NAD+ Supplements: Who Actually Benefits + Who's Wasting Money

NAD Plus Works. Whether It Works For You Is A Different Question.

The honest answer is that NAD plus works, but just like with everything that's sensationalized on the internet, it's been over claimed significantly.

To see why, you need the chain first, because NAD plus is not a hormone or a drug, it's a coenzyme your cells use to move electrons around, and almost every reaction that turns food into usable energy depends on it being present in the right place at the right amount.

Your mitochondria use it to run the electron transport chain. Your repair enzymes use it when DNA gets damaged. A family of proteins called sirtuins, which help regulate how cells respond to stress and fuel availability, need it as a substrate to work at all.

So when the pool runs low, the problem isn't one system. It's everything downstream of energy production and repair at once.

That's the part the marketing gets right, and it's why the pitch is so easy to sell.

Where it falls apart is the jump from "this molecule matters" to "more of this molecule helps you." Those are separate claims, and only the first one is settled.

Precursors like nicotinamide riboside and nicotinamide mononucleotide do raise the pool. That part is measurable. Elhassan and colleagues gave 1000 mg of nicotinamide riboside daily to aged men for 21 days and saw the muscle NAD metabolome shift, with downstream anti-inflammatory signatures showing up in the transcriptome (Elhassan et al., 2019).

Raising a number and changing how a person functions are not the same finding.

And who you are and your age and your lifestyle history is gonna have more of an effect on whether NAD plus is beneficial to you than anything. That sounds like a dodge. It isn't, because the size of any benefit depends entirely on how far your system has drifted from where it should be.

Think of it like topping up oil in an engine. If the sump is low, adding oil changes how the engine runs. If it's already full, you're just pouring oil on the floor and paying for the privilege.

As an example, if you're over 45 with metabolic dysfunction, the evidence for using peptides like NAD plus is absolutely supported. That's the population where the sump is actually low, and where the clinical work has been aimed.

But if you're young and healthy with most of your foundations in place like I teach, the evidence doesn't show that NAD plus supplementation is gonna have any functional benefit despite actually raising your NAD plus levels. I cannot point you to a study that closes this question in healthy young people, because most of the trials were never run on them. Because you're already healthy, it's not really gonna have any meaningful benefit to your actual ability to perform or feel better.

Even in middle-aged adults, the effects that do show up are modest and dose-dependent rather than dramatic. Yi and colleagues tested 300, 600 and 900 mg of NMN daily for 60 days and found walking distance and blood NAD concentration improved in a dose-related way, with the higher doses outperforming the lower ones (Yi et al., 2023).

That's a real signal. It's also a walking test in middle-aged adults, not a promise of feeling twenty again.

So the practical move is to work out which group you're in before you spend anything. If you're under 40, training consistently, sleeping properly, and your bloods are clean, there's nothing here for you to fix.

If you're over 45 and carrying insulin resistance, poor recovery, or a decade of bad metabolic history, that's the profile where the trials were run and where raising the pool has somewhere to go.

Everything I've said assumes your sleep, training, and diet are already handled, because those are the inputs that determine how much NAD your body makes and burns in the first place.

Supplements work on the margins of a system. The margins only matter once the system exists.

Research: Yi et al., Geroscience, 2023; Elhassan et al., Cell Rep, 2019.

References:

Yi L, Maier AB, Tao R et al.. The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial. Geroscience. 2023. https://pubmed.ncbi.nlm.nih.gov/36482258/

Brakedal B, Dölle C, Riemer F et al.. The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease. Cell Metab. 2022. https://pubmed.ncbi.nlm.nih.gov/35235774/

Elhassan YS, Kluckova K, Fletcher RS et al.. Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD(+) Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Rep. 2019. https://pubmed.ncbi.nlm.nih.gov/31412242/