Why NAD+ Matters More Than You Think
And Why Everyone Is Talking About It
If you have spent any time in the health and longevity space lately, you have probably heard people talking about NAD+. Athletes are using it. High performers swear by it. Longevity physicians consider it foundational. Patients who try it often say the same thing afterward: “I feel like myself again.”
So why has this single molecule become one of the most talked about therapies in modern wellness and functional medicine?
The answer is surprisingly simple. NAD+ is not a trend. It is biology. And many people today are running critically low.
What NAD+ Actually Is
NAD+ stands for nicotinamide adenine dinucleotide. While the name sounds technical, its role is straightforward. NAD+ is a coenzyme present in every living cell in your body. It is required for energy production, cellular repair, immune regulation, brain function, and metabolic signaling.
Every time your body creates energy from food, repairs DNA damage, regulates inflammation, or supports mitochondrial function, NAD+ is involved.
Without adequate NAD+, cells cannot efficiently produce ATP, which is the energy currency of the body. When levels decline, systems begin to slow down. People often describe this as fatigue, brain fog, slower metabolism, poor stress tolerance, or feeling older than they should.
NAD+ levels naturally decline with age, but modern life accelerates depletion dramatically. Chronic stress, infections, poor sleep, alcohol, environmental toxins, inflammation, and viral illness all consume NAD+ at a faster rate than the body can replenish it.
This is one reason so many people feel biologically exhausted even when their labs appear normal.
Why People Are Suddenly Obsessed With NAD+
The growing interest in NAD+ comes from a shift in medicine toward cellular health rather than symptom management. Instead of asking how to suppress symptoms, researchers are asking how to restore cellular function.
NAD+ sits at the center of that conversation. When NAD+ levels are restored, patients frequently report improvements in:
Mental clarity
Sustained energy rather than stimulation
Mood stability
Metabolic flexibility
Exercise recovery
Sleep quality
Stress resilience
Unlike stimulants that temporarily override fatigue, NAD+ works upstream by supporting mitochondrial efficiency and cellular repair mechanisms. Many people describe the experience not as feeling “wired,” but as feeling regulated.
Why IV NAD+ Works Better Than Oral Supplements
A common question is why IV NAD+ is recommended instead of capsules or powders. The answer comes down to bioavailability.
Oral NAD+ precursors such as nicotinamide riboside or NMN must pass through digestion, liver metabolism, and enzymatic conversion before becoming usable NAD+. Much of the compound is lost during this process, and absorption varies significantly between individuals.
IV administration bypasses digestion entirely and delivers NAD+ directly into circulation, allowing immediate cellular uptake. This creates therapeutic levels that cannot realistically be achieved through oral supplementation alone.
Clinically, this difference matters. Patients often notice more profound effects with IV therapy because the body receives enough NAD+ to shift cellular metabolism rather than simply maintain baseline levels.
This is why IV NAD+ has become one of our most popular memberships. Consistency matters. Just like exercise or nutrition, cellular restoration works best when supported regularly rather than occasionally.
The Caveat
When patients receive NAD+ by IV for the first time, it is common to notice temporary sensations during the infusion. These may include pressure or heaviness in the head, a tight or warm feeling in the chest, or mild gastrointestinal discomfort such as nausea or abdominal awareness. These effects are not allergic reactions but rather signs of metabolic activation as cells rapidly begin utilizing NAD+. Many experienced providers actually view this response as informative and sometimes use NAD+ tolerance as a functional indicator of underlying inflammation or cellular stress within the body. Individuals who are sleep deprived, highly stressed, inflamed, or recovering from illness tend to experience stronger sensations because their cells are more depleted and reactive. The encouraging part is that NAD+ works cumulatively. As cellular energy systems recover and inflammation decreases, infusions typically become much more comfortable, reactions lessen, and patients often notice smoother energy, improved resilience, and fewer side effects with each subsequent treatment.
NAD+ and Hidden Infections: EBV, Strep, and Viral Persistence
One of the most overlooked reasons people feel chronically depleted is persistent immune activation from latent infections. Viruses and certain bacteria do not always leave the body completely after an acute illness. Instead, they can enter a dormant or latent state.
Epstein Barr Virus (EBV), the virus responsible for mononucleosis, infects more than 90 percent of adults worldwide. After initial infection, EBV remains inside immune cells for life. In healthy conditions it stays quiet. Under stress, inflammation, hormonal shifts, or immune dysregulation, it can reactivate at low levels, contributing to fatigue, brain fog, and systemic inflammation.
Similarly, streptococcal bacteria can persist in biofilms or immune privileged tissues, continuing to stimulate immune responses long after the original infection appears resolved. Other viruses such as HSV and certain enteroviruses behave similarly, remaining dormant but metabolically active enough to strain the immune system.
When the immune system remains chronically engaged, NAD+ consumption increases dramatically. Immune cells require large amounts of NAD+ to respond to infection and repair inflammation-related DNA damage. Over time, this creates a depletion cycle where persistent immune activation drains cellular energy reserves.
NAD+ therapy helps interrupt this cycle in several ways.
It supports mitochondrial recovery in immune cells, improves cellular repair pathways, and activates enzymes called sirtuins and PARPs that regulate DNA repair and immune signaling. By restoring cellular energy availability, the body is better equipped to regulate viral latency rather than remain stuck in chronic inflammatory signaling.
Patients recovering from long viral illnesses, including EBV reactivation or post viral fatigue syndromes, often report gradual improvements in resilience, recovery capacity, and mental clarity with consistent NAD+ support.
Protecting the Brain and Preserving Cognition
One of the most exciting areas of NAD+ research involves brain health.
The brain consumes enormous amounts of energy. Neurons rely heavily on mitochondrial efficiency and DNA repair systems, both of which require NAD+. Declining NAD+ levels are associated with neuroinflammation, impaired synaptic signaling, and age related cognitive decline.
NAD+ activates sirtuin pathways that help protect neurons from oxidative stress and support cellular longevity mechanisms. Research suggests these pathways play roles in memory preservation, neuroplasticity, and metabolic regulation within the brain.
Patients often describe improvements that are difficult to quantify but deeply meaningful. Words come easier. Focus improves. Mental fatigue decreases. The sense of cognitive overwhelm softens.
Rather than stimulating the brain, NAD+ appears to restore the conditions necessary for optimal neurologic function.
Energy, Metabolism, and Feeling Like Yourself Again
Metabolism is not just about calories. It is about how efficiently cells convert fuel into usable energy.
Low NAD+ levels impair mitochondrial function, leading to reduced metabolic flexibility. This can contribute to weight resistance, poor exercise tolerance, and energy crashes despite adequate nutrition.
By supporting mitochondrial respiration, NAD+ helps cells utilize glucose and fatty acids more efficiently. Many patients notice improved endurance, better recovery after workouts, and more stable energy throughout the day.
The goal is not artificial energy. The goal is restored capacity.
Why NAD+ Became One of Our Most Popular Memberships
What we consistently see is that NAD+ works best when used proactively rather than reactively. Patients who receive NAD+ regularly often describe cumulative benefits. Their baseline energy improves. Stress recovery becomes faster. Illnesses feel less draining. Cognitive sharpness becomes more consistent.
Memberships allow patients to maintain cellular support in the same way they maintain fitness or nutrition habits. Instead of waiting until burnout or illness occurs, they build physiologic resilience over time. We adopted a form of Dr. Koniver’s protocol whereby patients receive a loading dose of 750 mg via IV over the course of 10 days, many patients split this up into three 250 mg doses. This is the annual loading dose, then patients transition to two 100 mg injections a month for the 11 months of the year. Most patients report finally feeling like their energy is back, they’re anxiety is reduce, they think more clearly, and have better exercise performance.
In a world that constantly demands output, NAD+ provides something many people have never experienced before. Biological support that helps the body keep pace with the life they want to live.
The Bigger Picture
The growing obsession with NAD+ is really a reflection of something deeper. People are realizing that health is not simply the absence of disease. It is the presence of energy, clarity, adaptability, and resilience.
At its core, NAD+ therapy is about restoring the body’s ability to repair itself, regulate inflammation, and produce energy efficiently.
When cellular health improves, everything built on top of it has a stronger foundation.
And often, patients discover that what they were missing was not motivation or discipline.
It was cellular capacity.
References
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Canto C, Auwerx J. NAD+ as a signaling molecule modulating metabolism. Cold Spring Harbor Symposia on Quantitative Biology. 2011;76:291-298.
Covarrubias AJ et al. NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology. 2021;22:119-141.
Mouchiroud L et al. The NAD+/Sirtuin pathway modulates longevity. Cell. 2013;154(2):430-441.
Henriksen BS et al. Epstein Barr virus persistence and immune regulation. Frontiers in Immunology. 2014.
Santoro MG et al. Viral infections and mitochondrial dysfunction. Trends in Microbiology. 2020.
Hou Y et al. NAD+ supplementation normalizes key Alzheimer’s features. Cell Reports. 2018.