NAD+ raises a handful of sensible questions. This page answers them in order, starting with the fundamentals and moving to applications.
Reviewed 2025-09-11. Anything still debated is marked as such rather than presented as settled.
The molecule was first described in the early twentieth century as a factor that promoted fermentation in yeast extracts. Later work linked it to hydrogen transfer and to the oxidation of nutrients in living tissues. Its structure was resolved as a dinucleotide, which explained why it could accept and donate electrons at specific enzyme sites. Today, NAD+ is recognized as a central substrate and signaling precursor, not merely a metabolic cofactor. Whether all observed NAD+ changes reflect causal signaling remains an open question.
Related compounds include NADH, the reduced form, and NADP+, which carries an additional phosphate group. NADP+ and NADPH often serve in biosynthetic and antioxidant reactions, while NAD+ and NADH are more associated with energy-yielding catabolism. Nicotinamide, nicotinic acid, and nicotinamide riboside are precursors that can enter salvage pathways. The exact contribution of dietary precursors to tissue NAD+ pools is an area of active investigation. Some studies measure labeled precursors to trace those routes.
Research on NAD+ spans biochemistry, aging biology, and metabolism. Studies often examine how NAD+ levels change with age, diet, exercise, or disease states, and whether precursor supplementation alters those levels. Findings in animal models do not automatically translate to humans, and measurement methods vary across studies. Questions about tissue-specific effects, long-term consequences, and causal relationships remain open. NAD+ itself is not established as a single therapeutic agent with a broad clinical role.
Nicotinamide adenine dinucleotide, abbreviated NAD+, is a dinucleotide composed of two nucleotides joined by phosphate groups. One nucleotide contains adenine; the other contains nicotinamide. The molecule exists in oxidized (NAD+) and reduced (NADH) forms, and the reversible hydride transfer between them underlies many metabolic oxidation-reduction reactions. In cells, NAD+ serves as an electron acceptor in pathways such as glycolysis, the citric acid cycle, and oxidative phosphorylation. Its concentration and redox ratio vary by compartment, tissue, and metabolic state.
Beyond redox chemistry, NAD+ is consumed as a substrate by enzymes that transfer ADP-ribose or remove acetyl groups. Sirtuins use NAD+ in deacylation reactions, poly(ADP-ribose) polymerases use it in DNA damage responses, and CD38 hydrolases convert it to signaling metabolites. Because these enzymes compete for the same pool, changes in NAD+ availability can influence multiple cellular processes. The relative contribution of each consumption route differs by cell type and condition, and precise quantitative links remain an active area of study.
| Property | Value | Notes |
|---|---|---|
| Chemical name | Nicotinamide adenine dinucleotide (oxidized form) | NAD+ denotes the oxidized redox state |
| Common synonyms | Diphosphopyridine nucleotide; coenzyme I | Older names appear in historical literature |
| Molar mass | About 663.43 g/mol | Free acid value; salts and hydrates differ |
| Appearance | White to off-white powder | The purified solid is white; solutions are clear |
| Solubility | Highly soluble in water | Aqueous buffers are common laboratory solvents |
In glycolysis, the tricarboxylic acid cycle, and fatty acid oxidation, NAD+ is reduced to NADH at specific dehydrogenase steps. NADH then delivers electrons to the mitochondrial electron transport chain, mainly at complex I, supporting oxidative phosphorylation and ATP production. The balance between NAD+ and NADH, often expressed as a ratio, influences metabolic flux and redox homeostasis in different cellular compartments. Cytosolic and mitochondrial pools are connected but not identical, and their ratios can differ substantially because of compartment-specific enzymes and transport systems.
Beyond redox chemistry, NAD+ serves as a substrate for enzymes that cleave the molecule and transfer its ADP-ribose moiety or remove acetyl groups. Sirtuins consume NAD+ during deacetylation, poly(ADP-ribose) polymerases use it in DNA damage responses, and CD38 enzymes hydrolyze it to signaling metabolites. These consumption pathways mean that NAD+ availability can influence gene regulation, DNA repair, and calcium signaling. Cellular NAD+ concentrations decline in some tissues with age in animal models, but whether this decline is a cause or consequence of aging in humans remains an active open question.
Biosynthesis occurs through salvage, Preiss-Handler, and de novo pathways. In mammals, the salvage pathway from nicotinamide predominates, and NAMPT is often described as rate-limiting. Nicotinamide riboside and nicotinic acid enter related routes that converge on NAD+ production. Tissue NAD+ concentrations vary widely and are maintained by a balance of synthesis and consumption. Some studies report age-related declines in certain tissues, but whether these changes cause disease or can be reversed to improve human health remains an open question.
NAD+ stands for nicotinamide adenine dinucleotide, the oxidized form of a coenzyme found in all living cells. The molecule consists of two nucleotides, adenine and nicotinamide ribose, joined through phosphate groups. Its chemical formula is C21H27N7O14P2, and the free acid has a molar mass near 663.43 grams per mole. In redox reactions, NAD+ accepts a hydride ion and becomes NADH. The pair NAD+ and NADH participates in hundreds of metabolic reactions, including steps in glycolysis, the citric acid cycle, and oxidative phosphorylation.
15-Oxo-ETE). Other eicosanoid oxoreductases that use NAD+ and NADH as co-factors include: 12-hydroxyicosatetraenoate dehydrogenase which metabolizes 12-hydroxyeicosatetraenoic acid (12-HETE) and LTB4 to their corresponding 12-oxo analogs and 11-hydroxy-TXB2 dehydrogenase, which metabolizes TXB2 to its 11-oxo analog; and 15-hydroxyprostaglandin dehydrogenase (NAD+) which metabolizes (5Z,13E)-(15S)-11alpha,15-dihydroxy-9-oxoprost-13-enoate to its 15-oxo analog. Other eicosanoid oxireductases that use NADP+ and NADPH as cofactors include LTB4 12-hydroxy dehydrogenase which metabolizes LTB4 to its 12-oxo analog, and 15-hydroxyprostaglandin-D dehydrogenase (NADP+), 15-hydroxyprostaglandin-I dehydrogenase (NADP+), and 15-hydroxyprostaglandin dehydrogenase (NADP+) which metabolize PGD2, PGI2, and (13E)-(15S)-11alpha,15-dihydroxy-9-oxoprost-13-enoate, respectively, to their corresponding 15-oxo analogs.
The first step in the NADP-ME type C4 pathway is the conversion of pyruvate (Pyr) to phosphoenolpyruvate (PEP), by the enzyme Pyruvate phosphate dikinase (PPDK). This reaction requires inorganic phosphate and ATP plus pyruvate, producing PEP, AMP, and inorganic pyrophosphate (PPi). The next step is the carboxylation of PEP by the PEP carboxylase enzyme (PEPC) producing oxaloacetate. Both of these steps occur in the mesophyll cells: pyruvate + Pi + ATP → PEP + AMP + PPi PEP + CO2 → oxaloacetate PEPC has a low KM for HCO−3 — and, hence, high affinity, and is not confounded by O2 thus it will work even at low concentrations of CO2. The product is usually converted to malate (M), which diffuses to the bundle-sheath cells surrounding a nearby vein. Here, it is decarboxylated by the NADP-malic enzyme (NADP-ME) to produce CO2 and pyruvate. The CO2 is fixed by RuBisCo to produce phosphoglycerate (PGA) while the pyruvate is transported back to the mesophyll cell, together with about half of the phosphoglycerate (PGA). This PGA is chemically reduced in the mesophyll and diffuses back to the bundle sheath where it enters the conversion phase of the Calvin cycle. For each CO2 molecule exported to the bundle sheath the malate shuttle transfers two electrons, and therefore reduces the demand of reducing power in the bundle sheath.
Fatty change, or steatosis, is the accumulation of fatty acids in liver cells. This can be seen as fatty globules under the microscope. Alcoholism causes development of large fatty globules (macro-vesicular steatosis) throughout the liver and can begin to occur after a few days of heavy drinking. Alcohol is metabolized by alcohol dehydrogenase (ADH) into acetaldehyde, then further metabolized by aldehyde dehydrogenase (ALDH) into acetic acid, which is finally oxidized into carbon dioxide (CO2) and water (H2O). This process generates NADH, and increases the NADH/NAD+ ratio. A higher NADH concentration induces fatty acid synthesis while a decreased NAD level results in decreased fatty acid oxidation. Subsequently, the higher levels of fatty acids signal the liver cells to compound it to glycerol to form triglycerides. These triglycerides accumulate, resulting in fatty liver.
A 15-hydroxyicosatetraenoate dehydrogenase metabolizes 15-hydroxyicosatetraenoic acid (i.e. 15(S)-hydroxy-5Z,8Z,11Z,13E-eicosatetraenoic acid or 15-HETE) to its 15-keto analog, 15-oxo-ETE, using NAD+ and NADH rather than NADP+ and NADPH as its co-factors. 15-Oxo-ETE appears to have a somewhat different spectrum of activities than its precursor, 15-HETE (see 15-Hydroxyicosatetraenoic acid
Fatty change, or steatosis, is the accumulation of fatty acids in liver cells. This can be seen as fatty globules under the microscope. Alcoholism causes development of large fatty globules (macro-vesicular steatosis) throughout the liver and can begin to occur after a few days of heavy drinking. Alcohol is metabolized by alcohol dehydrogenase (ADH) into acetaldehyde, then further metabolized by aldehyde dehydrogenase (ALDH) into acetic acid, which is finally oxidized into carbon dioxide (CO2) and water (H2O). This process generates NADH, and increases the NADH/NAD+ ratio. A higher NADH concentration induces fatty acid synthesis while a decreased NAD level results in decreased fatty acid oxidation. Subsequently, the higher levels of fatty acids signal the liver cells to compound it to glycerol to form triglycerides. These triglycerides accumulate, resulting in fatty liver.
Sources: en.wikipedia.org
National teams June 3 – 9: 2019 FIBA Under-16 Americas Championship in Belém The United States defeated Canada, 94–77, to win their sixth consecutive FIBA Under-16 Americas Championship title. The Dominican Republic took third place. Argentina took fourth place. Note: All teams mentioned above have qualified to compete at the 2020 FIBA Under-17 Basketball World Cup. June 16 – 22: 2019 FIBA Under-16 Women's Americas Championship in Puerto Aysén The United States defeated Canada, 87–37, to win their second consecutive and fifth overall FIBA Under-16 Women's Americas Championship title. Chile took third place. Puerto Rico took fourth place. Note: All teams mentioned above have qualified to compete at the 2020 FIBA Under-17 Women's Basketball World Cup. September 22 – 29: 2019 FIBA Women's AmeriCup in San Juan The United States defeated Canada, 67–46, to win their third FIBA Women's AmeriCup title. Brazil took third place. Note: The first eight teams have qualified to compete at the Americas 2020 Olympic pre-qualifying tournaments. Club teams January 18 – March 31: 2019 FIBA Americas League San Lorenzo defeated Guaros, 64–61, to win their second consecutive FIBA Americas League title.
A 15-hydroxyicosatetraenoate dehydrogenase metabolizes 15-hydroxyicosatetraenoic acid (i.e. 15(S)-hydroxy-5Z,8Z,11Z,13E-eicosatetraenoic acid or 15-HETE) to its 15-keto analog, 15-oxo-ETE, using NAD+ and NADH rather than NADP+ and NADPH as its co-factors. 15-Oxo-ETE appears to have a somewhat different spectrum of activities than its precursor, 15-HETE (see 15-Hydroxyicosatetraenoic acid
15-Oxo-ETE). Other eicosanoid oxoreductases that use NAD+ and NADH as co-factors include: 12-hydroxyicosatetraenoate dehydrogenase which metabolizes 12-hydroxyeicosatetraenoic acid (12-HETE) and LTB4 to their corresponding 12-oxo analogs and 11-hydroxy-TXB2 dehydrogenase, which metabolizes TXB2 to its 11-oxo analog; and 15-hydroxyprostaglandin dehydrogenase (NAD+) which metabolizes (5Z,13E)-(15S)-11alpha,15-dihydroxy-9-oxoprost-13-enoate to its 15-oxo analog. Other eicosanoid oxireductases that use NADP+ and NADPH as cofactors include LTB4 12-hydroxy dehydrogenase which metabolizes LTB4 to its 12-oxo analog, and 15-hydroxyprostaglandin-D dehydrogenase (NADP+), 15-hydroxyprostaglandin-I dehydrogenase (NADP+), and 15-hydroxyprostaglandin dehydrogenase (NADP+) which metabolize PGD2, PGI2, and (13E)-(15S)-11alpha,15-dihydroxy-9-oxoprost-13-enoate, respectively, to their corresponding 15-oxo analogs.
Fatty change, or steatosis, is the accumulation of fatty acids in liver cells. This can be seen as fatty globules under the microscope. Alcoholism causes development of large fatty globules (macro-vesicular steatosis) throughout the liver and can begin to occur after a few days of heavy drinking. Alcohol is metabolized by alcohol dehydrogenase (ADH) into acetaldehyde, then further metabolized by aldehyde dehydrogenase (ALDH) into acetic acid, which is finally oxidized into carbon dioxide (CO2) and water (H2O). This process generates NADH, and increases the NADH/NAD+ ratio. A higher NADH concentration induces fatty acid synthesis while a decreased NAD level results in decreased fatty acid oxidation. Subsequently, the higher levels of fatty acids signal the liver cells to compound it to glycerol to form triglycerides. These triglycerides accumulate, resulting in fatty liver.
Sources: en.wikipedia.org
5-HEDH is an NADPH dehydrogenase oxidoreductase enzyme. It transfers a hydrogen cation (or hydron) H+ from 5(S)-hydroxy (i.e. 5(S)-OH) residues of its fatty acid targets to nicotinamide adenine dinucleotide phosphate+ (NADP+) to form 5-oxo (i.e. 5-O=) counterparts of its targets plus reduced NADP+, i.e. NADPH. The reaction (where R indicates a long chain [14 or more carbons] fatty acid) is: NADP+ + 5(S)-hydroxy fatty acid (i.e. 5(S)-OH-R) ⇌ {\displaystyle \rightleftharpoons } NADPH + H+ + oxo fatty acid (i.e. 5-O=R) The reaction appears to follow a ping-pong mechanism. It is fully reversible, readily converting 5-oxo targets to their corresponding 5(S)-hydroxy counterparts. The direction of this reaction is dependent on the level of NADP+ relative to that of NADPH: The immediate metabolic precursor to 5(S)-HETE, 5(S)-hydroperoxy-6S,8Z,11Z,14Z-eicosatetraenoic acid 5(S)-HpETE, can be converted to 5-oxo-ETE in a non-enzymatic dehydration reaction or chemical lipid peroxidation reactions. The physiological occurrence and relevancy of these reaction pathways has not been ascertained.
A 15-hydroxyicosatetraenoate dehydrogenase metabolizes 15-hydroxyicosatetraenoic acid (i.e. 15(S)-hydroxy-5Z,8Z,11Z,13E-eicosatetraenoic acid or 15-HETE) to its 15-keto analog, 15-oxo-ETE, using NAD+ and NADH rather than NADP+ and NADPH as its co-factors. 15-Oxo-ETE appears to have a somewhat different spectrum of activities than its precursor, 15-HETE (see 15-Hydroxyicosatetraenoic acid
In the evening hours of 24 June 2021, a rare, violent, and deadly long-tracked tornado struck several villages in the Hodonín and Břeclav districts of the South Moravian Region of the Czech Republic, killing six people and injuring 576 others. This tornado is the widest on record in Europe, at 3.5 kilometres (2.2 mi) maximum width. The tornado struck seven municipalities, with the worst damage in the villages of Hrušky, Moravská Nová Ves, Mikulčice and Lužice. This tornado was the strongest ever documented in modern Czech history and the deadliest European tornado since 2001. It was rated as an F4 on the Fujita scale and an IF4 on the International Fujita scale. This made it the first confirmed violent (IF4+) tornado in Europe since June 2017, when an IF4 tornado struck the village of Maloye Pes'yanovo in Russia, until the 2026 Ayyasha-Çaybeyi-Akçamezra tornado on May 3rd 2026, it was the only IF4 rated tornado to occur since the scale was introduced.
Clostridioides difficile has a highly diverse epigenome, with 17 high-quality methylation motifs reported so far, the majority pertaining to the 6mA type. Methylation at one of these motifs - CAAAAA, was shown to impact sporulation, a key step in C. difficile disease transmission, as well as cell length, biofilm formation, and host colonization. At least eight mainly temperate bacteriophages have been isolated from C. difficile, ranging in genome size from about 30 to about 60 kbp. Both environmentally and clinically derived C. difficile strains carry a diverse and prevalent set of prophages. Canada Pathogen Safety Data Sheets: Infectious Substances – Clostridium difficile, Public Health Agency, Canada, September 10, 2014. Type strain of Clostridium difficile, BacDive—the Bacterial Diversity Metadatabase
March 12 – 17: 2018 Youth Pan American Championships (Men) in Guadalajara In the final, Argentina defeated Mexico, 3–2. Canada took third place and Paraguay took fourth place. March 12 – 17: 2018 Youth Pan American Championships (Women) in Guadalajara In the final, Argentina defeated Uruguay, 4–0. Mexico took third place and Paraguay took fourth place. May 13 – 20: 2018 Asian Women's Hockey Champions Trophy in Donghae City South Korea defeated India, 1–0, to win their third Asian Women's Hockey Champions Trophy title. China took third place. October 18 – 28: 2018 Asian Men's Hockey Champions Trophy in Muscat Note: Due to heavy rain, both India and Pakistan took first place here. Malaysia took third place. July 11 – 15: IFA 2018 Fistball U18 World Championships in Roxbury Township July 24 – 28: IFA 2018 Fistball Women's World Championship in Linz
Sources: en.wikipedia.org
It indicates a formal positive charge on the nicotinamide ring. The molecule is not simply a protonated acid, and the charge is part of its redox chemistry.
NAD+ is the oxidized form, while NADH is the reduced form carrying two additional electrons and a proton. The two forms interconvert in many metabolic reactions.
No. NADP+ contains an extra phosphate group on the adenine ribose. NADP+ and NADPH tend to participate in different biosynthetic and antioxidant pathways.
NAD+ is a coenzyme found in all living cells. It carries electrons in metabolic reactions and also serves as a substrate for enzymes involved in signaling and DNA repair. Its oxidized and reduced forms are central to energy metabolism.