NAD⁺ - Our Questions Answered By Expert Jari Närhi

NADs (Nicotinamide Adenine Dinucleotides) are a hot topic right now and we've been talking about them a lot as you may have noticed.

NAD are the body’s natural forms of vitamin B3, playing a crucial role in energy metabolism, DNA repair, and cellular health. Low NAD levels are a clear indicator of underlying health issues, ranging from stress and diabetes to neurodegenerative diseases and cancer. They are also often associated with conditions such as chronic fatigue syndrome, long COVID, inflammation, and side effects from certain medications.

We have lots of questions in our NAD journey so far and Jari Närhi, CEO and Co-Founder of NADMED, was happy to answer them for us.

So, here goes!

1. Tell us a little bit more about how NAD works and what it does for our body.

NAD⁺ (Nicotinamide Adenine Dinucleotide) is a vital molecule derived from vitamin B3. It plays a key role in converting energy from food into ATP, the essential fuel that powers life. Think of NAD⁺ as a delivery truck transporting energy where it’s needed.

But its role doesn’t stop at energy production. NAD⁺ also supports DNA repair, immune function, and circadian rhythms. In fact, over 250 metabolic processes depend on NAD⁺ – all of them essential for maintaining health.

NAD⁺ levels naturally fluctuate in response to stress. When the body is under strain, NAD⁺ is rapidly consumed to support critical physiological adaptations. If levels drop too low, the body may struggle to metabolize drugs or respond effectively to treatments due to insufficient cellular energy.

2. Who should consider using NAD (supplements)? Is it for everyone?

Common symptoms of low NAD⁺ levels include fatigue and a general lack of energy. However, as these symptoms can stem from various causes, it's important to assess blood NAD⁺ levels to determine whether NAD⁺ -boosting supplements are appropriate. Low NAD⁺ levels have been associated with several conditions, including degenerative diseases, diabetes, chronic fatigue syndrome, obesity, and inflammation.

If NAD⁺ levels are found to be below the reference range, supplementation can be considered. However, any decision should be made in consultation with a healthcare professional. Regular monitoring during supplementation is essential, as individuals may respond differently to changes in NAD⁺ levels.

3. Is there anyone who should not take NAD (supplements)?

As with any vitamin, it’s important to provide the body only with what it truly needs. Vitamin B3, the key player in NAD⁺ production, is typically available through a well-balanced diet. For individuals without underlying health conditions or prolonged fatigue, supplementation with B3 or NAD⁺ is generally not recommended.

Contrary to popular belief, excessive intake of B3 or NAD⁺ -boosting supplements can be harmful. Overuse may contribute to insulin resistance and increase the risk of blood vessel inflammation. For safe supplementation, medical supervision and regular monitoring of NAD⁺ levels are strongly advised.

NAD⁺ -boosting supplements are not recommended for oncology patients, as there are currently no systematic studies confirming the safety of this approach in cancer care.

4. NAD supplement is not a short-term fix is it? How soon will you start to see and feel the benefits?

Oral NAD⁺ supplements, such as niacin, nicotinamide riboside (NR), and nicotinamide mononucleotide (NMN), have been shown to be highly effective in increasing NAD⁺ levels. Typically, levels begin to rise within a couple of weeks and may reach saturation within 3 to 6 months, depending on the dosage.

Patients with degenerative conditions have often reported symptom relief and improved energy within the first month of supplementation.

Once the desired NAD⁺ level is reached, regular monitoring is recommended to adjust the dosage as needed. If dietary changes alone are sufficient to maintain optimal levels, continued supplementation may not be necessary.

As always, it is advisable to consult a healthcare professional for follow-up and personalized guidance.

5. There are IV and now pen injection options - what is best? What do our readers need to know?

Currently, there is no scientifically compelling published evidence supporting the effectiveness of NAD⁺ IV infusions or pen injections in significantly increasing NAD⁺ levels in the body. Research suggests that the NAD⁺ molecule cannot easily cross the cell membrane, and no published data exist on how NAD⁺ levels in the blood change following IV or subcutaneous administration.

That said, individuals who receive NAD⁺ injections often report increased energy and improved overall well-being. However, the underlying mechanism for these effects remains unclear, and it is unknown whether NAD⁺ levels in tissues or organs are sustainably elevated. More research is needed to fully understand the biological impact and potential long-term benefits of these treatments.

6. A lot of people react badly to NAD supplements when they first try it, with side effects such as nausea. Does this mean you cannot continue using it or what do you recommend here?

Oral NAD⁺ supplements are generally well tolerated, though dosage plays a key role in side effects. Higher doses increase the likelihood of discomfort. For example, niacin taken at doses above 100 mg may cause a temporary flushing sensation, which typically fades after a few days of continued use.

When administered via IV, rapid infusion of NAD+ can sometimes lead to side effects like nausea or heart attack-like symptoms, that may feel extremely uncomfortable. These effects are less common when the dosage is properly managed, and the infusion is given at a controlled pace.

Research on oral NAD supplements is extensive, and they are generally considered safe when used appropriately, with proper medical oversight to maintain body NAD+ levels within the optimal range.

// Jari Närhi, CEO and Co-Founder of NADMED