NAD vs NAD+ vs NADH - What’s the Difference?

NAD (nicotinamide adenine dinucleotide) is a collective term for all the different forms NAD takes throughout the various chemical processes it takes in our body. However, you might find several supplement options that list NAD+ or NADH as the active ingredient. Is this different from NAD without the “+” symbol or “H” at the end?

Yes and No. Whenever someone uses the acronym NAD, what they are really encompassing is a process and not just one definitive molecule. NAD is found as two different molecular structures: NAD+ and NADH.

The transformation of NAD+ to NADH.

NAD+ and NADH are really depicting the same molecule undergoing a transformation. To illustrate this process, it’s best to observe NAD’s role in the mitochondria. Our mitochondria work hard to produce the energy our cells need to properly function. Mitochondria function like electric generators, commonly known as “the powerhouse of the cell”. NAD is a key component in this energy-making process. 

NAD is first introduced in this energy cycle as NAD+. NAD+ is what you might call the “raw” form of NAD. It simply acts as a vehicle. Creating NAD+ is like manufacturing the body of a pick-up truck. It’s brand new and doesn’t have any cargo in the truck bed. However, it will soon use its cargo space to carry forth critical components to the enzymes of the cell, including mitochondrial enzymes. 

NADH is what you might call the “loaded” form of NAD. Using the pick-up truck metaphor, NADH is like a truck with cargo. In this form, NADH is carrying a charged hydrogen molecule with two electrons. NADH’s primary purpose is to bring these charged electrons to the mitochondrial enzymes needed for the energy-making process. 

Notice that NADH does not carry the “plus sign”. This is because the positively charged hydrogen molecule cancels the positively charged NAD+ molecule. 

Once NADH arrives at the enzymes, they drop off their positively charged electrons and expel the hydrogen atom, subsequently becoming NAD+ again. The rest is taken care of by the enzymes. 

After the drop-off, NAD+ is now an empty pick-up truck again and is able to leave to collect more positively charged electrons. 

So what do you call it?

As NAD transports these positively charged electrons to the enzymes, it constantly changes back and forth between the forms NAD+ and NADH. So NAD’s molecular structure is solely based on what leg of the journey it currently sits. 

Therefore, it’s not really accurate to say your body needs more NADH since NADH doesn’t exist until NAD+ undergoes its second leg of its journey. When you see supplements that call themselves an NADH booster, it doesn’t really make sense since your cells use the micronutrients in the supplement to build the raw form of NAD first: NAD+. 

The key question is what ratio of NAD+ does your body need compared to NADH. 

While the optimal NAD to NADH ratio remains elusive, research suggests that a generally higher NAD to NADH ratio is favorable. A low NAD to NADH ratio has been linked to mitochondrial dysfunction and accelerated aging. 

When it comes to a plain NAD label, it’s not wrong to be identified as a NAD booster. Generating more NAD+ will naturally generate more NADH. However, the specificity of NAD+ is more indicative of what your cells are truly building when using NAD+ boosting supplements like Tru Niagen®.