NAD+ supplements: Your energy solution or expensive mistake?

The NAD+ supplement explosion in 2024-2025 is impossible to ignore. Every wellness influencer, longevity expert, and probably your best friend is raving about these "cellular energy boosters." The promises are alluring – increased energy, sharper thinking, feeling decades younger, and “cellular optimization”. With compelling evidence to push it further, the global NAD+ market is projected to explode from over $600 million to more than $2 billion by 2034.

As someone who once explored quick fixes in the world of health, fitness, and beauty, I often realized that the science claims and results did not add up. I've researched and applied strategies to manage my own exhaustion, hormone imbalances, and hypothyroidism, and from this experience here is what I have learned: supplements aren't magic bullets. They're tools, only powerful when you place them in an engine that's been properly tuned.

Here's the thing about cellular energy during perimenopause and menopause – it's not just about adding more fuel to your tank. Your entire energy production system is being rewired by hormonal changes, and throwing supplements at a dysregulated system often backfires spectacularly. 

Think of it this way: Are you bungy jumping blindly through your hormonal transition, getting yanked up and down until the ride is mercifully over? Personally, I have been engineering a more controlled descent, floating gently to the ground with strategy and grace. How we experience hormonal transitions can either be a crash landing or a cushioned, gentle fall.

Our goal here isn't to crush your hopes about NAD+, rather it's to ensure you're one of the few who actually gets the results, not just expensive urine. Because when you finally get NAD+ supplementation right, it can be genuinely transformative. The word "yet" in our title? There's crucial foundation work to be done first so that NAD+ can work for you. 

Your body's energy currency: What NAD+ does and why it matters

Every cell in your body contains thousands of tiny powerhouses called mitochondria. Picture them as miniature generators that convert the food you eat into usable energy (ATP). NAD+ is like the essential currency these generators need to function – without adequate NAD+, your cellular powerhouses sputter, stall, and eventually will be cleared as debris. This description is very simplified and obviously the complexity of reactions has much more depth.

What I want you to remember is that when NAD+ levels are optimal, magic happens. Your cells and their generators hum along efficiently, energy production flows steadily, DNA repair processes work like a well-oiled machine, and your body maintains a vitality and vibrant resilience you remember having in your thirties. When the cells are working in a symphony, it creates the youthful feeling many strive for while chasing longevity protocols. The cells are more efficient at doing their job so that you can enjoy the people, places, and things you love to experience. 

NAD+ also activates sirtuins – proteins scientists call the "guardians of your genome" that protect against cellular aging, support healthy metabolism, and support quality sleep. And here's where perimenopause throws you a curveball: your NAD+ levels don't just decline gradually like they do with normal aging – they can nosedive. During menopause, the rapid decline in estrogen contributes to a corresponding plummet in NAD+ within the body. Estrogen plays a crucial role in regulating cellular processes that support mitochondrial function, cellular repair, decreasing inflammation, all of which depend heavily on NAD+.

Even more concerning, the enzyme CD38, which actually breaks down NAD+, shows dramatically increased activity in aging ovaries, leading to faster depletion of NAD+ in reproductive tissues. It's like having a leak in your energy tank just when you need fuel most.

NAD+ is used up as the body desperately tries to keep some sort of normal balance. This reduced NAD+ availability directly impacts the symptoms you're living with: that insidious fatigue that coffee can't touch, frustrating brain fog that makes you feel like you're thinking through molasses, sluggish metabolism that makes weight management suddenly impossible, and the general certainty that your body is just not responding the way it used to.

It's all connected. Your cellular energy crisis is real, and it has a name. 

What’s going on with cellular energy

Understanding cellular energy during perimenopause and menopause requires grasping how multiple systems become dysregulated simultaneously, creating a cascade that burns through your NAD+ reserves at an alarming rate.

It’s important not to rush to resupply your system with NAD+ before understanding the crucial interplay of these vital systems. 

First, there's the relentless sleep disruption. You know this intimately – falling asleep easily enough, then suddenly wide awake at 3 AM with a racing mind, replaying every conversation from 1997. Research from the Journal of the Endocrine Society confirms that sleep disturbances affect nearly one-third of the general population, but this increases dramatically during hormonal transitions.

During perimenopause, declining progesterone – which has natural sleep-promoting effects – leaves you vulnerable to insomnia and fragmented sleep. There are generally two stages of sleep: rapid eye movement (REM) and deep sleep (non-REM). “REM sleep facilitates learning and memory and is important for the development of the central nervous system. Lack of REM sleep may result in enhanced emotional reactivity, adverse health effects, and higher mortality” (Haufe & Leeners, 2023). 

Poor sleep alone devastates cellular energy. Your mitochondria desperately need recovery time to repair and regenerate, but chronic sleep disruption keeps them in constant crisis mode, burning through NAD+ just to maintain basic functions.

This lack of restorative sleep triggers a dangerous secondary cascade: inflammation. When your cells don't get their nightly repair window, your immune system stays on high alert. This is adding to low-grade, systemic inflammation that becomes a persistent, unwelcome guest throughout your body.

This isn't just joint aches – we're talking about cellular-level inflammation that forces your cells to redirect precious energy toward damage control instead of fueling your daily life and providing you with extra energy. 

Then, subtly but powerfully, your body's internal master clock starts to falter. Research published in Cell Reports Medicine reveals that around 8% of lipid metabolites exhibit daily rhythms in human serum and tissues, and these temporal patterns become severely disrupted during metabolic dysfunction.

Your circadian rhythm isn't just about sleep schedules – it's the conductor of a sophisticated orchestra delegating when your cells produce energy, when they repair themselves, when they detoxify, and when they rest. This includes the timed and strategic breakdown and building of collagen essential to movement and total body health. When this internal timing system is not supported, signals become scrambled and your cells are confused about when they are supposed to perform based on their job description. It’s like they’re sleeping on the job because the body itself has not been able to rest!

Here's something particularly eye-opening: Blood glucose dysregulation creates massive disruption in the daily rhythm of cellular metabolism, and we know this well through many scientific studies. You might not have diabetes, but blood glucose irregularities are extremely common during perimenopause due to developing insulin resistance as estrogen declines.

This means your cellular energy during menopause becomes unpredictable as your cells ride a glucose rollercoaster all day, struggling to use fuel efficiently, which further depletes your NAD+ reserves at precisely the moment you can least afford it.

Your cells aren't lazy or broken – they're working overtime, burning through their most precious resource just trying to keep you upright.

Why the "take a pill and feel better" approach fails

I understand that reading this can sound awful and if you have made it to this point, you are likely the kind of person who wants to take care of the problem before it gets worse. However, reaching for NAD+ supplements or injections as your first line of defense often disappoints, even when the supplements are high-quality and properly dosed.

The idea that you can simply "take a pill and it does something" assumes your body's metabolic machinery is functioning optimally — that the cells, despite going through this transitional rollercoaster, will just pick up where they left off — they won’t.  

Cells that are in chaos need to be supported and trained to function properly.

The metabolism assumption is dangerous. We assume metabolism just "happens," but its efficacy entirely depends on the upkeep of your internal engine. When your sleep is disrupted, inflammation is high, your circadian rhythms are scrambled, and your blood sugar is unstable, your body's ability to properly process and utilize any supplement becomes severely compromised.

Here's what I learned during my own health journey: the stressed body becomes more stressed when forced to metabolize supplements it's not prepared to handle effectively. If your foundational systems are dysregulated, adding NAD+ supplements is like asking someone who's juggling sharp knives to catch a few burning torches at the same time.

The foundation revelation: Why your energy house needs solid ground first

Consider your body like your home that requires some maintenance and maybe you’re interested in making some high-end renovations. Before breaking down walls you will likely consult with a planner to make sure the foundation can withstand the renovations your are about to invest in. Having a strong foundation is key to any renovation project.

Foundation work is about fixing the wiring (your nervous system), repairing the plumbing (your circulatory and lymphatic systems), and shoring up the structural integrity (your sleep and metabolic health) before you invest in premium upgrades.

Depending on how well the house has been maintained to this point will give any architect an idea of the amount of foundational work that needs to be done. 

How we age can be influenced. How we experience hormonal transitions can either be a crash landing or a cushioned gentle fall. The choice isn't whether you'll go through this transition – it's how you'll experience it.

Either way, our bodies will figure out how to get by. It just depends how you want to feel during the ride.

Christian Simpson, a coach I have listened to and worked with over the years would say, "It's hard to see the picture when you're in the frame." You're living this transition daily, managing symptoms, juggling responsibilities. You need someone with perspective to help you see the full landscape of what your body actually needs.

The Foundation Project isn't about restriction or deprivation – it's about creating the optimal conditions where your body can actually thrive. When your sleep becomes restorative, your stress response becomes regulated, your movement supports rather than depletes you, and your nutrition works with your changing hormones instead of fighting them, then targeted supplements become incredibly powerful amplifiers.

This is the difference between surviving your hormonal transition and genuinely flourishing through it.

References:

1. Haufe, A., & Leeners, B. (2023). Sleep disturbances across a woman's lifespan: What is the role of reproductive hormones? Journal of the Endocrine Society, 7, 1-14. https://doi.org/10.1210/jendso/bvad036

2. Sinturel, F., Chera, S., Brulhart-Meynet, M.C., et al. (2023). Circadian organization of lipid landscape is perturbed in type 2 diabetic patients. Cell Reports Medicine, 4, 101299. https://doi.org/10.1016/j.xcrm.2023.101299

3. Lapatto, H.A.K., Kuusela, M., Heikkinen, A., et al. (2023). Nicotinamide riboside improves muscle mitochondrial biogenesis, satellite cell differentiation, and gut microbiota in a twin study. Science Advances, 9, eadd5163. https://doi.org/10.1126/sciadv.add5163

4. Elhassan, Y.S., Kluckova, K., Fletcher, R.S., et al. (2019). Nicotinamide riboside augments the aged human skeletal muscle NAD+ metabolome and induces transcriptomic and anti-inflammatory signatures. Cell Reports, 28, 1717-1728. https://doi.org/10.1016/j.celrep.2019.07.043

5. Su, Y., Wang, M., Chen, J., et al. (2025). Progress in understanding how clock genes regulate aging and associated metabolic processes. Frontiers in Physiology, 16, 1654369. https://doi.org/10.3389/fphys.2025.1654369

6. de Guia, R.M., Agerholm, M., Nielsen, T.S., et al. (2019). Aerobic and resistance exercise training reverses age-dependent decline in NAD+ salvage capacity in human skeletal muscle. Physiological Reports, 7(12), e14139. https://doi.org/10.14814/phy2.14139

7. Accio Business Intelligence. (2025). Trend of NAD+ supplements. Retrieved October 26, 2025, from https://www.accio.com/business/trend-of-nad-supplements