NAD+ in Costa Rica: what it is, what the studies measured and what is missing
· Novatheris
Anyone searching for NAD+ in Costa Rica finds a lot about energy and aging, and little about what was actually measured. This article gathers what has been published, with its source. And it clears one thing up from the start: NAD+ is not a peptide. It is a coenzyme, a small molecule that helps enzymes do their work.
What NAD+ is
NAD+ stands for nicotinamide adenine dinucleotide. Its formula is C21 H27 N7 O14 P2 and it weighs about 663.4 Da. It is made of two pieces called nucleotides, joined by their phosphates.
Almost every cell in the body uses it nonstop, and in two ways (Covarrubias et al., 2021).
First: it carries electrons in the reactions that pull energy out of food. That happens in glycolysis, in the Krebs cycle and in the respiratory chain of the mitochondria. In this role NAD+ is not used up, it just goes back and forth.
Second: it is consumed as raw material by other enzymes. Sirtuins, which help regulate genes. PARPs, which repair DNA. And CD38, an immune system enzyme. These do use it up, and the cell has to make it again.
Why NAD+ comes up when talking about age
NAD+ levels fall with age in several species, including humans. That drop is linked with a loss of metabolic function (Covarrubias et al., 2021).
A 2016 paper in mice pointed to CD38 as one of the main drivers. With age there is more CD38, and more CD38 uses up more NAD+. In mice without CD38, NAD+ stayed higher over the years and the mitochondria worked better (Camacho-Pereira et al., 2016).
Something falling with age does not mean raising it brings back what was lost. That is the question the trials try to answer, and the answer is not clear yet.
The good evidence is from precursors, not from NAD+
Almost all the serious human trials, randomized and with placebo, did not use NAD+. They used two molecules the body turns into NAD+, called precursors, taken by mouth: nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN).
The most cited NR trial had 24 healthy adults who completed it. Blood NAD+ went up and it was well tolerated. Blood pressure dropped a little, but that drop was not significant after statistical correction. The authors call it an exploratory finding, not a result (Martens et al., 2018).
The NMN trial had 25 women with prediabetes. NAD+ rose in some blood cells, and muscle insulin sensitivity improved. But NAD+ inside the muscle itself did not change, in the treated group or the placebo group (Yoshino et al., 2021).
That detail matters. Raising NAD+ in the blood is not the same as raising it inside the tissue.
Why whole NAD+ does not get into the cell easily
NAD+ is a large molecule with an electric charge. It does not easily cross the membrane of a healthy cell.
Outside the cell there are enzymes, mainly CD38, that cut it into smaller pieces. Those pieces can get in, and inside, the cell puts NAD+ back together (Nikiforov et al., 2015; Billington et al., 2006).
There is no published data on how much of the NAD+ placed outside the cell reaches the inside of a human cell intact.
The only study with NAD+ in people
With NAD+ directly into a vein, the only controlled study we found is a small pilot. It had 11 healthy men: 8 received NAD+ and 3 received saline (Grant et al., 2019).
The study measured one thing: how NAD+ and its pieces changed in blood and urine over 6 hours. Along with NAD+, nicotinamide and ADP-ribose went up, which are exactly the pieces it gets cut into. It is a sign that part of the NAD+ breaks down outside the cell.
It measured no health outcome and followed no one afterward.
That makes it a useful starting point for anyone studying how NAD+ moves through the body, and nothing more. Eleven people over a few hours cannot say what happens with repeated exposure, in other groups of people, or inside the tissues that matter. Those questions are still open, and no published trial has answered them yet.
What is still unknown
For the notebook:
- There are no randomized trials of decent size with injected NAD+.
- The only pilot with NAD+ into a vein had 11 people and measured only metabolites.
- Raising NAD+ in the blood does not guarantee raising it inside the tissue.
- It is not known how much outside NAD+ gets into the cell whole.
- Even the oral precursor evidence has results still to be confirmed.
How it is stored
NAD+ comes lyophilized, which means dry: a powder whose water was removed with cold and vacuum. It is kept at -20 °C, closed and away from bright light. Let the vial reach room temperature before opening it, so moisture does not get in. Once reconstituted, it goes to 2 to 8 °C and for a short time.
NAD+ in Costa Rica: where to find it
If you need it for your research, the NAD+ page has its chemical data, the storage note and the purity information, with the +99.5% standard we ask of outside laboratories such as Janoshik and Freedom Diagnostics. NAD+ also comes in the Energy kit, together with MOTS-c and SS-31. Delivery takes 2 hours in the GAM and 24 hours in the rest of Costa Rica. For research use only.