Why is everyone talking about NAD+?
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They’re all over social media. Hailey Bieber and Jennifer Aniston have raved about them and, again and again, three letters are popping up relating to everything from boosting energy to beauty: NAD. Well, NAD+ to be precise. But what is it?
NAD+ simply means nicotinamide adenine dinucleotide and is a ‘found in every cell of the body, essential for cellular energy, DNA repair and overall metabolic health,’ explains Dr Duca Botoaca, aesthetic doctor and founder of the Dr Ducu Clinics.
Dr Ducu adds: ‘As we age, our natural levels decline, which can contribute to fatigue, brain fog and reduced resilience.
‘At Dr Ducu Clinics, we offer NAD+ IV therapy as part of our integrative wellness approach, because intravenous delivery ensures far greater bioavailability than oral tablets, which often break down in the digestive system before they can be properly absorbed. When delivered via IV, NAD+ goes straight into the bloodstream, allowing the body to make immediate use of it at a cellular level.’
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In every cell
Cosmetic and Plastic Surgeon Dr Paul Banwell of Pantheons Clinic said: ‘NAD+ is a natural molecule found in every cell and is fundamental to energy production in our body as well as being critical for cellular maintenance and repair. It stands for nicotinamide adenine dinucleotide.
‘The main NAD+ benefits include optimising skin health, cognitive ability, cardiovascular health and helping to restore youthful energy, strength and performance. A healthy lifestyle with a good diet and regular exercise can help maintain NAD+ levels but research has shown that supplementation can boost overall levels significantly and therefore minimise this natural decline.
‘Supplements such as the ARTIS London Regenerative Complex can give you the boost of NAD+, alongside other essential nutrients, to aid in longevity.
‘Supplements that aid longevity provide a comprehensive solution for those seeking to enhance their cellular health and longevity. There is no better time to prioritise your health.’
What is best way to take them? Jabs or tabs?
‘Both are considered an effective way to increase NAD+ levels, however IV is considered more direct and is absorbed faster as it goes directly into the bloodstream,’ says Dr Banwell. ‘However, although IV is great for an immediate boost, it is sadly associated with nausea and sickness in many patients.
‘Some oral preps are very large, which make them difficult to take, as well, so it’s important to find capsules that are high strength and can be taken daily, such as the ARTIS London Regenerative Complex.’
So how do they work?
Nick Urban is a high performance health consultant, data scientist and instructor at School of Biohacking. He says: ‘NAD+ is a vital coenzyme found in all living cells, across all animals. It acts like your cells’ battery, required to generate cellular energy. NAD+ works by shuttling electrons between molecules to create cellular energy (known as ATP) during a process called cellular respiration.
‘Like a battery, NAD exists in two forms: NAD+ (the oxidized form, which can accept electrons) and NADH (the reduced form, after it grabs electrons). Cycling between these two states powers energy generation in the mitochondrial electron transport chain. The more NAD+ available, the more energy your body produces to power organs and processes throughout the body. Increasing NAD+ levels also enables longevity proteins called sirtuins, which help keep cells young.’
Nutritional Therapist Ros Simmons says: ‘NAD⁺ is a coenzyme found in every cell of the body and it’s vital for converting nutrients into energy, supporting our DNA repair, and regulating cellular stress. As we age, our NAD⁺ levels naturally decline, which can contribute to fatigue, slower recovery, poor metabolic function, and visible signs of ageing like dull skin or lack of resilience.
‘Supplementing with NMN, a precursor to NAD⁺, can help replenish those levels and support overall cellular function. This can translate into feeling more energised, focused, and resilient and over time, those internal benefits can show externally too, as skin, mood, and metabolism all rely on that cellular energy. Some people even say that they sleep better and hair grows more, but there’s no research to support that.’
Dr Ed Robinson is an award-winning aesthetician, hair loss and skincare expert and runs clinics in Cheshire and London’s Harley Street.
He says: ‘NAD+ acts as a key molecule in mitochondrial function - the process our cells use to produce energy. It also activates sirtuins, a group of proteins associated with longevity, DNA repair, and reduced inflammation. By boosting cellular energy and enhancing the body’s ability to repair and regenerate, NAD+ is being explored not only for anti-ageing purposes but also for potential roles in brain health, addiction recovery, and chronic fatigue.’
So what age is best to start?
Nick Urban says: ‘NAD+ appears especially beneficial for those over the age of 60, but some individuals in their early 40s supplement it too. Here's why. Everyday living activates DNA repair and inflammation, which consume NAD+ via enzymes like PARP and CD38. As we age, we deplete NAD+ faster than we can regenerate it. Research suggests that NAD+ levels can decrease by up to 50% by age 40. When this happens, cells produce ATP less efficiently, DNA repair slows, and longevity proteins turn off. Scientists have linked declining NAD+ to three core drivers of the aging process: mitochondrial dysfunction, genomic instability, and deregulated nutrient sensing.
‘Although there’s no universal consensus on the optimal age to begin supplementation, practitioners generally recommend starting around age 40+. It’s likely most beneficial for those 60+ or with unhealthy lifestyles.’
The debate remains, which is best, tablet or injection? Social media shows everyone from celebs to influencers popping pills or sitting with a drip attached to their arms.
Ros Simmons says: ‘While NAD⁺ IV drips are an option, they’re costly and invasive. Personally, I think the move towards the oral NMN supplement (go for ones with the 99% purity level) can be a more practical, sustainable solution.’
Injectable NAD+ bypasses breakdown in the liver and enters the bloodstream directly
Nick Urban adds: ‘To understand the difference between NAD+ products, it’s important to understand how the body uses NAD+. There are two types: NAD+ itself, and NAD+ precursors. Precursors are molecules that convert into NAD+ inside the body. NAD+ itself cannot be effectively taken as a tablet - it's too large, is broken down in the stomach, and very little is absorbed into cells. Precursors like: NMN (Nicotinamide mononucleotide), NR (Nicotinamide riboside), and Niacin are more stable and more readily taken up by the body’s cells.
‘Some situations warrant IV or injectable NAD+, but for most people, precursors (tablets, capsules, or powders) are best. Injectable NAD+ is indeed more bioavailable because it bypasses “first-pass” breakdown in the liver and enters the bloodstream directly. Injectable NAD+ is considered most effective for neurological uses. However, its main issue is bio-incompatibility: when injected, NAD+ goes into the spaces between cells, where it doesn’t naturally occur in high levels, except during a cellular stress state called the 'Cell Danger Response'.
‘Since there are no known transporters to bring full NAD+ into cells, the body must break it down into precursors like NMN and NR before using it. Injected NAD+ is broken down more rapidly and can form more potentially harmful byproducts such as NAM (nicotinamide).’
Healthy ageing
In terms of when to take them, some experts say the sooner the better. Ros Simmons, though, says: ‘I’d say it’s worth taking NMN from your mid-30s onwards, particularly if you’re noticing dips in energy, hormonal changes, or simply want to support healthy ageing in a more proactive, long-term way.’
Dr Ed Robinson says: ‘NAD+ plays a key role in energy production, DNA repair, and cellular metabolism. NAD+ levels naturally decline with age, which has been linked to fatigue, reduced cognitive function, and slower cellular repair. NAD+ can be administered through various methods, including oral supplements (such as nicotinamide riboside or NMN), intravenous (IV) infusions, and intramuscular or subcutaneous injections (under the skin). Some people also explore NAD+ nasal sprays or transdermal patches, though these are less common and less studied.’
Regarding the best way to administer them, he says:
‘IV or injectable NAD+ is believed to offer faster and more direct bioavailability as it bypasses the digestive system and delivers the NAD+ straight into the bloodstream. Oral supplements can be effective, especially when taken consistently, but they may be broken down during digestion and converted into precursors rather than active NAD+. For those seeking a more immediate effect - such as enhanced energy or cognitive clarity - IV, subcutaneous or intramuscular is often preferred.’
So, is it worth it?
Dr Ducu says: ‘In terms of effectiveness, yes, NAD+ can absolutely be worth it, particularly when part of a tailored programme for fatigue, stress recovery, anti-ageing or detoxification. Patients often report clearer thinking, improved energy, and better sleep quality after a course of treatments. However, it’s important to be assessed professionally before starting any NAD+ protocol to ensure it aligns with your individual health needs and goals.’
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