The Fountain of Youth- NAD+

Since the beginning of time humans have been fighting our natural aging process, this theme is found crossculturally in different lore- the search for the revered Fountain of Youth, The Elixir of Life- we’ll go to extreme lengths for means of youthful immortality.   In our modern era this search is not through crusades but, instead, by means of creams, injections, supplements, and infusions.  One of the latest age fighting trends is NAD+.  Nicotinamide adenine dinucleotide, or NAD+, has been touted by celebrities, podcasters, and even some scientists as the newest approach to decreasing our biological age. So what exactly is NAD+ and are all these health claims true?  

NAD+ is the active form of vitamin B3.  It is found in every cell in your body and plays crucial roles as a cofactor (or helper molecule) in cellular energy production and metabolism, in cellular health and response to stress, in detoxification pathways, in DNA repair and gene expression, in anti inflammatory responses, and in regulating the body’s circadian rhythm.  All of these important biological functions do support a body working in a more youthful way- without fatigue or brain fog, absent from disease (specifically metabolic and neurogenic diseases), freedom from pain associated with inflammation and toxin build up, quick to recover from exercise, injury, or illness, and with a healthy sleep/wake cycle.   Another interesting and relevant fact when it comes to NAD+ and youth, is that NAD+ status seems to naturally decrease as we age- this  makes sense as we consistently increase the demand for DNA repair and antiinflammation as we age.  Similarly, any bodily process that increases these demands (detoxification, healing, lack of sleep, exercise etc.) will simultaneously decrease NAD+ status. 

Given the extremely important functions, it is no surprise that vitamin B3 is an essential vitamin, meaning that we cannot simply produce it internally and must consume it in our diet.  Here is where the story becomes a bit more complicated- NAD+ is the active form of vitamin B3- the one that is actually working in the body.  However we do not eat, digest, and absorb NAD+ in that active form and, instead, we synthesise NAD+ from a family of pro-vitamin B3 nutrients.  That family consists of niacin,  niacinamine, nicotinamide mononucleic acid (NMN), and nicotinamide riboside (NR).  

Famously, niacin and niacinamide are referenced historically in the nutrition world as our dietary sources of vitamin B3.  After consumption, digestion, and absorption these pro vitamins are converted, through a series of reactions, into NAD+, active vitamin B3.  In other words, NAD+ cannot be made without the presence of one of these precursors in our diet.  Animal foods such as poultry, beef, fish, and eggs are rich sources of niacin and niacinamide,  as are certain plant foods like peanuts, legumes, lentils, avocado, mushrooms, and whole grains.  A diet high in these pro-vitamin B3 forms will naturally increase NAD+ in the body through the aforementioned conversion pathway.  Supplementation with niacin or niacinamide will, similarly, increase NAD+.  While these foods and supplements do increase NAD+, that process is not a quick one and the conversion involves a multistep process, funneling the niacin/nicatinamine through several vitamin B3 precursors before the final product.  The conversion can take hours to days and, depending on the individual nutritional status, age, disease state etc, it may take weeks to months to see a significant increase in muscle and whole body NAD+ status.  

You might be wondering, if the whole point is to increase NAD+ status, why not just consume NAD+ itself?  Firstly, NAD+ is not found in its whole form in foods so we’d have to rely on supplementation to consume it.  While there are NAD+ supplements on the market, the molecule has poor bioavailability in that whole form- it is unstable and highly susceptible to gastric juice breakdown- meaning the NAD+ itself will go largely unabsorbed into the blood stream and bodily tissues.  It should be noted that there are supplements that are touting a specialized delivery system through liposomal NAD+.  This system aims to improve the absorption of  the molecule as a whole, but these supplements are often much more expensive and some sources suggest the biotechnology is not enough to overcome the instability of the NAD+ molecule through digestion.      

This leads us to our other pro vitamin B3 options - NMN & NR.  These molecules exist further down the biological conversion pathway from niacin/niacinamide to NAD+, meaning that supplementing with these vitamins will produce increases in NAD+ more quickly comparatively to niacin or niacinamide.  NMN & NR may be a better option for individuals who are in a higher degree of need or deficiency- ie: those recuperating from injury/illness or with an increased inflammatory response, those experiencing chronic fatigue, or people recovering from addiction.  

So where does this leave us on our path towards eternal youth?  As with most nutrition topics- we are left with the somewhat unsatisfactory answer of: it depends. While NAD+ can surely support healthy aging and perhaps an even slowed progression of aging, much of the recommendations as far as intake and supplementation will depend on your unique status.  What is for sure is that we should all be consuming niacin rich foods to support NAD+ status in the body.   As we do begin to age, especially as symptoms like soreness, fatigue, trouble sleeping etc. begin to emerge- supplementation with niacin may be helpful to keep those natural NAD+ stores where they need to be.  Furthermore, in the event of more NAD+ depletion- like in chronic disease states or inflammation, post viral infection, extreme exercise, or addiction recovery we might consider supplementation with a pro vitamin B3 like NMN that may work a bit more quickly to get the NAD+ status back to its optimal level.  For these instances one may even consider a loading phase- with supplementation of higher dose NMN for some time-  leading gradually into a maintenance phase with niacin supplementation/dietary support alone thereafter.  

While NAD+ can support healthy aging, we are much more likely to find peace in our journey through supporting the aging body that we’re in to feel and function at its best.  If you'd like insight into your personal NAD+ status, supplementation suggestions, or other nutrition related topics please reach out!!


* It is important as we assess status and symptoms that may be associated with lower levels of NAD+ to work with a  health care professional to confirm that your symptoms are not arising from something more serious like a thyroid disorder or cancer.

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