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How to Replenish NAD Naturally

As we age, our DNA accrues damage. The fragile nucleic acids that structure DNA are highly sensitive to sunlight, inflammation, and other factors that come along with living life. Because of this, all organisms feature DNA repair machinery. That’s where NAD comes in. This industrious molecule is a repair crew, an energy maker, and a longevity activator all in one. And so, if you’re interested in healthy aging, it’s wise to familiarize yourself with NAD.

NAD and Aging

Unfortunately, as we age, NAD levels fall because:

We make less of it

We use more of it (we require lots of NAD to repair age-related DNA damage)

More of it gets destroyed

This decline, research suggests, does not help us age gracefully. Aging is marked by genomic instability, mitochondrial dysfunction, and various functional declines linked to NAD depletion. The last decade of NAD research has been exciting. More recently, noted Harvard researcher David Sinclair (and colleagues) published a 2023 study suggesting that restoring NAD levels with the NAD precursor, nicotinamide mononucleotide (NMN), improves biomarkers of cardiometabolic health in middle-aged and older adults.

What is NAD?

NAD (nicotinamide adenine dinucleotide) is a molecule—a co-factor—that facilitates chemical reactions in your body. These reactions support the function of the nutrient-sensing pathways mTor and AMPK, which influence metabolism, repair, and aging itself. NAD also regulates a group of proteins called sirtuins crucial for DNA expression. NAD is so essential to life that it’s found in all living cells. Let’s review its primary functions.

DNA Repair

NAD supports DNA repair by activating an enzyme called PARP-1. The activation of PARP-1 is one of the main drivers of NAD depletion. For example, the activation of PARP-1 to repair skin sensitive to UV light depletes significant amounts of NAD.

Energy Metabolism

NAD accepts and donates electrons to turn glucose and fatty acids into ATP to help turn food into energy. These “redox reactions” are essential to life.

Sirtuin Activation

These enzymes, also called sirtuins, are central to aging and regulate the sleep-wake cycle among other things. Researchers have shown that supplementing with “sirtuin activators” (like NAD precursors and resveratrol) have improved endurance, organ function, and overall longevity.

Higher NAD levels appear to help activate sirtuins, triggering DNA repair and other beneficial processes. With lower NAD levels, sirtuins stay switched off and you lose all of those anti-aging benefits.

Ways To Replenish NAD Naturally

For best results, take a holistic approach to NAD repletion. Consider supplements like NMN—yes— but don’t neglect lifestyle factors like exercise, fasting, and sun protection.

#1 Exercise

Exercise keeps you young. It keeps you strong and functional while reducing the risk for most chronic diseases. NAD may be part of this story. Exercise supports NAD levels by increasing the activity of the NAD-synthesis enzyme, nicotinamide phosphoribosyltransferase (NAMPT.)

#2 Fasting and calorie restriction

Your NAD production system is continuously monitoring your energy supply. When energy levels are low—such as when you haven’t eaten much—NAD production ramps up. This extra NAD activates sirtuins and puts your body into “repair mode.” In repair mode, cells clean themselves via autophagy and mitophagy, and PARP-1 restores damaged DNA.

Calorie restriction can kick off this system, but be mindful not to overdo it. The dangers of chronic undereating—muscle loss, bone density issues, fatigue—are no joke. A safer strategy is temporarily restricting calories with intermittent fasting (IF). There’s still a danger of undereating, but IF is more about limiting when vs. how much you eat.

#3 Curtail DNA-damaging activities

Anything that damages DNA will deplete NAD. And though you can’t stop all age-related DNA damage, you can avoid the big offenders. Take sun exposure, for instance. Some sun exposure is healthy, as it helps you synthesize vitamin D—but too much UV light damages skin and sucks up considerable amounts of NAD.

#4 Support methylation

Methylation means adding methyl groups to DNA, proteins, or other molecules. This process influences many biochemical systems and functions in the body. One of these systems is NAD production. Healthy methylation helps you recycle NAD (i.e., keep levels higher) through the aptly-named “salvage pathway.”

A fundamental way to support methylation is to ensure you get enough methyl factors like B12, riboflavin, and TMG.

At Southeast Aesthetic + Wellness we offer NAD as a subQ injection option. Interested in learning more? Reach out to Angel Turlington WHNP-BC at to inquire.

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