By Chloé Nefdt, Professional Nurse & Founder of IVgo
Let me paint you a picture. You're standing in the supplements aisle - or more likely, scrolling through an Instagram ad at midnight - staring at a product that promises to "reverse the signs of ageing" and "restore your youthful glow." The bottle is sleek. The testimonial is from a woman who looks suspiciously airbrushed. The price tag has three digits and no scientific references.
You buy it anyway. Because you're 38, your under-eyes look like you've been studying for finals for the last decade, and hope is a powerful marketing tool.
I get it. I really do. The desire to age well - or at least to stop feeling like your body is accelerating away from you - is one of the most human impulses there is. And the anti-ageing industry knows it, which is why it's projected to be worth over $420 billion by 2030. Most of that money will be spent on products that do approximately nothing.
So when people ask me whether NAD+ "really works" for anti-ageing, I understand the scepticism. You've been burned before. Probably by something with "collagen" on the label.
Here's what I can offer: the actual science, an honest assessment of what NAD+ can and can't do, and a firm refusal to pretend that any molecule - including this one - is a time machine.
A Quick Refresher on NAD+ (And Why Your Levels Are Dropping)
I've written a comprehensive guide to NAD+ - what it is, how it works, why it matters - in my complete NAD+ article. If you haven't read that, it's worth your time for the full picture.
The short version: NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell in your body. It's not a supplement someone invented. It's a molecule you were born producing, and it's essential for energy metabolism, DNA repair, cellular signalling, and about 500 other enzymatic reactions that keep you functioning as a human being rather than a pile of entropy.
The problem - and this is the part that matters for ageing - is that your NAD+ levels decline significantly as you get older. Research by Yoshino et al. (2018) in Cell Metabolism showed drops of up to 50% between ages 40 and 60. That's not a subtle dip. That's your cells losing half their supply of a molecule they depend on for basically everything.
The question isn't whether NAD+ declines with age. It does. The question is whether restoring it actually changes anything meaningful. And that's where the research gets interesting.
The Science of NAD+ and Ageing: What the Research Actually Shows
This is the section where I need you to put down the marketing brochures and pick up the peer-reviewed journals. The relationship between NAD+ and ageing isn't speculation - it's one of the most actively researched areas in longevity science. But the nuance matters.
The Sirtuin Connection
In 2013, Gomes et al. published a landmark paper in Cell demonstrating that declining NAD+ levels directly impair mitochondrial function through a mechanism involving a protein called SIRT1 - one of seven sirtuins, a family of enzymes sometimes called "longevity regulators." The remarkable finding: when NAD+ was restored in aged mice, markers of mitochondrial function in their muscle tissue resembled those of much younger animals.
Read that again. Not "slightly improved." Resembled younger tissue.
David Sinclair's lab at Harvard has been at the centre of this research. His team's work has shown that sirtuins - which require NAD+ to function - regulate DNA repair, gene expression, inflammation, and cellular stress responses. When NAD+ drops, sirtuins can't do their jobs. When NAD+ is restored, they get back to work.
The Imai Lab and the NAD+ World
Shin-ichiro Imai's group has been equally pivotal. Their research established the "NAD+ world" hypothesis - the idea that NAD+ acts as a systemic signalling molecule that coordinates ageing across multiple organs, not just individual cells. It's not just that your skin cells are running low on NAD+. Your brain, your muscles, your liver - they're all affected, and they're communicating that deficit to each other.
The Preclinical Evidence
Zhang et al. (2016) published in Science a study showing that NAD+ replenishment improved DNA repair capacity in aged mice and protected against radiation-induced DNA damage. The implications for ageing are significant: DNA damage accumulation is one of the hallmarks of biological ageing, and NAD+ appears to support the repair machinery that keeps it in check.
Rajman et al. (2018) in Cell Metabolism provided a comprehensive review of NAD+-boosting molecules and their therapeutic potential, concluding that "NAD+ intermediates represent a promising avenue for the treatment of age-related diseases." Their analysis covered everything from cardiovascular health to neurodegeneration to metabolic function.
The "But" You've Been Waiting For
Here's where I earn your trust by being straight with you: most of this research is preclinical. Mice. Worms. Cell cultures. The results are compelling - genuinely exciting, in fact - but the leap from "reversed ageing markers in mouse muscle tissue" to "will make a 45-year-old human biologically younger" is a leap that the science hasn't fully made yet.
Human data is growing. Martens et al. (2018) in Nature Communications showed that nicotinamide riboside (an NAD+ precursor) supplementation in healthy older adults was well-tolerated and elevated NAD+ levels. Yoshino et al. (2021) in Science demonstrated metabolic benefits of NMN supplementation in prediabetic women. These are real human trials with real results.
But we don't yet have a 10-year controlled study in 5,000 humans proving that NAD+ supplementation extends lifespan or reverses biological age by X years. Anyone who tells you otherwise is either misinformed or trying to sell you something.
What we have is a molecule with a robust biological rationale, strong preclinical evidence, encouraging early human data, and a safety profile that gives us reason to be optimistic. That's more than most things in the anti-ageing space can claim. But it's not the same as proof.
What "Anti-Ageing" Actually Means Here
This is important, because "anti-ageing" means very different things depending on who's saying it.
When a skincare company says "anti-ageing," they mean: this cream might make your wrinkles look slightly less pronounced under certain lighting conditions, temporarily.
When longevity researchers say "anti-ageing," they mean: interventions that slow, halt, or partially reverse the underlying biological processes of ageing at the cellular level - DNA damage, mitochondrial dysfunction, telomere shortening, cellular senescence, and the chronic low-grade inflammation that drives most age-related disease.
NAD+ sits firmly in the second category. Its relevance to ageing isn't about how you look. It's about how your cells function. Specifically:
Cellular energy production. Your mitochondria need NAD+ to produce ATP. When NAD+ declines, so does your cells' ability to generate energy. That's not cosmetic - it's metabolic.
DNA repair. Every day, your DNA sustains tens of thousands of lesions from normal metabolic activity, UV exposure, and environmental stress. NAD+-dependent enzymes like PARPs are essential for repairing that damage. Less NAD+, less repair, more accumulated damage.
Inflammatory regulation. Chronic low-grade inflammation - sometimes called "inflammaging" - is increasingly recognised as a driver of age-related disease. NAD+ helps regulate inflammatory pathways through its interaction with CD38 and sirtuin-mediated mechanisms.
Cognitive function. NAD+ supports neuronal health and neurotransmitter production. The brain is metabolically one of the most demanding organs in the body - it consumes roughly 20% of your energy at rest. When cellular energy production falters, your brain notices first.
None of this is going to make you look 25 in the mirror. But it may influence how your body ages at the level that actually matters - inside the cells.
NAD+ vs. the Anti-Ageing Supplement Industry
Since you've almost certainly been marketed at least three other "anti-ageing" products this week, let me give you an honest comparison.
Collagen supplements. Hugely popular. The logic sounds good - collagen is a structural protein in skin, so eating it should help, right? The evidence is mixed at best. Some studies show modest improvements in skin hydration and elasticity (Bolke et al., 2019, Nutrients), but the mechanism is debatable. Collagen you swallow gets broken down into amino acids in your gut - your body doesn't necessarily rebuild it as skin collagen. It's like eating a LEGO house and hoping your body assembles a LEGO car.
Resveratrol. The red wine molecule. Had its moment in the sun after Sinclair's early work suggested it activated sirtuins. Subsequent research has been... disappointing. A large 2014 study by Semba et al. in JAMA Internal Medicine found no association between dietary resveratrol and longevity, cardiovascular disease, or cancer in humans. The doses used in mouse studies would require you to drink several hundred glasses of wine per day. Please don't.
Retinoids (topical). Actually have strong evidence - for skin specifically. Tretinoin is one of the few topical agents with robust clinical data for reducing wrinkles and improving skin texture. But it works on your skin's surface and immediate subdermal layers. It doesn't address the cellular and metabolic ageing processes that NAD+ targets.
NMN and NR supplements (oral NAD+ precursors). These are in the same family as NAD+ therapy, and the research is genuinely promising. But oral bioavailability is a real limitation - a significant portion gets lost in digestion before reaching your cells. I cover this comparison in detail in my NAD+ guide.
NAD+ (direct, via injection pen). Targets the fundamental cellular machinery of ageing. Strong preclinical evidence, growing human data, high bioavailability when delivered subcutaneously. Doesn't fix your wrinkles, but may support the cellular processes that determine how well - not just how long - you age.
I'm biased, obviously - I administer NAD+ therapy for a living. But I wouldn't offer it if the science didn't hold up to scrutiny. And I wouldn't tell you it's "proven" to reverse ageing, because it hasn't been. What it has is a stronger evidence base than most things fighting for your attention in this space.
What My Clients Actually Report
I want to be transparent about the difference between clinical evidence and client experience. What follows is anecdotal - real feedback from real people, but not controlled trial data. I include it because it's honest, and because it's what people actually want to know.
Energy. This is the most consistent report. Not a caffeine buzz - a sustained, even energy throughout the day. Clients describe it as "feeling like they did five years ago" or "getting to evening without the 3pm wall." Most notice this within the first two weeks.
Mental clarity. The brain fog lifts. Clients report sharper focus, better recall, and an easier time sustaining attention during demanding tasks. One client - a lawyer - told me she stopped reaching for her third coffee by day ten. She sounded almost offended that it was that straightforward.
Sleep quality. Several clients report falling asleep more easily and waking feeling more rested. This aligns with the science - NAD+ plays a role in circadian rhythm regulation through its interaction with SIRT1 and the CLOCK-BMAL1 complex.
Recovery. Athletes and gym-goers consistently report faster recovery from training. Less soreness, quicker return to baseline, better performance in subsequent sessions. The mitochondrial energy production mechanism makes this biologically plausible.
General "feeling better." This one's hard to quantify, but it comes up enough to mention. A sense of wellbeing, resilience, and physical capacity that clients often describe as feeling more like themselves.
What I don't hear - and what I wouldn't expect - are reports of visible physical rejuvenation. Nobody's come back to me claiming their grey hair reversed or their laugh lines disappeared. Which brings me to an important section.
What NAD+ Won't Do
I'd rather lose a sale than lose your trust, so here's the list:
NAD+ won't erase your wrinkles. Wrinkles are a function of collagen breakdown, sun damage, repeated facial movements, and genetics. NAD+ doesn't target these mechanisms directly. If someone's selling NAD+ as a wrinkle cure, walk away.
NAD+ won't make you 25 again. Ageing is multifactorial, progressive, and - let's be honest - irreversible in any total sense. NAD+ may support your cells' ability to repair and function more efficiently, but it's not a rewind button.
NAD+ won't replace exercise, sleep, or a decent diet. I cannot stress this enough. NAD+ works at the cellular level, but so does everything else you do to your body. If you're sleeping four hours a night, eating exclusively from petrol station shelves, and haven't exercised since 2019, an injection pen is not going to undo that. Fix the foundations first. NAD+ amplifies a healthy baseline - it doesn't create one.
NAD+ won't work overnight. This isn't a filler appointment. Cellular repair takes time. Most clients notice changes within one to two weeks of consistent use, with cumulative benefits building over the full course.
NAD+ won't replace medical treatment for age-related disease. If you have a diagnosed condition - cardiovascular disease, diabetes, neurodegenerative disease - NAD+ therapy is not a substitute for the treatment your doctor has prescribed. It may be a complement to it, but that conversation happens with your medical team, not with an Instagram caption.
How IVgo Delivers NAD+ Therapy
Since this comes up in every consultation: IVgo does not deliver NAD+ via IV drip. We use a subcutaneous injection pen - a pre-loaded, pen-style device similar to an insulin pen that you self-administer at home after I've trained you.
Here's why that matters, and how the process works:
Step 1: Consultation and screening. Every NAD+ client undergoes a health history review. I arrange blood work, which is reviewed by a doctor before we proceed. We're checking for contraindications, potential interactions, and baseline markers. This step is non-negotiable - I've covered why in my side effects article.
Step 2: I come to you. IVgo is fully mobile across Cape Town. I arrive at your home, office, or wherever suits you. During this visit, I deliver your injection pen, demonstrate correct technique, and make sure you're completely comfortable with self-administration before I leave.
Step 3: You self-administer. Two doses per week, each taking seconds. No clinic visits, no 3-hour drip sessions, no rearranging your calendar.
Step 4: Ongoing support. Questions, concerns, weird symptoms, or just wanting to check in - I'm a WhatsApp message away. Not a chatbot. A registered nurse who knows your health history.
The injection pen model means higher bioavailability than oral supplements (bypassing the gut entirely), fewer side effects than IV infusion (slower, steadier absorption - no flushing, no nausea), and a level of convenience that makes long-term use sustainable. Because consistency is where the real benefits compound.
Frequently Asked Questions
Does NAD+ actually slow ageing?
The preclinical evidence is strong: NAD+ restoration has been shown to reverse markers of biological ageing in animal models, particularly through sirtuin activation, DNA repair support, and mitochondrial function improvement. Human data is still building, but the biological rationale is robust. What we can say honestly is that NAD+ targets several of the recognised hallmarks of ageing at the cellular level. Whether that translates to measurable lifespan extension in humans is a question the research hasn't definitively answered yet - but the direction is promising.
What age should I start NAD+ therapy for anti-ageing benefits?
NAD+ levels begin declining in your 30s, with the steepest drops occurring between 40 and 60. Most of my clients are in the 35–55 range, though I've worked with people in their late 20s (typically high-performing athletes or professionals) and their 70s. There's no single "right" age - it depends on your health goals, baseline levels, and how your body is responding to the ageing process. The consultation is where we work that out together.
Is NAD+ therapy better than NMN or NR supplements for anti-ageing?
NMN and NR are NAD+ precursors - your body has to convert them into NAD+ through enzymatic steps, and a portion is lost in digestion along the way. Direct NAD+ via injection pen bypasses that conversion entirely, delivering the molecule your cells actually use. The research supports all three approaches, but bioavailability favours direct NAD+ for those who want the most efficient delivery. I compare these in detail in my NAD+ guide.
Can I combine NAD+ with other anti-ageing treatments?
Yes, in most cases. NAD+ works at the cellular and metabolic level, so it complements rather than competes with topical treatments (like retinoids), lifestyle interventions (exercise, sleep optimisation), and other evidence-based approaches. I screen for interactions with medications and other supplements during your consultation. The goal is always a coherent strategy, not a pile of uncoordinated interventions.
How long before I see anti-ageing benefits from NAD+?
The energy and cognitive improvements typically show up within one to two weeks. The deeper cellular benefits - DNA repair support, inflammatory modulation, mitochondrial function - are cumulative and build over time. This is a long game, not a quick fix. Most of my clients who are specifically interested in longevity benefits commit to ongoing monthly courses.
The Bottom Line
NAD+ is not a fountain of youth. If you came here hoping I'd tell you that a monthly injection pen will make you look and feel 25 again, I'm sorry to disappoint. That product doesn't exist - and anyone selling it is selling you a fairy tale.
What NAD+ is - based on the current evidence - is one of the most scientifically credible tools we have for supporting the cellular machinery that determines how well you age. The sirtuin research is real. The DNA repair data is real. The mitochondrial function improvements are real. And the early human studies are pointing in the right direction.
The honest position is this: we know NAD+ declines with age. We know that decline correlates with - and likely contributes to - the hallmarks of biological ageing. We know that restoring NAD+ levels reverses some of those markers in preclinical models. And we know that human supplementation is safe, well-tolerated, and associated with meaningful improvements in energy, cognition, and metabolic function.
Is it proven to extend your lifespan? Not yet. Is it the most evidence-backed molecule in the anti-ageing conversation right now? I'd argue yes - by a comfortable margin.
What I offer through IVgo is NAD+ therapy delivered properly: with medical screening, clinical oversight, a delivery method that actually gets the molecule where it needs to go, and a nurse who'll give you a straight answer when you ask whether it's right for you.
Ageing well isn't about chasing miracles. It's about making informed decisions with the best available evidence. And right now, NAD+ is one of those decisions worth having a real conversation about.
Ready to have that conversation?
Call or WhatsApp 074 604 5555 | Visit ivgo.co.za | Instagram: @ivgo_cape_town
Chloé Nefdt is a SANC-registered Professional Nurse and the founder of IVgo, Cape Town's mobile IV therapy, NAD+ and peptide service. She operates across greater Cape Town and is available 7 days a week.
References:
- Gomes, A.P., et al. (2013). Declining NAD+ induces a pseudohypoxic state disrupting nuclear-mitochondrial communication during aging. Cell, 155(7), 1624–1638.
- Zhang, H., et al. (2016). NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science, 352(6292), 1436–1443.
- Rajman, L., Chwalek, K., & Sinclair, D.A. (2018). Therapeutic potential of NAD-boosting molecules: the in vivo evidence. Cell Metabolism, 27(3), 529–547.
- Imai, S., & Guarente, L. (2014). NAD+ and sirtuins in aging and disease. Trends in Cell Biology, 24(8), 464–471.
- Yoshino, J., Baur, J.A., & Imai, S. (2018). NAD+ intermediates: the biology and therapeutic potential of NMN and NR. Cell Metabolism, 27(3), 513–528.
- Martens, C.R., et al. (2018). Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications, 9(1), 1286.
- Yoshino, M., et al. (2021). Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science, 372(6547), 1224–1229.
- Bolke, L., et al. (2019). A collagen supplement improves skin hydration, elasticity, roughness, and density. Nutrients, 11(10), 2494.
- Semba, R.D., et al. (2014). Resveratrol levels and all-cause mortality in older community-dwelling adults. JAMA Internal Medicine, 174(7), 1077–1084.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. NAD+ therapy is not a registered medicine in South Africa. The anti-ageing claims discussed in this article are based on preclinical and early clinical research - they have not been evaluated or approved by SAHPRA or any regulatory body. Always consult a qualified healthcare professional before starting any new treatment. Individual results vary.