NAD+
Nicotinamide adenine dinucleotide — a critical cellular coenzyme for mitochondrial energy production, sirtuin activation, and DNA repair. Declines ~1%/year from age 30. One of the most researched longevity compounds.
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell, playing a central role in mitochondrial energy production through the electron transport chain. It is also a required substrate for sirtuins (SIRT1-7) — proteins linked to cellular stress response and longevity — and for PARP enzymes involved in DNA repair.
NAD+ levels decline approximately 1% per year from around age 30. By age 60, many individuals have less than half the NAD+ levels measured at age 20. This decline is associated with mitochondrial dysfunction, reduced metabolic efficiency, and impaired DNA repair — all implicated in the aging process.
Supplementation approaches range from oral precursors (NMN, NR) to subcutaneous injections to IV infusion. Physician practice has used IV NAD+ for energy, cognitive, and addiction contexts. Injectable SC use (50–100 mg/day per Joseph) provides a practical middle path. Evidence quality varies significantly by route, indication, and study design.
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NAD+ has a generally favorable safety profile. IV administration can cause chest tightness, nausea, and flushing during rapid infusion — resolved by slowing infusion rate. Long-term high-dose safety not fully established. Research use only for injectable forms. Not WADA-prohibited (verify current list). Oral precursors (NMN, NR) are widely available as supplements.