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The Role Of NAD+ In Health And Aging

An image of an older woman who is smilingNicotinamide adenine dinucleotide, or NAD+, is a coenzyme that is part of all living cells. A coenzyme is a compound that binds with enzymes to help catalyze reactions. NAD+ and NADH are the two different forms NAD can be found in. They are what is called a “redox couple”, meaning they are a reduced (gaining electrons) and oxidized (losing electrons) form of NAD. NAD+ accepts electrons, becoming reduced in the process. It is, therefore, an oxidizing agent.

NAD is crucial for your metabolism - the way your body uses energy. It carries electrons from one reaction to another. With NAD+, redox reactions help with the cellular creation of energy, which happens in the mitochondria. Mitochondria are the energy factories inside your cells, and they create ATP, the energy currency of life.

Your body has a limited amount of NAD+ and the amount declines as you age. Because it is such an important compound for so many physiological processes, it goes without saying that its decline can negatively affect your health. NAD+ is also essential for sirtuins to function properly. Sirtuins are proteins that are involved in cellular energy production and overall metabolism.

NAD+ is Involved in Very Important Functions

Energy is needed for every physiological function in your body, but there are some specific functions that NAD+ is especially important for. They include:

  • Sensory and motor functions in the brain and nervous system
  • Cell signaling repair
  • DNA repair
  • Endothelial function in the vascular system
  • Protection of the kidneys
  • Gluconeogenesis and fatty acid oxidation in the liver
  • Protection of the heart
  • Insulin secretion in the pancreas
  • Insulin sensitivity and fatty acid oxidation in the muscles
  • Immunity
  • Inflammation
  • Lipogenesis in adipose tissues
  • Fertility

Because of these important functions, some recovery programs have used NAD+ supplementation or therapy.  In this article, we’ll get into how NAD+ supplementation and/or therapy may be useful for adrenal fatigue recovery, detoxification, and anti-aging. We’ll also cover some precautions for its use.

How NAD+ is Used to Create Energy

An image of a man running on a tredmillThe first and most important use of NAD+ is in the creation of cellular energy from food. When you eat, your food has to go through three stages of conversion to turn into energy that your body can use.

The first is glycolysis, which is the pathway that converts glucose into pyruvate. The energy that is released during this process is then used to create ATP and NADH. The second is the citric acid cycle, or the Krebs cycle, where the oxidation of acetyl-CoA in proteins, carbohydrates, and fats into ATP and carbon dioxide happens. That’s how stored energy is released.

In these two first stages, NADH is created from NAD+. Then, in the third stage, which is called the electron transport chain, the NADH is split into NAD+, which creates H+. H+ is used for the pump inside mitochondria to create ATP. This is the stage where most of the ATP is produced.

This energy creation process is of particular importance if you have Adrenal Fatigue Syndrome (AFS). AFS is a condition that is a result of chronic stress. Its symptoms include fatigue, insomnia, weight gain, brain fog, anxiety, mild depression, low libido, PMS, infertility, hypoglycemia, salt and sugar cravings, heart palpitations, lowered immunity, food and drug sensitivities, dry skin, hair loss, and an inability to handle stress.

Chronic stress causes these symptoms by way of dysregulating the adrenal glands and the overall NeuroEndoMetabolic (NEM) Stress Response.

Adrenal Fatigue and NAD+

When your body is facing stress, its first line of defense is the adrenal glands. They produce cortisol, your body’s main anti-stress hormone. But because your adrenals are a component of the Hormone Circuit of the NEM, if they are affected, they will affect all the other circuits. The six NEM circuits are the Hormone, the Bioenergetics, the Cardionomic, the Neuroaffect, the Inflammation, and the Detoxification Circuits.

With AFS symptoms, many of them (for example fatigue) can be helped with NAD+ supplementation or NAD+ therapy.

The fatigue in AFS is a state of low energy, where your energy and nutrient stores are depleted. That’s why using NAD+ can help with this issue since it is crucial in mitochondrial ATP production. The more energy your cells can create from food, the more energy your body has to function and repair.

We usually recommend NADH as part of the first line of defense nutrients for AFS recovery. Other compounds in this group include vitamins C, D, E, B5, B6, and B12, as well as magnesium, iodine, glutathione, lecithin, inositol, D-ribose, collagen, CoQ10, pantethine/pantothenic acid, and digestive enzymes. The use of gentle nutrients has been one of the most useful recovery tools for our patients, including those with advanced adrenal fatigue.

The levels of NAD+ in your body will not only impact your adrenals, but they will also impact all six NEM circuits. And we’re going to pay special attention to your Detoxification Circuit.

The NEM’s Detoxification Circuit

An image of a woman with a image of lungs, liver, and digestive system on her shirtYour Detoxification Circuit is composed of your liver, immune system, and interstitium (extracellular matrix). The liver is your body’s main clearinghouse, and if it’s congested or slow, it will allow the toxins in your system to build up. Your immune system is what attacks and gets rid of anything that could harm your body. And your interstitium helps get rid of cellular debris.

If your Detoxification Circuit is not working optimally, your Inflammation circuit will dysregulate as well. Inflammation will begin to accumulate and spread throughout your body, causing a variety of issues. For example, inflammation that spreads throughout your gastrointestinal tract can create food sensitivities and digestive problems. Inflammation that spreads to your brain and nervous system can cause brain fog, mental health issues, and neurological symptoms.

Inflammation is at the root cause of most, if not all, chronic conditions.

NAD+ has anti-inflammatory activities that can help a lot with this. Plus, because it supports insulin sensitivity and immunity, it can aid with inflammation as well. Insulin resistance and unstable blood sugar levels can cause a lot of inflammation. If left unaddressed, they can even lead to serious chronic conditions, such as metabolic syndrome and type 2 diabetes.

An immune system that is working properly attacks and gets rid of pathogens, toxins, and metabolic byproducts. It also helps get rid of dead and damaged cells. And inflammation is part of a healthy immune response. But a dysregulated Inflammation Circuit will create issues with immunity, and that can allow toxins and pathogens to remain in and damage your body.

NAD+ Therapy for Detoxing

Recently, many addiction treatment centers are starting to use NAD+ therapy. That’s because it seems to help flush out the substance from a user’s system. It seems to also help with withdrawal symptoms and curbing the cravings for the substance.

Because of its mood-enhancing and energy-boosting properties, it can help patients feel better while they are detoxing. This can prevent them from seeking the substance to feel better. It is usually given via IV drip, bypassing the stomach and going directly to the brain.

Because of these properties, and because it is an all-natural therapy, you can use it for many other types of detoxes and treatments, not just for substance abuse. It’s especially popular as an anti-aging treatment.

Aging can bring with it not only a decline in physical health but also in cognitive clarity and capacity as well. NAD+ has been shown to help with both, and especially with cognitive strength due to the energy it helps create. Brain fog is not just a symptom of AFS, it is also a sign of congestion, and detoxification can be very beneficial for mental clarity in that sense.

For anti-aging, overall wellbeing, and detoxification that is not related to addiction treatment, one session of NAD+ therapy may be enough. A top-up once every couple of months could also be useful.

But there are ways to increase your NAD+ levels through diet, exercise, and supplementation as well.

How to Raise NAD+ Levels

There are a few ways to raise your NAD+ levels, they include:

  • An image of a DNA double helix with a piece being replaced by a someone holding tweezersActivating 5 AMP-activated protein kinase (AMPK), which is an enzyme that helps with the homeostasis of cellular energy. Supplementing with fish oil, or omega-3 fatty acids can help increase AMPK levels.
  • Using NAD precursors, such as nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR). NMN is a derivative of niacin, which is a form of vitamin B3. NR is also a form of vitamin B3, and both NR and NMN can be used to generate NAD+.
  • Using CD38, SARM, and PARP inhibitors. These are proteins and enzymes that take part in the decline and degradation of NAD+, and so inhibiting their activity can help mitigate that loss.

The use of the above, plus doing intermittent fasting seems to bring the biggest benefit. Exercising and eating a healthy diet will also help with NAD+ levels. But there are two caveats you need to know before doing any of the above.

Precautions When Supplementing or Changing Your Diet and Lifestyle

The first is that you should not do any type of therapy or take any type of supplements without supervision if you have AFS. AFS can make your system susceptible to paradoxical reactions. Also, supplements and therapies need to be individualized for your specific condition and needs for them to work effectively or at all.

Not only that, even changing your diet and exercise routine too radically can add unnecessary pressure on your adrenal glands and your entire NEM. This can cause adrenal crashes and slow your recovery process significantly. In AFS recovery, especially in the early stages of recovery, we do not recommend any kind of fasting. You need to replenish your lost nutrient stores and stabilize your blood sugar levels first.

The second is that NAD+ needs to be balanced with methylation. That can include taking 2-5 grams of trimethylglycine a day, taking 10-30 mg of vitamin B2 a day, and taking 1000-3000 mcg of SAMe or methylcobalamin a day. You can also get your homocysteine levels measured as it is a marker of methylation. Again, you won’t want to do any of this by yourself as it needs professional guidance.


NAD+ is a coenzyme that is in all living cells. It is extremely important for many physiological functions. But especially for the creation of ATP, the energy currency of life, by your cells’ mitochondria. Your metabolism, as well as every single function in your body, needs ATP to work. Without sufficient amounts, your health and quality of life suffer a lot. Your aging process will also speed up.

NAD+ levels decline naturally with age. And along with their decline comes a decline in health. So it goes without saying that you should aim to raise its levels if you want to slow down your aging process and improve your health.

One thing that NAD+ therapy can help with is detoxification. It can be useful in balancing your NEM’s Detoxification circuit, to help your body get rid of toxins and pathogens promptly. It’s also very important for immunity and inflammation. NAD+ can be so useful for detoxing that it is now being used in drug rehabilitation centers.

An image of a woman in a hospital bed while a nurse injects medicine into an IV bagBut if you have AFS or NEM dysregulation, we caution you from undertaking any kind of therapy or supplementation routine without supervision. You may end up experiencing paradoxical reactions or adrenal crashes if you make the wrong move. Following the guidance of an experienced professional will help you navigate the recovery process and avoid these kinds of pitfalls.

Please don’t let these precautions deter you from using nutrients and supplements in your supervised recovery, as they are some of your most important recovery tools.

Want Advice on Supplements for AFS Recovery?

The Dr. Lam Nutritional Coaching team can offer you a free** no-obligation phone consultation at +1-626-571-1234 where we will privately discuss your symptoms and what your options are. You can also send us a question through our Ask The Doctor system by clicking here.

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Dr. Lam's Key Question

NAD+ is a coenzyme that is involved in energy production in cells. It’s important for most of your body’s functions. But it has a special ability to help with inflammation, immunity, and detoxification. It’s even used in drug rehabilitation centers to flush out substances and curb cravings and withdrawal symptoms.

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