NAD+ is a molecule every cell depends on for energy production and repair of damaged genetic material, and it is taken to slow ageing. Cells cannot absorb it directly, so raising it means taking one of its raw materials orally — usually a form of vitamin B3 — or receiving an intravenous infusion. Blood levels rise reliably; health gains largely do not follow, and infusions have been linked to deaths. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Seated blood pressure | 110–120 / 70–75 mmHg | The one endpoint with replicated benefit |
| Whole-blood NAD+ | No established target; track change from own baseline | Confirms the product is absorbed and active |
| Fasting glucose | 75–86 mg/dL (4.2–4.8 mmol/L) | Detects the glycaemic drift seen with gram-dose nicotinic acid |
| Glycated haemoglobin (HbA1c) | 4.8–5.2% | Confirms glucose control over months, not a single morning |
| Alanine and aspartate aminotransferase (ALT, AST) | 10–26 U/L (both) | Catches hepatic strain at gram-level dosing |
| Uric acid | 3.5–5.5 mg/dL | Nicotinic acid competes with urate for renal excretion and can trigger gout |
| High-sensitivity C-reactive protein (hs-CRP) | Below 0.5 mg/L | Inflammation drives NAD+ consumption, so it frames expected benefit |
| Estimated glomerular filtration rate (eGFR) and creatinine | eGFR above 90 mL/min/1.73 m² | Screens for the kidney disease that changes the risk calculus |
| Homocysteine | 5–7 µmol/L | Reflects methyl-group availability, which clearing surplus nicotinamide consumes |
| Lipid panel with LDL and HDL cholesterol | LDL below 100 mg/dL; HDL above 50 mg/dL | Relevant only on the nicotinic acid route, which shifts both |
| Six-minute walk distance or timed chair-stand | Individual baseline | Anchors the performance claims that motivate most use |
Cadence: Repeat panel at 12 weeks, then every 6–12 months. Gram-dose nicotinic acid warrants tighter follow-up, at 6 and 12 weeks and then every 3–6 months.