity.Animal studies suggest that NAD precursor NR may also cause tumors, although effects in animals don’t always translate to humans.NAD+ precursors like NMN and NR are found in foods like meat, dairy products, broccoli, cabbage, and avocado.Various NAD+ supplements may have slightly different advantages and disadvantages.For instance, nicotinic acid may lower lipid levels, while NR has been shown to increase lifespan and metabolic stress in animals.Always discuss supplement use with a healthcare provider, pharmacist, or RD to ensure you optimize therapy.
NAD+ supplements are popular remedies promoted as “antiaging” supplements. Some people take them for conditions like dementia and diabetes.Keep in mind, though, that there’s very little evidence that these supplements are effective in humans.
NAD+ supplements are popular remedies promoted as “antiaging” supplements. Some people take them for conditions like dementia and diabetes.
Keep in mind, though, that there’s very little evidence that these supplements are effective in humans.
It is not known. Despite some effectiveness in animal models, strong clinical trials are needed before NAD+ supplements can be recommended.
There are risks associated with the use of any supplement.Side effects of NAD+ supplements can include flushing, headache, and liver toxicity.Animal studies suggest that NAD precursor NR may also cause tumors, although effects in animals don’t always translate to humans.
There are risks associated with the use of any supplement.
Side effects of NAD+ supplements can include flushing, headache, and liver toxicity.
Animal studies suggest that NAD precursor NR may also cause tumors, although effects in animals don’t always translate to humans.
NAD+ precursors like NMN and NR are found in foods like meat, dairy products, broccoli, cabbage, and avocado.
Various NAD+ supplements may have slightly different advantages and disadvantages.For instance, nicotinic acid may lower lipid levels, while NR has been shown to increase lifespan and metabolic stress in animals.Always discuss supplement use with a healthcare provider, pharmacist, or RD to ensure you optimize therapy.
Various NAD+ supplements may have slightly different advantages and disadvantages.
For instance, nicotinic acid may lower lipid levels, while NR has been shown to increase lifespan and metabolic stress in animals.
Always discuss supplement use with a healthcare provider, pharmacist, or RD to ensure you optimize therapy.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Poljšak B, Kovač V, Milisav I.Current uncertainties and future challenges regarding NAD+ boosting strategies.Antioxidants (Basel). 2022;11(9):1637. doi:10.3390/antiox11091637Imai S, Guarente L.NAD+ and sirtuins in aging and disease.Trends Cell Biol. 2014;24(8):464-471. doi:10.1016/j.tcb.2014.04.002Mehmel M, Jovanović N, Spitz U.Nicotinamide riboside-The current state of research and therapeutic uses.Nutrients. 2020;12(6):1616. doi:10.3390/nu12061616Makarov MV, Trammell SAJ, Migaud ME.The chemistry of the vitamin B3 metabolome.Biochem Soc Trans. 2019;47(1):131-147. doi:10.1042/BST20180420Food and Drug Administration.Letter from FDA CFSAN to Inner Mongolia Kingdomway Pharmaceutical Limited regarding NDI 1259 - B-nicotinamide mononucleotide (NMN).MedlinePlus.Tryptophan.National Institute of Health Office of Dietary Supplements.Niacin.Campbell JM.Supplementation with NAD+ and its precursors to prevent cognitive decline across disease contexts.Nutrients. 2022;14(15):3231. doi:10.3390/nu14153231Xie N, Zhang L, Gao W, et al.NAD+ metabolism: Pathophysiologic mechanisms and therapeutic potential.Signal Transduct Target Ther. 2020;5(1):227. doi:10.1038/s41392-020-00311-7Wei Z, Chai H, Chen Y, et al.Nicotinamide mononucleotide: An emerging nutraceutical against cardiac aging?.Curr Opin Pharmacol. 2021;60:291-297. doi:10.1016/j.coph.2021.08.006Nadeeshani H, Li J, Ying T, et al.Nicotinamide mononucleotide (NMN) as an anti-aging health product - Promises and safety concerns.J Adv Res. 2021;37:267-278. doi:10.1016/j.jare.2021.08.003Brakedal B, Dölle C, Riemer F, et al.The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson’s disease.Cell Metab. 2022;34(3):396-407.e6. doi:10.1016/j.cmet.2022.02.001Yoshino M, Yoshino J, Kayser BD, et al.Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women.Science. 2021;372(6547):1224-1229. doi:10.1126/science.abe9985Braidy N, Villalva MD, van Eeden S.Sobriety and satiety: Is NAD+ the answer?.Antioxidants (Basel). 2020;9(5):425. doi:10.3390/antiox9050425Elhassan YS, Kluckova K, Fletcher RS, et al.Nicotinamide riboside augments the aged human skeletal muscle nad+ metabolome and induces transcriptomic and anti-inflammatory signatures.Cell Rep. 2019;28(7):1717-1728.e6. doi:10.1016/j.celrep.2019.07.043Dall M, Hassing AS, Treebak JT.NAD+ and NAFLD - caution, causality and careful optimism.J Physiol. 2022;600(5):1135-1154. doi:10.1113/JP280908Hwang ES, Song SB.Possible adverse effects of high-dose nicotinamide: Mechanisms and safety assessment.Biomolecules. 2020;10(5):687. doi:10.3390/biom10050687Poljsak B, Kovač V, Milisav I.Healthy lifestyle recommendations: Do the beneficial effects originate from NAD+ amount at the cellular level?.Oxid Med Cell Longev. 2020;2020:8819627. doi:10.1155/2020/8819627Sharma A, Chabloz S, Lapides RA, et al.Potential synergistic supplementation of NAD+ promoting compounds as a strategy for increasing healthspan.Nutrients. 2023;15(2):445. doi:10.3390/nu15020445Viljoen M, Swanepoel A, Bipath P.Antidepressants may lead to a decrease in niacin and NAD in patients with poor dietary intake.Med Hypotheses. 2015;84(3):178-182. doi:10.1016/j.mehy.2014.12.017Conze D, Brenner C, Kruger CL.Safety and metabolism of long-term administration of NIAGEN (Nicotinamide Riboside Chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults.Sci Rep. 2019;9(1):9772. doi:10.1038/s41598-019-46120-z
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Poljšak B, Kovač V, Milisav I.Current uncertainties and future challenges regarding NAD+ boosting strategies.Antioxidants (Basel). 2022;11(9):1637. doi:10.3390/antiox11091637Imai S, Guarente L.NAD+ and sirtuins in aging and disease.Trends Cell Biol. 2014;24(8):464-471. doi:10.1016/j.tcb.2014.04.002Mehmel M, Jovanović N, Spitz U.Nicotinamide riboside-The current state of research and therapeutic uses.Nutrients. 2020;12(6):1616. doi:10.3390/nu12061616Makarov MV, Trammell SAJ, Migaud ME.The chemistry of the vitamin B3 metabolome.Biochem Soc Trans. 2019;47(1):131-147. doi:10.1042/BST20180420Food and Drug Administration.Letter from FDA CFSAN to Inner Mongolia Kingdomway Pharmaceutical Limited regarding NDI 1259 - B-nicotinamide mononucleotide (NMN).MedlinePlus.Tryptophan.National Institute of Health Office of Dietary Supplements.Niacin.Campbell JM.Supplementation with NAD+ and its precursors to prevent cognitive decline across disease contexts.Nutrients. 2022;14(15):3231. doi:10.3390/nu14153231Xie N, Zhang L, Gao W, et al.NAD+ metabolism: Pathophysiologic mechanisms and therapeutic potential.Signal Transduct Target Ther. 2020;5(1):227. doi:10.1038/s41392-020-00311-7Wei Z, Chai H, Chen Y, et al.Nicotinamide mononucleotide: An emerging nutraceutical against cardiac aging?.Curr Opin Pharmacol. 2021;60:291-297. doi:10.1016/j.coph.2021.08.006Nadeeshani H, Li J, Ying T, et al.Nicotinamide mononucleotide (NMN) as an anti-aging health product - Promises and safety concerns.J Adv Res. 2021;37:267-278. doi:10.1016/j.jare.2021.08.003Brakedal B, Dölle C, Riemer F, et al.The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson’s disease.Cell Metab. 2022;34(3):396-407.e6. doi:10.1016/j.cmet.2022.02.001Yoshino M, Yoshino J, Kayser BD, et al.Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women.Science. 2021;372(6547):1224-1229. doi:10.1126/science.abe9985Braidy N, Villalva MD, van Eeden S.Sobriety and satiety: Is NAD+ the answer?.Antioxidants (Basel). 2020;9(5):425. doi:10.3390/antiox9050425Elhassan YS, Kluckova K, Fletcher RS, et al.Nicotinamide riboside augments the aged human skeletal muscle nad+ metabolome and induces transcriptomic and anti-inflammatory signatures.Cell Rep. 2019;28(7):1717-1728.e6. doi:10.1016/j.celrep.2019.07.043Dall M, Hassing AS, Treebak JT.NAD+ and NAFLD - caution, causality and careful optimism.J Physiol. 2022;600(5):1135-1154. doi:10.1113/JP280908Hwang ES, Song SB.Possible adverse effects of high-dose nicotinamide: Mechanisms and safety assessment.Biomolecules. 2020;10(5):687. doi:10.3390/biom10050687Poljsak B, Kovač V, Milisav I.Healthy lifestyle recommendations: Do the beneficial effects originate from NAD+ amount at the cellular level?.Oxid Med Cell Longev. 2020;2020:8819627. doi:10.1155/2020/8819627Sharma A, Chabloz S, Lapides RA, et al.Potential synergistic supplementation of NAD+ promoting compounds as a strategy for increasing healthspan.Nutrients. 2023;15(2):445. doi:10.3390/nu15020445Viljoen M, Swanepoel A, Bipath P.Antidepressants may lead to a decrease in niacin and NAD in patients with poor dietary intake.Med Hypotheses. 2015;84(3):178-182. doi:10.1016/j.mehy.2014.12.017Conze D, Brenner C, Kruger CL.Safety and metabolism of long-term administration of NIAGEN (Nicotinamide Riboside Chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults.Sci Rep. 2019;9(1):9772. doi:10.1038/s41598-019-46120-z
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Poljšak B, Kovač V, Milisav I.Current uncertainties and future challenges regarding NAD+ boosting strategies.Antioxidants (Basel). 2022;11(9):1637. doi:10.3390/antiox11091637Imai S, Guarente L.NAD+ and sirtuins in aging and disease.Trends Cell Biol. 2014;24(8):464-471. doi:10.1016/j.tcb.2014.04.002Mehmel M, Jovanović N, Spitz U.Nicotinamide riboside-The current state of research and therapeutic uses.Nutrients. 2020;12(6):1616. doi:10.3390/nu12061616Makarov MV, Trammell SAJ, Migaud ME.The chemistry of the vitamin B3 metabolome.Biochem Soc Trans. 2019;47(1):131-147. doi:10.1042/BST20180420Food and Drug Administration.Letter from FDA CFSAN to Inner Mongolia Kingdomway Pharmaceutical Limited regarding NDI 1259 - B-nicotinamide mononucleotide (NMN).MedlinePlus.Tryptophan.National Institute of Health Office of Dietary Supplements.Niacin.Campbell JM.Supplementation with NAD+ and its precursors to prevent cognitive decline across disease contexts.Nutrients. 2022;14(15):3231. doi:10.3390/nu14153231Xie N, Zhang L, Gao W, et al.NAD+ metabolism: Pathophysiologic mechanisms and therapeutic potential.Signal Transduct Target Ther. 2020;5(1):227. doi:10.1038/s41392-020-00311-7Wei Z, Chai H, Chen Y, et al.Nicotinamide mononucleotide: An emerging nutraceutical against cardiac aging?.Curr Opin Pharmacol. 2021;60:291-297. doi:10.1016/j.coph.2021.08.006Nadeeshani H, Li J, Ying T, et al.Nicotinamide mononucleotide (NMN) as an anti-aging health product - Promises and safety concerns.J Adv Res. 2021;37:267-278. doi:10.1016/j.jare.2021.08.003Brakedal B, Dölle C, Riemer F, et al.The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson’s disease.Cell Metab. 2022;34(3):396-407.e6. doi:10.1016/j.cmet.2022.02.001Yoshino M, Yoshino J, Kayser BD, et al.Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women.Science. 2021;372(6547):1224-1229. doi:10.1126/science.abe9985Braidy N, Villalva MD, van Eeden S.Sobriety and satiety: Is NAD+ the answer?.Antioxidants (Basel). 2020;9(5):425. doi:10.3390/antiox9050425Elhassan YS, Kluckova K, Fletcher RS, et al.Nicotinamide riboside augments the aged human skeletal muscle nad+ metabolome and induces transcriptomic and anti-inflammatory signatures.Cell Rep. 2019;28(7):1717-1728.e6. doi:10.1016/j.celrep.2019.07.043Dall M, Hassing AS, Treebak JT.NAD+ and NAFLD - caution, causality and careful optimism.J Physiol. 2022;600(5):1135-1154. doi:10.1113/JP280908Hwang ES, Song SB.Possible adverse effects of high-dose nicotinamide: Mechanisms and safety assessment.Biomolecules. 2020;10(5):687. doi:10.3390/biom10050687Poljsak B, Kovač V, Milisav I.Healthy lifestyle recommendations: Do the beneficial effects originate from NAD+ amount at the cellular level?.Oxid Med Cell Longev. 2020;2020:8819627. doi:10.1155/2020/8819627Sharma A, Chabloz S, Lapides RA, et al.Potential synergistic supplementation of NAD+ promoting compounds as a strategy for increasing healthspan.Nutrients. 2023;15(2):445. doi:10.3390/nu15020445Viljoen M, Swanepoel A, Bipath P.Antidepressants may lead to a decrease in niacin and NAD in patients with poor dietary intake.Med Hypotheses. 2015;84(3):178-182. doi:10.1016/j.mehy.2014.12.017Conze D, Brenner C, Kruger CL.Safety and metabolism of long-term administration of NIAGEN (Nicotinamide Riboside Chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults.Sci Rep. 2019;9(1):9772. doi:10.1038/s41598-019-46120-z
Poljšak B, Kovač V, Milisav I.Current uncertainties and future challenges regarding NAD+ boosting strategies.Antioxidants (Basel). 2022;11(9):1637. doi:10.3390/antiox11091637
Imai S, Guarente L.NAD+ and sirtuins in aging and disease.Trends Cell Biol. 2014;24(8):464-471. doi:10.1016/j.tcb.2014.04.002
Mehmel M, Jovanović N, Spitz U.Nicotinamide riboside-The current state of research and therapeutic uses.Nutrients. 2020;12(6):1616. doi:10.3390/nu12061616
Makarov MV, Trammell SAJ, Migaud ME.The chemistry of the vitamin B3 metabolome.Biochem Soc Trans. 2019;47(1):131-147. doi:10.1042/BST20180420
Food and Drug Administration.Letter from FDA CFSAN to Inner Mongolia Kingdomway Pharmaceutical Limited regarding NDI 1259 - B-nicotinamide mononucleotide (NMN).
MedlinePlus.Tryptophan.
National Institute of Health Office of Dietary Supplements.Niacin.
Campbell JM.Supplementation with NAD+ and its precursors to prevent cognitive decline across disease contexts.Nutrients. 2022;14(15):3231. doi:10.3390/nu14153231
Xie N, Zhang L, Gao W, et al.NAD+ metabolism: Pathophysiologic mechanisms and therapeutic potential.Signal Transduct Target Ther. 2020;5(1):227. doi:10.1038/s41392-020-00311-7
Wei Z, Chai H, Chen Y, et al.Nicotinamide mononucleotide: An emerging nutraceutical against cardiac aging?.Curr Opin Pharmacol. 2021;60:291-297. doi:10.1016/j.coph.2021.08.006
Nadeeshani H, Li J, Ying T, et al.Nicotinamide mononucleotide (NMN) as an anti-aging health product - Promises and safety concerns.J Adv Res. 2021;37:267-278. doi:10.1016/j.jare.2021.08.003
Brakedal B, Dölle C, Riemer F, et al.The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson’s disease.Cell Metab. 2022;34(3):396-407.e6. doi:10.1016/j.cmet.2022.02.001
Yoshino M, Yoshino J, Kayser BD, et al.Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women.Science. 2021;372(6547):1224-1229. doi:10.1126/science.abe9985
Braidy N, Villalva MD, van Eeden S.Sobriety and satiety: Is NAD+ the answer?.Antioxidants (Basel). 2020;9(5):425. doi:10.3390/antiox9050425
Elhassan YS, Kluckova K, Fletcher RS, et al.Nicotinamide riboside augments the aged human skeletal muscle nad+ metabolome and induces transcriptomic and anti-inflammatory signatures.Cell Rep. 2019;28(7):1717-1728.e6. doi:10.1016/j.celrep.2019.07.043
Dall M, Hassing AS, Treebak JT.NAD+ and NAFLD - caution, causality and careful optimism.J Physiol. 2022;600(5):1135-1154. doi:10.1113/JP280908
Hwang ES, Song SB.Possible adverse effects of high-dose nicotinamide: Mechanisms and safety assessment.Biomolecules. 2020;10(5):687. doi:10.3390/biom10050687
Poljsak B, Kovač V, Milisav I.Healthy lifestyle recommendations: Do the beneficial effects originate from NAD+ amount at the cellular level?.Oxid Med Cell Longev. 2020;2020:8819627. doi:10.1155/2020/8819627
Sharma A, Chabloz S, Lapides RA, et al.Potential synergistic supplementation of NAD+ promoting compounds as a strategy for increasing healthspan.Nutrients. 2023;15(2):445. doi:10.3390/nu15020445
Viljoen M, Swanepoel A, Bipath P.Antidepressants may lead to a decrease in niacin and NAD in patients with poor dietary intake.Med Hypotheses. 2015;84(3):178-182. doi:10.1016/j.mehy.2014.12.017
Conze D, Brenner C, Kruger CL.Safety and metabolism of long-term administration of NIAGEN (Nicotinamide Riboside Chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults.Sci Rep. 2019;9(1):9772. doi:10.1038/s41598-019-46120-z
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