NAD+ has been called everything from the molecule your cells run on to the latest fashionable infusion. There is some truth in both. It really does sit at the centre of how your cells make energy and repair themselves, and levels really do appear to fall as we get older. Whether topping it up changes how you age is a different question, and a more careful one. The honest answer is more interesting than either the hype or the dismissal.
This article sets out what NAD+ actually does, why it declines, what the human research shows so far, and how we think about it at Sequoia Clinic in Dubai, where NAD+ is a tool within a physician-led plan rather than a product on a menu.
The Short Answer
NAD+ is a helper molecule that every cell uses to turn food into energy and to carry out repairs. Levels appear to fall as we age. Supplements and infusions can raise those levels reliably, and animal research looks genuinely promising. What has not yet been shown in people is that raising them changes how you age.
That makes NAD+ worth considering as part of a plan built on measurement, and worth treating with caution as a standalone purchase. The rest of this article explains why.
What NAD+ Is
NAD+ is short for nicotinamide adenine dinucleotide, which is the last time that phrase appears here. It is a helper molecule found in every living cell in the body. Think of it less as a fuel and more as something the cell's machinery needs to hand for that machinery to run at all.
Its best known job is energy. Turning the food you eat into fuel your cells can actually use depends on NAD+ at several points along the way. Without enough of it, that process slows.
Its second job is the one that drew the attention of longevity researchers. Two groups of enzymes use NAD+ up as a raw material. One group repairs damaged DNA. The other helps regulate metabolism, inflammation and how the cell copes with stress.
The important part is that every time those enzymes do their work, they spend NAD+. Your cells have to keep making more. The balance between how fast you make it and how fast you spend it is what sets the level available at any moment.
How NAD+ Relates to Ageing
Three findings from the research explain why NAD+ became a focus for longevity medicine.
NAD+ levels appear to fall with age. In animal studies this is consistent and well documented across tissues. In humans the picture is thinner: a 2025 review in Nature Metabolism noted that an age-related decline has been observed consistently only in a limited number of human studies, partly because measuring NAD+ inside tissue is difficult. The decline is likely real, but it is probably not uniform, and it varies between people.
The decline is mostly about spending, not just making. Long-running, low-level inflammation ramps up an enzyme that breaks NAD+ down in bulk. Accumulated DNA damage keeps the repair enzymes busy, and that drains the supply too. In other words, the things that age us also eat into the molecule that helps the cell resist them.
Raising NAD+ improves ageing markers in animals. Studies in mice show that restoring NAD+ levels can improve the function of mitochondria, the structures that produce most of the cell's energy, as well as muscle performance and several measures associated with healthier ageing. This is the evidence behind most of the enthusiasm. It is also where the caution begins, because mice are not people, and human trials have been considerably more modest.
At Sequoia Clinic, NAD+ IV therapy is offered within the Longevity pillar, prescribed by a physician after reviewing your blood work and health history, and integrated into a wider plan. The reason for that framing is exactly the evidence described here: NAD+ is useful in context, and the context has to be measured first.
What the Human Research Shows
Human studies of NAD+ fall into two groups, and it is worth keeping them separate.
Supplements taken by mouth
Most trials use what are known as precursors: molecules your body converts into NAD+ after you swallow them. You will see them sold as NR (nicotinamide riboside), NMN (nicotinamide mononucleotide) and ordinary niacin. The consistent finding is that these reliably raise NAD+ in the blood, often substantially, and that people tolerate them well over the periods studied.
What is less consistent is whether that rise translates into anything you would notice. Some trials have reported small improvements in muscle function, blood pressure and the flexibility of the arteries, usually in participants who were older or in poor metabolic health. Other trials of similar design found little effect. The 2025 Nature Metabolism review concluded that the clinical benefits so far are modest and that larger, longer trials are needed. A 2026 review in Ageing Research Reviews reached a similar position: promising mechanism, limited outcome data. That is the honest state of the science.
NAD+ given by infusion
An infusion skips digestion and delivers NAD+ itself rather than something the body has to convert. This is the form used in clinics, including ours, and the form that generates the most discussion. The controlled trial evidence for intravenous NAD+ specifically is limited, and most of what clinicians describe, including improvements in energy, clarity and recovery, comes from clinical experience rather than large published trials. We are candid about this with patients. An infusion is a reasonable option for the right person within a monitored programme; it is not a treatment whose effect on the ageing process has been demonstrated in humans.
What Actually Lowers NAD+ in Everyday Life
Before considering supplementation, it helps to know what drains the pool. Several of these are especially relevant to life in Dubai.
- Alcohol. Metabolising alcohol consumes NAD+ directly. Regular drinking, of the sort that comes with client dinners and weekend brunches, is one of the most reliable ways to lower it.
- Sun and DNA damage. Ultraviolet exposure damages DNA in skin cells, which puts the repair enzymes to work and uses up NAD+ in the skin. In Dubai this is a year-round factor, not a summer one.
- Poor sleep and disrupted body clock. NAD+ production follows a daily rhythm. Short sleep, late nights and frequent long-haul travel disturb it. We have written about what the research suggests on sleep, stress and longevity, and the mechanisms overlap considerably.
- Ongoing inflammation and excess weight. Both increase the activity of the enzyme that breaks NAD+ down in bulk.
- Inactivity. Exercise increases the enzyme that makes NAD+, so its absence removes one of the body's own ways of topping the pool up.
The practical point is that the fundamentals that protect NAD+ are the same fundamentals that protect health generally. No infusion compensates for their absence.
Who NAD+ Support May Suit
Given the evidence, we think NAD+ support is worth discussing for a fairly specific group of people, rather than for everyone who has read about it.
It may be worth discussing if any of these sound like you:
- You have persistent fatigue that routine testing has not explained.
- You are managing a demanding schedule and recovery feels slower than it used to.
- You are already committed to a long-term health plan and want to know whether NAD+ belongs in it.
It is less likely to be the right first step if nobody has looked at the underlying picture yet. A thyroid problem, low iron, a sleep disorder or a metabolic issue will not be fixed by NAD+. Each of those is common. Each is measurable. Each is treatable.
This is why we start with diagnostics. The Sequoia Assessment looks at blood biomarkers, hormones and body composition before any longevity treatment is recommended, so that NAD+ is prescribed because the picture supports it, not because it is popular.
What Treatment Actually Involves
If NAD+ is appropriate, the process at a clinic like ours is deliberately unhurried. Your physician reviews your history, blood work and goals, sets a dose, and decides whether other nutrients belong in the same infusion. Sessions are slow, typically between one and a half and four hours depending on the dose, because NAD+ infused too quickly commonly causes flushing, nausea, chest tightness or cramping. A slower rate, adjusted to how you respond, avoids most of this. Some physicians recommend a short loading phase followed by maintenance sessions; the frequency is then adjusted to your response and to how your markers move over time.
Risks and Considerations
NAD+ precursors have been well tolerated in trials of up to a year or so. Infusions are generally well tolerated when delivered slowly under supervision, with the temporary effects described above being the most common. The long-term safety picture beyond a year is not yet established, simply because the long studies have not been done. There is also an open scientific question about NAD+ in the context of existing cancer, since rapidly dividing cells have high energy demands; this is one reason a medical history is taken before any treatment, and why NAD+ is not offered without physician oversight. As with any longevity intervention, the sensible position is measured optimism: a plausible mechanism, a good safety record so far, and modest human outcome data.
Frequently Asked Questions
Does NAD+ really work for ageing?
The evidence is mixed. NAD+ precursors reliably raise blood NAD+ in humans, and animal studies show improvements in ageing markers. Human trials so far show modest, inconsistent benefits in measures such as muscle function and blood pressure. Larger and longer trials are needed before anyone can say NAD+ changes how people age.
Can NAD+ reverse ageing?
No treatment has been shown to reverse ageing, and NAD+ is no exception. The research suggests NAD+ may support cellular energy production and repair processes that decline with age. "Support" is the accurate word. Claims of reversal go well beyond what the human evidence currently shows.
How can I slow down ageing?
The measures with the strongest evidence are unglamorous: regular aerobic and resistance exercise, seven to eight hours of consistent sleep, a diet that keeps blood glucose and lipids stable, limited alcohol, no smoking and diligent sun protection. Treatments such as NAD+ belong on top of those foundations, guided by testing, not in place of them.
What are signs that I am ageing well?
Useful signs include stable energy through the day, restorative sleep, good cardiorespiratory fitness and strength for your age, blood markers such as glucose, lipids and inflammation within healthy ranges, and recovery from exertion or illness that has not slowed noticeably. These are measurable, which is why we assess them rather than guess.
Are NAD+ infusions better than oral supplements?
Infusions deliver NAD+ directly and bypass digestion, while oral precursors are converted by the body and have more published trial data behind them. Neither has been shown superior for long-term ageing outcomes. The right choice depends on your goals, your blood work and a physician's judgement, which is a conversation worth having before choosing either.
The Long View on NAD+
Sequoia Clinic is a DHA-licensed, physician-led longevity and aesthetics clinic in Al Barsha, Dubai. We think NAD+ is one of the more scientifically interesting tools in longevity medicine, and one of the more oversold. Used within a plan that starts with measurement and rests on the fundamentals, it can have a sensible place. Used as a shortcut around them, it rarely does.
If you are considering NAD+ therapy, a consultation at Sequoia Clinic can help determine whether it may be suitable for your individual needs and goals. Book a consultation with our clinical team.
.png)
.png)
.png)
