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What Are NAD+ Levels? What They Mean and What Tests Can Show

By TotalCareMedical.com Health Team

Short answer: NAD+ (nicotinamide adenine dinucleotide) is a molecule that researchers measure in samples such as blood, and in research studies, in the brain. “NAD+ levels” means the amount found in one of those measurements. In the sources we reviewed, NAD+ levels are not well enough characterized to say what a single number means for an individual, and measurements can differ a lot between laboratories. If you are concerned about a symptom, the useful next step is a conversation with a clinician about that symptom, not a NAD+ number.

What People Mean by “NAD Levels”

The phrase can refer to very different measurements. One example: Florida Atlantic University's clinical research unit describes a study seeking 20 adults aged 65 to 80 (10 healthy volunteers and 10 people with Alzheimer's disease). It measures brain NAD with proton magnetic resonance spectroscopy (1H-MRS), an MRI-based technique, across two sessions eight months apart. The stated goal is to detect changes in brain NAD for possible future use as a biomarker that supports treatment development. That is research into a possible tool, not a way for an individual to interpret a personal result.

Research on NAD+ in blood plasma is a separate area with its own measurement problems, covered next. We did not find a source in our review that shows how a blood measurement relates to NAD in the brain, so treat these as different questions.

Does NAD+ Really Fall With Age?

You may see the claim that NAD+ drops steadily as people age. The published picture is less settled. A 2021 review in Nutrients by Peluso and colleagues concluded that how NAD+ levels change during aging is “still poorly characterized.” It noted that the human studies it covered were cross-sectional and had relatively few participants, and it called for much larger studies, preferably following the same people over time.

The review also described three reports on plasma NAD+ and aging whose results were very discrepant, from no effect of aging to an almost complete loss with age. The authors suggested that standardized, mass-spectrometry-based methods could reduce the analytical variability that may account for some of those differences.

What We Know vs. What Is Still Unproven

What the sources we checked support

  • NAD is being studied as a possible brain biomarker. FAU's research unit describes a study aimed at detecting changes in brain NAD in Alzheimer's disease for possible future biomarker use.
  • Brain NAD can be measured with imaging in a research setting. FAU describes using 1H-MRS for this.
  • Human data on age-related change are limited. The 2021 Nutrients review describes the human studies as cross-sectional and relatively small.
  • Plasma results have varied widely between reports. The same review calls for standardized methods.

What is unproven, unclear, or not covered by our sources

  • Whether a “normal” or “low” NAD+ number means anything for your health. The sources we reviewed do not provide a reference range for individuals.
  • Whether blood NAD+ reflects NAD+ in tissues such as the brain. We found no source in our review that answers this.
  • Whether NAD+ testing sold directly to consumers is accurate or useful. We did not review the methods of any specific commercial test, so we cannot say how reliable one is.
  • Whether raising NAD+ improves how you feel or how you age. None of the sources we reviewed address this, and this article makes no such claim.
  • Whether the FAU measurements will work as a biomarker. The page describes this as a goal of ongoing research, not a result.

Should You Be Concerned About Your NAD+ Level?

Based on the sources we reviewed, a NAD+ number is not a diagnosis, and none of them show that a particular number calls for treatment. Persistent fatigue, memory changes, unexplained weight change, or low mood have many possible causes that a clinician can evaluate with a full history and established tests.

Talk with a clinician or pharmacist sooner if you take prescription medicines, are pregnant or nursing, have a chronic condition, or are thinking about starting a supplement. Seek urgent care for sudden or severe symptoms.

Questions to Bring to a Clinician

  1. What could be causing the symptom I am worried about, and which established tests make sense first?
  2. If I have already had a NAD+ test, what method did the lab use, and is there a reference range you trust for it?
  3. Would the result change anything you would recommend, and if not, is it worth paying for?
  4. Are any supplements I take or am considering safe alongside my medicines and conditions?
  5. What should I track at home, and when should I follow up?

Related Reading

NAD+ also comes up in supplement discussions. Our separate page, Best NMN Supplements with Resveratrol, is a product-focused review and may contain affiliate links, so it is a different kind of page from this one. For how we handle sources and health information, see our editorial policy and medical disclaimer.

This article is for general education and is not medical advice. It does not diagnose or treat any condition and does not recommend any product.

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