Dr. Alexander Landfield
Board-Certified Neurologist & Medical Director
NAD+ (nicotinamide adenine dinucleotide) is one of the most important molecules in human biology. At Rani Beauty Clinic in Renton, WA, Dr. Landfield offers NAD+ injection therapy based on a growing body of evidence connecting NAD+ levels to energy, repair, and healthy aging.
What NAD+ does in every cell: NAD+ serves as a crucial coenzyme in metabolic reactions throughout the body. Its primary role is as an electron carrier in the mitochondrial electron transport chain, the cellular machinery that produces ATP (adenosine triphosphate), the energy currency of all cells. Without adequate NAD+, cellular energy production is impaired.
NAD+ and the sirtuins: NAD+ is the essential substrate for a family of enzymes called sirtuins (SIRT1 through SIRT7). Sirtuins regulate gene expression, DNA repair, inflammation, metabolism, and cellular stress responses. They are sometimes called longevity genes because their activity is associated with increased lifespan in model organisms. Sirtuins cannot function without NAD+, so declining NAD+ levels directly impair sirtuin activity.
NAD+ and DNA repair: Your DNA sustains thousands of lesions every day from normal metabolic activity, UV exposure, and environmental factors. The enzyme PARP-1, which plays a critical role in DNA repair, requires NAD+ as a substrate. When NAD+ levels decline, DNA repair capacity decreases, potentially allowing damage to accumulate and contribute to aging and disease.
The age-related decline: NAD+ levels decline significantly with age. By age 50, most people have approximately 50 percent less NAD+ than they had at age 20. This decline is attributed to increased NAD+ consumption by repair enzymes responding to accumulated damage, decreased production by the NAD+ biosynthesis pathways, and increased activity of CD38, an enzyme that degrades NAD+.
The consequences of NAD+ decline: Reduced cellular energy production leads to fatigue and decreased cellular function. Impaired sirtuin activity compromises gene regulation and stress responses. Decreased DNA repair capacity allows damage accumulation. Mitochondrial dysfunction reduces the efficiency of energy metabolism. These interconnected effects contribute to many aspects of aging.
NAD+ restoration strategies: NAD+ levels can be supported through several approaches. Direct NAD+ injection delivers the coenzyme into muscle tissue for absorption into the bloodstream. NAD+ precursor supplementation (NMN, NR) provides the building blocks for NAD+ biosynthesis. Lifestyle factors including exercise, caloric restriction, and adequate sleep support endogenous NAD+ production.
Why injection delivery: Oral NAD+ supplementation faces bioavailability challenges. The molecule is large and subject to degradation in the digestive system. NAD+ precursors like NMN and NR are better absorbed orally but require enzymatic conversion to NAD+. Direct injection bypasses these limitations, delivering NAD+ into the body in its active form for more immediate cellular availability.
The skin connection: Your skin cells depend on NAD+ for energy production, DNA repair, and collagen synthesis. Age-related NAD+ decline directly affects skin cell function, contributing to visible aging. Restoring NAD+ levels may support better skin cell function, enhanced response to aesthetic treatments, and improved overall skin quality.
Current research: NAD+ biology is one of the most active areas of aging research. Studies are exploring its potential role in neuroprotection, cardiovascular health, metabolic disease, and longevity. While the cellular biology is well-established, clinical applications are still evolving. At Rani Beauty Clinic, we offer NAD+ therapy as part of a comprehensive wellness approach and monitor the emerging evidence closely.
