Spending a fortune on anti-aging serums? Addicted to collagen skin care treatments? Dreaming of Botox to obliterate your wrinkles? Our external appearance is often the sole part of aging we address. Despite getting older being a natural process, trying to feel younger may have more to do with wellness than our skin care routine.
With the global wellness industry expected to reach $9 trillion by 2028, nicotinamide adenine dinucleotide (NAD+) is predicted to be 2025’s new Ozempic—at least, in terms of popularity. “NAD+ is a critical coenzyme—meaning it’s required for life—found in every cell in your body and in all living organisms,” the biology professor leading NAD+ research Leonard Guarente tells ESSENCE.
As we grow, just like collagen and elastin in our skin, NAD+ declines by about 50 percent by middle age. However, the purpose of the coenzyme is not just the appearance of eternal youth. “The goal of increasing NAD+ to youthful levels is to extend healthspan, the period of life during which you’re able to do the things you need and want to do, free of disease and age-related limitations.”
Below, Guarente breaks down NAD+, how it works, and all the benefits.
What is NAD+?
NAD+ is a coenzyme produced by our body. “It plays a key role in mitochondria in the production of chemical energy for cells,” Guarente says. However, just like other bodily functions responsible for aging, “our NAD+ levels decline as we get older—by middle age, NAD+ has declined by about 50%.”
What is the history behind NAD+?
The coenzyme was first discovered in 1906 by British biochemists Arthur Harden and William John Young. “They identified NAD+ while studying yeast fermentation, noticing that it acted as a key factor in accelerating the process,” he says, which later gained more awareness as a result of a disease prevalent in the south in the early 1900s.
According to Guarente, pellagra is characterized by what are known as the four Ds; dermatitis, diarrhea, dementia, and death. “Pellagra turned out to be a disease of NAD+ deficiency and the molecules that could prevent and/or cure it were termed vitamin B3s,” he says, which Conrad Elvehjem, a professor at the University of Wisconsin-Madison, proved in 1937.
From the 1940s on, “the US FDA established standards for the fortification of flour with vitamin B3 and pellagra was eradicated in the US.”
How does NAD+ work?
“NAD+ works as a coenzyme by helping an enzyme (like Sirtuin 1) to perform its job,” he says. According to Guarente, the enzyme breaks down the NAD+ coenzyme, which leaves behind nicotinamide, a water-soluble form of vitamin B3. “The leftover nicotinamide is then recycled by the cell and turned into NAD+ once again.”
Why is it popular right now?
Although the coenzyme was discovered over 100 years ago, “labs, including my own at MIT, have uncovered the important role of NAD+ in the aging process,” Guarente says. With the anti-aging market expected to reach up to $80 billion dollars by 2030, and biohacking—using technology to optimize the human body—on the rise, NAD+ is a natural component of beauty’s current landscape.
Wellness brand Elysium launched a landmark human study which showed you can safely and sustainably increase NAD+ levels by 40% with oral supplements, theirs going for $40 a bottle, meanwhile celebrities and wellness fanatics alike endorse the coenzyme through IV drips. However, new findings in what is dubbed “longevity science” (and other age-reversal break through drugs) can be credited to the recent spike in popularity as well.
“In my lab specifically, we showed that genes called ‘sirtuins’ are incredibly important for longevity in many organisms,” he says. With sirtuin activity requiring NAD+ to function, “as we get older, our sirtuin activity slows down and we presume aging speeds up.” As a result, boosting NAD+ to keep sirtuins running is expected to have the opposite effect, slowing down aging.
What are the benefits?
With research conducted in both healthy and diseased populations, ranging from menopause to ALS, Parkinson’s disease to frailty, boosting NAD+ to youthful levels has proven to have a number of benefits. For one, the coenzyme can promote healthy aging, making you feel good for your age instead of just looking it. Meanwhile, NAD+ can provide a consistent production of cellular energy and protect your DNA from stressors, targeting aging at the cellular level.
How should NAD+ be administered?
Although NAD+ is a buzzword, knowing how to administer the benefits safely and effectively is crucial. “First, it’s important to know that you don’t want to administer NAD+ itself—whether via oral supplementation, injection, or IV administration, it is wholly ineffective,” Guarente says. “The reason for this is because NAD+ is big and charged and thus does not get into cells.”
Instead, “you want to increase NAD+ using smaller, uncharged NAD+ precursors,” like NR and NMN. “There is a great deal of research in humans supporting the safety and efficacy of oral supplementation with NAD+ precursors—NR and NMN—to increase NAD+ levels.”
While “injecting NAD+” precursors through an IV drip may be popular, “it is painful, costly, has the potential for side effects from the IV administration, and is unnecessary given that we know oral administration is effective.”
Can NAD+ precursors be applied topically?
Unlike an anti-aging cream or skin care treatment, NAD+ can not penetrate the skin, therefore does not work as a topical application. As an alternative, “niacinamide is in many topical products and it works because it is an early NAD+ precursor,” he says.
Similar to the relationship between retinol and tretinoin, “In theory, topical NR or NMN—later NAD+ precursors—would work even better than niacinamide because they are closer to NAD+, but there are challenges with creating topical products with these precursors because they’re not very stable in water.”
Does NAD+ have any side effects?
“I have heard a range of side effects of IV infusion, at least anecdotally, including nausea, vomiting, flushing of the face and body, itching or burning, dizziness, headaches,” he says. Instead, he does recommend a specific oral supplement, which has no side effects at all. “Elysium’s Basis has been sold for nearly 10 years and, at the recommended dose, Basis raises NAD+ levels in humans by 40 percent.”
