Healthy Aging Strategy: Optimizing NAD+ Levels for Youthful Cellular Function

Juanita O. Enogieru – Life Extension Wellness Specialist

Health Benefits of NAD+

Many individuals are seeking innovative natural methods to combat aging by supporting optimal cellular function. Improving NAD+ (nicotinamide adenine dinucleotide) levels is one strategy that may promote healthy aging and cellular function.

What is nicotinamide adenine dinucleotide (NAD+)’s role in the body?

NAD+ is a coenzyme needed for various mechanisms associated with normal cellular metabolism. As one gets older, NAD+ levels decline by up to 50%.1 NAD+ levels can also be depleted by obesity and lifestyle choices such as poor diet and excessive alcohol consumption.2-4 Maintaining healthy NAD+ levels while aging is crucial because NAD+ plays roles in critical cellular processes like DNA damage repair and the normal functioning of sirtuin proteins, which contribute to healthy aging.5

How does boosting NAD+ support healthy aging?

Boosting NAD+ levels activates sirtuin signaling and function, improves mitochondrial function, and boosts the body’s natural DNA repair process.2 Preclinical studies have shown that enhancing NAD+ levels promotes longevity through a variety of mechanisms.6

One way boosting NAD+ supports healthy aging is by promoting healthy sirtuin function. Sirtuins are NAD+ dependent enzymes that modulate some aspects of cellular aging by influencing important processes such as DNA repair and inflammatory responses. They also promote healthy cell proliferation.2

While compounds such as resveratrol have been shown to activate sirtuins, NAD+ is still needed for sirtuins to function. Suboptimal levels of NAD+ can hinder beneficial sirtuin function leading to vascular inflammation, increased fat storage, insulin resistance and neurodegeneration in the brain.2,5,7

NAD+ and DNA Repair

Another way in which NAD+ supports healthy aging is by helping facilitate that body’s natural DNA repair processes. DNA is highly vulnerable to damage, which can lead to broken DNA strands and mutations. Accumulated DNA damage contributes to the aging process and can result in immune senescence and deadly diseases like cancer.

An enzyme called PARP-1 plays a major role in repairing DNA damage.8 However, to carry out its function, PARP-1 consumes significant amounts of NAD+. As NAD+ is depleted, the ability of PARP-1 to repair DNA is significantly hindered.2 So, supporting efficient PARP-1 function by boosting NAD+ levels may assist with regaining youthful cell functionality and mediating accumulation of damaged cellular DNA.

Additionally, the tumor suppressor gene p53 protects against unhealthy cellular proliferation that can lead to cancer. Healthy NAD+ levels are required to support p53 activation, which is modulated by SIRT1.10 It interacts with PARP-1 to stimulate the response to DNA. When DNA damage persists, p53 becomes depleted during the repair process, which decreases NAD+ levels.9 The good news is that replenishing NAD+ in cells can encourage the body’s natural DNA repair processes.

What is nicotinamide riboside (NR), and why use it to boost NAD+ levels?

Nicotinamide riboside (NR) is a form of vitamin B3 that occurs naturally in yeast, bacteria and mammals in trace amounts. One cup of milk provides approximately 150 mcg of NR per cup.

NR does not cause the flushing effects often associated with niacin. Preclinical studies suggest that NR supplementation results in increased longevity as well as other health improvements, including neuroprotection, sirtuin activation, weight management, promoting the natural DNA repair process and healthy glucose metabolism.1,10 NR is an effective precursor for promoting healthy NAD+ levels.

Nicotinamide Riboside (NR) Vs. Nicotinamide Mononucleotide 

Nicotinamide riboside (NR) is an effective supplemental precursor for enhancing NAD+ levels. The rationale for using NMN is that it converts to NAD+ more readily because it is the molecule directly before NAD+ (immediate precursor to NAD+). Once inside the cell, NMN is effective at raising NAD+. However, outside of the cell, NMN derived from diet and/or supplementation must be converted to NR before entering the cell. So, before the body can use NMN, it must be converted to NR and then back into NMN!

Therefore, based on the metabolic use of NR and the clinical evidence of its benefits, 100 mg or 250 mg of NR is a reasonable dosing strategy for boosting levels of NAD+. It can also be paired with resveratrol to encourage healthy sirtuin function, maintain healthy cellular metabolism and support longevity.

Whether alone or paired with resveratrol, supplementing with nicotinamide riboside (NR) to boost NAD+ levels is an evidence-based strategy for promoting health and longevity.10

About the author: Juanita Enogieru is a nutritionist and Life Extension wellness specialist working with the community to build healthy and balanced nutritional habits. While pursuing an education in medicine and attempting to help her body heal, it became apparent that there was a gap in medical practices with regard to nutrition and an abundance of misinformation about balanced nutritional practices. After obtaining a bachelor’s degree in Health Education from the University of Florida, she worked with non-profit organizations to deliver nutrition education to community members. Wanting to learn more about nutrition and how herbs could be used to help the body heal, she pursued a master’s degree in Dietetics and Nutrition and shortly began working with Life Extension. With the understanding that everyone has a unique biochemical individuality, it is vital to address each individual based on their specific needs and biochemical make-up. Her mission now is to offer guidance, support and education to individuals based on balanced nutritional insights that address the mind, body and spirit.


  1. Cell Metab. 2018;27(3):529-547.
  2. J Biomed Sci. 2019;26(1):34.
  3. Critical reviews in biochemistry and molecular biology. 2013;48(4):397-408.
  4. Experimental and molecular pathology. 2016;100(2):303-306.
  5. Trends in Cell Biology. 2014;24(8):464-471.
  6. Ageing Res Rev. 2018;47:1-17.
  7. Pharmacol Res. 2018;128:345-358.
  8. Nature Reviews Molecular Cell Biology. 2017;18:610.
  9. Cell Cycle. 2014;13(11):1661-1662.
  10. Translational Medicine of Aging. 2018;2:30-37.

Live Foreverish Podcast: Staying Focused on Long Drives

Do you have a long commute to work? Are you taking a road trip this summer? Between phones, kids, touch screens in the car, and everything else… distractions while driving cause thousands of people to lose their lives every year. Learn how to stay focused on the Live Foreverish podcast!

Nutrients that Support Focus

Whether you have kids in the back seat or are experiencing highway hypnosis on long drives, distracted driving is obviously dangerous. So, what is the solution? Scientists have identified nutrients such as sage and spearmint that can help improve your focus! Dr. Crystal Gossard explains the research. Available for download or Listen now on

About Live Foreverish: Join Dr. Mike and Dr. Crystal as they sit down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and helpful advice to help you live your life to the fullest. If you like what you hear, please take a moment to Give Live Foreverish a 5-star rating on iTunes!

Tired of Insomnia? Helpful Herbs and Sleep Hygiene

Ashley Wyckoff, Bachelor of Science

Insomnia affects approximately 24 million people, or 10% of the U.S. adult population.1,2 Symptoms of insomnia go beyond just trouble falling asleep; people who experience sleep disturbances also tend to have low energy, fatigue, difficulty concentrating and emotional changes.

Since sleep disturbance is such a prevailing problem, there are many options on the market for those affected by insomnia. The good news is there are herbs that have been clinically shown to help. Plus, lifestyle habits can play a role. Get some sleep with these lifestyle hacks and clinically studied herbs!

As with many health conditions, it is important to get to the root cause. Stress, improper sleep hygiene and circadian rhythm imbalance can all cause insomnia. Poor mental health can not only cause one to not be able to fall asleep, but also for the little sleep that one gets to not be replenishing.3 One’s “sleep hygiene” comprises the customs and routines a person has that influences their sleep.4 A circadian rhythm is one’s sleep/wake cycle that can be disturbed by travel, daylight savings and change in routine.3

The Best Herbs for Sleep

Honokiol is a polyphenol found in magnolia bark, leaves and seed cones. It has been found to promote the GABAA receptor, allowing the neurotransmitter to better bind to their active sites.5 The GABAA receptor is fast-acting and results in sedation and reduced stress.6,7

Lemon balm is an herb that is part of the mint family.8 It can help support GABA levels by inhibiting the enzyme that normally degrades it.9

Chamomile is a flower commonly used in herbal infusions. It has been shown to have many benefits due to the high amounts of bioactive components, flavonoids and terpenoids in it. One compound in particular, apigenin, works in the central nervous system to reduce stimulation.10

Ashwagandha is an herb that has been used for thousands of years. It is an adaptogen which allows you to adapt better to stress.11

How to Improve Sleep Hygiene and Circadian Rhythm

Avoid stimulants at night: Stimulants such as caffeine, alcohol and even the blue light from electronics can make it more difficult to fall and stay asleep. Alcohol, while it can help some people fall asleep, typically results in waking up in the middle of the night. Electronics’ bright lights can cause your body to not produce the melatonin it should at night.12,13

Sleep environment: Make your sleep environment as relaxing as possible. Make sure your room is dark, quiet and comfortable. Try to avoid watching TV, eating or doing other activities in bed. This helps train your body to correlate being in bed to sleeping.14

Yoga/exercise: Exercising regularly can help improve sleep quality and has been shown to support mood.12,15 Yoga can also be a relaxing activity to do before bed or to help your body wake up in the morning.

Keep a sleep/wake routine: It is important to keep a schedule by going to bed and waking up at consistent times, even on the weekend. This helps keep your circadian rhythms in balance. It can also help to have the same routine every night.12

Insomnia comes with more problems than just feeling tired. Inadequate amounts of sleep can lead to depression, cognitive impairment and other illnesses.3,15 However, that does not mean there is nothing to help. Finding the cause of your sleep disturbance and then implementing better sleep hygiene could help you improve your sleep. Stress-reducing herbs can also help you to relax and have higher quality sleep.

About the Author: Ashley Wyckoff, BS, is a product operation specialist at Life Extension headquarters in South Florida. She holds a Bachelor of Science in Biology from the University of Florida. In her spare time, she enjoys hiking, reading and yoga to keep her mind and body healthy. She believes in equal access to quality healthcare and it is her goal to make it a reality.


  1. United States Census Bureau. QuickFacts: United States. Table. Accessed 7/10/2019.
  2. Medscape online. News & Perspectives page. What is the prevalence of insomnia? Accessed 7/10/2019.
  3. Mayo Clinic. Insomnia. Symptoms & causes. Last updated 10/15/2016. Accessed 7/10/2019.
  4. Yang, Chien-Ming et al. “Maladaptive sleep hygiene practices in good sleepers and patients with insomnia.” J Health Psychol. 2010;15(1):147-55.
  5. Alexeev, Mikhail et al. “The natural products magnolol and honokiol are positive allosteric modulators of both synaptic and extra-synaptic GABA(A) receptors.” Neuropharmacology vol. 62,8 (2012): 2507-14. doi:10.1016/j.neuropharm.2012.03.002
  6. Hasler, Gregor et al. “Effect of acute psychological stress on prefrontal GABA concentration determined by proton magnetic resonance spectroscopy.” The American journal of psychiatry vol. 167,10 (2010): 1226-31. doi:10.1176/appi.ajp.2010.09070994
  7. Nutt, D. GABAA Receptors: Subtypes, Regional Distribution, and Function. Journal of Clinical Sleep Medicine. 2006;2(suppl 2): S7-S11.
  8. Najafian, S. Storage conditions affect the essential oil composition of cultivated Balm Mint Herb (Lamiaceae) in Iran. Industrial Crops and Products. 2014;52:575-81.
  9. Weeks, BS. Formulations of dietary supplements and herbal-extracts for relaxation and anxiolytic action: Relarian. Med Sci Monitor. 2009;15(11):Ra256-62.
  10. Srivastava, Janmejai K et al. “Chamomile: A herbal medicine of the past with bright future.” Molecular medicine reports vol. 3,6 (2010): 895-901. doi:10.3892/mmr.2010.377
  11. Kaushik, Mahesh K et al. “Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction.” PloS one vol. 12,2 e0172508. 16 Feb. 2017, doi:10.1371/journal.pone.0172508
  12. Irish, Leah A et al. “The role of sleep hygiene in promoting public health: A review of empirical evidence.” Sleep medicine reviews vol. 22 (2015): 23-36. doi:10.1016/j.smrv.2014.10.001
  13. National Sleep Foundation. Sleep Problems, Sleep Routine, Sleep Tools & Tips, The Science of Sleep. Why Electronics May Stimulate You Before Bed. Copyright 2019. Accessed 7/11/2019.
  14. National Sleep Foundation. Sleep Hygiene. Copyright 2019. Accessed 7/11/2019.
  15. Fortier-Brochu, Émilie et al. Insomnia and daytime cognitive performance: a meta-analysis. Sleep Med Rev. 2012;16(1):83-94.

Live Foreverish Podcast: Men’s Health Series with Michael A. Smith, M.D. & Christopher Mohr, Ph.D., R.D.

National Men's Health Month

Did you know that June was National Men’s Health Month? If not, that’s okay. We’ve got you covered with important information on men’s health topics in our new podcast series. While these dedicated health months are helpful to build awareness, men should be focused on their health year-round! The series is available for download, or you can listen now on

In this special Live Foreverish podcast series, you’ll hear from Christopher Mohr, Ph.D., R.D., a nationally recognized Registered Dietitian and sports nutritionist who has worked with professional athletes, including the Cincinnati Bengals and WWE Wrestlers. Featured in this three-part series:

Episode 1: Maintaining Muscle Mass for Longevity
Exercises for increasing muscle and best times to work out

Episode 2: Nutrition for Men: Protein, Minerals and Supplementation
Healthy fats, fruits & vegetables and protein intake (types and how much for men)

Episode 3: Personalize Your Preventative Health Care Regimen with Lab Testing
Hormone testing: testosterone and estrogen balance and thyroid function

About Live Foreverish: Join Dr. Mike and Dr. Crystal as they sit down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and helpful advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

Migraines: Relief is Possible with These Healthy Habits

Julia Dosik BS, MPH

If you are one of the over 37 million Americans that suffers from migraines, here’s some help! You may be wondering what you can do to keep these draining headaches at bay. Well, the first place to start is to understand the facts around them.

To learn about auras and the causes & triggers of migraines, check out our Migraine Headaches 101 blog post.

Natural Methods for Prevention and Relief of Migraines

Although relief is found for some migraine sufferers through OTC or prescription medications, consider more natural approaches and lifestyle changes for migraine prevention and relief. While there is unfortunately not a way to do away with migraines forever, there are healthy lifestyle habits that may help extend your time between migraine attacks.

1. Adequate Water Hydration It is extremely important to drink enough water to hydrate your body throughout the day. The most common suggestion is to drink about eight 8-ounce glasses of water per day, which is about 2 liters (or half a gallon) per day. Of course, the amount of water will increase based on daily activity level.

2. Regular Exercise Dr. Andrew D. Hershey, a headache specialist and the chair and director of the Division of Neurology at the Headache Center in Cincinnati, states that exercise helps both the body and the brain. He recommends patients with migraines exercise 4-5 times per week for 45 minutes. 1

3. Healthy Sleep Cycles If you are a migraine sufferer, it’s vital to get adequate sleep every night for prevention. Around 7-8 hours of sleep is the common recommendation, along with going to sleep around the same time each night. Also, avoid playing on your phone and/or computer right before you go to sleep as the blue light emitted from these devices can make it harder for your brain to wind down and fall asleep.

4. Well-Balanced Diet Since prolonged hunger may bring on migraines, it’s important to avoid skipping meals and to focus on a well-balanced diet consisting of fruits, nuts, vegetables, protein and good fats (i.e. avocado, cheese, eggs, extra virgin olive oil, etc.). With that being said, it is also important to avoid the specific foods or food groups that you notice trigger your migraines.

5. Stress-Reduction Techniques Techniques such as meditation, breathing exercises, taking a walk (without your phone) and being mindful of all your surroundings, journaling and anything else that brings you relief from the daily stressors of life can be advantageous for migraine prevention.

Dietary Supplements: CoQ10 and Magnesium

In addition to these lifestyle habits, regular intake of the antioxidant CoQ10 and the mineral magnesium can also contribute to migraine prevention and relief.

Not only is CoQ10 an important nutrient for energy production in the body, human studies also show that it can help make migraines shorter in duration and less severe, all without the side effects seen in prescription medications.2 If you are a premenopausal woman with migraines, there is even better news! A new 2018 study revealed that taking CoQ10 consistently for three months can lead to significantly fewer migraine attacks and when they did occur, they did not last as long and were less severe.3

Magnesium is a vital mineral that plays a role in over 300 biochemical reactions in the body. One of its major roles is relaxing smooth muscles within the blood vessels, which supports healthy blood flow in the body. When it comes to the brain, magnesium is essential in controlling brain electrical activity such as balancing excitatory-to-inhibitory actions of nerve cells as well as helping to boost blood flow. Studies show migraine sufferers are deficient in magnesium.4 For migraine prevention, magnesium oxide is one of the most frequently recommended nutrients by neurologists for their migraine patients. In fact, magnesium’s effectiveness is seen primarily in patients who have or have had aura with their migraines.5

Don’t Give Up, Don’t Give in!

Although migraine headaches come with a host of distressing symptoms, educating yourself on your triggers and avoiding them as best as you can could make a world of difference. Maintain your healthy lifestyle habits, take your nutrients daily (and medication as needed), be gentle with yourself when one does come on and take all the rest that you need! Migraines DO pass. You are NOT alone in what you are experiencing. For even more helpful migraine information, visit the Life Extension Migraine Headache Health Protocol.

About the Author: Julia Dosik, BS, MPH, is a clinical corporate trainer at Life Extension headquarters in South Florida. She holds a Bachelor of Science in biology and psychology as well as a Master of Public Health specializing in health education. Julia utilizes a mix of in-person, virtual and written training to educate employees and consumers on how the human body functions and the importance of supplementing with science-backed ingredients. It is her deepest belief that high-quality dietary supplements are fundamental to an individual’s physical and mental well-being.

  2. Shoeibi A, Olfati N, Soltani Sabi M, et al. Effectiveness of coenzyme Q10 in prophylactic treatment of migraine headache: an open-label, add-on, controlled trial. Acta Neurol Belg. 2017 Mar;117(1):103-9
  3. Dahri M, Tarighat-Esfanjani A, Asghari-Jafarabadi M, et al. Oral coenzyme Q10 supplementation in patients with migraine: Effects on clinical features and inflammatory markers. Nutr Neurosci. 2018Jan 3:1-9.
  4. Mauskop A, Varughese J. Why all migraine patients should be treated with magnesium. J Neural Transm. 2012 May;119(5):575-9.

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