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Importantly, supplementation can **increase** measurable NAD+ metabolism: in a 2018 randomized, placebo-controlled crossover trial published in Nature Communications by Martens and colleagues at the University of Colorado Boulder (24 healthy middle-aged and older adults), 1,000 mg/day of the NAD+ precursor nicotinamide riboside (500 mg, twice daily) elevated NAD+ in blood cells by roughly 60% versus placebo over 6 weeks, with no serious adverse events reported

Jackson AA, Persaud C, Hall M, Smith S, Evans N, Rutter N: Urinary excretion of 5-L-oxoproline (pyroglutamic acid) during early life in term and preterm infants

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