Scientists from the University of Oslo (UiO), Akershus University Hospital (Ahus), and a network of international collaborators have published a compelling expert opinion in Nature Aging. This significant contribution unites over twenty-five leading researchers from around the world, encompassing clinicians, metabolic scientists, and renowned authorities in the field of ageing biology. Together, they present a comprehensive perspective on nicotinamide adenine dinucleotide (NAD⁺), a molecule that is emerging as a central player in maintaining cellular health. Their collective insight highlights an expanding international commitment to uncovering how this minute but vital compound could hold the key to promoting healthier ageing and protecting against debilitating neurodegenerative diseases such as Alzheimer’s and Parkinson’s.
Often described as a cell’s “fuel regulator,” NAD⁺ performs a wide array of crucial biological functions. It supports the body’s ability to generate energy, facilitates the repair of damaged DNA, and helps sustain normal cellular operations. However, as humans age, NAD⁺ levels naturally diminish—a decline increasingly associated with impaired memory, muscle weakness, fatigue, and the development of several age-related disorders. As Dr Jianying Zhang, one of the paper’s lead authors, explains, “Fine-tuning NAD⁺ metabolism holds promise for delaying age-related health decline as well as diseases associated with premature ageing. Yet, to truly unlock its therapeutic potential, we must deepen our understanding of appropriate dosing, long-term safety, and individual variability in response to NAD⁺ augmentation strategies.” Zhang’s remarks encapsulate a growing consensus within the scientific community that while NAD⁺ offers extraordinary potential, much remains to be explored before it can be effectively translated into clinical practice.
The expert opinion synthesises years of research, integrating findings from numerous preclinical and clinical studies investigating ways to elevate NAD⁺ levels. Most notably, these efforts have centred on the administration of vitamin B3-related precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). Early experimental outcomes have been promising, with some human trials suggesting improvements in cognitive performance, motor coordination, and metabolic efficiency. Nonetheless, the researchers emphasise the need for larger-scale and long-term clinical studies to confirm these preliminary observations. Only through such rigorous and sustained investigation, they argue, can the true therapeutic potential of NAD⁺ enhancement be accurately assessed across a spectrum of diseases and physiological conditions.
The publication arrives at an especially opportune moment, as both scientific and public interest in NAD⁺ biology have reached unprecedented levels. Around the world, including in Norway, numerous clinical trials are currently underway to evaluate the safety and efficacy of NAD⁺ precursors, such as NR and NMN. These compounds have simultaneously gained considerable commercial traction, forming part of a rapidly expanding market for so-called “longevity supplements.” Yet this surge in popularity has also given rise to significant debate regarding the relative effectiveness of different NAD⁺ boosters and the reliability of claims made by supplement manufacturers. In this context, the Nature Aging article offers not merely scientific analysis but also much-needed clarity amid the surrounding uncertainty and speculation.
“This is precisely why we believe the timing is right for an expert perspective,” remarks Dr Evandro Fei Fang-Stavem, senior author of the article and head of the Fang Lab at UiO and Ahus. “NAD⁺ is essential for life itself, but there remains a great deal of confusion and misinformation about how best to use NAD⁺-related supplements and therapies. Our work consolidates the available evidence, delineates current gaps in knowledge, and provides a roadmap to guide future research and clinical applications.” Dr Fang-Stavem’s statement reflects the article’s broader ambition: to steer both researchers and clinicians towards a more coordinated and scientifically grounded understanding of NAD⁺ biology, while cautioning against premature assumptions driven by hype rather than evidence.
The sentiment is echoed by Professor Torbjørn Omland, MD, PhD, MPH, Deputy Head of the Institute of Clinical Medicine and co-author of the paper, who notes that the review provides a vital bridge between basic researchers and clinicians. “There is a clear knowledge gap regarding NAD⁺ and its clinical implications,” he observes. “This paper delivers the latest expert guidance for those investigating NAD⁺ biology and will serve as a valuable resource for the numerous NAD⁺-related clinical trials currently underway. These studies span an impressive range of conditions, from neurological and cardiovascular diseases to general age-related decline.” In essence, the review functions as both a scholarly synthesis and a practical reference for a field that is rapidly evolving but still in need of unifying principles and robust data.
Ultimately, the authors call for continued international collaboration, larger and more diverse participant pools, and stringent methodological standards to ensure that the promising science of NAD⁺ can be translated into tangible medical progress. They emphasise that while the enthusiasm surrounding NAD⁺ supplementation is understandable—given its role in cellular energy and repair—the field must proceed with careful scientific scrutiny rather than commercial enthusiasm. The promise of NAD⁺ lies not only in its biochemical properties but also in the research community’s ability to harmonise its understanding of how, when, and for whom NAD⁺ therapies can be most beneficial. With this Nature Aging publication, the University of Oslo, Ahus, and their global partners have made a crucial contribution to that collective effort—laying the foundation for a future in which the biology of ageing can be harnessed to improve both lifespan and healthspan for generations to come.
More information: Jianying Zhang et al, Emerging strategies, applications and challenges of targeting NAD+ in the clinic, Nature Aging. DOI: 10.1038/s43587-025-00947-6
Journal information: Nature Aging Provided by University of Oslo, Ullevaal University Hospital
