What We Test & Why It Matters
NAD+ (Nicotinamide Adenine Dinucleotide)
The oxidised form and primary electron carrier in mitochondrial energy production (ATP synthesis). Also a key substrate for sirtuins (longevity enzymes) and PARPs (DNA repair). Declines naturally with age.
NADH (Reduced NAD+)
The reduced form of NAD+, produced when NAD+ accepts electrons during metabolic reactions. NADH delivers electrons to the mitochondrial electron transport chain, directly powering ATP production.
NADP+ (Nicotinamide Adenine Dinucleotide Phosphate)
The oxidised form of the anabolic redox pair. NADP+ is critical for biosynthetic reactions including fatty acid synthesis, cholesterol production, and maintaining the glutathione antioxidant system.
NADPH (Reduced NADP+)
The reduced form, serving as the cell’s primary reductive biosynthetic currency. NADPH drives antioxidant defence (glutathione recycling), detoxification, and immune cell respiratory burst.
Nicotinamide (NAM) (Vitamin B3 form)
A form of vitamin B3 and a direct NAD+ precursor via the salvage pathway. Elevated levels may indicate recent B3 supplementation or high dietary niacin intake. Very high levels may inhibit sirtuin activity.
Nicotinic Acid (NA) (Niacin)
Another form of vitamin B3 that supports NAD+ synthesis via the Preiss–Handler pathway. Found in meat, fish, and fortified foods. High-dose supplementation may cause flushing.
NAD+/NADH Ratio CATABOLIC
Reflects the balance of cellular energy metabolism. A higher ratio indicates efficient mitochondrial function and energy production. A low ratio may suggest metabolic stress or mitochondrial dysfunction.
NADP+/NADPH Ratio ANABOLIC
Reflects the balance between biosynthetic demand and antioxidant capacity. This ratio indicates how well your cells maintain their reductive reserves for detoxification and immune defence.
NAD/NADP Index (Niacin Number) COMPOSITE SCORE
A composite score calculated as (NAD+/NADH × NADP+/NADPH) × 100, comparing catabolic energy production with anabolic biosynthetic capacity. This single number summarises your overall NAD+ metabolic health, reflecting mitochondrial function, metabolic resilience, and age-related decline in NAD+ biosynthesis. Optimal levels (90–350) support energy production, DNA repair, immune function, and longevity.
Common Causes of Low NAD+ Levels
Ageing
NAD+ levels decline significantly with age. By age 60, levels may be less than half of those seen in younger adults, affecting cellular energy and repair.
Chronic Inflammation
Persistent inflammation activates CD38 and PARP enzymes, which consume large amounts of NAD+, accelerating its depletion.
Poor Diet
Insufficient intake of niacin (B3) precursors — found in poultry, fish, legumes, and mushrooms — limits the body’s ability to synthesise NAD+.
Alcohol & Lifestyle
Excessive alcohol consumption depletes NAD+ through increased demand on detoxification pathways. Sleep deprivation and chronic stress also contribute.
