posted by DrBannock_IOPN 16h ago

Do NAD+ supplements really work?

We keep getting athletes coming into clinic asking if oral NAD+ pills will speed up tissue repair or resolve post-training fatigue. From a biological standpoint, swallowing intact NAD+ is functionally useless given its molecular size and instability in the gut, whereas precursors like NR or NMN actually demonstrate plasma elevation in human trials. Even then, before anyone throws hundreds of pounds at cellular coenzymes, are we actually meeting basic daily energy availability and protein targets? I would be curious to hear how others here separate the precursor data from marketing claims.

Nutrition is a performance variable.

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LabRatLouisBoston, MA11 points16h ago

Spot on about intact NAD+. If you swallow actual NAD+, your digestive enzymes chop it up into basic nicotinamide anyway. The human trial data for oral NR and NMN is real for elevating blood levels, but elevated serum levels don't automatically translate to faster tendon remodeling in healthy adults.

Preclinical is not a promise.

PMarinoFitWhite Plains, NY7 points15h ago

I fell down the NMN rabbit hole last year when recovering from a biceps tear. The literature shows it improves vascular elasticity and insulin sensitivity, but it didn't do anything for my rehab speed that kettlebell eccentrics and sleeping 8 hours hadn't already done.

Evidence first, ego last.

Mod_HelenMadison, WI8 points15h ago

Keep it focused on the actual science and mechanisms here. No vendor sourcing or specific protocol talk, those posts will get pulled.

Read the pinned rules. They are short.

CoachTerrellAtlanta, GA8 points15h ago

People will spend $200 a month on NMN pills while sleeping five hours a night and eating 60 grams of protein. Get your load management and basic nutrition right first.

You cannot inject your way out of a bad program.

DrBauer_CLTCharlotte, NC5 points14h ago

In clinic, the biggest mistake I see with high-dose NAD+ precursors or IV pushes is ignoring the methylation tax. Processing these molecules consumes hepatic methyl donors, which can drain your B12 and folate levels over time if you aren't monitoring baseline labs.

Independent primary care, whole person.

DreTheTrainerNew York, NY2 points14h ago

Every new client wants the magic pill. NAD+, peptides, whatever. I always ask: what is your adherence rate on basic sleep and hydration over the last 30 days? It's usually under 50%.

Better body, better habits.

DrReleford_DPMLos Angeles, CA4 points13h ago

From a microvascular standpoint in wound care, improving cellular metabolism sounds great on paper. But if peripheral circulation is compromised or the patient has uncontrolled blood sugars, no precursor supplement is going to repair lower extremity tissue on its own.

Save limbs. Save lives.

MarlinaV_PNWSeattle, WA2 points13h ago

I used oral NR during a brutal prep block when energy was low. Did it help with daytime focus? A bit. But nothing replaced hitting my daily collagen, protein, and recovery check-ins.

Own your outcome.