What NAD+ Is and Why It Declines
Nicotinamide adenine dinucleotide (NAD+) is a coenzyme found in every cell of the body. It plays a central role in energy metabolism, DNA repair, and cellular signaling. NAD+ levels decline significantly with age — by approximately 50% between ages 40 and 60 — which has made it a significant target in longevity research.
Key Research Findings
Research on NAD+ precursors (NMN, NR) and direct NAD+ supplementation has shown improvements in cellular energy production, mitochondrial function, and activation of sirtuins — proteins involved in cellular stress response and longevity pathways. Human clinical data is more developed for NAD+ than for many other longevity compounds, with several small trials showing promising results.
Administration Routes
NAD+ can be administered orally (as precursors NMN or NR), subcutaneously, intramuscularly, or intravenously. IV NAD+ has the highest bioavailability but requires clinic visits. Subcutaneous administration offers a middle ground — higher bioavailability than oral with the convenience of home administration after physician training.
Combining NAD+ With Peptide Protocols
NAD+ is commonly combined with peptide protocols targeting longevity — particularly Sermorelin and Epitalon. Physicians designing longevity protocols often include NAD+ as a foundational component alongside peptide-specific interventions.