You may have recently seen NAD+ supplements promoted for energy, anti-aging or overall health. But what exactly are they? And do they work?
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Naturopathic medicine specialist Jacob Hill, ND, breaks down what NAD+ supplements are, what the research shows and what to keep in mind before using them.
What are NAD supplements, and how do they work?
NAD supplements are products that contain ingredients your body converts into nicotinamide adenine dinucleotide (NAD). NAD is a molecule found in every cell of your body that plays a key role in turning food into fuel.
“NAD is involved in a lot of processes throughout your body,” Dr. Hill says. “But a primary role of NAD is energy production.”
NAD is difficult for your body to absorb in supplement form. So, these products typically contain ingredients called NAD precursors. These are substances your body uses to make NAD on its own.
NAD precursors can include different forms of niacin (vitamin B3), like nicotinamide. They can also include related molecules, like nicotinamide riboside and nicotinamide mononucleotide.
Niacin itself (nicotinic acid) isn’t as commonly used in NAD supplements. It may have a higher risk of side effects and toxicity when you use it in high doses.
Some supplements combine NAD precursors with other nutrients and herbs. The effect the supplement has on your body — and its potential side effects — depends on which NAD precursors are used and any other added ingredients.
You may see these products labeled as NAD supplements, NAD+ supplements or nicotinamide adenine dinucleotide supplements. Although they’re sometimes used interchangeably, NAD+ is actually a specific molecule in your body.
“NAD+ accepts electrons when we break down food and carries them to places throughout the cell, including the mitochondria, which are the powerhouse of the cell,” Dr. Hill says. “That’s where cells make most of our adenosine triphosphate (ATP), the main energy source for the body.”
Because NAD is involved in so many energy-related processes, researchers are interested in whether boosting NAD levels could help conditions linked to low energy or cellular stress.
Potential benefits of NAD+ supplements
Fans of NAD+ supplements say they can help boost energy levels and ward off signs of aging. That’s because your NAD levels decline with age — and as your NAD levels drop, your cells may become less efficient at making energy and repairing damage.
“That’s where a lot of the current interest in these supplements comes from — the potential anti-aging and longevity benefit,” Dr. Hill says. “But research in this area is still developing. The long-term benefits and risks are unclear until more research is available.”
Researchers are exploring whether NAD supplements may play a role in other health areas as well. But Dr. Hill stresses that these uses are still being studied, and so far, evidence is limited or inconclusive.
Areas of interest include:
Cardiovascular health: Because heart cells rely heavily on energy, researchers want to know whether supporting NAD levels could help cellular function in your cardiovascular system.Neurologic conditions: NAD’s role in cellular repair has sparked interest in conditions like Parkinson’s disease, though research is still early.Metabolic health: As NAD is involved in metabolism, scientists are studying potential connections to conditions like Type 2 diabetes and obesity.Possible risks and side effects
NAD supplements are generally considered safe for most people. But side effects are still possible, especially when taken at higher doses. Side effects can depend on which NAD precursors are used in supplements, too.
Potential NAD supplement side effects include:
Nausea or stomach discomfortHeadachesLightheadednessDiarrheaMuscle crampsSkin irritation
Supplements that contain niacin (nicotinic acid) may also cause flushing, which feels like a temporary warmth in your skin. They can also cause liver toxicity at high doses.
And finally, an important note: For the most part, these side effects only apply to NAD precursors when you take them in supplement form.
“Some of these NAD precursors are found in food, too,” Dr. Hill points out. “The side effects usually only come when they’re concentrated in higher doses, like in a capsule.”
Who should be cautious with NAD supplements?
Different NAD precursors can have different effects that may not be safe for everyone. Because NAD supports energy production, it could have unintended consequences for some people.
“We think about cancer in particular,” Dr. Hill says. “Cancer cells use a lot of energy to grow. So, there’s concern that trying to increase energy production by using NAD supplements could potentially support the growth of cancer cells. This isn’t conclusive, but it’s an area of concern.”
Always speak with your healthcare provider before trying NAD supplements if you:
Have cancer or a history of cancerHave advanced liver diseaseAre pregnant or breastfeedingAre considering long-term, high-dose use
“We don’t have long-term safety data related to most NAD supplements,” Dr. Hill reiterates. “So, if you’re interested in using them longer term, it’s best to speak with your healthcare professional first.”
What to look for in a NAD supplement
If you’re considering an NAD supplement, Dr. Hill urges you to pay close attention to how products are made and labeled:
Turn to third-party testing. This means a supplement company has sent their product for testing to an independent laboratory to make sure it meets regulations for quality, safety and proper ingredients. Because supplements aren’t regulated the same way medications are, third-party testing adds an extra layer of safety and transparency.Avoid proprietary blends. A proprietary blend lists ingredients without telling you how much of each one is included. “That’s a problem,” Dr. Hill warns. “You need to know exactly what’s in the capsule.”Look into the company’s reputation. “Reputable companies often have a variety of products and established manufacturing processes,” Dr. Hill notes. “If a company only makes one product, it’s not necessarily bad. But you want to be sure they have quality controls in place.”Pay attention to the details. Dr. Hill also cautions against prices that seem unusually low or extremely high, as well as products that promise quick fixes or cures.Food and lifestyle alternatives to NAD supplements
If you’re interested in supporting your body’s NAD levels, Dr. Hill suggests starting with approaches like food and exercise rather than supplements.
“You can increase your NAD levels through food and healthy lifestyle habits,” he says. “It’s a safer and more natural way to start than supplements.”
Foods rich in NAD precursors provide the building blocks your body uses to make NAD. Examples of these foods include:
PoultryFishEggsDairy productsWhole grainsNuts
Regular physical activity also encourages your cells to increase energy production.
“When I work with people on improving energy and supporting cellular health and healthy aging, lifestyle medicine recommendations come first,” Dr. Hill adds.
Final thoughts
In the end, the safest route is always to speak with a healthcare provider before trying any new supplement, including NAD supplements.
“Working with a healthcare provider helps ensure that you’re using the right product, form and dose for your needs,” Dr. Hill emphasizes. “They can also help you find other ways to achieve your health goals, no supplements needed.”
