Redox biologyAug 21, 2026

Changes in blood NAD and glutathione levels in health, disease, aging, and with NAD-boosting treatment

Longevity & Aging Weekly Brief ↗PubMed ↗DOI ↗

Updated Aug 22, 2026

Abstract

A 4-6 fold increase in blood NAD⁺ was observed in healthy individuals following high-dose nicotinic acid treatment.

NAD⁺, NADH, NADP⁺, NADPH, GSH, and GSSG metabolites were quantitatively measured from a single whole-blood sample using a standardized enzymatic cycling assay.
In a healthy population aged 18-70 years, these metabolites displayed a normal distribution and did not change with aging.
A lower NAD⁺/NADH ratio is associated with specific diseases and may be affected by high-dose B3 vitamin treatments.
Distinct 'redox fingerprints' of NAD and glutathione forms may be present in various degenerative diseases, including cancers.
Redox profiling could serve as a potential marker for disease pathology and treatment response.

Simplified

Nicotinamide adenine dinucleotides (NAD⁺, NADH, NADP⁺ and NADPH) and glutathione (GSH and GSSG) metabolites are vital regulators of redox state, enzyme functions, and metabolic flux in hundreds of cellular metabolic reactions. NAD⁺/NADH ratio increases during fasting and has been associated with health outcomes in model systems. A low ratio occurs in specific diseases, treated with high-dose B3-vitamin forms, so-called NAD⁺-boosters. Still, neither healthy human values nor NAD⁺ booster-treated or disease-related levels of NAD(P)(H) or glutathione have been established in humans. Here, we report a standardized workflow of enzymatic cycling assays to quantitatively measure NAD⁺, NADH, NADP⁺, NADPH, GSH, and GSSG from a single whole-blood sample. In the blood of a healthy population aged 18-70 years, these metabolites follow a normal distribution and remain unchanged during aging. High-dose nicotinic acid, a B3 vitamin, resulted in 4-6-fold increase of blood NAD⁺ in healthy individuals, suggesting the need for personalized dosing and follow-up in treatment and drug trials. Our data also indicate disease-dependent "redox fingerprints" of NAD and glutathione forms in different degenerative diseases, including cancers. The evidence highlights the potential of redox profiling as an indicator of probable pathology and as a measure of treatment response.

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Changes in blood NAD and glutathione levels in health, disease, aging, and with NAD-boosting treatment

Abstract

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