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Accumulating evidence shows that activation of Nrf2 upregulates key genes involved in redox homeostasis, including SLC7A11, glutathione synthetase, and glucose-6-phosphate dehydrogenase, thereby increasing the production of reduced cofactors such as NADPH, GSH, and CoQ10, which collectively enhance cellular antioxidant capacity and counteract disease-associated oxidative stress (277)

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Thus, direct NAD + administration may exhibit unique effects compared to NAD + precursors and modulators, warranting further investigation, especially given the rise of wellness and anti-aging clinics offering intravenous NAD + therapy, while clinical evidence is still scarce 119