NAD, one molecule you’ve never heard of, is integral to your thyroid health

NAD, one molecule you've never heard of, is integral to your thyroid health

My seven year old son loves to jump, climb, and run. As he leaped through the air full of energy the other night, I thought, “Now that’s a boy naturally full of NAD.”

Written by OB/GYN Alyssa Dweck, MS, MD, FACOG 

There’s a molecule in every single one of our living cells that’s also pretty hot in the world of anti-aging right now. It’s called NAD (nicotinamide adenine dinucleotide). Biochemists have known about the coenzyme since 1906, but it wasn’t until much more recently that scientists learned we can lose the molecule over time. Now it’s gaining renewed interest because of its role in aging and metabolic health. 

Cellular Metabolism & Thyroid Health

The connection between hypothyroidism, an underactive thyroid gland, and cellular energy isn’t one that’s talked about a whole lot. To help us understand the connection between hypothyroidism and cellular energy, let’s first consider what your thyroid gland does. The thyroid, which is at the base of the neck (just above the Adam’s apple in men), produces multiple thyroid hormones, which influence the body’s metabolic rate. This is integral to essentially every bodily function and influences one’s appetite, caloric burn rate and weight, energy and fatigue levels, heart rate, and sleep patterns to name a few!

More broadly, the thyroid gland regulates metabolism, and like most bodily functions, does so on a cellular level. Your metabolism revolves around cellular chemical reactions—everything from building up complex molecules like proteins and DNA to breaking down food molecules like fats and sugars. Cellular energy is vital to all. By breaking down complex molecules, cells can harness the energy they store to generate the energy they need to carry out virtually every cellular process.

When more thyroid hormone is released, metabolism increases. When less thyroid hormone is around, things slow down. Hypothyroidism occurs when the thyroid gland is underactive and less thyroid activity is seen. This has widespread effects on metabolism. In fact, women experience thyroid disease more commonly than men, and this is particularly common after women give birth and during menopause.

Many molecules are involved in cellular metabolism, but one stands out as central to this process. It’s that critical coenzyme, NAD.

NAD is Integral to Your Health

NAD is central to many metabolic processes. So much so that scientists even consider NAD to be a “master regulator” of cellular metabolism. Every living cell has NAD and uses it to carry out its day-to-day functions. 

It “burns” the food we eat. Our cells use NAD as fuel for all cellular functions involved in caloric intake, digestion, and energy expenditure. NAD literally fuels the cells to allow energy stored in food to be converted into other forms of usable energy. 

It helps produce your hormones (and your proteins, and your DNA). As a central regulator of cellular metabolism, NAD is involved in a multitude of chemical reactions in your body. For example, NAD is used to create steroid hormones, including the sex hormones estrogen and testosterone. It’s also involved in the metabolic processes that build important biological molecules like your genetic material. 

It keeps mitochondria healthy. You may remember from high-school biology class that mitochondria are the powerhouses of the cell. As such, they need NAD to do their job. Maintaining mitochondrial health is especially important for energy-hungry cells like skeletal muscle cells, neurons, and kidney cells to name a few. Declines in both mitochondrial function and NAD levels are associated with aging. This seems like a chicken-and-egg problem, but preclinical studies have shown that increasing NAD levels with supplements can improve mitochondrial function.

It helps maintain your internal body temperature. The same processes that generate cellular energy also generate heat to help maintain internal body temperature. A higher basal metabolic rate not only means more fuel is burned and energy generated, but more body heat generated, too. Some mitochondria, particularly in specialized tissues like brown fat, can go one step further and become heat-generating machines in times of need. Brown fat works to serve as a protective measure against hypothermia and low core body temperature, particularly in newborns.

It helps support muscle function. Preclinical studies in mice provide insight into the importance of NAD for maintaining muscle mass and function as we age. One study found that artificially lowering NAD levels in the muscles of young mice caused a progressive decline in muscle function. Increasing NAD levels with supplementation reversed many of these changes. Another study found that increasing NAD levels in older mice helped improve their muscle strength and endurance.

Levels of NAD In Your Cells Aren’t Constant

Our NAD levels can vary through our lifetimes. Metabolic stresses like overeating and excessive alcohol consumption can cause NAD levels to decline. Researchers have also observed that NAD declines with age.

How to Boost NAD

It is possible to generate NAD with the various forms of B3 vitamins found in our diets. That’s because the B3s—niacin, nicotinamide, and nicotinamide riboside—are precursors to NAD in our cells. NAD precursors are molecules that can be used to create more NAD in our cells.

The B3 vitamins niacin and nicotinamide are found in foods that range from fortified grains to meats to mushrooms and potatoes. And, one form of vitamin B3, nicotinamide riboside (NR), is found in trace amounts in cow’s milk. But, for those of us looking to replenish a shrinking supply of NAD, diet alone may not be enough.

Promising research surrounding B3 vitamins and other NAD precursors have exploded in the last few years. Nicotinamide Riboside NR (available now in a supplement), has been clinically proven to safely and effectively increase NAD in humans. Unlike niacin, NR does not cause flushing in high doses. And unlike nicotinamide, it does not appear to inhibit sirtuins, aka your longevity genes.

NR was first discovered as a NAD precursor in 2004 by Dr. Charles Brenner, a Stanford-educated PhD specializing in cancer biology. Seventeen human studies are currently in progress, on top of the four that have already been published.

Women strive to take a close look at their health,often by paying careful attention to diet and nutrition, thoughtful exercise regimens, and utilizing various aesthetic anti-aging efforts. Optimizing cellular health is quite possibly the secret sauce we have been hoping for, especially as we aim to address long-term health over time.

About Alyssa Dweck MS, MD, FACOG 

Dr. Dweck is a practicing gynecologist in Westchester County, New York and Assistant Clinical Professor in the Department of Obstetrics, Gynecology, and Reproductive Science at the Mount Sinai School of Medicine. As an author of three books, a Massachusetts General Hospital, Vincent Memorial OB/GYN Service consultant, and accomplished triathlete, Dr. Dweck offers her expertise across various platforms in an effort to destigmatize gynecologic issues and support women’s health across the country. She resides in Westchester County with her husband, their two sons, and their extraordinarily girly English bulldog.

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About Dana Trentini

Dana Trentini M.A., Ed.M., founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. This is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links including the Amazon Services LLC Associates Program.


  1. I love Hypothyroid Mom…and I have learned so much. I am considering taking NAD but am concerned about the possible implications on my thyroid function (which by the way is all but non existent). Any feedback out there? I didn’t see that question specifically answered and thought someone out there might have experienced it? Thanks!

  2. In May 2017 I was hit with Hashimoto’s after a very stressful event in my life. I believe the stress, poor gut health and family history played a role in triggering it. Anyway, the first few months I thought I was dying. I came across your site and others and in addition to taking NP Thyroid I changed my diet completely and started taking supplements and a couple of herbs. That worked very well for me. I lost weight, looked great but still didn’t feel great and that seemed to be an obstacle I couldn’t get around until I found out about NR. I’ve been taking NR for only 4 weeks now and in this past week I have felt better than I have in years. I just wanted to say thank you for all the advice and information you offer.

    • What is NR? I’ve been on meds for about a year and don’t feel good ever.

      • NR is short for nicotinamide riboside. It is said to boost NAD+ in the mitochondria and NAD+ keeps our cells alive and healthy, helps to repair damaged DNA and other benefits. Another NAD+ booster is called NMN or nicotinamide mononucleotide and while NR has helped me tremendously, I’ve read some very interesting articles and studies about NMN lately that make it sound like it may be better for me, so I’ll be trying that one next.

  3. Robin Moore says

    Thanks for the website. I’ve learned from this, not from my doctor. I understand this is not to replace a doctor’s advice. Well, my second doctor since being diagnosed told me me one thing about hypothyroidism, that i could lose my voice completely. This was the extent of it! Research and this website which contains doctor information has helped since i have bo insurance and my symptoms are gaining on me. I thought I was becoming a hypochondriact! The symtoms are numerous like diabetes. Thank you for educating us!!

  4. Monica Krainer says

    Is there a current, comprehensive list of doctors to help with the healing process? By region, state, or, hopefully, city?

    • That’s an excellent question as I’ve run the gambit of most in the NJ area with zero to sub zero help. I’ve been following Sara Gottfried on Instagram and she provides a wealth of self help information (no Dr recommendation to date), but helpful still. Keep the faith

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