Not medical advice. I am a software engineer, not a physician. This page documents my own protocol and the research I read while building it. Talk to a qualified clinician before changing your supplementation, diet or any treatment. Lab reference ranges quoted here vary by laboratory and by individual.
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Nicotinamide adenine dinucleotide (NAD+) is a coenzyme present in every living cell. It is essential for hundreds of metabolic reactions, including energy production in mitochondria, DNA repair via PARP enzymes, and activation of sirtuins — a family of seven proteins that regulate cellular aging, inflammation, and stress resistance. By age 50, NAD+ levels decline to roughly half of what they were at age 20, contributing to mitochondrial dysfunction, accumulated DNA damage, and the hallmarks of aging.
The longevity research community has converged on NAD+ restoration as one of the most promising interventions for healthspan extension. Unlike caloric restriction (which also raises NAD+), supplementation with NAD+ precursors like Nicotinamide Riboside (NR) and NMN offers a practical, daily approach to replenishing this critical molecule.
NAD+ functions as an electron carrier in mitochondrial energy production (the electron transport chain) and as a substrate consumed by sirtuins and PARPs. When NAD+ is abundant, sirtuins (particularly SIRT1 and SIRT3) are highly active, producing downstream effects that resemble the benefits of caloric restriction and exercise:
Key insight: NAD+ decline is not just a biomarker of aging — it is a cause of aging. Restoring NAD+ levels reactivates the same protective pathways triggered by fasting and exercise, making it a powerful complement to lifestyle interventions.
Rajman, L., Chwalek, K., & Bhatt, D.L. (2018). Therapeutic potential of NAD-boosting molecules. Cell Metab, 27(3), 529-547. PubMed
The following supplements target different nodes of the NAD+ and mitochondrial longevity pathway. They are listed in the full supplement stack with dosing schedules.
| Supplement | Role | Timing | Link |
|---|---|---|---|
| Nicotinamide Riboside (NR) | Direct NAD+ precursor; raises intracellular NAD+ by 40-60% | 300 mg 3x/day (900 mg total) | Stack |
| NMN (Nicotinamide Mononucleotide) | Alternative NAD+ precursor; converts to NAD+ via NMNAT enzymes | Per protocol | Stack |
| CoQ10 + PQQ | CoQ10 supports electron transport chain; PQQ stimulates mitochondrial biogenesis via CREB/PGC-1α | With breakfast (fat-soluble) | Stack |
| Taurine | Longevity-associated amino acid; declines with age; supports mitochondrial function and reduces oxidative stress | With meals | Stack |
| Astaxanthin | Most potent carotenoid antioxidant; accumulates in mitochondrial membranes; protects against lipid peroxidation | With breakfast (fat-soluble) | Stack |
| Creatine | Phosphocreatine energy buffer; supports ATP recycling in brain and muscle; neuroprotective | Any time daily | Stack |
Martens, C. R., et al. (2018). Chronic NR supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun, 9, 1286. PMID: 29992272. PubMed
Yi, L., et al. (2023). NMN supplementation: a clinical trial meta-analysis and systematic review. J Adv Res, 2023. PMID: 36482258. PubMed
While direct NAD+ blood testing is not yet widely available clinically, several surrogate markers track the processes that NAD+ decline accelerates: chronic inflammation, glycation, vascular damage, and nutrient status. Monitor these through the preventive lab tests protocol.
| Test | What It Measures | Frequency | Link |
|---|---|---|---|
| CRP / hs-CRP | Systemic inflammation — inflammaging is driven by NAD+ decline and sirtuin inactivation | Every 6 months | Details |
| HbA1c | 90-day average blood sugar; glycation damages proteins and accelerates aging | Every 6 months | Details |
| Lipid Panel | Cholesterol, LDL, HDL, triglycerides — cardiovascular risk tracks with biological age | Annually | Details |
| Homocysteine | Methylation marker; elevated levels indicate impaired one-carbon metabolism and vascular risk | Annually | Details |
| Vitamin D (25-OH) | Immune modulation and cellular signaling; deficiency accelerates telomere shortening | Every 6 months | Details |
A January 2026 head-to-head clinical trial in 65 healthy adults directly compared NMN, NR, and NAM (nicotinamide) for the first time. After 14 days of supplementation, both NMN and NR comparably increased circulating NAD+ concentrations by approximately 2-fold, while NAM showed no significant increase. Crucially, the study provided mechanistic evidence that gut bacteria convert NMN and NR to nicotinic acid, a potent NAD+ precursor, suggesting the microbiome plays a key role in NAD+ metabolism. A separate February 2026 study found that NMN supplementation reduced inflammatory signaling in exercised human skeletal muscle, though it also raised concerns about potentially suppressing mitochondrial replenishment from phagocytes to repairing myofibers.
The clinical trial pipeline for NAD+ precursors in 2025-2026 has shifted focus toward neurodegenerative diseases (Alzheimer's, Parkinson's) and metabolic disorders (obesity, type 2 diabetes). However, it remains that whether long-term NAD+ supplementation can delay functional aging in the general healthy population has not been clearly established. The current evidence supports NAD+ boosting as biologically plausible but still investigational for anti-aging claims.
NMN.com (2026). Scientists Unveil Results from Human Trial Directly Comparing Three NAD+ Precursors. NMN.com
April 2026 Systematic Review: A PRISMA-guided review in Ageing Research Reviews confirmed that oral NR/NMN reliably raises NAD-related biomarkers in humans, but clinical effects on metabolic, vascular, and performance outcomes remain mixed. Longer, adequately powered RCTs with clinically meaningful endpoints are still needed. Source