NAD+ and Exercise: Does Boosting NAD+ Improve Athletic Performance?

Key Takeaways:

• Exercise supports the body's NAD+ machinery. Aerobic and resistance training increased skeletal-muscle NAMPT, the rate-limiting enzyme in NAD+ recycling, in younger and older adults. Resistance training also raised muscle NAD+.
• NAD+ precursors raise NAD+ levels in the body. In a randomized, placebo-controlled trial, NR with pterostilbene increased whole-blood NAD+ by an average of 40%. NR and NMN have also been shown to affect NAD+-related metabolism in muscle.
• Early human trials have shown promising functional results. NMN improved ventilatory-threshold measures in recreational runners, and NR improved walking performance in adults with peripheral artery disease.

Related Products:

Basis: contains NR and pterostilbene, which work together to support cellular aging and healthy DNA by increasing NAD+ levels and activating SIRT1.

Signal: contains NMN, honokiol, and viniferin. These ingredients work synergistically to support metabolic aging and mitochondrial function by increasing NAD+ and activating SIRT3.

NAD+ is essential to the cellular reactions that produce energy, and exercise itself supports the body’s ability to make and recycle it. NAD+ precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) can also raise NAD+ levels. But does more NAD+ translate into better athletic performance?

The short answer: Researchers have begun to study the question, but the evidence is still emerging. Human studies show that NAD+ precursors can raise NAD+ in blood and affect NAD+-related metabolites in muscle. Specific functional benefits have also appeared in two trials: NMN improved ventilatory-threshold measures in recreational runners, and NR improved walking performance in adults with peripheral artery disease.

Other studies have not found consistent gains in VO₂max, strength, power, or recovery. That is not necessarily a failure of NAD+ support: Basis was designed to support cellular health and healthy aging, not to act as a direct performance enhancer.

The more useful question is whether supporting NAD+ biology can complement exercise and help maintain the cellular processes on which performance depends. Here’s what researchers have studied so far and where supplementation may fit. 

Why NAD+ matters for exercise

NAD+, or nicotinamide adenine dinucleotide, is a coenzyme found in every cell in the body. It plays two fundamental roles that are relevant to exercise.

First, NAD+ helps convert the energy in food into ATP, the molecule cells use for energy. It accepts electrons during glycolysis and the citric acid cycle, becoming NADH. NADH then carries those electrons to the electron transport chain, where they contribute to ATP production and NAD+ is regenerated.

This cycle is essential during both aerobic and anaerobic exercise. Without enough available NAD+, glycolysis cannot continue efficiently. During sustained aerobic activity, NAD+ and NADH are also central to the mitochondrial processes that generate most of the ATP used by working muscles.

Second, NAD+ is consumed by enzymes involved in cellular maintenance and adaptation. These include sirtuins, which help regulate metabolism and mitochondrial function, and PARPs, which participate in DNA repair. In other words, NAD+ is involved not only in producing energy, but also in many of the cellular processes that help the body respond and adapt to stress.

Our guide to what NAD+ is and why it matters explores this biology in greater depth.

Exercise supports NAD+ metabolism

Exercise does more than increase the body’s demand for energy. Over time, it can strengthen the pathways involved in maintaining NAD+.

One of the most important components of this system is nicotinamide phosphoribosyltransferase, or NAMPT. NAMPT is the rate-limiting enzyme in the NAD+ salvage pathway the primary route by which cells recycle nicotinamide into new NAD+.

In a study of younger and older adults, skeletal-muscle NAMPT was inversely associated with age across 57 participants. Among the training cohorts, 12 weeks of exercise increased NAMPT in both age groups. Aerobic training increased it by 12% in younger adults and 28% in older adults, while resistance training increased it by 25% and 30%, respectively.

A separate 10-week resistance-training study in 16 middle-aged, overweight, previously untrained adults found increases in skeletal-muscle NAD+ and NADH concentrations, NAMPT protein levels, and global sirtuin activity. Participants also gained strength and experienced localized muscle growth.

These studies do not mean that exercise raises NAD+ in every tissue or under every condition. They do show that consistent aerobic and resistance training can support NAD+ salvage capacity the ability of cells to recycle nicotinamide into new NAD+ in skeletal muscle, including later in life.

NAD+, exercise, and aging

NAD+ metabolism changes with age, making the preservation of NAD+ an important focus of healthy-aging research. Studies have reported age-related declines in NAD+ or the enzymes involved in its production across several human tissues. A 2025 review in Nature Metabolism found that the strongest evidence remains tissue-specific and called for more targeted clinical research. Understanding where NAD+ declines and in which tissues can help researchers identify where restoring NAD+ is most likely to support healthy function and design trials around the outcomes that matter.

Skeletal muscle offers one important piece of the picture. In a cross-sectional study comparing younger adults with exercise-trained, normally active, and physically impaired older adults, NAD+ was lower in older muscle, with the lowest levels observed among physically impaired participants. Exercise-trained older adults had levels closer to those observed in younger participants.

“NAD+ abundance positively correlated with average number of steps per day and mitochondrial and muscle functioning. Our work suggests that a clear association exists between NAD+ and health status in human aging.”

—Georges E. Janssens and colleagues, Nature Aging

Because the study was observational, it cannot establish that higher NAD+ caused better muscle function or that exercise alone caused the differences in NAD+. It does, however, connect NAD+ abundance with physical activity and muscle health in humans.

It also raises a reasonable research question: If exercise supports NAD+ metabolism, could an NAD+ precursor provide additional support particularly as the body’s ability to maintain NAD+ changes with age? Human trials have begun to answer parts of that question. As with all clinical research, each study can answer only the questions it was designed to test, so its findings must be interpreted in light of the population, intervention, duration, and outcomes measured.

The premise behind NAD+ supplementation is restorative rather than super-physiological: countering an age-associated decline, not pushing NAD+ indefinitely higher. In a 2024 review of human trials, Elysium co-founder and chief scientist Leonard Guarente, Ph.D., and his coauthors described the goal this way:

“At an appropriate dose of compounds, this increase can roughly replenish the NAD+ lost due to aging without causing non-physiologically high NAD+ levels.”

—Leonard Guarente, David A. Sinclair, and Guido Kroemer, Cell Metabolism

The statement describes the rationale for supplementation, not evidence of an athletic-performance benefit. It also generalizes across human NR and NMN trials rather than establishing the optimal dose for every precursor, product, tissue, or individual.

Does boosting NAD+ improve athletic performance?

NAD+ precursors reliably raise NAD+ in blood

The clearest evidence concerns the biomarker itself. In one of Elysium’s randomized, double-blind, placebo-controlled clinical trials of Basis, the recommended daily dose of NR and pterostilbene increased whole-blood NAD+ by an average of 40% after 30 days and safely sustained that increase through the end of the study. Basis is also backed by more than 20 clinical trials of the product and its ingredients, including studies of liver health, muscle injury and repair, and age-related frailty.

This first human trial of Basis established an essential foundation for subsequent research: that the finished supplement could safely and sustainably raise NAD+ levels in humans. With that foundation in place, later trials could investigate whether sustained NAD+ support influences tissue-specific and functional outcomes, including those related to skeletal muscle, healthy aging, and physical performance.

NR can affect the NAD+ metabolome in muscle

In a study of 12 older men, participants took 1,000 milligrams of NR daily for 21 days. Researchers observed changes in the skeletal-muscle NAD+ metabolome as well as reductions in several circulating inflammatory cytokines. They did not find improvements in mitochondrial respiration or other measures of mitochondrial bioenergetics during the short study.

The finding helps bridge an important gap: Oral NR can reach and alter NAD+-related metabolism in human muscle. Whether those biochemical changes produce functional benefits and under what conditions requires longer and larger studies designed around those outcomes.

NMN has shown an early aerobic-performance signal

One encouraging direct performance result comes from a six-week study of 48 recreational runners. Participants combined exercise training with different daily doses of NMN or placebo. The NMN groups improved oxygen uptake and power at the first and second ventilatory thresholds, with the researchers attributing the change to enhanced skeletal-muscle oxygen utilization.

“NMN increases the aerobic capacity of humans during exercise training, and the improvement is likely the result of enhanced O2 utilization of the skeletal muscle.”

—Bing Liao and colleagues, Journal of the International Society of Sports Nutrition

VO₂max and measures of cardiac function did not improve. That makes the result narrower than a general claim that NMN “boosts aerobic capacity,” but still potentially meaningful: Ventilatory thresholds help describe how much work an athlete can sustain before fatigue rises sharply.

The study offers a promising signal, not a final answer. It was small, conducted at a single site, and included only 12 participants in each group. The result needs to be replicated in larger and more diverse populations.

NR improved walking performance in people with peripheral artery disease

In a six-month randomized, double-blind trial of 90 adults with peripheral artery disease, participants taking 1,000 milligrams of NR daily improved their six-minute walk distance by 17.6 meters compared with placebo, meeting the study’s prespecified statistical criterion. NR also improved peak treadmill walking time by 2.1 minutes at six months. In a post-hoc analysis limited to participants who took at least 75% of their assigned pills, NR improved six-minute walk distance by 31 meters compared with placebo.

This was not a study of athletes. Participants had peripheral artery disease, their average age was 71, and impaired circulation limited their walking ability. The findings therefore cannot be generalized to healthy or trained populations. Still, the trial is important because it demonstrated that NR can improve a functional measure of walking performance in a human population not only change NAD+-related biomarkers.

Results vary by population and outcome

Other trials have found biochemical changes without corresponding functional improvements. In a seven-day crossover study of eight healthy young men, 1,000 milligrams of NR daily affected NAD+-related metabolites in muscle but did not increase skeletal-muscle NAD+ concentration. It also did not change fuel utilization, mitochondrial respiration, or cellular signaling involved in adaptation to endurance exercise.

An Elysium-affiliated randomized trial in 32 adults ages 55 to 80 tested NR and pterostilbene following experimentally induced muscle injury. Supplementation increased whole-blood NAD+, but it did not improve muscle stem-cell recruitment, muscle regeneration, strength recovery, or other measured recovery outcomes.

Taken together, the positive and null findings show why population and endpoint matter. Raising NAD+ in blood is well established; whether that translates into a functional benefit may depend on health status, tissue, outcome, dose, and duration.

Human trials at a glance

What the evidence means for athletes

Taken together, the human research supports three conclusions:

1. Exercise supports NAD+ metabolism. Aerobic and resistance training can increase skeletal-muscle NAMPT, and resistance training has been shown to increase skeletal-muscle NAD+ in previously untrained middle-aged adults.

2. NAD+ precursors can raise NAD+ and affect NAD+-related metabolism. Basis is clinically proven to increase whole-blood NAD+ by an average of 40%, and studies of NR and NMN have detected changes in skeletal muscle.

3. Specific functional benefits have appeared in some populations, but not consistently. NMN improved ventilatory-threshold measures in recreational runners, while NR improved walking performance in adults with peripheral artery disease. Other trials have not found improvements in VO₂max, strength, power, or recovery, and the peripheral-artery-disease findings cannot be generalized to healthy athletes.

Age, baseline NAD+ status, metabolic health, training history, dose, and duration may all influence the response to supplementation. Researchers are still working to determine which populations and outcomes are most likely to benefit. At present, the evidence does not justify assuming that an older or less-trained person will experience a larger performance improvement or that a trained athlete has no room to benefit.

Ways to support NAD+ levels

Exercise

Consistent aerobic and resistance exercise is one established way to support NAD+ metabolism in skeletal muscle. It also produces adaptations that no supplement can replace, from improved cardiovascular fitness and insulin sensitivity to greater strength and muscle mass.

NAD+ supplementation should therefore be considered alongside exercise not as an exercise mimetic or substitute for training.

Diet and recovery

The body can make NAD+ from several dietary precursors, including forms of vitamin B3 such as niacin and nicotinamide, as well as the amino acid tryptophan. Fish, poultry, peanuts, mushrooms, and whole grains are among the foods that contribute these nutrients.

Sleep, adequate nutrition, and time between demanding sessions remain essential to performance and recovery. They also support the broader metabolic health in which NAD+ biology operates.

NAD+ precursor supplements

NR and NMN are among the most widely studied NAD+ precursors used in supplements. Both feed the pathways the body uses to make NAD+, although their metabolism and distribution across human tissues are still being investigated.

Basis combines NR with pterostilbene to support cellular energy, healthy DNA, and healthy aging. In a randomized, double-blind, placebo-controlled clinical trial, Basis increased whole-blood NAD+ by an average of 40% at the recommended dose. It is NSF Certified for Sport and independently tested for quality and purity.

Signal combines NMN with Elysium’s SIRT3 Activation Complex, a blend of honokiol and viniferin designed to support mitochondrial health and cellular metabolism. In a randomized, double-blind, placebo-controlled trial of healthy adults, participants taking 250 milligrams of NMN daily had 40% higher whole-blood NAD+ levels than those taking placebo after four weeks. Signal is also NSF Certified for Sport and independently tested for quality and purity.

The products are designed around different aspects of aging biology. Basis provides broad cellular-aging support through NR and pterostilbene. Signal is formulated specifically around mitochondrial and metabolic aging through NMN and SIRT3 support. They can be taken separately or together. Our guide to NR and NMN explains the differences in greater detail.

NAD+ support versus performance supplements

It is useful to distinguish a supplement that supports the cellular biology of healthy aging from one with established effects on a performance endpoint.

Creatine, for example, has a deep evidence base for supporting strength, power, and training adaptation. Creatine+ is Elysium’s advanced creatine system for longevity, strength, and cognition. NAD+ precursors operate at a different level: They support cellular energy metabolism and pathways involved in healthy aging, but they should not be presented as producing the same direct ergogenic effects as creatine.

These approaches are complementary rather than interchangeable. The right choice depends on whether your primary goal is direct performance support, long-term cellular health, mitochondrial support, or a combination of these priorities.

How to evaluate an NAD+ supplement

If you are considering NAD+ support as part of a training routine, look for:

• Human evidence. Has the finished formulation or at least the specific ingredient and dose been studied in people?

• An outcome you can identify. Does the claim describe an actual study endpoint, such as an increase in NAD+, rather than promising a vague feeling or an unsupported performance gain?

• Transparent dosing. Are the amounts of the active ingredients disclosed?

• Independent quality testing. Has the product been tested for identity, purity, and contaminants?

• Sport certification. For competitive athletes, certification such as NSF Certified for Sport provides additional assurance that the product has been tested for substances prohibited in sport.

Where NAD+ support fits in a training plan

NAD+ is essential to the biology that makes exercise possible, and exercise itself helps maintain the body’s NAD+ machinery. Supplementation can provide additional, measurable NAD+ support: Basis increased whole-blood NAD+ by an average of 40% at its recommended dose, and 250 milligrams of NMN increased blood NAD+ by 40% after 30 days in a separate human study.

Human trials have produced some positive functional results: NMN improved ventilatory-threshold measures in recreational runners, and NR improved walking performance in adults with peripheral artery disease.

Neither finding establishes a predictable athletic-performance benefit, and results in a clinical population cannot be generalized to healthy athletes. They do, however, justify continued research into how health status, training history, dose, duration, and the outcome being measured influence the response.

The most accurate way to think about NAD+ support is as one component of a long-term approach to cellular health. It works alongside training, nutrition, sleep, and established performance strategies not in place of them.