NAD+
NAD+ featured article
Nicotinamide adenine dinucleotide (NAD+) is a cofactor (a molecule that assists enzymes in chemical reactions) that plays an essential role in multiple physiological processes, such as energy metabolism, DNA repair, and immune activation. It is necessary for the activity of sirtuins, a class of enzymes involved in longevity, and poly-ADP-ribose polymerases (PARPs), a family of DNA-repair enzymes. Cellular NAD+ production declines with age, however, and its depletion likely drives the onset and progression of multiple age-related conditions such as metabolic dysregulation and neurodegenerative disease.
The human body can synthesize NAD+ from a variety of dietary sources, including tryptophan (an amino acid) and the three forms of niacin (vitamin B3) – nicotinamide (NAM, also called niacinamide), nicotinic acid (NA), and nicotinamide riboside (NR) – commonly referred to as niacin equivalents. Of these three, NA is the primary source of NAD+. These precursors are not equally allocated...
Episodes
Dr. Rhonda Patrick reviews how L-carnitine, CoQ10, alpha-lipoic acid, and PQQ affect mitochondrial energy metabolism.
Dr. Charles Brenner explains how nicotinamide riboside raises NAD and compares oral NR with NAD, NMN, and intravenous delivery.
Dr. Charles Brenner explains how nicotinamide riboside raises NAD metabolites and what human studies show about exercise recovery.
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Dr. Rhonda Patrick reviews how L-carnitine, CoQ10, alpha-lipoic acid, and PQQ affect mitochondrial energy metabolism.
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Dr. Charles Brenner explains how nicotinamide riboside raises NAD and compares oral NR with NAD, NMN, and intravenous delivery.
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Dr. Charles Brenner explains how nicotinamide riboside raises NAD metabolites and what human studies show about exercise recovery.
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Nicotinamide adenine dinucleotide, or NAD, is in every cell of your body and plays a central role in energy metabolism, mitochondrial...
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Dr. Rhonda Patrick and Dr. Charles Brenner discuss NAD precursors, NR versus NMN, NAD IV drips, and what truly boosts NAD for recovery and longevity.
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Dr. Rhonda Patrick discusses iron imbalances, urolithin A, NAD+ boosters, vitamin K2 and hormone replacement therapy in women.
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Rhonda Dementia Vitamin K Sulforaphane Sauna Glutathione Triglycerides Time-Restricted Eating NAD+ Microplastics Pollution PfasDr. Rhonda Patrick explores collagen peptides, high-dose niacin and vitamin B6, avoiding nano- and microplastics in her latest Q&A.
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Q&A #45: Can Melatonin Help Older Adults Sleep—and Should You Supplement With Nicotinamide Riboside? PremiumDr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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Rhonda Vitamin D Exercise Brain Alzheimer's Parkinson's Cancer Microbiome Cholesterol Omega-3 Skin Sulforaphane Protein NAD+ Moringa Blood-Brain Barrier CocoaDr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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Rhonda Vitamin D Exercise Obesity Vitamin C Pregnancy Muscle Sulforaphane Sauna Time-Restricted Eating Blood Sugar Weight Loss NAD+Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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In this clip, Dr. Patrick talks about the effects of nicotinamide mononucleotide on cancer growth.
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Rhonda Aging Breast Cancer Omega-3 Probiotics Coffee Vitamin B12 Vaccine Vitamin K Skin Sulforaphane Sauna Time-Restricted Eating Protein COVID-19 NAD+ Moringa Supplements UbiquinolDr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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Rhonda Alzheimer's Gut Sleep Omega-3 Inflammation Vaccine Vitamin K Autism Sauna COVID-19 NAD+ SupplementsDr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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Rhonda Vitamin D Brain Cancer Epigenetics Aging Hormones Diabetes Vitamin C Antibiotics Vitamin K Sulforaphane Sauna Glutathione Oxidative Stress NAD+ CardiovascularDr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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In this clip, Dr. David Sinclair describes his personal resveratrol and nicotinamide mononucleotide supplementation habits.
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In this clip, Dr. David Sinclair discusses the economic issues associated with research using nicotinamide riboside and nicotinamide mononucleotide.
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In this clip, Dr. David Sinclair discusses the current state of research on nicotinamide mononucleotide.
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In this clip, Dr. David Sinclair discusses the stability issues encountered with nicotinamide riboside and nicotinamide mononucleotide.
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In this clip, Dr. David Sinclair describes the NAD+ salvage pathway and how boosting cellular NAD+ levels may be beneficial in slowing aging.
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In this clip, Dr. David Sinclair describes the role of NAD+ in the regulation of the body's circadian clock and sirtuin production.
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Rhonda Exercise Cancer Sleep Omega-3 Probiotics Fasting Pregnancy Coffee Melatonin Sauna Vegetarian Time-Restricted Eating Breast Milk Senescence Metformin NAD+Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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Rhonda Omega-3 Fasting Circadian Rhythm Mushroom Sugar Sauna Saturated Fat Vegetarian Protein Dairy NAD+ Cardiovascular SupplementsDr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
Topic Pages
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NAD+
NAD+ is a ubiquitous redox cofactor that cycles between oxidized and reduced forms to shuttle hydride ions.
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Nicotinamide mononucleotide
Nicotinamide mononucleotide is an obligate NAD+ biosynthetic intermediate, enzymatically adenylylated by NMN adenylyltransferase to form NAD+.
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Nicotinamide riboside
Nicotinamide riboside is phosphorylated by NRK to NMN, then adenylated by NMNAT to restore intracellular NAD+.
News & Publications
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Nicotinamide riboside (NR) can markedly raise blood levels of NAD, a molecule involved in cellular energy production that has been studied for its potential to protect nerve cells in Parkinson's disease. A new study tested whether it could improve symptoms when taken alongside Parkinson's medication.
Researchers randomly assigned 410 people diagnosed with Parkinson's disease in the previous two years to receive 500 milligrams of NR or placebo twice daily for 52 weeks, alongside Parkinson's medication. The main study outcome combined movement and nonmovement difficulties in daily life with a clinician's movement examination. Higher scores on the 0–236 scale meant worse impairment.
- The combined symptom score rose 2.45 points with NR and fell 0.27 points with placebo over 52 weeks. The difference was below commonly used thresholds for clinical importance.
- Symptoms unrelated to movement also worsened more with NR, with a 4.22-point difference from placebo on a separate 0–360 symptom scale.
- Brain imaging showed no clear difference between groups in the loss of dopamine-producing nerve connections affected by Parkinson's disease.
- Although NR markedly increased blood NAD levels, brain imaging provided no clear evidence that it increased NAD levels in the brain compared with placebo.
The lack of a clear difference in the brain NAD measurement, despite the strong blood response and promising findings from earlier short-term trials, could have several explanations. With prolonged treatment, brain cells may adjust by reducing NAD production or increasing its breakdown. The brain measurement may also have not been sensitive enough to detect modest changes that could have provided further insight. Neither possibility, however, has been shown to explain the difference in symptom scores. Whether that difference reflected an interaction with Parkinson's medication, other effects of prolonged NR supplementation, or unrelated factors remains uncertain.
The trial challenges the idea that NR supplementation can make the brain more resilient to the underlying disease processes in Parkinson's disease. Whether different doses, treatment durations, or stages of the disease might produce different outcomes has yet to be determined.