Are Anti-Aging NAD+ Infusion Too Good to Be True?

I will be transparent,” says the designer Azeeza Khan. “The first time I heard about NAD+ was because Hailey Bieber was doing it.” The model was filmed sampling an intravenous drip laced with nicotinamide adenine dinucleotide (or NAD+) for an episode of The Kardashians. (Her pal Kendall Jenner was partaking too.)

Khan insists she isn’t one to crib longevity tips from famous 20-somethings, but her interest was piqued. NAD+ is a common co­enzyme that has become a target for algorithm-conscious wellness warriors and credentialed researchers alike. Evangelists believe it has the potential to disrupt stubborn realities of the aging process, from the loss of muscle mass to flagging energy stores.

From the depths of Calabasas to the medi-spas of Madison Avenue, celebrities and civilians alike have been loading up on NAD+ with Ozempic-like zeal. Bieber seems to have converted her husband, who can be seen hooked up to an NAD+ IV drip in his documentary Seasons. Jennifer Aniston has pronounced the molecule “fascinating.” Emily Oberg, founder of the label Sporty & Rich, administers her own doses at home, claiming improvements in her mood and stamina (and counting on a harder-to-measure cellular glow-up as she ages). Mara Raden—the clinical director of Raden Wellness, where Khan gets her NAD+ fix in Chicago—says her patients describe its effects as pure “brainpower.”

Sounds like a silver bullet (or snake oil, depending on your perspective), but there is theoretical science behind it. Michael Sagner, MD, founder and executive director of the nonprofit European Society of Preventive Medicine, explains that NAD+ is found in every cell in the human body, assisting with the most basic and essential functions: regulating energy production, cell metabolism, and the arbitration of cell survival. Sirtuins—a family of proteins that deals with inflammation and oxidative stress in cells—especially require NAD+ to work.

Shin-ichiro Imai, MD, a professor at Washington University School of Medicine in St. Louis, tells me that his lab has been focused on sirtuins for well over a decade. With MIT professor Leonard Guarente, Imai published a landmark paper in 2000 that helped establish the link between NAD+, sirtuins, and aging. “We found that the production of NAD+ declines as we age,” Imai says. And because energy decreases as we age too, it occurred to Imai and his peers that it might be worth investigating whether boosting NAD+ could offset the normal aging process. Imai homed in on the smaller molecules that cells use to produce NAD+, which can more easily penetrate cell walls. In 2016 he published another paper, illustrating that increasing one of those building blocks with a simple supplement could have a “multitude” of antiaging effects in mice. (Guarente was so bullish on the results that he later cofounded the supplement emporium Elysium Health, which now sells NAD+ precursors for human consumption.)

Scientists and doctors who study neurological disorders are particularly interested in what increasing NAD+ levels might do for their patients. Charalampos Tzoulis, MD, professor of neurology and neurogenetics at the University of Bergen and Haukeland University Hospital in Norway, runs a center that tests new treatments for diseases like Parkinson’s. After administering a megadose of one of the NAD+ precursors, Tzoulis and his team were able to show, among a small sample of patients with Parkinson’s, increased NAD+ levels in the brain, a durable metabolic response, and a “small, but significant” clinical improvement in symptoms. “And it was safe,” Tzoulis continues. “With no side effects.” He has since enrolled 400 patients in a more extensive follow-up trial, with results expected in June. If it works, he adds, “that will be big.” As Tzoulis cautions, though, dozens of promising interventions have failed in the past. Neurological disorders, aging in general—they’re thorny processes to disrupt.

Tzoulis isn’t surprised that those with no neurodegenerative conditions—from Aniston to Oberg to the average Happier Grocery shopper—have latched on to the research. “These diseases are associated with aging,” he says. “So people think, If NAD+ can help fight neurodegenerative disease, could I take it to prevent neurodegeneration?” With characteristic Norwegian bluntness, Tzoulis says scientists don’t have an answer. Yet. If his current trial demonstrates that NAD+ is a viable treatment option for Parkinson’s patients, he’ll move on to researching whether it can help prevent the disease. After that, he’ll investigate whether the general smoothie-imbibing population stands to benefit from supplementation. Still, he’s clear on his priorities. He and his team did not get into the NAD+ game for the Goop crowd. “We were not looking at wellness. We were not looking at wrinkles,” he states.