In 2013, David Sinclair, PhD, professor of genetics at Harvard Medical School, scored a big news splash when he took a group of old mice and restored the mitochondria in their muscles to a youthful state after injecting them with a molecule that boosted levels of nicotinamide adenine dinucleotide (NAD+). His findings sparked interest in NAD+ as a possible anti-aging molecule.

Lost in the hype was the fact that a handful of physicians had been working with NAD+ dating all the way back to the 1950s when Abram Hoffer, MD used mega-doses of niacin, a precursor of NAD+, to treat schizophrenics.

In 2001, after her daughter overcame drug addiction with an NAD+ therapy, Paula Norris-Mestayer MEd, LPC, FAPA opened a clinic to treat addicts using an intravenous NAD+ solution. Her husband, Richard Mestayer, MD, joined her and since then Springfield Wellness has treated close to 1300 patients.

From the earliest days of the clinic, Richard Mestayer noticed just how effective their treatment was. "After completing our protocol, we would refer our patients to a state-supported rehab center for outpatient follow-up. The director of that program sent us a letter saying that the patients we sent were six to nine months cognitively ahead of the patients who walked in off the street."

While the majority of Springfield Wellness patients are treated for chemical dependencies ranging from alcohol to heroin, the clinic has also helped patients suffering from PTSD, depression, chronic pain, Parkinson's, and Alzheimer's.

Addison Thompson, a retired New Orleans police officer, came to Springfield Wellness with Parkinson's. "11 years after my diagnosis with Parkinson's, I was taking a lot of medicines with little to no affect," he says. "I was unsteady on my feet. I had constant tremors causing me to have to eat with a spoon. I went to Springfield and they put me on an IV of 1000 milligrams of NAD+. Within an hour, I looked at my hands and realized I didn't have tremors any more.

"My tremors stopped almost immediately. I quit stumbling. I quit drooling at night. I feel wonderful. I'm almost 80 years old and I feel like I'm 60."

So what is NAD+ and what does it do?

NAD+, a molecule found in every cell of the body, is essential for life. It enables the conversion of the food we eat into the energy and chemical products the body needs. Researchers have recently found that NAD+ is also required as a substrate by enzymes that regulate the expression of genes involved in cell viability and in repair of damaged DNA. Through these reactions, NAD+ influences a variety of processes involved in cell health, including improving mitochondrial efficiency, enhancing cell viability, down-regulating inflammation, increasing the antioxidant capacity of cells and tissues, and activating the 'longevity' enzyme SIRT1.

Given the role NAD+ plays in such a wide range of critical functions, it is easy to understand why it might have a profound effect on health and aging.

With DNA damage linked to deteriorating health, NAD+'s function in DNA repair, through its relationship with poly(ADP-ribose) polymerase, is of vital importance. NAD+ also plays a part in the immune function. CD38, an enzyme that influences the ability of antigen presenting cells to stimulate antigen specific T-cells, uses NAD+ to do its work.

CD38 activity also influences behavior through the regulation of oxytocin production, an important hormone influencing social engagement, so it's possible that NAD+ might help with disorders like autism.

If NAD+ proves to have some sort of anti-aging function, its connection to the sirtuins could be significant. The sirtuins are a class of proteins that influence a wide range of cellular processes like aging, transcription, apoptosis, inflammation and stress resistance, as well as energy efficiency and alertness during low-calorie situations. SIRT1 activity is dependent on NAD+ availability.

With the understanding of NAD+'s significance in health along with the fact that NAD+ levels in the body decline with age, it is possible that increasing levels of NAD+ may have positive effects on longevity similar to what was seen in David Sinclair's mice.

With that in mind, a number of organizations are searching for ways to boost NAD+ levels, with several experimenting with NAD+ precursors like nicotinamide riboside. Oral supplementation with NAD+ itself does not appear to raise serum NAD+ levels because NAD+ is metabolized in the gut. IV infusion seems to be the only effective way to increase NAD+ using this modality.

Richard Mestayer, who, as mentioned earlier, has been giving NAD+ IV therapy for years at Springfield Wellness, wants to research the full spectrum of NAD+ applications. "We just completed a Pharmacokinetic study where we measured changes in the metabolome in response to intravenous NAD+," he says. "We wanted to answer a number of questions. How much of the NAD+ changes to precursors and how much changes to NADH? How does it change? How long does it last?

"We're putting together a study to measure NAD+ and NADH levels in the brain before and after IV therapy using a sophisticated MRI. We want to find out if we can raise NAD+ levels in the brain.

"There is a lot we'd like to study in the future. We want to research the influence of NAD+ on reducing addictive cravings; to understand any effect it may have on neurodegenerative diseases. And because we have found intravenous NAD+ to raise nitric oxide levels, I'm curious about any potential effect on cardiovascular health.

"The problem is that we're a small clinic and research is expensive. Pharmaceutical companies will be motivated to find patentable drugs that can increase NAD+ levels, but because NAD+ itself can't be patented, they probably won't have much motivation to study it."

Nonetheless, there is growing interest in NAD+ as a potential anti-aging compound, and with each week an increase in evidence of its efficacy. In future years, NAD+ may become a key piece of a healthy regiment.