Research guide / NAD+
What is NAD+? A Complete Research Guide.
Updated October 2026 · 9 minute read
NAD+ is a molecule found in every living cell, essential for turning food into energy and for repairing DNA. Its levels fall with age, which has made it one of the most studied targets in ageing research. This guide covers what is known, what human trials have found, and the many open questions.
01 / Overview
What is NAD+?
Nicotinamide adenine dinucleotide exists in an oxidised form (NAD+) and a reduced form (NADH). A 2023 Endocrine Reviews paper describes it as essential to all forms of life: it is a cofactor in the redox reactions that produce cellular energy and a substrate for signalling enzymes.[1]
Unlike most compounds in the Afiya Labs catalogue, NAD+ is not a peptide — it is a nucleotide-based coenzyme. It is grouped with research peptides because of shared interest in metabolism and cellular ageing.[2]
The central observation driving NAD+ research is that tissue NAD+ levels decline with age and in several age-related diseases. Whether restoring them produces meaningful benefits in humans is the open question.
02 / Mechanism
How does NAD+ work in the body?
A 2021 Nature Reviews Molecular Cell Biology review describes NAD+ as central to energy metabolism, DNA repair, and cellular signalling. Three enzyme families consume it: sirtuins (involved in gene regulation and stress responses), PARPs (DNA repair), and CD38 (immune signalling).[4]
As NAD+ falls, these enzymes compete for a shrinking supply. A 2023 Cold Spring Harbor review links this decline to all the hallmarks of ageing, including mitochondrial dysfunction, impaired autophagy, inflammation, and neurodegeneration.[5]
The body rebuilds NAD+ from precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). Most human research has studied these precursors rather than NAD+ itself.
03 / Published evidence
What does the evidence actually show?
In animal models, raising NAD+ has improved markers of metabolic health, muscle function, and neurodegeneration, according to a 2021 review in Mechanisms of Ageing and Development. These results led to several human trials of NAD+ precursors.[2]
Human trials confirm that precursors reliably raise blood NAD+ levels. The Endocrine Reviews authors note, however, that effects on clinical outcomes such as insulin sensitivity, muscle strength, or physical function have been modest or inconsistent — hence the paper's subtitle, "Potential Applications and Many Unknowns."[3]
A 2024 Nature Reviews Molecular Cell Biology review highlights ongoing controversies: how well NAD+ and its precursors reach different tissues, the role of gut bacteria in processing them, and untested assumptions about supplementation.[4]
04 / Safety evidence
Safety and open questions
Short-term human precursor trials have generally reported good tolerability. The Mechanisms of Ageing and Development review nonetheless discusses potential side effects of NAD+ augmentation as an active area of investigation.[4]
The 2024 Nature Reviews paper flags unappreciated factors that could contribute to risks of supplementation, including effects on metabolic by-products and on cells that rely heavily on NAD+, such as rapidly dividing cells. Long-term data is limited.[3]
Most published human data concerns oral precursors. Evidence for other forms of NAD+ administration is thinner, so findings from precursor trials should not be assumed to transfer.
05 / Regulators
Regulatory status
NAD+ and its precursors are not approved medicines for ageing or any age-related condition in major jurisdictions. Some precursors are sold as dietary supplements in certain countries, a category with different evidence requirements from medicines.[3]
In the UAE, the Emirates Drug Establishment maintains the public registered medical product directory. This guide does not use directory presence or absence to infer approval, legality, or permission for use; those questions require confirmation from the EDE. Afiya Labs lists NAD+ strictly as a laboratory research reference material.[6]
06 / Quick answers
Frequently asked questions
Is NAD+ a peptide?
No. NAD+ is a coenzyme built from two nucleotides. It is grouped with research peptides because of shared interest in metabolism and cellular ageing.
Does NAD+ reverse ageing?
That has not been shown in humans. NAD+ declines with age and raising it improves several markers in animals, but human trials have reported modest or inconsistent effects on clinical outcomes.
What are NR and NMN?
Nicotinamide riboside and nicotinamide mononucleotide are precursors the body converts into NAD+. Most human NAD+ research has used these precursors.
What are sirtuins?
Sirtuins are a family of enzymes that need NAD+ to work. They help regulate gene activity and stress responses, which is why they feature prominently in ageing research.
Does Afiya Labs sell NAD+ for human use?
No. Afiya Labs lists NAD+ as a laboratory research reference material only. It is not a medicine and is not presented as suitable for human use.
07 / Sources
References and original records
- 1Nicotinamide Adenine Dinucleotide in Aging Biology: Potential Applications and Many Unknowns. Endocrine Reviews. 2023 · Oxford Academic.
- 2NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology. 2021 · Covarrubias et al..
- 3Roles of NAD+ in Health and Aging. Cold Spring Harbor Perspectives in Medicine. 2023 · Lautrup et al..
- 4Regulation of and challenges in targeting NAD+ metabolism. Nature Reviews Molecular Cell Biology. 2024 · DOI 10.1038/s41580-024-00752-w.
- 5Preclinical and clinical evidence of NAD+ precursors in health, disease, and ageing. Mechanisms of Ageing and Development. 2021 · DOI 10.1016/j.mad.2021.111567.
- 6Registered medical product directory. UAE Emirates Drug Establishment. Official public directory · checked October 2026.