Let’s be honest — if you’re reading this, you’re probably over 40. Except if you happen to be half of my staff — shoutout to the Gen Zers still coasting on free NAD+.
Your energy’s tanking. Your brain’s foggy. Your cells feel older than you do — and you’d sell well basically any number of things to feel twenty again.
So you do what every armchair biohacker does — you Google ‘anti-aging solutions near me.’ What’s at the top of that list? NAD+.
But the real story behind NAD+ is bigger than that IV bag, bigger than the wellness influencer selling patches, injections, and supplements — and way bigger than the billionaires quietly hoarding it behind the scenes.
Today, we’re investigating the truth about the molecule that might just keep your cells young — if you know how to use it right. That word anti-aging gets thrown around all over the place but think about what it really means to ‘reverse aging’. Is that really even possible? None of us are getting any younger so if there are secret back channel ways to tamper with a system designed to fall apart that just might have it reverse age instead, than we should be discussing such things.
I’m Dr. Kristen Lindgren and welcome to The Dysfunction Files, folks. NAD+ is definitely on that list of potential interventions that might just help turn back the clock of biologic aging. Let’s get into it.
What is NAD+ and Why Should You Care?
First, let’s decode this whole alphabet soup situation. NAD+ — nicotinamide adenine dinucleotide — is the molecule your cells use to make energy. If your mitochondria are the batteries, NAD+ is the jumper cable that sparks them to life.
NAD+ works as a cofactor in your favorite biochemical process — the electron transport chain. Don’t panic, we’re not talking about that again. Just suffice it to say, without it, you’re not making much in the way of energy.
It’s basically cellular currency — the universal crypto your body can’t live without. Here’s what it does:
ATP production
NAD+ is the spark plug for your cellular engine. Your cells burn food to make energy — but without NAD+, that whole process just doesn’t work. Full stop period end of story. NAD+ shuttles electrons inside your mitochondria — turning food and oxygen into ATP, your main energy currency. No NAD+, no ATP — no energy. Period.
DNA repair
NAD+ isn’t just about energy — it’s also your cell’s handyman crew. Every day, your DNA takes hits from stress, toxins, and sunlight. NAD+ fuels enzymes called PARPs that scan your DNA for damage and patch it up before small glitches turn into big problems. No NAD+, no handyman — and your DNA can get messy, fast.
Sirtuins
Think of sirtuins as your cellular mafia clean-up crew. These “longevity genes” keep your cells tidy, reduce inflammation, and slow aging. But they don’t work for free — they run on NAD+. No NAD+, no sirtuin action — which means your cells age faster, break down quicker, and can’t protect themselves as well.
Circadian rhythm
NAD+ helps run your sleep-wake cycle. Mess this up and you’re basically paying off mitochondrial debt with cellular payday loans.
All that to say that supplementation with NAD+ (and it’s precursors NMN and NR in some studies) suggest that it may play a role in improving cognitive function, endurance, blood flow, and overall longevity. In the anti-aging space, NAD+ has been studied extensively – well at least in animals anyway – and is being used to improve energy levels, metabolism, brain function, pain management, and DNA repair.
The unfortunate truth is that by your mid-40s, NAD+ levels naturally drop by about 50% compared to when you were twenty. Stress, inflammation, bad sleep, and a couple glasses of wine here and there all contribute to depletion of your NAD+ even faster.
So if you’re feeling tired for no good reason, NAD+ might be the missing special sauce.
An interesting under-the-radar angle is that some addiction clinics are using high-dose NAD+ infusions to help people detox from alcohol, tobacco, and opioids. The theory? NAD+ helps reboot the brain’s reward circuits and repairs cell damage from substance abuse, easing cravings and withdrawal. Big, flashy data? Not yet — it’s mostly anecdotal — but people swear by it, and it’s one more reason NAD+ has a cult following in functional medicine circles.
Now, you’re not born with a fixed NAD+ tank — I’ve heard some podcasters say this but actually no – your body makes it on the daily. But as you age, your recycling machinery gets rusty. So while you’re burning NAD+ to power energy, repair DNA, and keep cells young — your body just can’t keep up like it did at 20. That’s why topping it off smartly — or protecting what you have — can help slow that cellular slide.
How People are Chasing NAD+ Right Now
So the world wants more NAD+ — but how do you actually get it?
Let’s talk about the options — and what I actually trust in my practice.
IV NAD+ — The Instagram Biohacker Flex
This is the sexy option. High-dose NAD+ IV drips are every wellness clinic’s golden goose. Plushy chair, big IV bag, big price tag. Is it worth it? Well… depends how you do the math.
With an intravenous bolus, your mitochondria get a huge push— all at once. Which absolutely works. It’s powerful — It moves mountains – buttttt the side effects can honestly be brutal.
• Chest tightness
• Palpitations
• Anxiety attacks
• Nausea – like, a lot of people need to actually take anti nausea meds beforeheand
Cold sweats
• Everyone’s favorite “Am I dying?” moment halfway through the infusion
Nurses hate this. Patients hate it more during it. I get it though – everyone wants the Instagram selfie — but you have to weigh that against the potential chemical panic attack. Nobody dies from this. The negative side effects go away after a day and usually folks are feeling over the moon afterwards. This is the only reason people subject themselves to this. On the front end, there’s the risk of feel like crap, but some people say the feeling of being able to pick up the front end of their car on the back end is worth it.
So does IV NAD+ work? Absolutely — and in theory this is the preferred route of administration because you’re bypassing the gut and the liver. Absorption is guaranteed. But, it’s important to go slow, stay hydrated, and probably make sure there’s a few additional nutrients on board so your old and worn out mitochondria aren’t completely blown out of the water. I’m talking about methylated B vitamins, magnesium, trace minerals and glutathione. We rarely use IV NAD+ in my practice because my nurses all have PTSD about patients with chest pain.
Subcutaneous NAD+ — The Gentle Secret
These are tiny shots under the skin typically done 2-3 days/week. This route is much easier on the body than IV. Steady absorption, steadier levels, fewer horror stories. It’s my favorite for patients who want real mitochondrial support without needing a barf bag. The trade off is that you’re not getting that great big tsunami of NAD+ either. Again, some people find that one day of feeling like garbage worth it for a weeks worth of bliss. Everyone is different.
Transdermal NAD+ — Patches & Creams
Next up: the skin route. Compounded patches or creams allow NAD+ to slowly absorb through the skin. Not as flashy, not as fast, but very gentle — great for patients who react badly to IVs or have sluggish detox pathways. Having said that, NAD+ is a pretty big molecule – it doesn’t easily get from outside the skin to inside the bloodstream. Typically something has to push it in. Intravenous and subcutaneous NAD+ has been used for decades – we know for sure this works. Transdermal delivery systems are a little newer, like within the past 5-10 years, and they utilize something called ‘iontophoresis’.
Iontophoresis is basically a tiny electrical push for your skin. It uses a gentle, safe electric current to help move charged molecules — like NAD+ — through the top layers of your skin and deeper into your body, where they can actually do something instead of just rubbing off on your shirt.
Liposomal NAD+ — The Middle Ground
So they sell NAD+ pills but don’t take these. Your gut basically nukes it before it ever reaches your cells, let alone your mitochondria. Liposomes are like little fat bubbles that crafty scientists can hide things in – like NAD+. NAD+ wrapped in a fat bubble has a much better chance of dodging that digestive breakdown than just a plain pill. I’m on the fence with this — some patients swear by it, some feel nothing. I’ll say quality really matters here.
The NMN Controversy (And Why Big Pharma Cares)
OK – if you’ve read about NAD+, you’ve read about NMN — one of the best-known oral NAD+ boosters. NMN stands for Nicotinamide Mononucleotide. You see the reason for the alphabet soup? The words are positively mind-numbing. In mice studies, it’s linked to better endurance, sharper memory, and even longer lifespan. In humans? The jury’s still out but they are actively deliberating. Unlike those in the Diddy trial – they have officially left the courthouse. Dr. David Sinclair from Harvard is like ‘the guy’ in this space. He wrote a whole book on it called Lifespan – it’s excellent. Anyway. Recall, you can’t take NAD+ by mouth, but you can take one of its precursors.
When your body goes through the process of making NAD+ it first makes NMN which then gets converted into NR (or nicotinamide riboside) which then gets converted back to NMN again, and after this ridiculous do-sey-do, it magically turns into NAD+. So both NMN and NR are upstream of NAD+ and both are bioavailable when taken in a pill form so for a period of time – like a couple of years ago, NMN and NR were all the rage as the easy to take by mouth version of NAD+ supplementation. NMN being the more popular of the two as it’s closest in the production line.
People started buying NMN by the bucket online. Not because it was cheaper because it too is like a million dollars, but because it was easier. Then, in late 2022, – I know this part is going to shock you so hang on – the FDA stepped in and said: “Sorry, you can’t take NMN as a supplement because we’re planning on studying as a drug in clinical trials.” For real.
Amazon yanked every bottle of NMN overnight. Panic ensued. Some brands scrambled for loopholes. The Natural Products Association sued the FDA — and won a temporary stay of execution. So for now, NMN’s still on shelves in the US… until July 31, 2025.
After that? Who knows. Maybe Big Pharma locks it up in patents. Maybe the supplement world finds another workaround, maybe people go back to stockpiling it like normal preppers, or maybe we all just bit the bullet and use the real thing. NAD+
Either way — this is how you know you’re over the target. If something works to keep you healthier and out of your local doctors office, Pharma’s going to try to gatekeep it. Allegedly.
Does NAD+ Really Deliver?
The Good:
- Small studies do in fact show NAD+ and NMN can boost energy, brain fog, and metabolic function.
- In my practice, chronic fatigue, brain injuries, long COVID, Lyme — we see real benefit when used smartly.
The Caveat:
Most jaw-dropping anti-aging headlines? Still come from mice. Humans aren’t mice.
If your gut is wrecked, your liver’s congested, and your mitochondria are half-asleep — just supplementing with NAD+ won’t magically fix you. It’s a tool used in conjunction with other things, not a magic wand.
Who Should Think Twice?
I don’t think there are too many contraindications here – just a few things to be mindful of. Healthy cells use NAD+ for fuel and DNA repair. Cancerous cells also use NAD+ for fuel and DNA – whatever they’re doing to DNA once they’ve gone completely rogue. In the setting of an aggressive cancer, I probably wouldn’t advocate for NAD+ supplementation – at least not high dose. For the same reason we typically don’t use glutathione in patients with aggressive cancers. They can hijack detox tools and use them against you.
How to Boost NAD+ for Free
There are certainly other lifestyle interventions and supplements that work on these same pathways.
- Fasting: Intermittent or longer — your body naturally ramps up NAD+ when you stress it a bit (the good kind).
- Exercise: Movement turns on these ‘sirtuins’— the same longevity genes that use NAD+.
- Cold exposure: A quick cold plunge flips on NAD+ production.
- Polyphenols: Resveratrol (yes, red wine — but don’t get carried away), blueberries, dark chocolate, EGCG or green tea.
- Circadian rhythm: Good sleep hygiene keeps your NAD+ cycle steady. Darkness at night, sunlight in the morning — your mitochondria love it.
Dr. Lindgren’s Closing Thoughts on NAD+
“So… is NAD+ the real deal? Honestly? Yes — but it’s not magic. If you skip the boring stuff — like sleep, movement, stress management, good nutrition — and think you can just drip your way back to your 20s, you’re gonna be very disappointed and a few grand poorer – if you’re using IVs – the injections, the patches, the liposomal formulations – way less painful in the pocketbook department.
NAD+ works when your foundation works. The real anti-aging flex is to get your mitochondria tuned up first — then sprinkle in the shiny extras like NAD+ or NMN – while supplies last of course remember the July 31 deadline. You can’t escape aging— but there are ways you can outsmart it.
