A Brief Primer on NAD+NAD+ stands for nicotinamide adenine dinucleotide, which is a coenzyme in all living cells. To simplify, NAD+ helps our cells turn food into energy that our brain and body can utilize. There is a direct correlation between having low NAD+ levels and having increased aging, death of cells, poor brain function, and a host of other effects.To maintain high levels of NAD+ with lifestyle alone, ensure healthy circadian rhythms (regular sleep schedule), reduce alcohol consumption, reduce sugar / carb consumption, and stamp out chronic inflammation. Essentially, live a health-conscious lifestyle.But even when we do this rigorously, the aging process harms our ability to produce and maintain high levels of NAD+. This is where supplementation becomes important.
Nicotinamide Riboside + Pterostilbene for Anti-AgingThe best supplement for improving NAD+ levels is nicotinamide riboside, but this isn’t the only tool that avid biohackers can use.Wealthier (and more pain tolerant) individuals often use NAD+ therapy or NAD+ injections, which are direct bloodstream injections to increase NAD+ levels. This has an added benefit of increasing bioavailability (how much our body uses) versus the oral nicotinamide riboside supplement.The problem with this treatment is that it is cost ineffective for most people (think thousands of dollars for a few treatments) and it can be quite uncomfortable and painful. Even though it is highly efficient, it’s both expensive and painful, which rules out a lot of people.Furthermore, the evidence is pretty clear that nicotinamide riboside supplements alone can increase NAD levels by 2.7 times the baseline, which works well either way…...but nicotinamide riboside and pterostilbene combined work even betterAccording to a November 2017 study from Aging and Mechanisms of Disease, dosing both nicotinamide riboside AND pterostilbene combined had a safe and sustainable positive effect on NAD+ levels.The study was well-done including randomized, double-blind, and placebo controlled elements (the gold standard) and focused on 120 healthy adults between the ages of 60 - 80. One could argue that a study focused on elderly populations (60 - 80) is less valuable, but the fact that these participants were considered healthy is refreshing and unusual.It is typically challenging to parse whether a nootropic or therapy will provide a benefit to a healthy adult if scientific literature focuses on people who are sick. To have a study that looks at healthy adults and looks at a nootropic stack (combination of ingredients) is rare and fortuitous.The reason scientists went this route is evident in their publication. Nicotinamide riboside has been studied in animal models successfully as with humans, but “...the question remained whether increases in NAD+ could be sustained over longer time courses…”Pterostilbene (a naturally occurring analog of resveratrol) was chosen because it had high bioavailability and helped to significantly increase NAD+ levels over the long term.The study focused on a single dose of 250 mg nicotinamide riboside, which boosted plasma NAD+ levels by 40%, and a double dose of 500 mg nicotinamide riboside boosted levels by 90%. These are pretty substantial increases that can have positive long term effects.
Getting Started (Without the Hype)If we stopped there, it would be pretty evident there is a scientifically backed reason to combine nicotinamide riboside and pterostilbene, but the drama in the anti-aging community never ceases to amaze.The study has been criticized because one of the main funding sources and proponents was a company called Elysium. Despite this, a publication in Nature is highly prestigious, the study was well-done and even with a slight conflict of interest, great results speak for themselves.The question around the study itself led to questions around Elysium as a business (which is currently embroiled in major lawsuits despite having a stellar board of scientific advisors and nobel laureates). For such a powerhouse company, it is odd that Elysium sells only a single product (Basis).Either way, the biggest problem is whether or not the company is sustainable selling that single product with a pending lawsuit with the sole licensed manufacturer of nicotinamide riboside.A far more sustainable and long-lasting solution would be to purchase the truNiagen product alongside pterostilbene with the right doses and simply take them together. Not only is this more reliable (because there is no lawsuit threatening to kill the supply), but it is also more affordable.To get a bottle of Basis from Elysium it costs $60 per bottle whereas purchasing TRU NIAGEN and pterostilbene separately costs much less.