What the HECK is NAD? (And Should You Be Taking It?)

If you spend time in wellness circles (or on social media), you’ve probably heard rumblings about NAD, a buzzy little molecule some are calling the key to better energy, sharper focus, and even loftier claims like “reverse aging.”

Any time inexplicably ageless celebrities and influencers start crediting something as some kind of secret weapon, we start to wonder … Should we all be taking an NAD supplement?

And then, we ask the experts. Let’s dig into what NAD is, what it does, and whether it’s worth the hype.

What is NAD?

NAD (nicotinamide adenine dinucleotide) is a tiny molecule present in every cell, helping your body to turn food into usable energy. Think of it as a rechargeable battery, constantly cycling between two forms, NAD+ and NADH (the oxidized and reduced forms), to keep your cells running smoothly.

As we age, those levels naturally decline, but scientists are increasingly interested in whether supplements can help restore them.

Recently, NAD has become a buzzword in the wellness space, often referring to supplementation delivered in a variety of forms — IVs, injections, oral tablets, and more.

How NAD “Works”

“NAD+ is what fuels our cells to produce energy,” explains Chloe Bates, clinical team lead at Pause Studio, a wellness studio in Nashville. “We were taught in middle school science that mitochondria are the powerhouse of the cell because they produce ATP, which powers our cells and gives us energy.”

NADH acts as a carrier, feeding the mitochondria to generate ATP — the “energy currency” of the cell. The body constantly converts one form of NAD to another as part of normal metabolism.

NAD’s Three Primary Functions

1. Energy production
   • Nutrients from food are broken down and fed into your mitochondria.
   • NAD picks up high‑energy electrons from this process (as NADH) and delivers them to the “power chain” that makes ATP, your main energy molecule.
2. Repair and maintenance
   • Some enzymes that repair DNA or help control inflammation and stress responses need NAD⁺ to work.
   • As we age or when we’re under stress, we may burn through more NAD⁺ on repair work.
3. Cellular communication
   • NAD and its breakdown products act as signals, instructing cells on how to respond to stress, damage, and metabolic changes.

When NAD Levels Are Supported

“When NAD levels are properly supported, clients notice greater energy levels and enhanced mental clarity and focus,” explains Chloe of Pause Studio. “NAD is also supportive in anti-aging. It aids in repairing damaged DNA caused by environmental stressors like UV light and increases collagen, elastin, and keratin production — promoting firmer skin.”

When NAD Levels Decline

Without enough NAD, your cells can’t make energy efficiently or keep up with any repairs needed. As we age, NAD levels tend to fall, and this drop has been linked to tired cells and age‑related diseases. It’s no wonder older adults — and younger people anxious about aging — are asking about NAD.

“NAD levels naturally begin to decline around age 30, and lifestyle factors such as poor diet, insufficient sleep, and high stress can accelerate that decline. Lower levels can contribute to fatigue, brain fog, slower recovery, and reduced overall resilience,” says Chloe.

Are You a Good Candidate for NAD-Related Supplementation?

Melissa Rhodes, owner and Aesthetic NP-C at Ona Skincare in Nashville, shares that supplementation with NAD is “… less about stopping aging and more about supporting how well your body functions as you age. Think of it as helping your cells do their job better, not turning back the clock.”

Melissa stresses that this isn’t a first-line treatment, and she breaks the explanation down like this:

The most appropriate candidates tend to be:

• Patients with persistent fatigue or burnout, despite solid lifestyle habits
• Those navigating perimenopause or midlife metabolic shifts
• High-performing individuals feeling a decline in energy, focus, or recovery
• Patients already engaged in a comprehensive wellness plan (nutrition, sleep, hormones)

And just as important, who is not an ideal candidate:

• Someone looking for a quick fix without lifestyle changes
• Patients who haven’t addressed sleep, nutrition, or stress first
• Patients with active cancer or high risk for cancer 

“If the foundation isn’t there, NAD won’t feel like the solution you’re hoping for,” adds Melissa. “We tend to recommend Niagen, which is an NAD precursor that helps your body produce its own NAD, rather than supplementing NAD, which can cause the body to decrease the production of its own.” 

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Limitations and Cautions

Swallowing NAD (or its precursors) doesn’t magically pour it into your cells, though. The molecule is large and electrically charged, making it difficult to transport across cell membranes. When taken orally, much of it is broken down first in the gut and bloodstream, so many practitioners deliver NAD through IVs or injections. And all agree that human studies around NAD so far have been small-scale or short-term. 

“It is very important for patients to understand the limitations of NAD,” cautions Dr. Christopher Sizemore, OB-GYN and Chief Medical Officer for Nashville’s Diana Health. “Most of the interest around NAD comes from animal and cellular studies. While the biology of how NAD works is exciting, we don’t yet have strong evidence showing proven clinical outcomes in humans.”

“While NAD is essential for cellular energy and declines with age, the evidence supporting supplementation is still emerging. I want patients to make informed decisions rather than assume these products are proven or risk-free,” says Heather Craig, Registered Dietitian and owner of HBC Nutrition.

For some people, NAD treatment may even be dangerous, say Sasha Carroll, RN, and Tara Johnson, NP, peptide specialists at Level Wellness Franklin. “Contraindications of NAD treatment include active or recent cancer, autoimmune disease, kidney disease, and liver disease … It is not recommended for those with cancer and these diagnoses due to it acting as a fuel for cellular metabolism and energy production, which can inadvertently accelerate growth and survival of cancer cells.”

Another important factor is the quality and source of your supplements.

“Not all NAD-related products or peptides are created equally. Where they are manufactured, how they are compounded, and whether they are properly tested for purity and sterility matter significantly,” explains Sierra Waine, founder of Society Wellness and Skin Spa in Birmingham.

“In a space that is growing quickly, there can be a wide range in quality, and patients are not always aware of that,” she adds. “I would urge people not to order these things online or from their sister’s friend, who orders them from some unknown source.”

Try the Basics First

While the jury is still out on NAD, every practitioner we spoke to agreed that supporting NAD levels comes down to lifestyle rather than supplementation. Things like “prioritizing consistent, high-quality sleep, eating a balanced diet, staying active, and managing stress,” says Chloe of Pause Studio.

If you notice that, despite prioritizing these lifestyle interventions and getting your annual blood tests and checkups done, you still don’t have the energy you used to, then NAD+ intramuscular or intravenous supplementation may be a good option to discuss with your healthcare providers.

“I encourage patients to consider a monitored short trial of NAD if the other proven interventions are not achieving the desired results,” says Dr. Sizemore.

“Everything should be used thoughtfully, and in moderation alongside medical care, so labs and medical history by a provider remain important,” adds Melissa of Ona Skincare. “The science around NAD is exciting … but we’re still in the early stages regarding large-scale human outcomes. Some patients report improved energy, mental clarity, or recovery, but responses vary. We don’t position this as a cure or a guarantee; it’s one tool in a bigger strategy.”

The Bottom Line

Experts say that NAD supplementation is not a universal fix and that more human clinical studies are needed. However, it works for some people and may be worth trying if your symptoms and lifestyle align with the criteria mentioned above.

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