In this episode, Dr. Rhonda Patrick breaks down the essential role of NAD⁺ in cellular energy and aging. She explains how everyday stressors and natural aging deplete NAD⁺ levels, leading to mitochondrial dysfunction and DNA damage. The discussion explores whether NAD⁺ precursors like NR and NMN—known to increase NAD⁺ in animals—can do the same in humans. While early data is promising, questions remain about their long-term safety and effectiveness in people.
Why This Matters:
NAD⁺ is a linchpin in the body’s energy systems, playing a critical role in mitochondrial function, DNA repair, and overall metabolic health. As NAD⁺ levels drop with age, the body becomes more vulnerable to chronic disease and cellular decline. Interventions like NR and NMN may offer a proactive way to support energy production and delay age-related deterioration—but they need to be applied with evidence, caution, and expert guidance.
At Clay Health & Care, we track these innovations closely to help people stay ahead of aging by understanding their biomarkers, using targeted therapies, and making informed decisions about their long-term healthspan.
In this clip, Dr. Eric Verdin, President and CEO of the Buck Institute for Research on Aging, breaks down the science behind NAD⁺—a vital coenzyme required by our mitochondria to produce cellular energy. NAD⁺ levels rise during fasting and decline naturally with age, affecting critical enzymes like sirtuins and PARPs that are essential for DNA repair and healthy aging.
Dr. Verdin explores leading hypotheses on why NAD⁺ declines over time: either it’s being depleted to repair accumulated DNA damage, or the body’s ability to recycle it simply deteriorates with age. NAD⁺ supplementation has emerged as a potential strategy to restore cellular energy and counteract some aging-related symptoms, though the science is still evolving
Why This Matters:
As we age, energy production and cellular repair processes slow down—impacting everything from brain function to physical endurance. Replenishing NAD⁺ levels is one of several emerging strategies to optimize mitochondrial health and slow biological aging.
At Clay Health & Care, we explore these advances with clinical rigor, offering cutting-edge therapies like NAD⁺ IVs and supplements as part of personalized health optimization programs.
Join Dr. Craig Koniver, a board-certified physician, as he delves into the therapeutic potential of peptides and hormones to boost physical and mental health. This episode covers key therapies like GLP-1 for weight loss, BPC-157 for healing, growth hormone-boosting peptides, and supplements like CoEnzyme Q10, NMN, and testosterone therapy. Dr. Koniver explains how these treatments enhance performance, improve sleep, support cognitive function, and promote longevity. Learn about dosages, sourcing, safety, and the critical role of working with experienced physicians. Whether you’re considering these therapies or simply curious about their benefits and risks, this episode offers the scientific insights you need to optimize your health and performance.
Why This Matters:
Peptide and hormone therapies are increasingly being explored for their potential to enhance both mental and physical well-being. From weight management to improving cognitive function and recovery, these treatments offer tailored solutions to optimize health and performance. Understanding how peptides and hormones work—along with their potential risks and benefits—is essential for anyone looking to improve their quality of life, longevity, or athletic performance.
At Clay Health & Care, we prioritize evidence-based approaches and individualized care to help you make informed decisions about your health journey, ensuring that your wellness strategies are both effective and safe.
Unless you find yourself steeped in the world of performance and longevity, Nicotinamide Adenine Dinucleotide (NAD⁺) may not be a household name yet—but it’s steadily getting there. This essential molecule is rapidly emerging as a focal point in conversations about cellular health, aging, and energy metabolism. And for good reason: NAD⁺ is fundamental to how our bodies produce energy, repair cells, and respond to stress. Without it, life—at least as we know it—doesn’t function.
So what exactly is NAD⁺? Why does it decline with age? And what are researchers uncovering about its role in longevity and performance?
What is NAD⁺?
NAD⁺ is a coenzyme found in every living cell. Think of it as a cellular power broker—essential for converting the food you eat into energy your body can actually use. It plays a critical role in redox reactions (the transfer of electrons), which power your mitochondria—the “engines” of your cells.
In short, NAD⁺ is a major player in keeping your cells alive, energized, and functioning.
It doesn’t stop at energy metabolism. NAD⁺ is also involved in:
DNA repair
Inflammation regulation
Gene expression via sirtuins (a family of proteins tied to aging)
Stress responses
Circadian rhythm balance
Which means: from brain clarity to muscle repair to how you recover from a tough workout, NAD⁺ is pulling the strings behind the scenes.
Why Does NAD⁺ Matter More as We Age?
NAD⁺ levels naturally decline with age. By the time we’re in our 40s or 50s, we may have half the NAD⁺ we did in our youth. That drop is associated with a cascade of effects:
Slower metabolism
Increased oxidative stress
Reduced mitochondrial efficiency
Decreased cognitive performance
Lower physical endurance
Weakened cellular repair mechanisms
In vivo NAD assay reveals the intracellular NAD contents and redox state in healthy human brain and their age dependences, Xiao-Hong Zhu | Study Link
In simpler terms: less NAD⁺ = less energy, less resilience, and a greater vulnerability to the effects of aging.
How Does the Body Produce NAD⁺ Naturally?
Before we ever consider supplements or therapies, it’s important to understand that your body already makes NAD⁺—in three main ways:
1. Preiss-Handler Pathway Converts niacin (vitamin B3) from the diet into NAD⁺.
2. De Novo Pathway Builds NAD⁺ from tryptophan (an amino acid found in protein-rich foods like turkey and eggs).
3. Salvage Pathway Recycles NAD⁺ from other molecules that have already been used. This is the most efficient and heavily relied upon method.
However, as we age, these pathways become less efficient. Enzymes that break down NAD⁺ become more active, and the body’s ability to recycle it declines. This metabolic slowdown is one of the major reasons scientists are now focusing on ways to support or restore NAD⁺ levels.
Can Lifestyle Affect NAD⁺ Levels?
Yes—and dramatically. Here are a few ways to naturally support your body’s NAD⁺ production:
✔️ Exercise regularly – especially endurance training, which upregulates key NAD⁺-related enzymes ✔️ Eat a nutrient-dense diet – foods rich in B vitamins, tryptophan, and antioxidants ✔️ Get adequate sleep – sleep is when cellular repair ramps up, and NAD⁺ is key to that process ✔️ Minimize chronic stress – high cortisol levels can suppress the enzymes needed for NAD⁺ regeneration
These aren’t just good wellness habits—they’re also direct inputs into the machinery that maintains your NAD⁺ levels.
Why Is NAD⁺ in the Zeitgeist Now?
Although NAD⁺ was discovered more than a century ago, its connection to aging and performance is a relatively recent frontier.
In 2020, a pivotal review published in Pharmaceuticals by Radenković and Verdin explored NAD⁺’s emerging role in what’s now referred to as longevity medicine. It highlighted how replenishing NAD⁺—through precursors, lifestyle changes, or therapies—could improve mitochondrial health, increase resilience to metabolic stress, and slow age-related decline.
As a result, NAD⁺ is now part of the conversation among elite athletes, biohackers, and researchers alike. It’s no longer just about lifespan—it’s about healthspan.
Given the decline in NAD⁺ with age, many are exploring ways to supplement it. Oral NAD⁺ precursors like NR (nicotinamide riboside) and NMN (nicotinamide mononucleotide) are popular, though more research is needed to confirm their absorption and clinical efficacy.
Another promising method is subcutaneous NAD⁺ injections. These allow for a slow, sustained release of NAD⁺ into the body’s fat stores, which then gradually enter circulation. While more clinical studies are underway, early anecdotal reports are compelling—individuals often describe:
Elevated energy
Improved focus and mental clarity
Enhanced recovery after exercise
Better sleep quality
Greater stress resilience
It’s an exciting area, but one that calls for responsible, science-backed implementation.
“When it comes to subcutaneous NAD⁺ injections, the clinical effects are impressive—patients often report increased energy, sharper cognition, better sleep, and enhanced well-being. The slow absorption into fatty tissue offers a sustained release, making it a convenient, less invasive option for long-term benefits like improved metabolism and stress resilience.”
Written by Dr. Allen Gorman, Medical Director @ Clay Health & Care Dr. Allen Gorman is a physician-scientist with a focus on metabolism, aging, and cellular repair. His clinical and research work spans two decades, with a passion for translating complex science into actionable health strategies.
Reviewed by Andrew Browning, Coaching Director @ Clay Health & Care Andrew Browning is a performance coach and educator with nearly two decades of experience in training, teaching, and behavior change. As Clay’s Coaching Director, he combines deep knowledge in exercise physiology, metabolic health, and recovery with a passion for helping people build sustainable habits that fuel performance at every level.
