Why I’m not sold on the NAD+ drip

The IV bag is having its moment. The science is having second thoughts.

If you've wandered into a wellness clinic lately, you've probably seen it. Someone reclined in a chair, IV bag dripping, chasing the molecule of the moment: NAD+.

NAD+ is the little spark plug inside every one of your cells. It helps turn food into energy, helps repair your DNA, and keeps your cellular machinery humming. Here's the not-so-fun part: your NAD+ levels drop as you age. Lower spark, slower hum.

So, of course, the longevity world went hunting for a way to top it back up, and the flashiest answer became the IV NAD+ drip.

I get the appeal. It feels dramatic and high-tech and very "I'm optimizing." But I've watched this trend for a while now, and the shine is wearing off.

The problem with the drip

NAD+ is a big molecule. Getting it into your cells, where it actually does the work, is not as simple as putting it in your bloodstream. Your body tends to break it down into smaller pieces first anyway.

The human evidence is thin. There are surprisingly few solid clinical trials behind the anti-aging claims people make about IV NAD+. Lots of vibes, not much data.

It's expensive, it eats up an afternoon, and that flushing feeling during a fast infusion? Not the spa day you were promised.

Translation? We may be flooding the front yard while the tank in the basement stays low.

So what actually moves NAD+ in humans?

Two things. And they work like a team.

1. Fill the tank.

Your cells build NAD+ from smaller precursors. One of the best-studied in people is NR (nicotinamide riboside). In randomized, placebo-controlled human trials, oral NR reliably raised NAD+ levels in the blood. One six-week study in healthy midlife and older adults lifted intracellular NAD+ by roughly 60% (Martens, 2018)!

2. Plug the leak.

Part of why NAD+ falls with age isn't just that you make less, it's that you burn through it faster. A hungry enzyme called CD38 ramps up as we age and guzzles NAD+ like it's happy hour. Enter apigenin, the gentle little flavonoid in chamomile, parsley, and celery. Apigenin helps dial CD38 down, which means less of your NAD+ gets drained.

The "NR raises NAD+" story is backed by human trials. The "apigenin quiets CD38" story is genuinely compelling but still lives mostly in lab and animal research, with human studies catching up. So I won't promise you apigenin is a miracle, but filling the tank while slowing the leak is just good sense.

(Fun neighborhood fact: quercetin, apigenin's roommate in Damage Control, plays on the same CD38 team.)

How to HOP to it

The basics (that still matter)

1. Move after meals. Exercise is one of the most reliable ways to support your own NAD+ machinery. A brisk walk counts.
2. Sleep like it's your job. Your NAD+ runs on a daily rhythm, and short sleep throws it off.
3. Feed the factory. Foods with the building blocks (dairy, fish, mushrooms, whole grains, leafy greens) give your cells raw material.

The HOP Box play

1. Nicotinamide riboside (NR). Gives your cells a well-studied building block to make NAD+. The human-proven way to fill the tank.
2. Apigenin. Helps quiet CD38, the enzyme that drains your NAD+ as you age.
3. Quercetin. Apigenin's teammate on the same anti-drain job.

The bottom line

You don't need a $600 drip and an afternoon in a recliner to take NAD+ seriously. Fill the tank with a precursor your body can actually use, slow the leak your cells spring with age, and let the boring, consistent, human-tested stuff do the heavy lifting. Not as Instagrammable as an IV pole. Just more likely to work.

Now, HOP to it!

Dr. Amy Killen & the HOP Team

References

Elhassan YS, Kluckova K, Fletcher RS, et al. Nicotinamide riboside augments the aged human skeletal muscle NAD+ metabolome and induces transcriptomic and anti-inflammatory signatures. Cell Rep. 2019;28(7):1717-1728. 

Grant R, Berg J, Mestayer R, et al. A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6-hour intravenous infusion of NAD+. Front Aging Neurosci. 2019;11:257.

Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9:1286.

Trammell SAJ, Schmidt MS, Weidemann BJ, et al. Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nat Commun. 2016;7:12948.