NAD+ is an essential compound which is associated with the repair of DNA damage and the maintenance of healthy mitochondria. Without NAD*, as David Sinclair has often said, we’d be dead in seconds.
NAD+ levels start out high when we’re young but drop steadily as the years go by. By the time we’re in our sixties, the levels are a tiny fraction of what they were when we were young adults. It’s not the only important compound to think about boosting; nitric oxide, glutathione, and AKG are equally important in my estimation. See this article. But it’s a key one, and there are several possible ways to boost it.
Health issues and NAD+
Some medical conditions can also cause low NAD levels. According to an article called Implications of altered NAD metabolism in metabolic disorders,
“Numerous studies have shown that NAD levels decrease with aging and under disturbed nutrient conditions, such as obesity. Additionally, a decline in NAD levels is closely related to the development of various metabolic disorders, including diabetes and fatty liver disease.”
But even if we’re healthy, the aging process itself is associated with lower levels.
I’m 69 and have been through stretches when I was obese and struggling with insulin resistance. So in theory, my levels should be pretty low.
But I’ve also been taking both NAD+ precursors (mainly NMN) and NAD+ stabilizers (such as apigenin) for about three years now and doing some other things (such as losing excess body fat, exercising and cold showers) hoping to increase my NAD+ levels.
NAD+ boosters have come down in price significantly over the past year — if you buy it in bulk (as a powder) from a good supplier, it’s less than $1 a gram. But it’s still nice to know whether it’s doing something concrete that can be measured. So a few months ago I decided that it made sense to me to take a look “under the hood” to see how my levels were actually looking.
What the tests measure
The NAD+ tests which are available currently don’t measure tissue levels, but blood levels of the compound. (It would take a medical biopsy, a painful and expensive procedure, to measure tissue levels directly.)
Fortunately, according to a 2019 study, plasma levels of NAD+ do correspond in a meaningful way to tissue levels and to our state of health. As the authors wrote, “age-related impairments are associated with corresponding alterations in the extracellular plasma NAD+ metabolome” with implications for “the treatment and prevention of age-related diseases.” So after thinking about it for a few months, I decided to have my levels tested to see how I was doing.
Several different companies sell NAD tests; the one I took was through DoNotAge. Like other companies’ tests, the one they sell isn’t cheap, but it was a little lower (with their discount code) than the price charged by their competitors.
One thing that made me hesitate is that I had not established a baseline (pre-supplementation) for comparison, the reason being that NAD tests weren’t available till very recently. An ideal situation would be to get tested before you start supplementing; thebn take NMN, NR or other precursors for a year or so; then get tested again.) But I decided that even without a baseline, I’d still like to get an idea how I was doing. And it would give me a baseline for future comparisons.
Optimizing the test
- To get the most accurate reading, it’s recommended to take NAD tests in the morning when levels are naturally highest. I actually took it in the mid-afternoon, not so much by planning, but because I lucked into a time slot when I was free to focus on it and decided to do it while it was on my mind.
- If I take the test again, I may measure it in the morning to give a better comparison with the results of others who are measuring early in the day.
How the test works
- The test itself was easy, and one I could perform at home; it’s blood-based, but there’s no need for a blood draw in a lab. I ordered the test kit and received it through the mail.
- On my testing day, I wiped one of my fingers with an alcohol swab from the test kit; punctured it with a sterile needle in a little piece of plastic that had been provided; then squeezed my finger to get some blood flowing and dripping from the jab.
- I dripped the flood into five circles on a little piece of cardboard. The idea was to fill the circles completely with dripping blood.
- I was afraid I might run out of blood, because mine has always clotted quickly. I actually did run dry halfway through. So I poked myself in another finger and got enough bleeding going to fill all five circles.
- I squeezed my finger to cause a little more bleeding, then put a bandaid on, let the card dry for an hour or so, put some fixative (which is also part of the test kid) on it, and mailed it to the lab for testing. I used certified mail so I could track the card and make sure it had been received. After mailing it in, it took about ten days to get the results.
- According to the test, my blood level of NAD+ is 41.9μm.
- For comparison, the average for people taking the test is 34μm.
- The maximum that can be detected by the test is 100μm.
Interpreting the results
All in all I was happy with my tested levels. It was nice to see that they were “in the green” and above the average for people who get tested. I’m taking them as an indication that the NAD boosters I’ve been taking, along with the lifestyle changes I’ve made, are working.
But I’d still like get my levels higher, so have made some changes in my supplementation protocol. I may have the test redone in a few months.
Before getting tested, I’d been taking a gram of NMN a day. But I had fallen into only taking it on feasting, not fasting, days (i.e., three days a week). After the test I went back to taking it every day.
I also decided to add a little NR to the NMN I’d been taking, and raise the NMN dosage a little. I’m currently taking 1.5 grams of powdered NMN every morning, along with 0.5 grams of NR.
If you decide to supplement, there are many good companies to choose from. I’m currently taking both NMN and NR from DoNotAge. (I don’t think we need to take both, but I like doing so because in theory it should give an additional boost: “belt and suspenders.”)
I also sometimes take their apigenin (though I’ll skip it if I’m eating parsley that day).
I take the NMN and NR in the mornings along with a “fasting mimicking smoothie”, then (usually) take the apigenin in the late afternoon. I switched the apigenin to later in the day after finding that it made me a little sleepy. I’ll sometimes take it at night for that reason.
Should you get tested?
If you can afford the test, I do think it’s a good resource for measuring whether the supplements you’re taking are having the desired effect. I am glad I got tested; it’s nice to know what’s going on internally. But if you have to choose between buying a test and buying supplements to boost your NMN levels, I’d go with the latter.
As with anything, I would recommend shopping around and comparing prices. Most tests are actually conducted by the same company; the supplements sellers are an intermediary. If you decide to go with the company I went with, DoNotAge. for the test, their discount code (PATHWAYS) will save you about $24 on the test.
A member of the Facebook Life Extension group asked after reading this article whether I’m also taking DoNotAge’s TMG. My reply:
The NMN, NR, and apigenin that I take are all from DoNotAge. (I also take their SIRT6 activator, Ca-AKG and several other supplements.) I also take their TMG and several other of their supplements.
I used to take half as much TMG as I was taking NMN. So when I was taking 1 gram of NMN, I was taking 1/2 gram of TMG.
But these days, I’m taking 1.5 grams of powdered NMN (which is quite a bit cheaper than the kind in capsules), plus 0.5 grams of NR. This comes to 2 grams of NAD precursors.
So in theory I should be taking 1 gram of TMG (following the usual recommendation).
However, I usually take the NAD boosters along with a big scoop of a greens powder which is also rich in folate, which also replenishes the methyls. So still I’m only taking 1 capsule (1/2 gram) of TMG.