NAD has been discussed in the wellness world for years. In 2019, Jennifer Aniston mentioned it in an interview with the LA Times. It appeared in an episode of The Kardashians in 2022. However, it’s only recently broken through to the masses. Within the last year, it seems like every health and wellness influencer is talking about it, so let’s talk about why.
What is NAD?
To understand why influencers are obsessed with NAD, we first need to look at what it does inside your cells. NAD is found in every cell of your body and helps convert food into energy. There are two forms of NAD: NAD⁺ and NADH. They work together to shuttle electrons by cycling between an “empty” state (NAD⁺) and a “loaded” state (NADH). NAD⁺ accepts electrons released from food molecules and becomes NADH. NADH then carries these electrons to the mitochondria, our cellular powerhouses, where they generate ATP, the cell’s usable energy. After delivering its electrons, NADH is converted back into NAD⁺, ready to repeat the process.
This electron shuttling is also involved in cellular maintenance and repairing your DNA, basically a whole lot of really important and fundamental stuff that your body does to maintain homeostasis.
“NAD helps your cells make energy by carrying electrons from one chemical reaction to another. This process powers nearly everything your body does, and it keeps your cells working properly as you get older.”--The Cleveland Clinic
But there’s a catch: this cellular powerhouse doesn't stay at peak capacity forever, providing just the opening health and wellness influencers needed to start touting their NAD wares. Because NAD is the backbone of cellular energy, it was only a matter of time before the wellness industry rebranded this fundamental biological process as an anti-aging miracle.
There are multiple building blocks (i.e., precursors) used to boost NAD through supplementation: Nicotinamide Riboside (NR), Nicotinamide Mononucleotide (NMN), niacin, and tryptophan. NR and NMN are the two main precursors used in supplementation because they are more efficient.
NAD Supplementation
NAD supplements often come in one of three forms: oral, patches, or intravenous (IV) drips. These forms vary in important ways: price, route of administration, and ease of use.
The oral precursors come in capsule form, what you think of when you think of the word “supplement.” They vary in dosage and price, ranging from just under $20 to around $70, depending on the brand and quantity. As with any supplement, because they are largely unregulated, you can’t be totally sure about the quality and purity of the product.
The patches are slightly more expensive, ranging from $30 to $200, depending on factors such as how long the supply is supposed to last and the brand. Also, this route of administration lacks strong, high-quality evidence that it actually boosts NAD levels in the body.
IV drips are quite expensive because they require a lot of equipment and a qualified person to administer them. They can cost around $1000 per treatment. Additionally, because it’s a bit “invasive,” it carries a risk of infection at the administration site and the possibility of disease if the needles are not sterile. For this type of administration, having a qualified professional administer it and ensuring that sterile equipment is used is a must. There’s also the discomfort of sitting during the infusion.
Whether you're swallowing a capsule or receiving an infusion, every method shares the same glaring problem: a complete lack of long-term human safety and efficacy data. We don’t know whether increasing NAD levels in the body through supplementation actually produces the effects people claim it does. Even if it does, we don’t know what the long-term effects are. It’s possible, for example, that maintaining consistent NAD levels as we age could increase the risk of certain diseases and conditions, like cancer. This is largely why caution is warranted.
The Hype
As with most wellness products, the hype is way out in front of the science. We have mouse data, but famously, mice are not humans, and what they experience may not translate to humans. We have little high-quality human data and even less on long-term effects.
However, inconclusive evidence hasn’t stopped Wellness Warriors so far, so why would it now? Marketing for NAD supplementation has been aggressive. Influencers and celebrities love phrases like “anti-aging” and “reversing the biological clock.” For example, Hailey Bieber and Kendall Jenner are big proponents of NAD IVs. The two were shown receiving NAD infusions and praising the effects. Bieber was clipped saying she’ll take NAD all the time and “never age.”
While NAD+ supplements can raise NAD+ levels, there's no proof this translates to improved longevity or health status in humans. Long-term effects are unknown, and long-term safety questions—particularly regarding cancer risk—are not yet settled. ...the smart approach is to remain cautiously optimistic while waiting for more definitive evidence.... the proven strategies for healthy aging—rather than a buzzy new supplement—remain your best bet for maintaining cellular health as you age.” - Atria Health and Research Institute
While supplementation looks promising in a petri dish, we often overlook that our bodies are already built to maintain NAD through lifestyle choices. Before reaching for an expensive, unproven shortcut, it's worth remembering that exercise, a balanced diet, and good sleep aren't just 'good for you'—they are the original NAD boosters.
In longevity science, NAD remains a molecule of great interest and even greater uncertainty. The gap between promising mouse models and proven human outcomes is a chasm that hasn't been crossed yet. While precursors like NR and NMN may raise blood NAD levels, the central question remains: does that translate into changes that improve human health? Until clinical trials demonstrate clear benefits and address concerns about cancer risk and long-term metabolic effects, enthusiasm should be tempered with restraint. For now, the case for supplementation remains suggestive, not settled. For those looking to optimize their health today, the most prudent path is to stick to the fundamentals (e.g., diet, exercise, sleep) and let clinical trials provide the answers before turning yourself into a human experiment.
Katie Suleta, DHSc, MPH
Katie Suleta is a regional director of research in graduate medical education for HCA Healthcare. Her background is in public health, health informatics, and infectious diseases. She has an MPH from DePaul University, an MS in Health Informatics from Boston University, and has completed her Doctorate of Health Sciences at George Washington University.
