How to Increase NAD+ Levels Naturally

Every cell in your body contains NAD+, a tiny molecule derived from vitamin B3, essential for life, health, and longevity. However, NAD+ levels decline because of aging and contribute to low energy, metabolic dysfunction, and disease. 

The good news, however, is that there are many natural solutions for boosting NAD+. More NAD+ means more energy, vitality, and better overall health – and who doesn’t want that? 

Keep reading to learn more about this amazing molecule and the easy steps to support healthy levels. We’ll cover: 

• What is NAD+? 
• NAD+ functions and benefits
• The NAD+ and aging connection
• Diet and lifestyle strategies to increase NAD+
• NAD+ supplementation and benefits of a liposomal delivery system

Let’s dive in! 

What is NAD+?

NAD stands for nicotinamide adenine dinucleotide. It’s made from niacin (vitamin B3) and is found in every cell of the body. 

NAD+ is the oxidized or active form of NAD, meaning it can act as an antioxidant and accept an electron to neutralize a free radical. When it does this, it forms NADH, the reduced form. NADH recycles back into NAD+. Recycling is essential because we constantly need a supply of NAD+ for energy production and metabolic processes. 

While recycling is essential, the cell produces NAD+ from its precursors, nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). I’ll revisit the precursors when I discuss supplementation below. 

To learn more about the biochemistry of NAD+, please read NAD+ Supplement Therapy Benefits.

NAD+ Functions and Health Benefits

Seventy percent of NAD+ is concentrated in the mitochondria of cells and plays an integral part in energy production. NAD+ is a required coenzyme in glycolysis, the citric acid cycle, and the electron transport chain that turns calories (from carbohydrates, fat, and protein) into ATP. (Source 1)

In addition to making energy and supporting mitochondrial function on the cellular level, NAD+ serves other functions, including:

• Antioxidant to combat oxidative stress and DNA damage
• Signaling molecule for cell communication and survival
• Involved in cellular and DNA repair
• Maintaining circadian rhythm (Source 2, 3)

On a macro level, NAD+ supports: 

• Cognitive function 
• Mental health 
• Immune regulation 
• Cardiovascular health
• Healthy aging  (Source 2, 4, 5, 6)

Low NAD+ and Aging 

When you reach middle age, your levels of NAD+ are 50% lower than when you were young. It’s harder to synthesize and recycle NAD+. NAD+ depletion leads to mitochondrial dysfunction and metabolic decline. In essence, it makes cells age faster. (Source 2, 7)

Sirtuins are essential for understanding the aging process. Sirtuins are proteins (made from specific amino acids) involved in metabolic processes, genetic expression, and lifespan. Sirtuins require NAD+ to function. The production of NAD+ determines if aging speeds up or slows down. (Source 2, 8)

Working to raise NAD+ levels through dietary and lifestyle strategies has many health benefits, including: 

• Increased insulin sensitivity and decreased risk or progression of metabolic disease
• Improved mitochondrial function and energy production 
• Maintained stem cell health 
• Extended life span (Source 2)

Dietary and Lifestyle to Boost NAD+ 

Here are some ways to increase NAD+ levels naturally: 

Calorie Restriction 

It’s been known for a hundred years that calorie restriction slows aging and increases lifespan. (Source 9)

Calorie restriction requires the long-term consumption of fewer calories than your body requires. However, to do this healthfully, you need to eat whole, unprocessed food that continues to supply the body with essential nutrients. In addition, calorie restriction is challenging to maintain over the long term. 

Intermittent Fasting 

Intermittent fasting, or time-restricted feeding, improves life span independent of calorie intake. (Source 9)

Intermittent fasting involves eating all meals within a daily eating window and then fasting overnight to the next eating window. An easy way to start is with a 12-hour overnight fast. For example, finish dinner by 7 p.m. and eat breakfast after 7 a.m. From there, you can extend the fast to 14 hours or longer on some days if it’s a good fit for you. 

Ketogenic Diet 

A ketogenic diet is a high-fat, low-carb diet designed to shift metabolism into ketosis. In ketosis, cells primarily use fat to make energy in the mitochondria instead of glucose. A ketogenic diet increases NAD+ levels and may explain why the diet is beneficial for neurodegenerative disease, seizures, and other disorders. (Source 10)

To implement a ketogenic diet, keep carbohydrates low (under 50 grams per day), eat moderate protein, and choose plenty of healthy fats like avocados. Avoid relying on saturated fats as this can be destructive for health.

Drink Milk 

While many people are intolerant or sensitive to cow’s milk, if your tolerance is high, it can help support NAD+ levels. Milk is a natural source of nicotinamide riboside (NR), a precursor to NAD+. (Source 11)

As always, please work with your healthcare provider or dietitian for personalized advice regarding these dietary changes. 

Regular Exercise

Muscle mass declines with age, but physical exercise helps to maintain skeletal muscle mass and function. Muscle cells contain a lot of mitochondria and therefore have a greater need for NAD+. 

Studies show that aerobic exercise and strength training helps maintain NAD+ levels in muscles as we age. (Source 12)

Take Saunas

Saunas and other heat shock therapies are another option for increasing NAD+ levels. The high temperature creates a cellular stress response, influencing sirtuin activity. Heat shock increases the NAD+ to NADH ratio within cells. (Source 13)

Limit Sun Exposure

Some sun exposure is necessary for vitamin D production and other benefits, but too many UV rays may be detrimental to NAD+ levels. Remember that the roles of NAD+ include protecting and repairing cells. So, too much sun exposure may deplete NAD+ levels. Furthermore, a deficiency in NAD+ makes your skin more sensitive to UV rays. (Source 14)

Try Resveratrol 

Resveratrol is a polyphenolic compound in red grapes, red wine, peanuts, cacao, and other foods. Resveratrol is an antioxidant and anti-inflammatory agent that supports healthy aging. Newer research suggests that resveratrol and other polyphenols like quercetin may improve sirtuin and NAD+ metabolism. (Source 15)

Use NAD+ Supplements to Increase NAD+ Levels    

One of the most effective ways to increase NAD+ levels may be supplementing NAD+ itself. 

Most supplements on the market are a form of niacin or one of the NAD+ precursors, NR or NMN. These supplements need to be processed by cells to make the active NAD+, which requires ATP (and NAD+ is needed for ATP production). For many people, this conversion might not work optimally, especially as we get older. In addition, taking niacin itself can cause the uncomfortable side effect of flushing. 

So, it makes sense to use NAD+ itself, but the downside is that NAD+ has some instability issues because of its oxidized state. However, at Core Med Science, we’ve worked around this issue by packaging NAD+ in a liposomal delivery system. A phospholipid liposome mimics your body’s cell membranes, so it’s better absorbed and utilized by the body. It has an easier time making it into cells and the mitochondria of cells where needed. 

The other benefit of liposomal NAD+ is that you only need a small dose. If you are taking an NR supplement, you might need 1000 to 2000 mg to raise NAD+ levels, compared to a standard dose of liposomal NAD+ of just 100 mg. (Source 16)

Core Med Science’s Liposomal NAD+ provides active, stable, quality, and highly absorbable NAD+ in a sunflower-derived phospholipid and is physician formulated. It’s a true innovation in the NAD+ market!

While NAD+ levels decline with age and contribute to low energy and disease, there is a lot you can do to maintain and boost your NAD+ levels with daily lifestyle habits. A nutritious diet, exercise, and NAD+ supplements may be the key to a long and healthy life. 

References

1. Nikiforov, A., Dölle, C., Niere, M., & Ziegler, M. (2011). Pathways and subcellular compartmentation of NAD biosynthesis in human cells: from entry of extracellular precursors to mitochondrial NAD generation. The Journal of biological chemistry, 286(24), 21767–21778. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122232/ 
2. Schultz, M. B., & Sinclair, D. A. (2016). Why NAD(+) Declines during Aging: It's Destroyed. Cell metabolism, 23(6), 965–966. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088772/ 
3. Ramsey, K. M., Yoshino, J., Brace, C. S., Abrassart, D., Kobayashi, Y., Marcheva, B., Hong, H. K., Chong, J. L., Buhr, E. D., Lee, C., Takahashi, J. S., Imai, S., & Bass, J. (2009). Circadian clock feedback cycle through NAMPT-mediated NAD+ biosynthesis. Science (New York, N.Y.), 324(5927), 651–654. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738420/ 
4. Verdin E. (2015). NAD⁺ in aging, metabolism, and neurodegeneration. Science (New York, N.Y.), 350(6265), 1208–1213. Abstract: https://pubmed.ncbi.nlm.nih.gov/26785480/ 
5. Savitz J. (2020). The kynurenine pathway: a finger in every pie. Molecular psychiatry, 25(1), 131–147. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790159/ 
6. Matasic, D. S., Brenner, C., & London, B. (2018). Emerging potential benefits of modulating NAD+metabolism in cardiovascular disease. American journal of physiology. Heart and circulatory physiology, 314(4), H839–H852. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5966770/ 
7. Johnson, S., & Imai, S. I. (2018). NAD +biosynthesis, aging, and disease. F1000Research, 7, 132. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5795269/ 
8. Ji, Z., Liu, G. H., & Qu, J. (2022). Mitochondrial sirtuins, metabolism, and aging. Journal of genetics and genomics = Yi chuan xue bao, 49(4), 287–298. Full text: https://www.sciencedirect.com/science/article/pii/S1673852721003581?via%3Dihub 
9. García-Flores, L. A., Green, C. L., Mitchell, S. E., Promislow, D. E. L., Lusseau, D., Douglas, A., & Speakman, J. R. (2021). The effects of graded calorie restriction XVII: Multitissue metabolomics reveals synthesis of carnitine and NAD, and tRNA charging as key pathways. Proceedings of the National Academy of Sciences of the United States of America, 118(31), e2101977118. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346868/ 
10. Elamin, M., Ruskin, D. N., Sacchetti, P., & Masino, S. A. (2020). A unifying mechanism of ketogenic diet action: The multiple roles of nicotinamide adenine dinucleotide. Epilepsy research, 167, 106469. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250869/ 
11. Trammell, S. A., Yu, L., Redpath, P., Migaud, M. E., & Brenner, C. (2016). Nicotinamide Riboside Is a Major NAD+ Precursor Vitamin in Cow Milk. The Journal of nutrition, 146(5), 957–963. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6879052/ 
12. de Guia, R. M., Agerholm, M., Nielsen, T. S., Consitt, L. A., Søgaard, D., Helge, J. W., Larsen, S., Brandauer, J., Houmard, J. A., & Treebak, J. T. (2019). Aerobic and resistance exercise training reverses age-dependent decline in NAD+ salvage capacity in human skeletal muscle. Physiological reports, 7(12), e14139. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6577427/ 
13. Raynes, R., Pombier, K. M., Nguyen, K., Brunquell, J., Mendez, J. E., & Westerheide, S. D. (2013). The SIRT1 modulators AROS and DBC1 regulate HSF1 activity and the heat shock response. PloS one, 8(1), e54364. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3548779/ 
14. Fania, L., Mazzanti, C., Campione, E., Candi, E., Abeni, D., & Dellambra, E. (2019). Role of Nicotinamide in Genomic Stability and Skin Cancer Chemoprevention. International journal of molecular sciences, 20(23), 5946. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929077/ 
15. Tovar-Palacio, C., Noriega, L. G., & Mercado, A. (2022). Potential of Polyphenols to Restore SIRT1 and NAD+ Metabolism in Renal Disease. Nutrients, 14(3), 653. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837945/ 
16. Connell, N. J., Houtkooper, R. H., & Schrauwen, P. (2019). NAD+ metabolism as a target for metabolic health: have we found the silver bullet?. Diabetologia, 62(6), 888–899. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509089/