NAD, NMN, NR, and Injectable NAD: What Actually Makes Sense?

If you spend any time around the longevity world today, you will quickly hear about Nicotinamide adenine dinucleotide (NAD) and the supplements that are supposed to raise it.

People talk about NAD like it is the master switch for aging, energy, brain function, and metabolism. Podcasts, clinics, and supplement companies all have their version of the story.

And like most things in health and longevity, there is some real science mixed with a lot of marketing.

Let’s break down what NAD actually is, what NMN and NR do, and where injectable NAD fits into the picture.

What NAD Actually Does

NAD is a molecule found in every cell in your body. It plays a central role in cellular metabolism and energy production.

Without NAD, your cells cannot efficiently convert food into usable energy.

NAD is also involved in:

• mitochondrial function
• DNA repair
• cellular stress responses
• activation of longevity pathways including Sirtuins

One of the reasons scientists became interested in NAD is that levels decline with age. Some research suggests that NAD levels may drop significantly between youth and older age.

That decline has led researchers to explore ways to restore NAD levels in the body.

Why People Don’t Just Take NAD Directly

You might think the simple answer would be to just take NAD itself.

The problem is that NAD is a large molecule, and when taken orally it does not easily enter cells intact. The body tends to break it down before it can be used.

That led researchers to focus on molecules the body can convert into NAD. These are called NAD precursors.

The two most widely discussed are Nicotinamide mononucleotide (NMN) and Nicotinamide riboside (NR).

Both of these compounds exist naturally in the body and are part of the pathway that produces NAD.

Very simply, the pathway looks like this:

Vitamin B3 → NR → NMN → NAD

Taking NMN or NR essentially provides the body with raw material to rebuild NAD through its normal metabolic pathways.

What the Research Shows So Far

The science around NAD and aging is fascinating, but it is still developing.

Animal studies have shown that raising NAD levels can improve mitochondrial function, metabolism, and certain markers associated with aging.

In humans, research has shown that NMN and NR do increase NAD levels in blood.

However, the big question remains unanswered.

Does raising NAD actually slow aging or meaningfully improve long-term health?

The answer today is: we don’t know yet.

The research is promising but still early.

The Rise of Injectable NAD

Because NAD itself is such a critical molecule, many wellness clinics now offer IV NAD infusions or injections.

The idea is that if NAD is delivered directly into the bloodstream, it could quickly boost cellular NAD levels.

These treatments can cost several hundred dollars per session, and patients often report feeling:

• increased energy
• improved mental clarity
• improved mood
• reduced fatigue

There is even some exploration of NAD infusions in addiction medicine during detox programs.

But scientifically, the picture is still unclear.

Even when NAD is injected into the bloodstream, it may still be broken down into smaller components before cells use it. In other words, the body may end up rebuilding NAD through the same pathways it would use with NMN or NR.

Another interesting detail is that NAD infusions often have to be administered very slowly. If the drip runs too fast, patients commonly experience flushing, chest pressure, nausea, or abdominal discomfort.

A Personal Perspective

I have been around the supplement and longevity world for a long time.

One of my close friends is Oz Garcia, who has spent decades advising actors, athletes, and people who are extremely serious about their health.

Oz has seen just about every supplement trend come and go.

When I asked him about NAD injections, his answer was simple and very practical.

He suggested that instead of paying $200–$250 per session for injectable NAD, it makes more sense to take NMN or NR powder and allow the body to build NAD naturally.

In his view, the metabolic pathway already exists. The body knows how to convert these precursors into NAD efficiently.

And from a cost perspective, it is dramatically cheaper.

The Bigger Picture

The NAD story highlights something interesting about the longevity field.

We are learning that aging is closely tied to cellular energy systems, mitochondrial health, and the body’s ability to repair itself.

NAD sits right in the middle of those systems.

But it is unlikely that one molecule alone will solve aging.

The strongest drivers of cellular health are still the basics:

• exercise
• metabolic health
• sleep
• nutrition
• stress management

Supplements like NMN or NR may support those systems, but they are not magic bullets.

My Approach

My personal approach is fairly simple.

I try to combine:

• the emerging science
• advice from people I trust who have spent decades studying nutrition
• and a little bit of common sense

When someone like Oz Garcia — someone who has been working at the highest level of nutrition for decades — suggests using NMN or NR powder instead of expensive NAD injections, that makes sense to me.

It respects the biology of how the body works, and it respects your wallet.

In the end, my philosophy has always been the same.

Blend good science, practical experience, and cost awareness.

That combination often leads to better decisions than hype alone.

Emotional Energetic States: Energy vs. Anti-Energy

  1. Fun vs. Rigidity
    • Fun: Represents a state of joy, playfulness, and light-heartedness. This energy is infectious and can uplift those around you.
    • Rigidity: Signifies strictness, inflexibility, and a serious demeanor. It can create barriers in communication and make interactions feel tense.
  2. Goddess in the Heart vs. Thinking (in the Head)
    • Goddess in the Heart: Symbolizes being present, compassionate, and connected to your emotions and intuition. It allows for deep, heartfelt connections with others.
    • Thinking (in the Head): Indicates being overly analytical, focused on the past or future, and disconnected from the present moment. This state can hinder genuine emotional connection.
  3. Aspirational Inspired vs. Negativity
    • Aspirational Inspired: Involves being motivated, hopeful, and driven by positive goals. This energy can inspire and motivate others.
    • Negativity: Involves pessimism, doubt, and negative vibrations. It can drain energy and discourage those around you.
  4. Zeus Decisive Fulfillment Achievement vs. Fear and Uncertainty
    • Zeus Decisive Fulfillment Achievement: Embodies confidence, decisiveness, and a sense of accomplishment. This state exudes strength and can lead others with assurance.
    • Fear and Uncertainty: Represents anxiety, hesitation, and lack of confidence. It can create instability and prevent effective communication.

The Importance of Emotional Energy in Communication

You cannot effectively communicate with others if you are stuck in a state of rigidity, overthinking, negativity, or fear. True connection happens on an energetic level, where emotions play a crucial role.

Key Points to Remember:

  • We connect energetically: Our emotional states influence our ability to connect with others. Being in a positive and present state enhances our interactions.
  • Physical Actions to Shift States: If you find yourself in misery, grief, or depression, physical actions like a hand clap or fist pump can help shift your energy.
  • Communicating Emotionally: To take people on an emotional journey with you, you need to be in touch with your own emotions. This allows you to communicate with authenticity and empathy.

By being aware of your emotional state and actively choosing positive energy, you can improve your ability to connect and communicate with others. This not only enhances personal relationships but also professional interactions and overall well-being.

Credit Michael Smikun July 5, 2024 morning huddle Unblinded my notes to the best of my ability

Killer Hormones

Feel free to read into that any way you want. I am finally of the age where I am measuring my hormones and I’ve noticed certain ones declining.

Let’s put it this way  you know how difficult it is to get an insurance company to pay for anything yet mine is happily paying out thousands of dollars a month to pay for my growth hormone.  They know that if your body is not repairing itself you’re going to decline rapidly. My testosterone also declined. However the most amazing thing about it is that its not the sex drive that suffered its the mental drive.

I still always wanted sex and was ready and willing but my numbers declined and so did my mood and desire to do anything. PS after i started supplementing I ran for US Congress. There is so much that you need to know about this.

First of all if you don’t have a baseline or youthful numbers you wouldn’t even know where to begin.  For example a mans testosterone can range anywhere from 200 to 800. So as a hairy Armenian, who could part the hair on my back with a comb, before laser hair removal. My numbers were always 900. Not saying this to brag, but if I declined to 400 that would be a disaster, a decline of half and I would be depressed at the very least.  So go get a doctor to write a cpt code so you can get it tested for free.

Yet a normal white Irish guy who’s been four or 500 his whole life would be happily functioning at four or 500. So if we both went to the doctor he would say we are both normal given the 200 800 range.  So if you don’t have a test get one, because you’ll need to refer to it 20 30 or 40 years from now because your endocrinologist is going want to know what your normal was. And we’re not even getting started.

Women also have a small amount of testosterone which is responsible for their sex drive. And if men are too low in estrogen they would have heart issues so we all need a test consisting of a full sex hormone panel  including estradiol progesterone and testosterone free and total for men.  In addition to that you need to know your inhibitory and excitatory hormones meaning the ones that wake you up and the ones that keep you calm and help you fall asleep.

Obviously your thyroid  needs to be measured and you need a comprehensive blood test.  But in addition there are companies like neuroscience that will measure your inhibitory and excitatory hormones.  You may have heard of epinephrine and norepinephrine or dopamine, those are all excitatory hormones which can be measured.  And you want to make sure that chemicals like serotonin, your happy sleepy neurotransmitter is abundant at night, As well as melatonin.  There are companies like neuroscience that actually measure a number of different hormones and neurotransmitters in urine and your saliva at various times of the day and night to get an indication of whether you’re hormones are helping or hurting you.

hormones 2

They then recommend TAAT or Targeted Amino Acids Therapy.  So they would give you various amino acids (high school biology amino acids make up proteins and are more or less abundant in different foods) for example you’ve all heard that turkey is abundant in tryptophan which many claim is the reason for the nap after Thanksgiving Turkey dinner.

Again apologies but impossible to not segue when explaining all of this even superficially.  But the bottom line is you can’t fight against your hormones I’ll even relate my personal experience if that helps you to understand a little better how much it can affect you.  I take testosterone as a shot once a week. Ironically what I’ve noticed is that towards the end of the week when my testosterone is low I am for a lack of a better word bitchy, but when my testosterone is high and I am strong I am much more confident and able to deal with pretty much anything. Men who take testosterone are also given an aromatase inhibitor, in simple terms if a man has too much testosterone he could convert the excess testosterone into estrogen ( voila man boobs)   As we get older we are not as efficient in utilizing testosterone. So some of our testosterone becomes dihdrotestosterone which causes male pattern baldness and some  actually converts into estrogen. So an aromatase inhibitor like anastrozole is taken to reduce the amount of estrogen slightly, Again not too much because we do need estrogen to protect our hearts. That’s why we measure everything. Women are given aromatase inhibitors to reduce the amount of estrogen in the case of estrogen positive cancers or cancerous thought to be fed by estrogen.

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So my first suggestion as always is to start with your family doctor. Anytime you’re not feeling well it could be because of a serious illness. They will probably do a CBC short for a complete blood test.  However you probably want a full hormone panel as part of that blood test. Word of caution if your doctor doesn’t right a proper CPT code your insurance will not pay for.  If your insurance doesn’t pay for it you could be looking at a $2000 bill if you’re measuring all the hormones as well.   So always check first.  If your doctor’s knowledge is less than mine you need to find a new doctor.

Now in all fairness my dear friend who’s a heart surgeon doesn’t know the difference between an amino acid and a vitamin because he never studied it. But he’s the guy you want if you need open heart surgery so everyone has their specialty. If you want to approach this problem conventionally you need to see an endocrinologist but at the very least you need to have an idea if your hormones are normal by the numbers.  Something as simple as low serotonin could cause sleep difficulties, anxiousness, weight or mood issues (Pharmassan Labs) Low cortisol in the morning could mean your thyroid is not functioning properly. However once serious issues are ruled out and the conventional doctors, including the endocrinologists have given up on you, you can actually take care of yourself with certain amino acids to assist in “waking yourself” up in the morning and helping you relax at night.  But always test first and check with your doctor for more serious issues, before you go on to your own vitamin or amino acid protocol.

Once you are in range the conventional doctors will send you home and tell you you are normal and that’s where you might want to intervene. In fact another famous New York doctor who wrote the book The Natural Hormone Solution was constantly criticized for not telling patients “exactly what to take”  It’s not a simple matter of treating to the numbers the range is too large.   That  is why I offered my personal information.   If it  helps you to understand and explain why the final exact amounts are determined by how you feel.  Even after administering a lot of tests she offers women progesterone and estrogen cream and tells them to adjust what they take depending on how they feel

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