NAD+ buying guide
How to increase NAD+ levels: what has actually raised them in people
In people, what has reliably raised NAD+ in blood is a precursor supplement: in an eight-week trial, nicotinamide riboside raised whole-blood NAD+ by 22%, 51% and 142% at 100, 300 and 1,000 mg a day. Exercise raises it in muscle, and whether any higher level improves health hasn’t been shown consistently in trials.
Precursor supplements raise the blood number
If the goal is a higher NAD+ reading in blood, the thing that has done it in trials is a precursor, a molecule the body converts into NAD+. In an eight-week randomized trial in overweight adults, nicotinamide riboside raised whole-blood NAD+ within two weeks, and the rise held for the rest of the study.
| Relative to 150 percent | Percent | |
|---|---|---|
| 100 mg a day | 22% | |
| 300 mg a day | 51% | |
| 1,000 mg a day | 142% |
The trial set out to measure how much reaches the blood and whether it is safe, not whether anyone felt better. It reported no flushing and no difference in adverse events against placebo.
Source: Scientific Reports 2019, PMID 31278280: an 8-week randomized, double-blind, placebo-controlled trial in overweight adults. Figures as stated in the abstract, “22%, 51% and 142%”, reached within 2 weeks and held for the rest of the study.
Other trials point the same way. A pharmaceutical NMN taken once or twice a day produced “substantial dose-related increases in blood NAD levels and its metabolome”. A 2018 trial concluded that nicotinamide riboside “is well tolerated and effectively stimulates NAD+ metabolism in healthy middle-aged and older adults”. And the 2026 study that measured seven cohorts found whole-blood NAD+ changed with nicotinamide riboside “as expected”, while age and lifestyle interventions didn’t move it.
Which precursor, and what it costs next to NAD+ itself, is a different question with its own page.
Exercise raises it in muscle
Exercise is the lifestyle change with the clearest measurements behind it, and they come from muscle. Sixteen untrained, overweight adults with an average age of 59 did 10 weeks of full-body resistance training, twice a week. Biopsies of the thigh muscle showed NAD+ up 127% and NADH up 99%. Before the training their muscle NAD+ was lower than that of trained college-age men; afterward the two groups were similar. There was no group that skipped the training, so the comparison is before and after.
| What people did | Where NAD+ was measured, and the study | What happened |
|---|---|---|
| Took nicotinamide riboside, 100 to 1,000 mg a day | Whole blood; Scientific Reports 2019 | Up 22% to 142%, more at higher doses |
| Took pharmaceutical NMN, 1,000 mg once or twice a day | Blood; J Gerontol A 2023 | Substantial dose-related increases |
| Did 10 weeks of resistance training | Thigh muscle, by biopsy; Aging 2020 | Up 127% in 16 middle-aged adults |
| Exercised | Immune cells in blood; Brain Behav Immun 2025 | Higher inside the cells during exercise |
| Made lifestyle changes | Whole blood; Nature Metabolism 2026 | Stayed where it was |
Blood and muscle are different places to look. The 2026 study found whole-blood NAD+ moved with nicotinamide riboside and not with age or with the lifestyle interventions it studied.
Source: Scientific Reports 2019, PMID 31278280; J Gerontol A 2023, PMID 35182418; Aging 2020, PMID 32369778; Brain Behav Immun 2025, PMID 39500416; Nature Metabolism 2026, PMID 42135539. Each row says what that study’s own abstract says.
A 2019 study found the same direction by another measure. Twelve weeks of aerobic training raised NAMPT, the enzyme that limits how fast muscle makes NAD+, by 12% in young adults and 28% in older ones; resistance training raised it 25% and 30%. A 2022 cross-sectional study found exercise-trained older adults had muscle NAD+ closer to that of young adults, and NAD+ tracked the number of steps people took a day.
Even one bout registers in the blood’s immune cells. In a 2025 trial, NAD+ inside those cells rose during exercise, along with expression of the gene for the enzyme that makes it.
Diet, weight loss and other lifestyle changes
Here the blood evidence is blunt. The 2026 study that measured whole-blood NAD+ across seven cohorts found it “remarkably stable with age and across lifestyle interventions”. Its abstract doesn’t say which interventions those were.
Losing weight changes the machinery, at least in fat. In a year-long program, people with obesity who lost 11.7% of their weight showed higher expression of NAMPT and SIRT1 in their fat tissue, and those who regained lost the SIRT1 gain. That’s gene activity in fat, not an NAD+ level, and whether NAD+ helps weight come off is a separate question with thinner evidence.
Diet turns up only as an association. In a community study of 1,518 adults, NAD+ levels differed with how much meat people ate (p = 0.01). An association like that says nothing about what changing a diet would do.
Is your NAD+ low to begin with?
Raising a level assumes it has fallen. In tissue it does fall with age: skin NAD+ in 49 surgical patients declined with age in both sexes, and an MR scanner found less NAD+ in older brains. In blood it’s far less clear. A 2025 review noted that an age-related decline in people “has been consistently observed only in a limited number of studies”, and the 2026 seven-cohort study found whole-blood NAD+ didn’t vary with age at all. Where NAD+ falls with age and where it doesn’t is laid out study by study.
There’s no reference range to hold a blood result against, either.
Do NAD supplements work?
They do the thing trials measure most reliably: they raise NAD+ in blood. Whether that makes anyone healthier hasn’t been shown. A 2026 systematic review of 33 human intervention studies found that oral NR and NMN “consistently demonstrated biochemical target engagement”, while their effects on function, metabolism, blood vessels and other outcomes “were heterogeneous and often null or endpoint-specific.” Its overall verdict was that “clinical effectiveness for anti-aging or wellness outcomes remains inconclusive.”
The pooled trials say the same in narrower terms. A 2025 meta-analysis concluded: “Current evidence does not support NMN and NR supplementation for preserving muscle mass and function in adults with mean age of over 60 years.” A 2026 meta-analysis of NMN found it well tolerated, and “Broad metabolic benefits were not evident”.
That trial evidence is about supplements this index barely prices. Of its 382 prices, 380 are for NAD+ itself and 1 is for an oral precursor. What sellers charge for NAD+ is on the NAD+ price index, seller by seller, and the full board shows every kind of figure they publish.
What the studies haven’t settled
What would turn a higher number into a known benefit is still missing.
Do diet, fasting or sleep raise NAD+ inside tissues, where the blood measurements say nothing moves?
Controlled human trials of a diet, fasting or sleep change that measure NAD+ in muscle or another tissue with a validated assay. The 2026 seven-cohort study measured whole blood only, and the evidence that exercise raises NAD+ comes from muscle biopsies.
Does raising NAD+ make anyone healthier? Supplements raise the blood number reliably; whether that changes an outcome a person would notice has not been shown consistently in trials.
Larger, longer randomized trials with a clinical endpoint named in advance. A 2026 systematic review of 33 human intervention studies found the outcome results heterogeneous and often null, and found no outcome trial at all of NAD+ given by vein or by intramuscular injection.
What is a normal NAD+ level, and is yours low? No reference range exists that a person could hold a test result against.
A validated reference range for NAD+ in a sample a clinic can actually take, tied to a health outcome. The two largest blood studies disagree about age: 1,518 people in one community cohort showed a decline in men only, and seven cohorts measured in 2026 showed whole-blood NAD+ holding steady with age, a result its authors say challenges the use of blood NAD+ as a biomarker of aging or lifestyle.
Read next
About this page
Nothing here is medical advice, diagnosis or treatment. This is a price index, and pages like this one exist because a reader cannot judge a price without knowing what the thing is. Talk to a licensed clinician before starting or stopping anything, and see the medical disclaimer.
Document sources read September 2026. The references below retain each source reading date and the date printed on the document itself. An editorial revision does not refresh those source records. If something here is wrong, the corrections page says how that gets fixed and what has been fixed before.
Sources
- Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults.
- MIB-626, an Oral Formulation of a Microcrystalline Unique Polymorph of β-Nicotinamide Mononucleotide, Increases Circulating Nicotinamide Adenine Dinucleotide and its Metabolome in Middle-Aged and Older Adults.
- Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults.
- Human whole-blood NAD+ levels do not vary with age or lifestyle interventions.
- Resistance training increases muscle NAD+ and NADH concentrations as well as NAMPT protein levels and global sirtuin activity in middle-aged, overweight, untrained individuals.
- Aerobic and resistance exercise training reverses age-dependent decline in NAD+ salvage capacity in human skeletal muscle.
- Healthy aging and muscle function are positively associated with NAD+ abundance in humans.
- Acute exercise boosts NAD+ metabolism of human peripheral blood mononuclear cells.
- Weight Loss Is Associated With Increased NAD(+)/SIRT1 Expression But Reduced PARP Activity in White Adipose Tissue.
- Association of Human Whole Blood NAD+ Contents With Aging.
- NAD+ precursor supplementation in human ageing: clinical evidence and challenges.
- Age-associated changes in oxidative stress and NAD+ metabolism in human tissue.
- In vivo NAD assay reveals the intracellular NAD contents and redox state in healthy human brain and their age dependences.
- NAD⁺ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence.
- The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis.
- Safety and Metabolism-Related Outcomes of Oral Nicotinamide Mononucleotide Supplementation in Adults: A Systematic Review and Meta-Analysis.