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Ask the Experts

Do NAD-Boosting Supplements Fight Aging?

by Jeanine Barone  

Q: Do NAD-boosting supplements have anti-aging effects and other benefits, as ads claimed?

A: It’s too early to say. It isn’t surprising that there is buzz about these pricey supplements since, as the ads boast, major universities are conducting research on them, some lab and animal studies have had intriguing results, and well-known scientists, including Nobel laureates, are on the advisory boards of some of the companies making the products.

The supplements are supposed to boost NAD, which stands for nicotinamide adenine dinucleotide. A key compound in all living creatures, NAD works with certain enzymes to allow cells to release energy via the mitochondria (commonly called the powerhouses of cells). It is also involved in DNA repair and other biochemical processes. Low NAD levels in the body are believed to impair mitochondrial function. Since NAD declines with age, as does mitochondrial function, it has been proposed that supplemental NAD could delay aging and the diseases associated with it.

Interest in NAD has grown in recent years as part of research looking at the potential role of mitochondria decline in many age-related medical conditions and diseases, including diabetes, Alzheimer’s, and cancer. In particular, researchers are studying enzymes that are dependent on NAD, notably sirtuins, which appear to be important in aging processes. Adding to the buzz is the fact NAD and sirtuins tie into a larger, complicated story involving long-term calorie-restriction, resveratrol (a compound found in grapes), and other key players in current “anti-aging” research, which has largely been done with fruit flies and rodents.

More alphabet soup

Another tongue-twisting compound involved in the NAD story is nicotinamide riboside (NR), a form of vitamin B3 (niacin) that is a precursor to NAD. That is, it boosts levels of NAD and also improves mitochondrial function. Trace amounts of NR are found in certain foods, such as those that contain yeast or whey.

Research into NAD precursors got a jolt in 2013, when a study by prominent scientists, published in the journal Cell, found that injections of another precursor (not NR) rejuvenated mitochondria in old mice. Subsequently, studies found that NR could improve muscle and stem cell function and extend the life span of old mice, as well as reduce a component of amyloid plaque and improve cognition in mice with Alzheimer’s. Note that these are all animal studies; so far there have been no clinical trials in humans demonstrating such benefits.

NR is marketed as a supplement called Niagen by a company that has licensed patents from the universities that discovered how to synthesize NR. The company also sells NR to other supplements makers; a Nobel prize winner in Chemistry is on the its advisory board. It sponsored a small “exploratory” six-week study, published earlier this year in Nature Communications, which confirmed that NR (in doses double that indicated on the supplement’s label) boosts blood levels of NAD in healthy middle-aged or older people. That doesn’t mean it will have anti-aging effects, of course.The company is seeking FDA approval for NR as a prescription drug to treat Cockayne syndrome, a rare genetic disease in children that has symptoms related to premature aging.

Another widely promoted NR supplement is called Basis, which also contains pterostilbene, a plant compound related to resveratrol. The company’s scientific advisory board boasts eight Nobel laureates (count them!) as well as other professors from prominent universities. It’s not clear if they are actually involved with the company’s research in any way or are just window dressing. The company doesn’t make explicit anti-aging claims, just that Basis is “the only daily supplement your cells need.” It sponsored an eight-week study, published in 2017 in Aging and Mechanisms of Disease, which confirmed that the supplement boosts NAD levels in older people.

Other preliminary human studies on NR are underway, including a small NIH investigation on its effects on immunity, or are awaiting publication.

Bottom line: The research on NAD boosters is intriguing but very preliminary, so we suggest waiting for large, well-designed clinical studies by independent researchers before shelling out about $50 a month for them. Even if such compounds are found to rejuvenate mitochondria and have other benefits in lab animals, that might not happen in humans. Meanwhile, it’s not known which NAD booster or dose would be best or who would be most to likely benefit. And the supplements’ side effects and long-term safety are unknown. Don’t be a guinea pig.

Also see DHEA: Anti-Aging in a Bottle?