In this article you will learn:
What NAD is and why it's important
What some theories are about increasing it in the body
How to increase your levels with lifestyle and product choices
Lazy Author Alert:
This article summarizes research that is expanded upon in great detail in my book, Dance Your Way Through Life. It is available on my books page. Grab a copy if you want the full and nerdy version.
When it comes to NAD, one word you will also hear being thrown around are sirtuins. The sirtuins are a family of genes that have been implicated in the aging process by many researchers, including the famous aging scientist Dr. David Sinclair. They control inflammation, telomere length, DNA repair, energy production and many other important processes in your body. Resveratrol, the common antioxidant supplement that many know about, acts on the sirtuins and facilitates the production of an important molecule called NAD or nicotinamide adenine dinucleotide.
This molecule is found in all cells and is essential to living. It is important for DNA repair, metabolism and energy production, and several other key processes. As we age, NAD levels decline and it is theorized that introducing NAD-supporting supplements into the body can rejuvenate aging tissues, restore youth, energy and our most valuable asset: time.
It’s certainly an exciting development in anti-aging that we can isolate and affect this molecule through supplementation. Companies like LifeVantage have created a special line of “NAD synergizers” called Protandim which supposedly increase NAD levels by 40% in as little as 30 days by acting on your sirtuin genes.
Other companies like TruNiagen sell a patented form of an NAD precursor that claims to raise your levels by 40-50% in 8 weeks. People like Dr. Sinclair take another precursor to NAD called NMN, or nicotinamide mononucleotide, instead of NAD because they argue it has better utilization. Nonetheless, it gives you an appreciation for how new this area of research still is.
As of the time of this writing, there is no commercially available NAD blood test or way to reliably assess its functional status in the body. There was a center in San Diego that was about to offer a commercially available blood test, but they closed in the spring of 2020 when businesses were forced to lock down due to COVID-19. There are also problems with measuring NAD in the serum versus measuring it inside the cells, and just like with your main nutrients this makes a difference in terms of evaluating the performance of both your body and of interventions in this area.
What this fundamentally means is that measuring the performance of any NAD supplement is ultimately subjective and based on personal experience.
The studies for these various supplements used clinical labs to assess their findings, but until there’s an accessible method to test it yourself on your own body with your own genes - these products have no way of being measured outside of subjective observations of energy, mood or performance. If you’re doing everything I've outlined in the The 5 Pillars of Optimal Health, it’s especially difficult to tell how much of an effect you’re actually getting compared to your complete nutrition program.
Other Ways to Boost NAD
While it’s true our NAD levels decline with age, the reality is there are a lot of ways to raise NAD naturally and through the interventions I've discussed in numerous other articles. NAD itself is a bulky molecule, so the only way to really “take” it is to take precursors that either encourage the production of NAD directly (as in NR, nicotinamide riboside, or NMN) or they work on the sirtuin genes to stimulate production through a combination of nutrients like in the Protandim supplements.
The vitamin niacin, or B3, is one of the key ingredients in this this complex pathway and many other nutrients will help to both produce and salvage NAD in your body. The usual things that you would do for your health like eating lots of organic vegetables, exercising, sleeping well and avoiding toxins all naturally boost NAD levels, and if you have SNPs in your sirtuin genes (welcome to the club) then taking extra resveratrol and a comprehensive antioxidant product like this one will support more NAD production.
Most of the current supplements on the market for NAD, especially NMN, are very expensive and some argue that taking other precursors, like straight up nicotinamide/niacinamide (a form of vitamin B3), may actually be detrimental to your health because of accumulation of one component in the salvaging pathway. This in turn may inhibit sirtuin activity through feedback and potentially steal resources away from DNA methylation. This is why I always opt for nicotinic acid as the best form of B3, even though you can get a niacin flush (which is harmless).
In simpler words, this is an incredibly complicated system and we haven’t exactly outsmarted it yet. The tools we have are promising, but they are just a start. The NAD precursor NR has shown a lot of potential and is safe compared to nicotinamide. But it’s also expensive at around $1.33 per pill, and it’s not yet clear what the optimal dosing would be, as there’s argument that too much may hamper the process and give you unintended aging effects like we just discussed.
Likewise, Dr. Sinclair takes 1 gram of NMN twice per day, but this would cost you a few hundred dollars per month to do. Which, again, begs the question of how else could you use your money to support natural NAD production and get at least 70-80% of that result but with considerable less money spent.
Another way to go about increasing your NAD levels is through ingesting certain specific plant compounds called flavonoids. There are many kinds, and a few have been discovered to disrupt a particular enzyme called CD38. This enzyme is responsible for breaking NAD down, and as we age the balance between NAD and CD38 shifts towards CD38, which in turn leads to a downward spiral of less NAD.
Certain plant compounds like quercetin, apigenin, luteolin, callistephin, kuromanin and
several others have shown some promising results in cell studies, but remember that there is no long-term research yet and it’s difficult to translate these benefits into the larger scale of our bodies. Also, to get all of these ingredients is expensive, and some have potentially undesirable side effects or interactions. Quercetin can be a thyroid antagonist (meaning it lowers thyroid performance) and this is often the case with many flavonoids, which can also be estrogenic - especially when taken in such concentrated forms and for long periods of time.
In the end, there are many pathways that lead to NAD in your body, and as you can plainly see, it’s not clear yet which way is the most optimal for long-term health — or even if these efforts are superior to supplying your body with The 5 Pillars of Optimal Health.
On top of this, there are no long-term trials that evaluate the effect of reducing your stress (which costs you nothing) in conjunction with the 5 Pillars and their impact on your NAD levels. If you’re approaching your health from fear and obligation, hurriedly trying to stave off death or any sign of aging with whatever you can throw at it — how does this attitude affect your NAD levels compared to someone who eats good food mindfully and takes their Vitamin G (Gratitude!) every day?
Another matter altogether concerns the things you don’t do and their impact on your NAD levels. Minimizing your toxins and avoiding excessive alcohol, smoking, drugs, prescription medications, pollution, excessive sunlight, charred meat, and any other thing that you know will age you, all may have a drastic impact on your long-term NAD levels compared to spending lots of money on a supplement and not taking these things into consideration.
In many ways, it’s often the things you don’t do that make a bigger difference than the ones you do. Yet, we have much less data when it comes to this way of looking at things in health. The point here is that there’s just simply no way to know the answer to these questions right now. And without a reliable way to test for the effects of these different compounds over time, and in comparison to other interventions, it’s an area that I personally prefer to just wait and see.
Still, some people swear by these products, and supplements like Protandim or TruNiagen may be worth a shot if you don’t have the desire to create a complete nutrition program right away. It’s not a longterm solution in my opinion, but it may work by giving you a boost which will fuel more disciplined behavior going forward and make all of the planning that's really needed a little easier.