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.

What Supplements Should I Take?

I promised to be the ultimate hack for health, happiness, and beauty. So here is what the top anti-aging scientists take:

Top anti-aging scientists and researchers often take a variety of supplements based on their research and understanding of the aging process. While individual regimens can vary, here are some common supplements that many of these experts incorporate into their daily routines:

Common Supplements Among Anti-Aging Scientists

  1. Vitamin D
    • Purpose: Supports bone health, immune function, and reduces inflammation.
    • Sources: Sun exposure, fortified foods, and supplements.
    • Evidence: Vitamin D deficiency is linked to various age-related diseases .
  2. Omega-3 Fatty Acids
    • Purpose: Supports heart health, reduces inflammation, and improves brain function.
    • Sources: Fish oil, flaxseeds, chia seeds.
    • Evidence: Omega-3s can reduce the risk of chronic diseases like heart disease and dementia .
  3. Resveratrol
    • Purpose: Mimics caloric restriction effects, potentially extending lifespan.
    • Sources: Red wine, grapes, berries, and supplements.
    • Evidence: Resveratrol may improve mitochondrial function and protect against age-related diseases .
  4. Nicotinamide Riboside (NR) / Nicotinamide Mononucleotide (NMN)
    • Purpose: Boosts NAD+ levels, essential for cellular energy and repair.
    • Sources: Supplements.
    • Evidence: Increasing NAD+ levels can enhance metabolic health and potentially extend lifespan .
  5. Curcumin
    • Purpose: Anti-inflammatory and antioxidant properties.
    • Sources: Turmeric spice and supplements.
    • Evidence: Curcumin reduces inflammation and oxidative stress, key drivers of aging .
  6. Coenzyme Q10 (CoQ10)
    • Purpose: Supports mitochondrial function and energy production.
    • Sources: Meat, fish, whole grains, and supplements.
    • Evidence: CoQ10 levels decline with age, and supplementation helps maintain cellular energy and reduce oxidative damage .
  7. Vitamin K2
    • Purpose: Supports bone and cardiovascular health by directing calcium to bones and away from arteries.
    • Sources: Fermented foods, dairy, and supplements.
    • Evidence: Vitamin K2 improves cardiovascular health and bone density .
  8. Magnesium
    • Purpose: Supports muscle and nerve function, bone health, and metabolic processes.
    • Sources: Green leafy vegetables, nuts, seeds, whole grains, and supplements.
    • Evidence: Adequate magnesium intake is crucial for many bodily functions and may help prevent age-related diseases .

Examples of Notable Figures and Their Regimens

  1. David Sinclair (Harvard Medical School)
    • Supplements: NMN, resveratrol, metformin (prescription), and vitamin D.
    • Focus: Increasing NAD+ levels and mimicking caloric restriction .
  2. Peter Attia (Physician, Longevity Specialist)
    • Supplements: Omega-3 fatty acids, vitamin D, magnesium, and others tailored to personal health metrics.
    • Focus: Reducing chronic disease risk and improving metabolic health .
  3. Rhonda Patrick (FoundMyFitness)
    • Supplements: Omega-3 fatty acids, vitamin D, magnesium, probiotics, and sulforaphane.
    • Focus: Comprehensive health optimization through diet and supplementation .

Personal Insights and Bets on Life

Growth Hormone and Testosterone

  • Rationale: At my age, the risk-reward ratio for taking growth hormone and testosterone is highly favorable. These supplements can improve muscle mass, energy levels, and overall vitality, which are crucial for maintaining a high quality of life.
  • Growth Hormone: Known for its anti-aging effects, improving skin elasticity, and increasing energy.
  • Testosterone: Vital for maintaining muscle mass, bone density, and libido.

Viagra

  • Rationale: Using Viagra to improve circulation in my brain and heart is a strategic decision. Better blood flow can enhance cognitive function and cardiovascular health.
  • Benefits: Besides its well-known use, it supports overall circulatory health, which is critical for maintaining organ function and preventing age-related decline.

Conclusion

We all place our bets in life. For me, taking growth hormone, testosterone, and Viagra are calculated risks with significant potential benefits. Combining these with a tailored supplement regimen can help optimize health and longevity.

References

  1. Healthline – Benefits of Vitamin D
  2. Mayo Clinic – Vitamin D
  3. Harvard T.H. Chan School of Public Health – Omega-3 Fatty Acids
  4. National Institutes of Health – Omega-3 Fatty Acids
  5. PubMed – Resveratrol: How Much Wine?
  6. WebMD – Resveratrol
  7. Healthline – Nicotinamide Riboside
  8. NIH – NAD+ Boosters
  9. Healthline – Benefits of Curcumin
  10. PubMed – Curcumin: Inflammation and Aging
  11. NIH – Coenzyme Q10
  12. Healthline – CoQ10 Benefits
  13. WebMD – Vitamin K2
  14. Healthline – Vitamin K2 Benefits
  15. NIH – Magnesium
  16. Healthline – Magnesium Benefits
  17. David Sinclair – Lifespan
  18. Harvard Health Blog – The Power of Resveratrol
  19. Peter Attia – Supplements
  20. FoundMyFitness – Rhonda Patrick

These insights, combined with the personalized approaches taken by leading scientists, illustrate the thoughtful and proactive strategies employed to enhance longevity and quality of life.

4o

Melatonin

Melatonin deserves a blog unto itself.  It  is a hormone secreted by the pineal gland. It is believed to regulate other hormones and maintains the body’s sleep wake cycle or rhythm. You produces more melatonin at night, and it drops from light. Exposure to bright lights or shift work or travel can interrupt your circadium rhythm.

Some scientists believe melatonin levels may be related to aging since the these levels drop as we age. They believe that is why  older adults have sleep problems.  Melatonin also has strong antioxidant effects. Evidence suggests that it may help strengthen the immune system.

If you are considering using melatonin supplements you should talk to your doctor first. In fact you need to look no further then something as innocuous as vitamin E. Its among the list to avoid before surgery since it would slow the clotting time.

People use melatonin for jet lag and studies suggest that for short periods of time melatonin is more effective than a placebo in reducing the time it takes to fall asleep, increasing the number of sleeping hours, and boosting daytime alertness.Heart Disease

Several studies show melatonin has cardioprotective properties, including antioxidant and anti-inflammatory effects. Research also suggests that melatonin may help lower blood pressure levels and improve cholesterol profiles. More research is needed.

PS beauty sleep is a real thing. If you are not getting your sleep it will affect your appearance.  In fact another supplement based on magnolia flower is extremely popular and so helpful we call it beauty sleep.  Two of our patients told us it helped them get off Ambien ( another long story people have hurt themselves sleep walking on Ambien)

More on that and other beauty supplements here

Also in one of the most underappreciated but favorite book of mine Stopping the Clock by Klatz and Goldman it has a list of over one hundred of the top anti aging scientists in the world and what their vitamin regimens were.  I was astounded that the most common “Supplement:” was melatonin, because of their belief that of its anti aging properties.