All of a sudden, IV bars are popping up everywhere, and the trend of getting a vitamin shot (via IV therapy) is all the rage. Nicotinamide-adenine dinucleotide (NAD) supplementation is also getting a lot of traction, and its anti-ageing claims are so convincing that it seems that it’s the very potion Snow White’s wicked queen was after! But is it all hype? Or is there some truth to the benefits that are expounded by the proponents of the latest health kick?
According to influencers on TikTok, celebrities, and health fanatics, NAD+ supplementation is “the bomb”. There are also quite a few NAD-boosting supplements, like NMN, NAD+, and NR-. So, what exactly is the science behind the drip, and how do you choose the one that will turn back the hands of time like the miracle drug in the 1990s dark comedy classic Death Becomes Her?
Paola Chellew chats with Dr Craige Golding, a specialist physician with a passion for anti-ageing medicine and integrative health, who helps us get to the bottom of NAD and its benefits.
What is NAD and its function?
Dr Craige: NAD consists of two nucleotides – nicotinamide and adenine – linked by a phosphate group and is found in every cell of the body. NAD can occur in a reduced or oxidised form: NAD+ is oxidised; NADH is the reduced form. It is involved in cellular metabolism, protein translational metabolism, and electron transfer. Simply put, it’s key to cellular health and ageing healthily.
If it occurs naturally, why can’t we make more?
Dr Craige: We slowly deplete our NAD levels as we grow older. It’s broken down by a molecule called CD38. Oxidative stress is one of the reasons we age. NAD is extensively involved in the electron transport chain and transfer of electrons, which is critical for energy production. This, again, declines as we age. So ideally, if we want to age healthily, we need to keep our NAD levels high.
Is this where supplements come into play?
Dr Craige: Yes. Personally, I use parsley juice and either NAD riboside, which helps increase NAD levels in the body, or NMN (nicotinamide mononucleotide), which is a favourite of Harvard University researcher Dr David Sinclair. NMN is a more stable molecule; it’s a precursor that helps your body produce NAD. We also do NAD intravenously at our practice. It offers great benefits. Further, it’s very expensive abroad, yet actually quite affordable here.
How is the correct dose (from one individual to the next) established?
Dr Craige: Well, that’s a difficult question because we don’t actually check NAD levels at any laboratory. We know that NAD levels decline with age. I use and recommend a daily dose of 1g of NMN.
I normally combine it with trans-resveratrol, a natural compound known for switching off inflammation-related genes. Together, these two target numerous ageing pathways, particularly those driven by oxidative stress – the build-up of free radicals resulting from mitochondrial metabolism. Since mitochondria are the powerhouses of the cell, generating most of the energy required for cellular function, protecting them is crucial for healthy ageing.
So, I don’t use NMN or NAD exclusively, but the sooner you start, the better, as it’s probably the number one anti-ageing thing to do.
Should it be prescribed by a doctor?
Dr Craige: NMN is available over the counter. But you should make sure you obtain it from a reputable nutraceutical company. If you want to do one thing (although I never suggest doing just one thing!), I would suggest daily NAD riboside (100–200 mg) or NMN (1 g).
What are the clinical benefits?
Dr Craige: Well, the main thing is lower oxidative stress (which we can measure through urine). The lower the oxidative stress, the less damage to your mitochondrial membranes and cell membranes from free radicals.
This is the pathology of ageing: free radicals cause all chronic diseases, with inflammation playing a key role as well. I like to keep inflammation markers down, but stopping cellular damage and ageing starts with combating oxidative stress. We get old, we age, we get sick, and we die because of oxidative stress or free radical damage to our membranes.
Keeping your oxidative stress down with antioxidants from fruits and vegetables, supplements, and NAD is simply common sense. And this is substantiated by plenty of clinical studies. I recommend reading Lifespan by David Sinclair, as well as Outlive by Dr Peter Attia*, who does a lot of NAD IV infusions for his patients.
Is it safe to administer NAD intravenously? Are there any side effects?
Dr Craige: I believe it’s very safe. NAD is used up so quickly in the electron transport chain and cellular metabolism that regular replenishment is required. I haven’t heard of any NAD toxicity – our bodies use it up so fast. So, if you stick to recommended dosage guidelines, you should be 100% safe and you’ll age healthily.
However, if done intravenously in an incorrect way, there could be problems. NAD must be administered via a very, very slow drip. We normally do a 250 mg drip over a couple of hours.
For how long should you undergo NAD therapy?
Dr Craige: It’s for life.
Is there anything you can do if you want to boost or preserve NAD levels naturally instead of taking the IV route?
Dr Craige: Parsley! It inhibits the breaking down of NAD caused by CD 38.
Could you comment on the IV bars that are found all over the country offering IV therapy?
Dr Craige: There’s no nurse or doctor present at many of these IV bars. There’s no resuscitation trolley. Legally, this could create problems if the patient has adverse reactions. Such reactions from IV therapies can be immediate and can be as severe as death!
The first serious incident that takes place in one of these IV bars, without a doctor present or resuscitation trolley on hand, is likely to bring about legal consequences. What they’re doing is unethical. The South African Medical Association does not approve of or endorse them. While they’re not being policed at the moment, it’s only a matter of time before a fatality triggers broader intervention.
A doctor, a nurse, and an emergency resuscitation trolley need to be present at all times. The Golding Institute’s SAMA-accredited Ethical IV Nutrient Therapy CPD (Continual Professional Development) course explicitly states this.
Any closing thoughts?
Dr Craige: Based on human trials, NAD pharmacology is a promising treatment strategy that appears to be safe for human use. That said, there is only suggestive evidence – more trials are required. Increasing health span involves a commitment to leading a healthy lifestyle.
Avoiding excessive alcohol use, smoking, and UV radiation exposure, as well as getting enough good sleep, eating a nutritious diet, and exercising regularly, may help you to increase or preserve NAD levels naturally, which, in the long run, will also help your budget.
*Dr Peter Attia is the founder of Early Medical, a medical practice that applies the principles of Medicine 3.0 to patients with the goal of simultaneously lengthening their lifespan and increasing their health span.
References:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7558103
https://www.today.com/health/ageing/nad-benefits-rcna180800
Paola Chellew is a freelance journalist and regularly writes for a number of publications. A former professional contemporary dancer, she has always loved the arts in all their forms. She has been a freelance writer for many years and has been published in various magazines including Live Out Loud, Private Life and Do It now magazines. Her passion for beauty and skincare started in her teens, when she would read every beauty editor’s picks and reviews. Serious about skincare, she has researched medical-grade products for over ten years, as well as aesthetic treatments to restore and repair skin to look its best. Having turned 60 last year, she has dedicated her blog to the “over 50s and beyond Club”, shining a spotlight on a generation that is seemingly side-lined by the beauty industry. “There is no age limit for when you stop being beautiful – a gorgeous lipstick, a sexy fragrance, radiant skin- these are not synonymous with youth- they are just things that add an extra sparkle to my day”.
📸 Profile photo credited to Lerissa Kemp Photography
- Paola Chellewhttps://www.aestheticappointment.co.za/author/paola-chellew
- Paola Chellewhttps://www.aestheticappointment.co.za/author/paola-chellew
- Paola Chellewhttps://www.aestheticappointment.co.za/author/paola-chellew
- Paola Chellewhttps://www.aestheticappointment.co.za/author/paola-chellew
MD, ABAARM, FAARFM, FICT, FCP (SA), MS USF, Member: NUGO, AAAM
Dr Craige Golding is a Specialist Physician and anti-ageing expert based in Johannesburg, South Africa. He specialises in integrative medicine, combining natural therapies, nutraceuticals, bio-identical hormones, intravenous treatments, and medical biotechnologies to optimise patient health.
Graduating Cum Laude as a medical doctor in 1993, Dr Golding became a specialist physician in 1999. He practised at Rosebank Clinic for eight years, managing its Intensive Care Unit. His passion for functional and anti-ageing medicine led him to pursue further qualifications, recognising that merely managing disease was not enough.
Dr Golding is the only doctor in Africa certified by the American Board of Anti-Aging and Regenerative Medicine (ABAARM) and has completed an advanced fellowship (FAARM). He holds a master’s degree in medical sciences (metabolic and nutritional medicine) from the University of South Florida and certifications in chelation therapy (ACAM), integrative cancer treatments (USA), and nutrigenomics (NUGO, Europe).
He is a faculty member of the Postgraduate Aesthetics Society of South Africa (AAAM) and founder of the Golding Institute. His academic achievements include awards in Psychiatry, Anaesthetics, and Pharmacology, reflecting his dedication to medical excellence.
Dr Golding is also the founder and director of The Golding Institute, which provides an opportunity for doctors and healthcare practitioners to deepen their knowledge and skills in the field of Integrative Medicine. Practitioners can contact The Golding Institute via email info@goldinginstitute.com or phone +27 10 534 7771.
- Dr Craige Goldinghttps://www.aestheticappointment.co.za/author/dr-craige-golding
