The Science of NAD+: What Providers Need to Know

Medicine’s shifting. Fast. And finally, for the better. Healthcare providers everywhere are moving beyond a “one-size-fits-all” approach toward more personalized and proactive care. Central to this movement is NAD+ (nicotinamide adenine dinucleotide), a powerful molecule you might remember vaguely from biochem that’s now transforming modern clinical practice.

NAD+ isn’t just another buzzword. According to a 2024 study published in npj Aging, NAD+ is the biochemical backbone powering cellular energy, DNA repair, and resilience¹, highlighting why NAD+ therapy is becoming an essential tool for healthcare providers aiming to optimize patient health. For providers, understanding NAD+ isn’t just academic—it may support patient outcomes such as increased energy, enhanced cognitive function, and an improved sense of well-being.

At Strive, we've successfully supported hundreds of providers integrating NAD+ into clinical practice. NAD+ therapy is most promising when tailored to individual patient goals—from improving energy and cognitive clarity to enhancing metabolic function and cellular repair.

What Is NAD+ and Why Is It Important for Providers?

Quick flashback to early 1900s science class: NAD+ is a coenzyme—found in every living cell—that plays a starring role in metabolism.²   It’s a key electron transporter, helping convert nutrients into energy (ATP), supporting DNA repair, and keeping our cells humming.³

But here’s what’s wild: even though we’ve known about it for over a century, we're only beginning to grasp how radically impactful it can be when we dial it up on purpose.⁴

It’s not just real—it’s ready to rewrite what “normal” can feel like.

Why NAD+ Actually Matters (Spoiler: It’s Not Just About Energy)

Think of NAD+ as the body’s spark plug. Without it, your cells can’t make energy efficiently. And where does energy get made? In the mitochondria. So when NAD+ is low, everything drags—fatigue, brain fog, metabolic issues, you name it.⁵

But NAD+ isn’t just about fueling up. It’s also about protecting and preserving. Meet sirtuins, a family of enzymes that can help regulate inflammation, stress response, even aging. These enzymes literally can’t work without NAD+.⁶

Low NAD+ = sleepy sirtuins. And sleepy sirtuins = cellular dysfunction, accelerated aging, and increased disease risk.³

NAD+ Depletion: Why Aging Feels Like It Does

Here's the thing: NAD+ levels naturally tank as we age^.7 It’s not your imagination—things do get harder, slower, and more tiring. That drop in NAD+ is a big reason why.

But here’s where providers get to rewrite the story: replenishing NAD+ doesn’t just slow the decline. It opens up new, regenerative pathways.⁸ New clinical possibilities for aging well, metabolically thriving, and mentally rebounding.

This isn’t about fighting aging—it’s about unlocking a different baseline entirely.

3 Ways Healthcare Providers Are Successfully Using NAD+

Providers integrating NAD+ therapy report promising results in three key clinical areas:

1. Neurodegenerative Conditions
   NAD+ can help maintain neuronal integrity and support cognition. Think Alzheimer's, Parkinson’s, cognitive decline—where neuroprotection matters, NAD+ has real potential.⁹
   
   
2. Chronic Fatigue & Metabolic Dysfunction
   NAD+ may help rev up mitochondrial efficiency. For patients in a chronic energy deficit, NAD+ can be the difference between surviving the day and actually living it.¹⁰
   
   
3. Addiction Recovery
   NAD+ shows promise in supporting neurotransmitter balance and neural repair, offering support in substance recovery and neural rewiring—an often-overlooked clinical use with big implications.²
   
   

How NAD+ Is Administered: 4 Methods Providers Should Know

NAD+ can be administered to patients in several ways, each with unique advantages suited to different clinical scenarios:

1. IV Infusion
   
   • Pros: Fast-acting, highly bioavailable, immediate cellular delivery.
     
     
   • Ideal for: Patients needing quick symptom relief, rapid energy replenishment, or intensive therapy protocols.
     
2. Subcutaneous or Intramuscular Injection
   
   • Pros: High bioavailability, bypasses the digestive system, allows for precise dosing.
   • Ideal for: Patients needing sustained NAD+ support, those who prefer periodic administration over daily supplements, or when the IV route isn’t practical.
     
3. Sublingual Troche
   
   • Pros: Rapid absorption through oral mucosa, needle-free, easy self-administration.
     
     
   • Ideal for: Patients seeking quick onset without IV therapy, improved convenience at home.
     
4. Nasal Spray
   
   • Pros: Rapid absorption via the nasal mucosa, needle-free, can support systemic and brain NAD+ levels.
     
     
   • Ideal for: Patients seeking non-invasive administration with fast CNS delivery, especially useful for cognitive support and neurological applications.

NAD+ Precursors Explained: NR vs. NMN

NAD+ precursors like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are catching deserved attention. Both effectively raise NAD+ levels but have slightly different pharmacokinetics.

Here’s the short version:

• NR: Well-tolerated, increasingly available, and helpful for general NAD+ boosting.¹¹
  
  
• NMN: Some research suggests a bit more direct, promising absorption, with some early edge in research for age-related decline.¹²
  
  

Which one’s right? Depends on your patient’s goals, lifestyle, and needs. (We’re always down to help you figure it out.)

 Looking to get NMN into your patients’ hands—quickly and reliably?
You can grab high-quality NMN directly from our supplement shop. No prescription needed.
👉shop.strivepharmacy.com

Because smarter health starts with simpler access—and we’re here for both.

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Potential Side Effects: What You Actually Need to Know

Most patients tolerate NAD+ therapies well. But yeah, there are things to keep in mind—especially with IV routes:

• Mild nausea
  
  
• Flushing
  
  
• Temporary fatigue
  
  
• Rare dizziness
  
  

The good news? These are sometimes manageable with hydration, controlled infusion rates, and setting real expectations with patients.

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NAD+ Therapy: Separating The Science from Hype

Let’s be real—NAD+ has hype. And hype invites nonsense.

Some people oversell it as a miracle cure. Others write it off entirely. But here’s the thing: NAD+ isn’t magic, and it’s not fluff. It’s an emerging tool with very real applications.

At Strive, we’re here to help you separate science from snake oil. We keep it honest and we always keep the patient at the center.

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Translating Science Into Information Patients Actually Get

You know the science. Now let’s make sure your patients feel it.

We help providers bridge the gap between clinical understanding and real-world explanation. It’s not just “NAD+ can enhance mitochondrial function”—it’s “this could help you wake up with energy, stay sharp at work, or finally kick that mid-afternoon crash.”

Real benefits. Real talk. Real connection.

Where Strive Comes In

We’re not just a pharmacy. We’re your NAD+ compounding partner.

From expertly compounded formulations to behind-the-scenes clinical support, we’re helping providers bring better, personalized care to their patients every single day.

The future of medicine isn’t coming someday. It’s happening now—and we’re in it with you.

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Final Take: NAD+ Isn’t the Future—It’s Now

The science of NAD+ isn’t some distant concept anymore. It’s real. It’s measurable. And it’s reshaping the entire conversation around vitality and longevity.

For providers who believe medicine should meet people where they are, NAD+ is a powerful tool—fueling better energy, sharper thinking, quicker recovery, and a new kind of vitality that actually sticks.

We’re not here to wait for the future. We’re here to build it.

Because this isn’t just about better outcomes. It’s about better lives.

This is more than medicine. It’s momentum.

Let’s Strive forward.

For Providers: Make NAD+ Personal—With Us

You’re not here to follow the status quo. You’re here to flip the script—on aging, on energy, on how care gets delivered.

Strive partners with forward-thinking providers to compound smarter NAD+ therapies that actually fit real lives. From custom dosing to clinical guidance, we make it easy to deliver powerful, personal medicine.

Ready to integrate NAD+ into your clinical practice?
👉Join the Strive provider network and get started today.

For Patients: Want NAD+ That’s Actually Tailored to You?

You don’t need another generic supplement. You need a care plan that meets you where you are—guided by someone who actually listens.
If you’re curious about how NAD+ can support your energy, brain health, or recovery, we’ll help you connect with a provider who’s already in your corner.

 Let’s help you feel like yourself again.
👉 Find a Strive provider near you.

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References 

1. Henderson JD, Quigley SNZ, Chachra SS et al. The use of a systems approach to increase NAD⁺ in human participants. npj Aging 10, 7 (2024). https://www.nature.com/articles/s41514-023-00134-0
2. Amjad S, Nisar S, Bhat AA, Shah AR, Frenneaux MP, Fakhro K, Haris M, Reddy R, Patay Z, Baur J, Bagga P. Role of NAD+ in regulating cellular and metabolic signaling pathways. Mol Metab. 2021 Jul;49:101195. doi: 10.1016/j.molmet.2021.101195. Epub 2021 Feb 17. PMID: 33609766; PMCID: PMC7973386.

3. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021 Feb;22(2):119-141. doi: 10.1038/s41580-020-00313-x. Epub 2020 Dec 22. PMID: 33353981; PMCID: PMC7963035.
4. Katsyuba E, Auwerx J. Modulating NAD+ metabolism, from bench to bedside. EMBO J. 2017 Sep 15;36(18):2670-2683. doi: 10.15252/embj.201797135. Epub 2017 Aug 7. PMID: 28784597; PMCID: PMC5599801.
5. Zapata-Pérez R, Wanders RJA, van Karnebeek CDM, Houtkooper RH. NAD+ homeostasis in human health and disease. EMBO Mol Med. 2021 Jul 7;13(7):e13943. doi: 10.15252/emmm.202113943. Epub 2021 May 27. PMID: 34041853; PMCID: PMC8261484.
6. Imai, Si., Guarente, L. It takes two to tango: NAD+ and sirtuins in aging/longevity control. npj Aging Mech Dis 2, 16017 (2016). https://doi.org/10.1038/npjamd.2016.17
7. McReynolds MR, Chellappa K, Baur JA. Age-related NAD+ decline. Exp Gerontol. 2020 Feb 22;134:110888. doi: 10.1016/j.exger.2020.110888. Epub ahead of print. PMID: 32097708; PMCID: PMC7442590.
8. Conlon NJ. The Role of NAD+ in Regenerative Medicine. Plast Reconstr Surg. 2022 Oct 1;150(4 Suppl ):41S-48S. doi: 10.1097/PRS.0000000000009673. Epub 2021 Sep 28. PMID: 36170435; PMCID: PMC9512238.
9. Lautrup S, Sinclair DA, Mattson MP, Fang EF. NAD+ in Brain Aging and Neurodegenerative Disorders. Cell Metab. 2019 Oct 1;30(4):630-655. doi: 10.1016/j.cmet.2019.09.001. PMID: 31577933; PMCID: PMC6787556.
10. Stein LR, Imai S. The dynamic regulation of NAD metabolism in mitochondria. Trends Endocrinol Metab. 2012 Sep;23(9):420-8. doi: 10.1016/j.tem.2012.06.005. Epub 2012 Jul 21. PMID: 22819213; PMCID: PMC3683958.
11. Freeberg KA, Udovich CC, Martens CR, Seals DR, Craighead DH. Dietary Supplementation With NAD+-Boosting Compounds in Humans: Current Knowledge and Future Directions. J Gerontol A Biol Sci Med Sci. 2023 Dec 1;78(12):2435-2448. doi: 10.1093/gerona/glad106. PMID: 37068054; PMCID: PMC10692436.
12. Shade C. The Science Behind NMN-A Stable, Reliable NAD+Activator and Anti-Aging Molecule. Integr Med (Encinitas). 2020 Feb;19(1):12-14. PMID: 32549859; PMCID: PMC7238909.