05 Jun NAD+, NADH, NADP & NMN: What Are the Different Types of NAD?

Nicotinamide adenine dinucleotide, or NAD, is a vital molecule found in every cell of the body. As we age, NAD levels naturally decline. Explore why NAD therapy has surged and the various forms that NAD takes within our bodies. 

What Is NAD and Why Is It Important?

Let’s take a closer look at the role NAD plays and why it is a wellness trend that is on the rise. NAD plays an important role in in these areas:

• Metabolism 
• Aging
• DNA repair
• Brain function
• Energy levels
• Mood
• Physical performance

NAD therapy is becoming a rising wellness trend because of growing public interest in cellular health, longevity, and optimized performance, especially among those seeking proactive, science-backed ways to support energy, brain function, and recovery. However, NAD levels decline with age, stress, poor diet, and chronic illness—factors many people are actively trying to counter.

NAD+ – The Oxidized Form

This form of NAD is the most well-known and widely used in therapy. NAD+ accepts electrons in metabolic reactions. It plays a central role in energy production via the Krebs cycle, also known as the citric acid cycle, which is a vital metabolic pathway for energy production.  

In a similar fashion, NAD+ is key to mitochondria energy production by converting and transferring electrons in the production of ATP (adenosine triphosphate), the primary energy currency that cells use to power various functions.

NAD+ is involved in many other areas of our body including:

• Anti-aging: Acts as a substrate for the enzymes that detect and repair damaged DNA.

• Detoxification: NAD+ is essential for the activity of the GSH enzyme which is a power antioxidant and detoxifier, neutralizing harmful free radicals and reactive oxygen species.
  

• Brain health: The brain, with its high energy demands and sensitivity to oxidative stress, depends heavily on adequate NAD+ levels to maintain optimal function. Research is increasingly showing that NAD+ depletion is linked to cognitive decline, neurodegenerative diseases, and age-related brain dysfunction.[1]

NADH – The Reduced Form

NADH, NAD plus hydrogen, is a reduced form of NAD. NADH donates electrons to the mitochondria where they are used to generate ATP (adenosine triphosphate – the body’s main energy source.) NADH in supplement form, is often marketed as a way to enhance energy, mental clarity, and stamina.

Differences Between NADH and NAD+ in Therapy Use

NAD+

Oxidized form

Accepts electrons

Supports metabolic reactions 

Used in DNA repair and signaling 

NADH

Reduced form

Donates electrons

Delivers energy to mitochondria

Used in ATP generation

NADP and NADPH – The Phosphorylated Forms

NADP – NAD plus phosphate in oxidized form and NADPH, it’s reduced form, are important coenzymes similar to NAD⁺/NADH but play distinct roles in anabolic (building) reactions rather than energy production. While less commonly used in therapy, NADP/NADPH are biologically significant. NADP accepts electrons and becomes NADPH. It acts as an electron carrier in biosynthetic reactions and antioxidant regeneration. 

NADPH donates electrons in processes such as:

• Fatty acid and cholesterol synthesis
• Detoxification of reactive oxygen species
• Regeneration of antioxidants like glutathione
• Immune cell activity

NMN and NR

NMN

NMN (Nicotinamide Mononucleotide) is a naturally occurring molecule that serves as a direct precursor to NAD+. As NAD+ levels decline with age, supplementing with NMN has garnered attention for its potential to restore these levels and promote healthy aging.

A 2023 study explored the bioavailability of NMN.[2] The study showed that doses up to 900 mg daily significantly increased blood NAD⁺ concentrations over 60 days. The supplementation was well-tolerated, with no adverse effects reported. 

NR

NR (Nicotinamide Riboside) is another NAD+ precursor and is converted into NMN in the body. While trace amounts can be found naturally in foods like milk, yeast, beer, fish, chicken and some vegetables, the amount is insignificant for elevating NAD levels. Supplements, such as Tru Niagen®, clinically studied and patented form of NR.

Effectiveness for Raising NAD Levels - NMN or NR

Which Type of NAD Is Best for You?

The type of NAD that is best for you depends on your health goals. Consulting with your healthcare provider is important and you can discuss whether your goal is enhanced energy, longevity, brain support or detox. 

NAD comes in many forms and your health goals play a role in determining how it is administered. For example, NAD+ is often administered via IV or injection. NR/NMN is best taken daily through oral supplements. Your healthcare provider can also provide high quality sources of NAD and work in partnership with you to meet your goals.

Get your NAD Injections with Concierge MD

There are several key forms of NAD that play distinct roles in cellular metabolism and health. NAD+ is the oxidized form, essential for energy production, DNA repair, and cellular signaling. 

NADH is the reduced form, which carries electrons to the mitochondria to help generate ATP. NADP+ and NADPH are similar molecules, but they are primarily involved in anabolic processes like fatty acid synthesis and antioxidant defense. 

Together, these forms of NAD support critical biological functions, and maintaining their balance is essential for healthy aging, metabolism, and cellular repair.

Concierge MD offers NAD injections that are easily self-administered and delivered to your home. These NAD+ shots are a quick and efficient way to replenish NAD levels supporting your body’s natural ability to heal, repair, and thrive.

Frequently Asked Questions

What’s the difference between NAD+ and NADH?

NAD+ is involved in energy metabolism, DNA repair, and cell signaling. NADH powers the electron transport chain during cellular respiration (NAD plus hydrogen)

Is NMN better than NR?

NR is converted into NMN, which is then converted into NAD+. NMN skips one step and may convert more directly to NAD⁺, possibly making it faster-acting in some tissues. However, NR has been studied in human clinical trials and has been established to increase NAD+ levels in the blood levels.

What is the most active form of NAD in the body?

NAD+ is the most active form of NAD in the human body for several reasons:

• Central to metabolism: NAD+ acts as a coenzyme in energy production, DNA repair, cell signaling, and oxidative stress response.
• Electron acceptor: It facilitates reduction-oxidation reactions by accepting electrons and becoming NADH, which is critical in ATP (energy) generation..
• Cellular signaling: NAD+ is a required substrate for the enzymes that regulate aging, inflammation, and genomic stability.

Can you take different types of NAD together?

Yes, you can take different types of NAD precursors together, but there’s no proven benefit to combining them versus using one well-studied option. Your health provider can help you choose the best option based on your health goals (e.g., energy, aging, brain support).

Which form of NAD is used in IV therapy?

NAD+ – the oxidized form of the molecule – is the type used most often in NAD IV therapy. It bypasses the digestive system, allowing for immediate absorption into the bloodstream and more efficient cellular uptake.