Will NAD+ really help you live a longer, healthier life? Or will it kill you?
Like most ultra-trendy supplements, claims are rampant but facts are elusive
Silicon Valley is the place to be if you’re going into supplement sales. No one is more determined to live forever while hanging onto a youthful image than the techno bros whose zip codes start with 94.
No one knows quite why this is so but the general speculation is that, since most of the bros majored in computer science, they’re lacking the liberal arts philosophy that might help them more gracefully accept their mortality (and run better web sites).
But for whatever reason, anti-aging and life extension are hot topics there these days and NAD+ supplements are flying off the pharmacy shelves and being regularly injected into the arms and buttocks of those seeking more years of vitality and, presumably, affluence.
What is NAD+?
Simply put, NAD+ is a coenzyme found in every cell of your body. It plays a crucial role in energy metabolism, DNA repair, and cellular health. Like much of our original equipment, it declines with age — so that by your 50s, you might have about half the NAD+ levels you had in your 20s. This decline has been linked to various age-related issues.
So, it’s easy to jump to the conclusion that keeping your NAD+ at higher levels like when you were, you know, young, might be a good thing or it might turn out to be damaging in the long run.
Regardless, supplement makers know a viral trend when they see one and are now claiming their wares can boost energy, improve cognitive function, enhance athletic performance, and even extend lifespan. Some Silicon Valley types and longevity enthusiasts are spending hundreds or thousands of dollars monthly on these supplements.
But human biology isn’t as simple as it sometimes seems and many scientists are urging caution. Spending big bucks on NAD+ supplements might be something you can afford but whether it’s a smart thing to do to your body isn’t quite as easy to determine.
Questions about NAD+
Human studies so far have been small and inconclusive and what works in mice or rats may not be what is good for humans. In the case of NAD+, it’s a little sobering to learn that recent research has raised questions about whether elevated NAD+ might potentially fuel cancer cell growth, though this is still being investigated.
Versha Banerji, a clinician-scientist at the University of Manitoba, summarized the concern in a Scientific American article: “It might still slow down the aging part, but it might fuel the cancer part. We just need to figure out more about the biology of both of those processes, to figure out how we can make people age well and also not get cancer.”
In the same article, Shashi Gujar, a cancer immunologist at Dalhousie University, noted that while researchers know that cancer cells “like NAD+,” it remains too early to determine whether adding NAD+ would cause those cells to grow rapidly.
You might think that Casey Means, nominated to be the U.S. Surgeon General by Health and Human Services Secretary Robert F. Kennedy Jr., would be an NAD+ booster, but that’s not the case.
“Hot longevity modalities like NAD injections, rectal ozone, and longevity peptides can’t overcome the toxic stew that we are living in. Fix the toxic environment first,” Means says in Issue #34 of her newsletter.
She emphasizes that foundational metabolic health must come first (via lifestyle, environment, etc.), and that you can’t rely on a “shot or a pill” to override deeper metabolic dysfunction.
Means is, therefore, cautious, even critical, of NAD injections as a “magic bullet” for longevity, especially in isolation from supporting lifestyle and environmental factors.
Watch out for the evidence gap
Despite marketing claims about longevity support, there is no conclusive evidence that NAD+ supplements promote longevity in humans. There are studies that find certain benefits, including these:
Scientists at the University of Oslo reviewed studies by 25 researchers. “Fine-tuning NAD⁺ metabolism holds promise for delaying age-related health decline as well as disease such as premature aging diseases” said Dr. Jianying Zhang, one of the lead authors. “But to truly unlock its potential, we need to better understand the right doses, long-term safety, and interindividual variability in response to NAD+ augmentation strategies.”
But another group of researchers, these at the University of Copenhagen, suggested that taking NAD+ supplements may be — at best — a waste of money. In a study published in the journal Cell Metabolism, scientists found that reducing skeletal muscle NAD+ levels in mice by 85 percent did not accelerate aging or impair whole-body metabolism.
“Our results suggest that skeletal muscle can tolerate substantial NAD depletion without loss of function or accelerated aging,” said Associate Professor Jonas Treebak, corresponding author of the study that was published in Cell Metabolism. “This challenges the prevailing view that NAD+ decline is a primary driver of muscle aging and frailty.”
The rather stark truth, NIH researchers say, is that many uncertainties remain: optimal dosing, long-term safety, tissue targeting, which populations benefit, and whether lifestyle interventions may compete with or complement NAD+ therapies.
Who wants to live forever?
As is so often the case, the issue comes down to who and what you want to believe. There will always be promoters of new technologies, inventions and ideas and there will always be skeptics.
There’s also the question of consumer demand. Those shelling out hefty sums of money each month for what they hope will be life-extending treatments presumably enjoy their lives and want them to go on indefinitely.
This isn’t really an existential concern for most people, who can’t afford the treatments in the first place and might not take them even if they could. Why?
Well, many people still hold religious beliefs and think a better life awaits them after this one ends. Others have worked hard at menial jobs and have barely gotten by for decades and are ready for a rest, even an eternal one. They’ve had it with working and being poor.
Most people are probably somewhere in the middle: the idea might sound good but they don’t feel an urgent need to act on it, especially if there’s a chance it either won’t work or might even cause cancer or some other disease to take them sooner than might otherwise be the case.
It’s an individual choice. Those with time and money might want to take a shot at living forever or, for that matter, going to Mars. Good luck to them.