The wellness industry is witnessing a surge in popularity for NAD+ (nicotinamide adenine dinucleotide) treatments, from intravenous drips to oral supplements, with celebrities like Hailey Bieber and Jennifer Aniston reportedly endorsing them. Clinics and supplement companies tout NAD+ as a solution for boosting energy, enhancing cognitive function, strengthening immunity, and slowing the aging process. However, medical professionals are divided on the scientific validity and safety of these trendy anti-aging interventions.
NAD+ is a molecule naturally present in all living cells, essential for converting food into energy and involved in DNA repair. Levels of NAD+ are known to decline with age, leading to the hypothesis that restoring these levels could mitigate age-related decline. This theory has fueled a lucrative market, with NAD+ IV drips costing up to £400 per session and at-home kits ranging from £350 for a month's supply. The broader NAD+ and NAD-precursor market is estimated to be worth hundreds of millions to billions of dollars globally, with projections indicating significant future growth.
Despite the widespread adoption and marketing of NAD+ products, some experts express caution. Dr. Michael Sagner, a clinical adviser specializing in longevity at King's College London, suggests that evidence for NAD+ efficacy in healthy humans remains limited, with many claims being extrapolated from animal studies. He highlights the difficulty in conducting long-term human trials to measure anti-aging effects, noting that while some disease-specific studies show promise, this differs from proving benefits for healthy individuals seeking to stay young.
Dr. Sagner also voices significant concerns about the safety and regulation of NAD+ IV drips, describing parts of this industry as "murky." He reports anecdotal evidence of clinics substituting NAD+ with less expensive substances or administering products that may carry risks, such as inflammation and allergic reactions, leading to side effects like headaches and dizziness. He argues that the body is designed to produce NAD+ internally from precursor compounds, and introducing it directly into the bloodstream intravenously is not advisable and could be dangerous.
For those seeking to increase NAD+ levels, Dr. Sagner suggests that oral nicotinamide riboside (NR), a known NAD+ precursor, is the most sensible approach. He emphasizes the importance of sourcing supplements from reputable providers, as quality control and regulation vary widely, especially for products not marketed as medicine, which are not subject to the same efficacy and safety evaluations by bodies like the MHRA in the UK.
Theoretical concerns have also been raised about the potential unintended consequences of artificially boosting NAD+ levels. Some scientists worry about an increased cancer risk, as NAD+ plays a role in cellular processes vital for cancer cell survival and growth. Another potential downside discussed is the generation of more biological waste products as cells become more metabolically active, contrasting with the slower metabolisms observed in many long-lived animals.
Conversely, some practitioners report positive outcomes. Dr. Enayat, a general practitioner and founder of a longevity clinic, states that approximately 75% of his patients experience symptom improvements, including enhanced energy, better sleep, and increased mental clarity, after undergoing NAD+ treatments. He acknowledges that NAD+ may be oversold and believes it is most beneficial for individuals who are deficient.
Both sides of the debate generally agree on a more measured approach. Dr. Sagner recommends measuring NAD+ levels if one suspects a deficiency and considering oral NR supplementation if levels are low, treating it like a deficiency rather than a broad anti-aging strategy. While this may improve energy levels, he stresses that there is still no definitive proof of long-term anti-aging benefits. For individuals considering NAD+ injections or IV drips, experts advise caution, particularly those with pre-existing health conditions, those on medication, or with a history of cancer. The consensus leans towards avoiding exaggerated claims, being wary of unregulated providers, and not assuming that increased intake guarantees better results.