What is NAD+?
For avid biohackers looking to improve physical and mental performance, there are few things with more cache than NAD+. The NAD stands for nicotinamide adenine dinucleotide (NAD), which is a coenzyme that is found in all living cells.
NAD+ is important in the electron transport chain (don’t worry, you don’t need to remember this). Suffice it to say, NAD+ is imperative for turning your food into energy that your body and brain can use.
Without adequate levels of NAD+, there are a host of downstream side effects including increased rate of aging , kills cells , it contributes to chronic fatigue , impairs brain function , and contributes to weight gain . Not good stuff.
The Harm of Low NAD+
Much of the scientific literature around NAD+ focuses on the harm in patients who suffer from low levels of this essential coenzyme. While this does not necessarily translate into a promotion of NAD+ supplements, it does suggest there is clear evidence that low NAD+ is “bad” in most situations.
For the brain, low NAD+ is associated with poor cognitive ability. As humans age, our levels of NAD+ decline. In a 2004 study in Drugs Under Experimental and Clinical Research scientists showed that an NADH supplement could improve the cognitive performance in human Alzheimer’s patients .
Animal models of Alzheimer’s disease showed similar positive trends  and there is evidence that NAD+ can similarly help in cases of Parkinson’s disease  and stroke (oxygen deprivation) .
For healthy adults, low NAD+ can also spell accelerated aging. Within the anti-aging and longevity communities, NAD+ is considered a major component of their lifespan enhancing approach.
As our levels of oxidative stress goes up, our levels of NAD+ goes down . This accelerates the aging process even further. In contrast, taking NAD+ while aging can decrease the activity of certain aging pathways like SIRT1 .
There are a host of other downsides associated with low NAD+ levels including:
- Increased fatigue – NAD+ supplements help treat chronic fatigue 
- Increased weight / fat gain (obesity) 
- Added risk of skin cancer 
- Causes immune deterioration 
How Do I Know if My NAD+ is Low?
Now that we have thoroughly scared you into believing NAD+ is one of the most important molecules to increase in your body (whoops!), it’s useful to help identify if NAD+ levels are low for you.
There are a few things that can reduce NAD+ and we will start with those rather than discussing expensive blood work (or other tests) to determine NAD+ levels. If you find yourself nodding in agreement to some of these contributing factors of low NAD+, consider how to overcome these issues.
The first of these contributing factors is our circadian rhythm. Without a healthy rhythm for our cells and internal clock, many aspects of our system are thrown out of whack. By simply not getting enough sleep (or sleeping at the right time), it can change the expression of certain genes like BMAL1 and CLOCK, which alter the production of NAD+ .
The second contributing factor for millions of people across the globe is alcohol consumption. There is a direct correlation between increased alcohol consumption and decreased NAD+ . This is yet more evidence that alcohol is a toxifier and an aging enhancer.
Another growing issue that causes NAD+ levels to decline is overeating and specifically carbohydrates and sugars. Added calories contributes to NAD+ decline, but the sugars and carbs that increase blood sugar and insulin levels double down on this side effect .
Finally, for people who struggle with chronic inflammation, the body becomes an environment unhealthy for high levels of NAD+ . This can create a chicken and the egg problem whereby lower NAD+ creates inflammation, which further compounds the problem.
To recap, if you are contributing to lower NAD+ through these lifestyle choices, make different ones:
- Poor circadian rhythm
- Alcohol consumption
- Overeating (carbs / sugar)
- Chronic inflammation
There are multiple ways to increase NAD+ in your system and some of them are lifestyle practices and others supplements. Generally, an approach of using both combined can be best so as to get the maximum effects.
One of the best tools that I’ve found for improving mental and physical performance (long term) is fasting. It’s simple because we are removing something to make us healthier rather than adding more. For NAD+, fasting or caloric restriction can have a positive effect on levels in our body.
By depleting our carbohydrate and nutrient levels (through fasting), our NAD+ can build up to work its magic . Typically, I follow a 16 / 8 intermittent fasting protocol daily. It’s easy because I simply skip breakfast.
Ketosis / Beta Hydroxybutyrate
Because excessive blood glucose and insulin levels can negatively impact NAD+, it is useful to use ketosis as a tool. A ketogenic diet is one that is heavily fat based, which provides too little glucose for our body to use it as fuel. Instead, our body starts using ketone bodies for the brain. One of these ketones is beta hydroxybutyrate, which can be taken in exogenous ketone (supplement) form.
A personal favorite (like fasting) is to use a sauna for health purposes. There are plenty of anti-aging benefits of activating heat shock proteins via saunas, but evidence also shows a benefit for NAD+ levels as well .
A catch-all habit for increasing NAD+ is physical exercise. If you don’t already know the benefits of exercise by now, this is the first place to start. Assuming you do, consider the NAD+ benefit an added bonus.
The supplement that has the greatest impact on NAD+ is nicotinamide riboside, which is a powerful nootropic utilized for a host of reasons. It is the best supplement to increase NAD+ and can do so by as much as 2.7 times baseline levels .
Compared to any other supplement, nicotinamide riboside completely blows away the competition. There is no other supplement that can compete.
Other supplements used for NAD+ increases:
- Resveratrol – Not recommended even though resveratrol has some evidence to suggest it increases NAD+
- Lithium – Again, not recommended solely for NAD+ benefits. There are other good arguments in favor of lithium supplementation, though.
Biohackers like Dave Asprey and many within his circle love NAD+ as a factor intimately involved in the aging process. For people who seek to end aging, overcome declining health, or simply live forever, this is one of the most interesting molecules to manipulate.
Even for those who seek healthier lives today rather than trying to stall the inevitable, NAD+ optimization is a powerful tool to improve our mental and physical performance at a fundamental level. Using NAD+ and the lifestyle habits that influence it, we can enhance our quality of life by treating the root rather than a symptom of greater health problems.
- References (Click to Expand)