Longevity

    NAD+ Restoration

    Replenishment of NAD+ (nicotinamide adenine dinucleotide), a critical coenzyme that declines with age. NAD+ supports DNA repair, sirtuin activation, energy metabolism, and healthy aging processes.

    TL;DR

    NAD+ restoration means raising cellular levels of nicotinamide adenine dinucleotide, a coenzyme that falls with age and drives energy metabolism and DNA repair.

    Why It Matters

    NAD+ is the electron carrier at the centre of glycolysis, the citric acid cycle and oxidative phosphorylation, and the required substrate for sirtuins, PARPs and CD38. Tissue NAD+ declines measurably with age, partly because CD38 expression rises with inflammation and consumes it. Lower NAD+ is associated with reduced mitochondrial output, slower DNA repair and blunted stress responses. Precursor supplementation with nicotinamide riboside or nicotinamide mononucleotide reliably raises blood NAD+ in trials; whether that translates into functional benefit is the open question, with results so far strongest for muscle and metabolic markers and weakest for subjective vitality.

    How to Measure

    Whole-blood or PBMC NAD+ can be measured by LC-MS/MS through specialist laboratories. Methods differ enough between providers that results are not comparable across labs, so use the same provider and treat trends rather than absolute values as meaningful.

    Biomarkers

    Whole-blood NAD+
    NAD+/NADH ratio
    Nicotinamide and methylnicotinamide metabolites
    CD38 expression on immune cells

    Optimization Protocol

    Start with the drivers of NAD+ consumption before adding precursors: manage chronic inflammation, limit alcohol, and protect skin from UV, all of which drive PARP and CD38 activity. Regular aerobic and resistance exercise raises NAD+ biosynthesis through NAMPT. Where supplementation is used, nicotinamide riboside at 250-500 mg/day or nicotinamide mononucleotide at 250-500 mg/day both raise blood NAD+ within weeks. Apigenin and quercetin inhibit CD38 in preclinical models, a complementary but unproven approach in humans.

    Lifestyle Levers

    • •Regular aerobic exercise to upregulate NAMPT
    • •Resistance training to raise skeletal muscle NAD+
    • •Limiting alcohol, which consumes NAD+ during metabolism
    • •Sun protection to reduce PARP-driven NAD+ use
    • •Adequate dietary niacin and tryptophan

    Supporting Supplements

    NMN

    Compound
    Likely effective
    Moderate Evidence

    Raising NAD is the one thing NMN has clearly been shown to do in humans.

    Apigenin

    Compound
    Insufficient evidence
    Moderate Evidence

    Apigenin inhibits the NAD-consuming enzyme CD38 in laboratory models, but human NAD data is absent.

    Supporting Research

    Frequently Asked Questions

    Typical Timeframe

    Blood NAD+ typically doubles within 2-4 weeks of precursor supplementation; functional changes, where they occur, take 8-12 weeks

    Research Summary

    Studies8
    Supplements2

    My Notes

    Sign in to add personal notes

    This information is for educational purposes only. Always consult a healthcare professional before starting any supplement regimen.