Supplements Updated 8 September 2026 5 min read

What is NAD+: A vital molecule for health and longevity

Written byPurovitalis News

NAD+ occurs in virtually every cell in your body. The molecule is involved in energy production, mitochondria and various processes around cell maintenance. It is precisely that central role that makes NAD+ an important topic within longevity and healthy ageing.¹

But what exactly is NAD+? What is the difference with NADH, why does the NAD+ balance change as we get older, and what role do exercise, nutrition and precursors such as NMN and NR play?

NAD+ and NADH: how does it work?

NAD stands for nicotinamide adenine dinucleotide. It occurs in cells as NAD+ and as NADH. Both forms work together continuously.

NAD+ takes up electrons and in doing so turns into NADH. NADH can then release these electrons again during the processes with which mitochondria produce ATP: the direct energy source for our cells.

So it is not a question of NAD+ or NADH, but of the balance between the two forms.

Why is NAD+ so important?

NAD+ is involved in thousands of reactions in the body. Three functions receive a great deal of attention within longevity:¹

Energy: NAD+ plays a central role in the conversion of nutrients into cellular energy.
Cell maintenance: enzymes such as PARP use NAD+ in processes that are involved in the maintenance of DNA.
Sirtuins: these NAD+-dependent proteins are involved in, among other things, gene activity, mitochondria, metabolism and the response of cells to stress.

NAD+ therefore recurs in several biological processes that change during ageing.

View supplements for energy

View the overview of NAD+ and healthy ageing

How does your body produce NAD+?

Your body can produce and recycle NAD+ via several routes.

The most important route in many tissues is the salvage pathway. In this route, nicotinamide (NAM) is reused. Via the enzyme NAMPT, NMN is formed, which is then converted into NAD+.

Other substances can serve as building blocks too:

NMN (nicotinamide mononucleotide)

A direct precursor within NAD+ metabolism.

NR (nicotinamide riboside)

Is first converted into NMN and then processed further into NAD+.

Niacin and nicotinamide

Two forms of vitamin B3 that contribute to the production of NAD+ via different routes.

Tryptophan

An amino acid that the body can also use to form NAD+, via a longer conversion route.

What happens to NAD+ as we get older?

As we get older, the NAD+ balance changes. Lower NAD+ levels are seen in various tissues, and at the same time processes that consume NAD+ can increase.¹

One enzyme that receives a lot of attention here is CD38. Research shows that the activity of CD38 can increase during ageing. CD38 consumes NAD+ and can also break down NMN. In animal research, the increase in CD38 was associated with lower NAD+ levels and changes in mitochondrial function.²

Inflammatory processes and senescent cells are also linked to this route.

What can you do yourself for your NAD+ balance?

NAD+ does not stand apart from your lifestyle. Exercise, sleep and nutrition in particular are connected to the processes with which the body produces and recycles NAD+.

Keep moving

Physical activity influences NAMPT, among other things, an important enzyme within the recycling of NAD+. Research into exercise shows that training can influence various parts of NAD+ metabolism in muscles.³

That is another reason to give strength training and cardio training a fixed place within a longevity routine.

Watch your sleep rhythm

NAD+ and enzymes such as NAMPT and sirtuins follow a day-night rhythm. A regular sleep-wake pattern fits in with this natural cycle.

Make sure you get enough vitamin B3

Vitamin B3 supplies substances that your body can use in the production of NAD+. Sources include meat, fish, peanuts, wholegrain products and various vegetables.

Fasting and meal timing are also being studied because of their relationship with energy metabolism, NAMPT and the circadian rhythm.

Can NMN and NR raise NAD+?

Alongside lifestyle, a lot of research is focused on NAD+ precursors. NMN and NR in particular receive attention here.

In a clinical study with 80 healthy middle-aged adults, higher NAD+ levels in the blood were measured after 30 and 60 days of NMN.⁴ For NR, human studies also show that the amount of NAD+ in the blood can increase. Recent reviews now bring together various studies on both precursors.⁵

View the NMN research

Raising an NAD+ level is something different from demonstrating that someone automatically becomes healthier or lives longer as a result. Research is therefore looking more and more at what changes in NAD+ actually mean for different tissues and functions.⁵

And what about NAD+ infusions?

NAD+ is also offered directly via an infusion. It then enters the bloodstream directly.

There is research into intravenous NAD+ and NR, but the amount of clinical data is much smaller than for oral NAD+ precursors. A recent review study also mentions practical points for attention such as the form of administration, tolerability and the still limited knowledge about optimal dosage and long-term effects.⁵

For daily use, research therefore places a lot of emphasis on substances that the body can use itself to produce NAD+.

View NAD+ Booster

View Liposomal NMN Capsules

Is NAD+ safe? What is known so far

Most clinical studies into NAD+ precursors last weeks to months and involve relatively small groups. Within that timeframe, NMN and NR were generally reported as well tolerated. In the study with 80 middle-aged adults, no serious side effects were reported after 60 days of NMN.⁴ Niacin and nicotinamide have a long history as forms of vitamin B3; niacin can cause a temporary flush at higher doses.

What is still lacking are large, long-term studies. A recent review therefore mentions optimal dosage and long-term effects as open questions.⁵ If you are pregnant, use medication or have a medical condition, it is wise to consult a doctor before using NAD+ precursors.

NAD+ in brief

NAD+ is an essential molecule that is central to cellular energy, mitochondria and various processes around cell maintenance. The body produces NAD+ itself and recycles it continuously.

As we get older, this balance can change. Exercise, sleep and vitamin B3 are connected to natural NAD+ metabolism. In addition, human studies show that precursors such as NMN and NR can raise NAD+ levels in the blood.

It is precisely that connection between energy metabolism, cell processes and ageing that makes NAD+ an important area of research within longevity.