NAD+ Explained

Written By Dr. Steven E. Bennett

Every cell in your body contains tiny power plants called mitochondria. Their main job is to take the food you eat and the air you breathe and turn them into a special kind of cellular fuel called ATP. To keep these power plants running, your body uses a helper molecule called Nicotinamide Adenine Dinucleotide (NAD+). You can think of NAD+ as a delivery shuttle that carries high-energy supplies directly to the power plants. Without enough of these shuttles, your cells cannot produce the energy your heart, brain, and muscles need to function at their best.

Beyond just making energy, NAD+ is the power source for your body’s internal "maintenance crew." Every day, your cellular blueprints, your DNA get slightly damaged by stress, toxins, and normal wear and tear. Your body has special proteins that act like repair workers to fix these blueprints, but they can only work if they have NAD+ to fuel them. If your NAD+ levels are low, these repair workers sit idle and the damage begins to pile up, which is one of the main reasons our bodies stop functioning well as we age.

NAD+ also acts as a vital signal that tells your cells to build brand-new power plants. When NAD+ levels are high, it activates special "guardians" in the cell that start a construction project to create fresh, efficient mitochondria. This internal renovation ensures that your body is constantly replacing old, worn-out power plants with new ones. For older people, this is especially important because it helps the body stay resilient, keep muscles strong, and maintain the energy needed to heal from physical stress.

When NAD+ levels drop, the body struggles to put out the "smoldering fires" of chronic inflammation. This inflammation is a primary cause of the stubborn, aching pain many people feel in their joints and muscles. For those with chronic injuries that never seem to get better, low NAD+ often means the cells simply do not have the "budget" to finish the repair work. By boosting NAD+, you help your immune system calm down and provide the energy necessary for old injuries to finally knit back together and heal properly.

Research shows that restoring these levels can help manage or even reverse many age-related health issues. For the brain, healthy NAD+ can protect against memory loss and diseases like Alzheimer’s and Parkinson’s. For the heart, it helps with Congestive Heart Failure (CHF) by giving the heart muscle the energy it needs to pump more effectively. For the lungs, it can reduce the chronic inflammation associated with COPD, making it easier to breathe. It is also a powerful tool for Neuropathy (nerve pain) because it helps repair damaged nerve fibers and reduces tingling or stabbing sensations.

Unfortunately, as we age, our supply of NAD+ naturally disappears. By age 40, most people have lost about half of their youthful levels, and by age 60, they may have only 20% left. This happens because certain enzymes in the body start to "steal" and consume NAD+ much faster than we can replace it, usually to deal with rising inflammation or to try and fix mounting DNA damage. As NAD+ is used up by these "thieves," there is not enough left to run your power plants or fuel your repair crews.

The good news is that we can restore these levels to support your recovery. It is much better to get a subcutaneous injection of NAD+ over taking precursors like NMN or NR. Oral supplements are not absorbed well through the digestive tract and must pass through the liver first. This "first-pass" process turns them into other substances (metabolites), meaning only a low percentage actually reaches your cells where it then still has to be converted into NAD+. You might have to consume as much as 2,000mg a day orally just to get enough to mildly affect the body, and this process may take months. With injections, however, you are getting 100% of the NAD+ directly. It bypasses the gut and liver entirely, goes to work immediately, and provides much quicker results for your energy and healing.


Mitochondrial Function and Energy Production

Research explaining the role of mitochondria as power plants and NAD+ as a delivery shuttle for cellular fuel can be found here:

DNA Repair and "Maintenance Crews"

Scientific documentation on how NAD+ fuels repair enzymes (PARPs and sirtuins) to fix damaged cellular blueprints:

Mitochondrial Biogenesis (Building New Power Plants)

Detailed mechanisms of how NAD+ signals the creation of new mitochondria to maintain physical resilience:

Inflammation, Chronic Pain, and Healing

Studies on the connection between low NAD+ and chronic inflammation, non-healing injuries, and joint pain:

Specific Age-Related Health Conditions

Clinical evidence and summaries regarding Alzheimer's, Parkinson's, CHF, COPD, and Neuropathy:

Age-Related NAD+ Decline and "Thieves"

Research confirming the 80% decline in NAD+ by age 60 and the role of "thieving" enzymes like CD38:

Subcutaneous Injections vs. Oral Supplements

Scientific rationale for injections over oral precursors (NMN/NR), including first-pass metabolism and dosage comparisons:

Dr. Steven E. Bennett
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