You wake up feeling sluggish, even after a full night’s sleep. Midday, your mind starts to fog, and your muscles feel weaker than they used to. Workouts that once left you energized now leave you drained. While these changes may seem like “just aging,” they can actually be signs of something deeper: a decline in your body’s NAD+ levels.

At Genesis Lifestyle Medicine, we help patients understand and address the underlying causes of fatigue, cognitive slowdown, and slower recovery. One of the most important, yet overlooked, root causes of aging is the connection between NAD+ and your mitochondria. In this article, we explain why this coenzyme is critical for your cellular power, how age and lifestyle can deplete it, and what you can do to restore your energy from the inside out.

What is NAD+?

Nicotinamide adenine dinucleotide (NAD+) is a coenzyme found in every cell of your body. Think of it as the molecule that keeps your body’s engine running. It plays a key role in redox reactions, which are the chemical exchanges that allow your cells to convert food into usable energy (ATP). Without adequate NAD+, your cells struggle to generate power, affecting everything from your brain function to your muscle performance.

How NAD+ fuels your mitochondria

Mitochondria are often called the “powerhouses” of the cell, and with good reason. They are the structures inside your cells that produce most of the ATP (adenosine triphosphate) your body relies on for every single function, from contracting your muscles to powering your brain cells. But just like a power plant needs a constant supply of quality fuel to generate electricity, your mitochondria depend on NAD+ to keep running at peak efficiency.

Here’s how it works: NAD+ acts like a molecular shuttle. During metabolism, it accepts electrons from the breakdown of carbohydrates, fats, and proteins, becoming NADH in the process. This is the key step that allows electrons to be delivered into the mitochondria’s “electron transport chain,” a series of reactions known as oxidative phosphorylation. This chain reaction is what ultimately produces ATP, your body’s usable energy.

When NAD+ levels are high, this process runs smoothly, producing plenty of ATP with minimal waste. But when NAD+ levels are low, mitochondria have to work harder with less fuel, resulting in reduced ATP output and an increase in damaging byproducts like reactive oxygen species (ROS). Over time, this imbalance can strain your cells, slow down repair, and contribute to the fatigue, brain fog, and muscle weakness that many people notice as they age.

The impact of NAD+ decline with age

Research shows that NAD+ levels drop significantly over time. In fact, NAD+ in human skin decreases by more than 50% between the ages of 40 and 60. This decline weakens mitochondrial function, slowing energy production and increasing oxidative stress.

Over time, the decline in NAD+ levels can lead to:

• Persistent fatigue despite adequate rest
• Greater reliance on caffeine or stimulants to stay alert
• Brain fog, forgetfulness, or reduced mental sharpness
• Slow recovery from exercise, illness, or injury
• Decline in physical endurance and muscle strength
• Increased muscle soreness or joint discomfort
• Frequent mood changes or irritability
• Noticeably duller or prematurely aging skin

These are often early warning signs that your cells aren’t producing energy efficiently. Over the years, chronically low NAD+ can contribute to metabolic disorders, cognitive decline, and other age-related health challenges. This can be combated by wellness treatment plans at Genesis Lifestyle Medicine.

Strategies to boost NAD+ levels naturally

Exercise regularly

Regular physical activity stimulates enzymes involved in NAD+ production, improving your body’s energy efficiency. Research shows consistent exercise can boost NAD+ levels in muscle tissue by up to 50%. Combining endurance training, like cycling or running, with resistance exercises helps maximize this effect, improving stamina and reducing oxidative stress.

Eat NAD+ supporting foods

Your body needs certain nutrients to create NAD+, and vitamin B3 (niacin) is one of the most important. Foods such as chicken, tuna, salmon, peanuts, and legumes supply these building blocks. A diet rich in NAD+ precursors helps maintain optimal cellular energy production and supports repair processes that keep your body functioning at its best.

Consider calorie restriction or intermittent fasting

Calorie restriction and intermittent fasting can activate sirtuins: specialized enzymes that require NAD+ to function. These play a key role in DNA repair, metabolic regulation, and slowing cellular aging. By reducing caloric intake, you encourage your body to recycle energy more efficiently, boosting NAD+ availability and enhancing overall mitochondrial performance.

Improve your sleep quality

High-quality sleep is essential for NAD+ synthesis and mitochondrial health. Disrupted or insufficient sleep throws off your circadian rhythm, which directly impacts the enzymes that produce NAD+. Maintaining a consistent bedtime, creating a dark and quiet sleep environment, and avoiding stimulants late in the day can help your body restore and sustain NAD+ levels.

Supplement with NAD+ precursors

Scientific studies show that compounds like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) can safely elevate NAD+ levels, particularly in middle-aged and older adults. These supplements bypass certain metabolic steps, making it easier for your cells to produce NAD+. They can help restore energy, improve focus, and support healthy aging.

If you suspect low NAD+ might be behind your fatigue, brain fog, or slower recovery, it’s worth looking deeper. At Genesis Lifestyle Medicine, we can help assess your cellular health and offer a tailored plan to restore energy production. From lifestyle strategies to advanced NAD+ therapies, we help you feel and perform at your best, not just today, but for years to come. Schedule your consultation today!