What Is NAD+ and Why It Matters for Energy, Aging, and Wellness
- Kimberly Moduno
- Jul 17
- 6 min read
What is NAD⁺ and do I need it?
Surely you’ve heard the buzz word NAD+ by now but what in the world is it? Scientifically explained NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme found in all living cells that is essential for metabolism and energy production. What this means is that NAD is needed for all of our cells to function properly and if our cells can’t function, neither can we. Our latest blog post explores why NAD+ is important and how to increase your NAD+ levels.
Why Is NAD⁺ Important for Your Body?
NAD⁺ and the Aging Process
NAD⁺ is closely linked to aging because it plays a central role in many cellular processes that maintain health and function. As we age, NAD⁺ levels decline, which contributes to many aspects of aging and age-related diseases. The older we get, the less we are able to function the way we did when we were younger which goes without saying but its important to understand why. As we age we have less energy, joints and muscles hurt more, we can’t think as clearly and forget things, our skin changes and our health declines. This can all be linked to the reduction of NAD+ available to our cells.
How NAD⁺ Supports Key Cellular Functions
NAD⁺ Supports Aging
NAD⁺ levels naturally decrease with age and in some tissues by up to 50% or more by middle age. This decline is thought to impair critical cellular processes, leading to aging symptoms and disease.
Do you remember the mighty mighty mitochondria? Maybe I’m the only biology nerd from high school. Anyway, Mitochondia is the energy factory of every one of our cells and NAD⁺ is essential for mitochondrial function. Low NAD⁺ = reduced ATP production = tired, less efficient cells — a hallmark of aging.
NAD⁺ Promotes DNA Repair
NAD⁺ activates PARPs which are enzymes that repair damaged DNA. With less NAD⁺, DNA damage accumulates over time, increasing cancer risk and cell dysfunction.
NAD⁺ Promotes Longevity Enzymes (Sirtuins)
NAD⁺ is required for sirtuins to work.
Sirtuins are a family of proteins that regulate:
Metabolism
Inflammation
Stress resistance
Circadian rhythms (sleep cycle)
NAD⁺ Decreases Chronic Inflammation
NAD⁺ plays a role in helping modulate immune response and inflammation. Low NAD⁺ may contribute to the chronic, low-grade inflammation seen in aging. Chronic inflammation, even at a low level, is often undetected until damage is already done. It is linked to diseases like heart disease, high blood pressure, arthritis, diabetes, high cholesterol, kidney disease, Alzheimer’s disease and much much more.
How to Increase Your NAD⁺ Levels
NAD+ Precursors and Supplements
NAD⁺ precursors are ingredients the body needs to make NAD+. A few of these precursors worth mentioning include NMN, NR, Niacin, and Nicotinamide. Like making a cake, we need to have the necessary ingredients and there is research showing that consuming these precursors can help increase the body’s NAD+ stores. However, it is important to recognize that just having all the ingredients may not suffice in making enough NAD+. Having all the ingredients is helpful, but the body’s process of making its own NAD+ may have also declined so it can be like having all the ingredients to make a cake but no baker or oven to make it. There are a number of supplements that are designed to repair and strengthen the body’s ability to produce its own NAD+. Not all supplements are created equal, so look for a reputable brand that is backed by research. At Horizon, we recommend Nuchido Time +.
NAD⁺ Injections and IV Therapy
NAD+ can be directly replaced into the body a number of ways but its important to know which route is best and why. Based on my research, IV (intravenous) and SubQ is the best route to directly replace NAD+. There are some oral supplements that claim to offer NAD+ replacement however NAD+ is a somewhat temperamental and unstable molecule meaning that in its purest form it cannot remain stable or beneficial once it has passed through the GI track. I personally have found the best benefit with giving myself subQ injections periodically throughout the week, but I have also experienced benefit with and IV drip administration. Topical NAD+ likely has some local benefits on the skin, but how much is absorbed into systemic use has not been consistently proven.
Lifestyle Changes
Infrared Sauna and Contrast (Cold) therapy
Infrared Sauna heat therapy and cold exposure (cold plunge) have been shown to increase NAD+ levels by activating stress response pathways that enhance mitochondrial function. Sauna therapy, particularly infrared sauna use, can increase heat shock proteins, which help maintain cellular integrity and support NAD+ recycling pathways. Similarly, cold exposure triggers hormesis, a biological response where cells adapt to stress by increasing NAD+ production and mitochondrial resilience. Studies suggest that regular infrared sauna use and cold exposure can significantly enhance cellular repair, improve circulation, and extend lifespan, making them excellent lifestyle tools for boosting NAD+ levels.
Exercise
Regular aerobic exercise increases NAD⁺ levels by stimulating mitochondrial biogenesis. High-Intensity Interval Training (HIIT) has proven to be especially effective.
Intermittent Fasting and Calorie Restriction
Intermittent fasting and calorie restriction activate sirtuins (longevity enzymes) and increase NAD⁺ production. There are peptide therapies that help patients achieve calorie restriction and simultaneously reduce inflammation which improves metabolic and cardiac health.
What to Know Before Starting NAD⁺ Therapy
There are a number of things to consider when choosing how you would like to start increasing your NAD+ like time and space for exercise, access to things like an infrared sauna or cold plunge, and the cost of therapies and supplements.
Here’s a list of things to think about as you build your personalized program to increase your NAD+:
It’s important to not rely on one route to sufficiently increase your NAD+ levels, but a combination of a few things can have a more synergistic and compounded effect.
Exercise and intermittent fasting are FREE and accessible to everyone, and have many benefits, not just increasing NAD+.
The cost of direct NAD+ replacement is more than the supplements, so if finances is a limiting factor I would start with the supplement, exercise and intermittent fasting.
SubQ NAD+ dosing is highly customizable to your needs. Some people opt for a little eat day, others find benefit in using it as needed for a little Boost of energy. I recommend starting with a small dose daily for at least two weeks and then adjust as needed. Additionally I recommend the supplement daily as well.
Infrared sauna and cold plunge is AWESOME. It seems scary - believe me I thought getting in cold water sounded NUTS - but after I did it I found it addicting and highly beneficial for a list of things. Highly recommend you find somewhere to give this a try.
Increasing your NAD+ is not a “fix all” but it certainly has its perks that make it well worth the effort and investment.
Frequently Asked Questions About NAD+
What is NAD+ and why is it important?
NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme essential for cellular energy production, mitochondrial health, and DNA repair. Low NAD+ levels are linked to fatigue, aging, and disease.
How does NAD+ therapy help with aging?
NAD+ levels decline as we age, reducing energy and cellular repair capacity. NAD+ therapy can boost mitochondrial function, support longevity enzymes like sirtuins, and reduce chronic inflammation.
What are the best ways to increase NAD+ naturally?
You can increase NAD+ levels through NMN or NR supplements, NAD+ injections or IV therapy, high-intensity exercise, intermittent fasting, and using infrared sauna or cold plunge therapy.
Is NAD+ therapy better through IV or supplements?
IV or SubQ NAD+ therapy offers immediate systemic effects and higher bioavailability, while supplements like NMN provide long-term support. A combination may offer the best results.
Are NAD+ supplements safe and effective?
Yes, many NAD+ precursors like NMN and NR are safe and backed by clinical research. Always choose high-quality, science-backed brands for optimal results.
What symptoms can improve with NAD+ therapy?
People report increased energy, improved mental clarity, better sleep, reduced joint pain, enhanced mood, and improved skin when using NAD+ therapy regularly.
Kimberly Losik, a board certified nurse practitioner, is the Founder, Owner and Medical Director of Horizon Med Spa and Wellness. Kimberly has earned multiple degrees including a bachelors in Kinesiology, a bachelors in Nursing, as well as a Masters in Nursing. For over a decade, she has earned experience in Orthopedics, Geriatrics, Internal medicine, Medical weight loss, aesthetics and anti-aging medicine. Her passion to help patients look and feel like the best version of themselves was the foundation of Horizon, which began in early 2020. Since then, she has attended numerous trainings, conferences and seminars to continue to offer patients the best solutions and aesthetic and antiaging medicine. Additionally, she is a clinical trainer for the company Inmode, an internationally recognized leader in the aesthetic industry.
Thanks for sharing this content. NAD+ is very important for energy, aging, and overall wellness. Many people now look for the Best Nad Injections as a way to support their health. Learning about NAD+ helps us understand how it can improve daily life and long-term wellbeing.