NAD+ (Nicotinamide Adenine Dinucleotide) is one of the most basic molecules in every cell in the body. Without it, the cell cannot produce energy, repair DNA, or maintain proper function. But it has a disturbing feature: its levels gradually decrease with age. A comprehensive expert review published in Nature Aging in March 2026, by more than 25 leading researchers from Oslo, Akershus, and Global, summarizes all the latest research on NAD+ and what it can do against brain diseases such as Alzheimer's and Parkinson's.
Why is NAD+ so important?
NAD+ acts as the "money bill" of the cell. Every great energetic action requires him:
- ATP production. It is the fuel of the cell. Without NAD+, there is no energy
- DNA repair. PARP enzymes, which repair DNA damage, consume NAD+
- Mitochondrial function. NAD+ is the basis of the metabolic cycle
- Sirtuins. Anti-aging enzymes that depend on NAD+
The decrease with age
The researchers document that NAD+ levels in the body's organs decrease at a non-uniform rate with age. The brain regions, especially the hippocampus (memory), and the center of the brain (basal ganglia, which is responsible for movement), lose NAD+ relatively quickly. For this reason, the decrease in NAD+ is directly related to:
- Alzheimer. Low levels of NAD+ in the brain of patients
- Parkinson. Decay of dopaminergic neurons that depend on NAD+
- Type 2 diabetes. A decrease in insulin sensitivity involves NAD+
- Heart diseases. Vascular function depends on NAD+
- Premature aging diseases (progeria): extremely low levels
What can be done?
The researchers looked at the three main approaches to raising NAD+:
- NR (Nicotinamide Riboside) supplement: a form of vitamin B3 that is converted to NAD+ in the body. Safety, extensively researched
- NMN (Nicotinamide Mononucleotide) supplement: one step closer to NAD+ in the biosynthesis pathway. More popular over the last few years
- NAM (Nicotinamide) supplement: classic vitamin B3. Cheap but considered less effective for some uses
All three have shown promising effects in early studies:
- improvement in metabolism
- Memory improvement among adults
- Improvement in muscle strength and physical function
- Improvement in insulin sensitivity
The balance quote
"Targeting NAD+ holds the potential to slow down healthy aging, and also treat premature aging diseases. But we need to better understand the correct doses, the long-term safety, and the individual variability in response to NAD+ boosting strategies," concludes Dr. Jianying Zhang, one of the authors of the review.
What don't you know yet?
The review honestly points out several areas that are still unclear:
- Across the blood-brain barrier. How many of the supplements actually reach the brain? Still not clear
- Long term. There are no experiments that follow users over 5-10 years
- Individual variation. Some people are very responsive, some not at all. Why?
- optimal doses. 250 mg? 1000 mg? Not clear
- Interaction with drugs. Especially the connection with supplements in cancer patients (as discussed in another study)
Who should you take?
Based on the review, populations that could benefit:
- People over 50 who feel a decrease in energy
- Type 2 diabetics (possible improvement in insulin sensitivity)
- People with a family history of Alzheimer's/Parkinson's
Populations that need caution:
- Active cancer patients (see previous Case Western study)
- Pregnant women
- People taking certain medications (consult a doctor)
The bottom line
NAD+ is one of the most promising areas in aging research. The new review in Nature Aging confirms the direction, but also warns: this is still a developing field. If you are considering an NR or NMN supplement, do so with knowledge, not inflated expectations. Combine them with physical activity, a Mediterranean diet, and quality sleep, these are the ways that have already been proven to raise NAD+ naturally.
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