This supplement has been called the fountain of youth. Doctors reveal all
The desire for youth and longevity is ubiquitous, with doctors, consumer product formulators, and infomercial hosts rushing to crack the ageing code.
Heck, even Cher once wished she could turn back time.
And while science has yet to identify a single cream or pill that can stop the clock, the concept of regenerative ageing, which is gaining traction on social media and among the medical community, is beginning to change how we think about getting older. “Unlike traditional approaches that focus on reversing symptoms, regenerative aging emphasises optimising the body’s biological functions to slow and repair cellular decline," explains Robyn Gmyrek, MD, a board-certified dermatologist in New York City.
What does this mean for your skin? Instead of a focus on treating things like wrinkles and laxity, the goal is to target the biological processes that create those visible signs of ageing, she says. “Aging has traditionally been thought of as degenerative, and with new regenerative therapies, there are more ways to maintain and even build the body up,” adds naturopathic doctor Nadia Musavvir, ND.
Those therapies include a variety of therapies and promising ingredients, including the current golden child: NAD+. TikTok is rife with videos detailing a lengthy list benefits and celebs are waxing poetic about game-changing NAD+ IV injections. You may be skeptical—and you're right to be so—but there is a growing body of research to support the effects of this intriguing molecule.
Is it the fountain of youth you—and Cher—have been looking for? Here’s what you need to know.
Miracle Molecule
Also known as nicotinamide adenine nucleotide (makes sense that it’s always abbreviated, right?), NAD+ is a coenzyme that's present in all the cells in our body. It assists the body with energy production, DNA repair, and overall cellular health, says Dr. Gmyrek, and research has also found that it plays a key role in regulating metabolism and circadian rhythm. And although NAD+ is ubiquitous because it’s required for energy production, cells in areas that need more energy, like the heart, brain, and muscle, rely on the molecule even more, adds Dr. Musavvir.
Why this is important to understand: Our levels of NAD+ decline as we age, says Leonard Guarente, PhD, Co-founder and Chief Scientist of Elysium Health. Exactly how much is hard to quantify, and also depends on what area of the body you’re talking about. For context, some research shows that the average concentration of NAD+ drops at least 50% in the skin and between 10 to 25% in the brain as we age.
All of the experts we spoke with agreed that NAD+ is an important molecule, and that there’s no denying its precipitous age-related decline. But there's some disagreement about how beneficial—or even possible—it would be to try and boost those levels. “The theory sounds good: Cells are aging and NAD+ is falling, so there must be a correlation between the two,” says Bobby Dubois, MD, PhD, a board-certified physician and host of the Live Long and Well podcast. But there are some issues with that theory. “First, you need to get NAD+ into the cells of your body, where it functions,” says Dr. Dubois. “Then, the 64 trillion dollar question becomes: If you even can get it there in the first place, how will it function once it's there and what will it actually improve anything?” he says.
In spite of these questions, consumer brands are scrambling to launch products—many of them supplements— aimed at delivering NAD+ and its supposed benefits to your body. “It’s a tough thing to determine, but we do have customer feedback and reports of more energy, better sleep, better clarity of thought, and improvement in skin,” says Dr. Guarente, whose company makes Basis, a supplement the brand claims can increase the body's own NAD+. A company-funded, but independently-conducted, randomized, double-blind, placebo-controlled study found that the combination of active ingredients found in Basis increased participants levels of NAD+ by up to 40% (these findings were published in Nature Partner Journals: Aging and Mechanisms of Disease).
These are promising findings, but Dr. Dubois notes that the effects can vary from person to person, adding that there’s no quantifiable way to test the benefits or baseline from which to measure changes. “A good friend told me that taking an NAD+ boosting supplement made his brain feel alive—I felt no different after several months of taking it,” he says. Dr. Dubois is one of many other researchers who are more cautious when it comes to recommended NAD+ supplementation.
Buyer Beware?
The biggest barrier is getting NAD+ into the body because it’s such a large molecule, says Dr. Guarente. For that reason, straight up ingestible NAD+ (for example, in a supplement) will likely be ineffective. It can't be absorbed and is likely broken down during the digestive process, Dr. Musavvir notes. So, if you are trying to up your NAD+ levels with a pill, it's best to make sure it contains an NAD+ precursor, a compound that helps to stimulate the body's own production of NAD+, says Dr. Guarente.
Also known as NAD+ boosters, these include things such as nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR), which is found in Basis. “NR can get into cells where it’s then converted into NAD; you’re essentially giving cells the building blocks to make more NAD+,” Dr. Guarente explains. (Studies conducted on oral supplementation haven’t shown any direct skin benefits.)
Intravenous NAD+ is another hot trend. “The body takes the NAD+, converts it into NMN, then shuttles it into the cells and then finally converts it back to NAD+,” says Dr. Musavvir. It's also become chatter because of how terrible it makes some people feel after taking it. “NAD+ is typically found inside a cell, so when it's infused into a vein or muscle, it goes into directly into the bloodstream, signaling to the body that an intracellular molecule has been detected outside of the cell and triggering an adaptive response,” Dr. Musavvir explains. That adaptive response can include chest tightness and nausea, making it very hard for some people to tolerate the infusions.
Basis NAD Supplement
Finally, there are topical products that contain NAD+ or its precursors—the use of which was pioneered by the brand Aramore, a line developed by scientists at Harvard and MIT that includes topical products and a supplement. “In theory, these should help with skin rejuvenation, but NAD+ is a very unstable molecule that's likely to degrade before reaching its target,” says Dr. Gmyrek. And again, size is a huge problem, pun intended. Like hyaluronic acid, this molecule is large, making it penetrate into skin difficult. Theoretically, NAD+ precursors such as NMN might be more promising for topical formulations, too, but more research is needed to show direct skin benefits, she says. (You've may have heard the word niacinamide—it's a B vitamin and an early precursor to NAD+ that's a popular in skincare products like serums.)
Other common skincare ingredients, including resveratrol (found in moisturizeers and in supplement form) and vitamin C, may also help to boost your skin's existing NAD+ levels, notes Dr. Gmyrek. Though research to support this is lacking, there are plenty of well-established benefits to using formulas with these ingredients. Point being, there’s likely no harm in trying skincare that claims to have some kind of NAD+ boosting effect, but take those particular promises with a (very large) grain of salt.
NAD+ Cell Energizing Lotion
Bottom Line: Should You Be Trying NAD+?
That's up to you. Topically, take a pass. Product-wise, stick with the tried-and-true stuff: sunscreen and retinol. "Simply protecting yourself from UV damage can making a huge difference, since we know that 80% of the visible signs of aging come from sun exposure," Dr. Gmyrek advises. NAD+ injections or IVs are pricey and notably uncomfortable, taking that off the table for many as well.
That leaves NAD+ supplements. And even here, the jury is still out, says Dr. Gmyrek, who says she’d still like to see larger, more longterm studies on the benefits of those NAD+ precursors mentioned earlier. Dr. Guarente notes that, given that much of the initial research was done in yeast and mice, it’s just now that more data is being collected in humans.
Dr. Dubois adopts a more skeptical standpoint. “It’s an exciting area of research but it hasn’t been shown to have an impact on people—that could mean that in five years from now, these purported benefits may be debunked,” he says. Will taking NAD+ (or its precursors, in this case) hurt you? Probably not, he says. (Although as always, consult with your doctor before starting any new supplement.) But he echoes a similar sentiment as Dr. Gmyrek, advising that you stick with time-tested health practices that undoubtedly improve quantity and quality of life, such as exercise, sleep, and mind-body harmony.
At the end of the day, NAD+ is neither all hype and no science, nor all science and no hype. Take the purported benefits with a grain of salt, and if you want to work it into your wellness routine, make sure you've got the basics covered, too.
Sorry, Cher.
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