Evaluating NAD and NAD precursors for health and longevity

When it comes to potential “longevity drugs,” separating legitimate promise from unfounded claims can be a challenging and frustrating task, and the greater the hype, the more difficult it can be to filter out the noise in search of a signal. For one particular therapy, hype (and commercial popularity) has surged over the last several years: nicotinamide adenine dinucleotide, or NAD. Indeed, we would be hard-pressed to overestimate the importance of this molecule for many cellular processes necessary for survival, and declining levels of NAD have been implicated in age-related diseases and cellular senescence. Thus, NAD-boosting therapies – i.e., NAD itself or NAD precursors, mainly NR (nicotinamide riboside) and NMN (nicotinamide mononucleotide) – have garnered attention for numerous purported benefits, including lifespan extension, improvements in metabolic health, exercise performance enhancement, and others.

But do we have evidence that supplementing NAD levels with exogenous NAD or NAD precursors can improve health and longevity? Why did NAD become such a focal point in the conversation about lifespan extension in the first place? Which, if any, of the alleged benefits of supplementing with exogenous NAD are supported by existing evidence? And are some NAD-boosting treatments more effective than others? In this article, we turn our attention to these questions and more as we attempt to disentangle fact from fiction and advertising claims from scientific evidence with respect to the therapeutic value of NAD and NAD precursors.