CoQ10 vs. NAD+: What’s the Difference?

CoQ10, or coenzyme Q10, and NAD+, or nicotinamide adenine dinucleotide, have a lot in common. For one, they are naturally occurring within the body and play a role in your energy production. Also, it's typical to have an age-related drop in both as you rack up the birthdays.

And finally, there are supplements that support healthy levels of both CoQ10 and NAD+ so that you can stay on top of your game.

If you're in the market for an energy or healthy aging supplement, you may have already gone down the rabbit hole of comparing the product claims for both CoQ10 and NAD+ formulas and might need a little help sorting through the differences between each. Maybe you're wondering which one is going to give you more pep in your step, if you should take them together, or if one of these options is better suited to your own needs.

Sorting through all the various things you hear about CoQ10 and NAD+ can be quite the challenge! Let's talk about the similarities and differences between CoQ10 and NAD+, why they're both critical to powering you up, and how to decide which supplements will help you take charge of your health, your energy production, and your longevity goals.

What is CoQ10?

We'll begin with CoQ10 supplementation, which has reached the position of respected royalty in the world of nutrition. This coenzyme is present in every cell in your body, specifically in the cells' powerhouses, the mitochondria.

Without CoQ10, your mitochondria couldn't produce any energy. And if you're thinking, no problem, I'll just gulp a triple espresso instead—sorry. Your body needs energy to do everything it does, not just to put some extra pep in your step.

CoQ10 helps your body in so many ways. It helps keep your heart healthy, it supports your kidney function, it's important for healthy aging, it's one of your body's foremost antioxidants and a fearless fighter of free radicals, it keeps your energy levels humming, and it is even valuable for maintaining healthy blood pressure already in the normal range.

What are the best CoQ10 supplements?

As a nutritional supplement, CoQ10 comes in two forms in the United States: ubiquinone and ubiquinol. The difference between these ingredients comes down to biochemistry, but the ubiquinol form has been demonstrated to be better absorbed, while ubiquinone is the more commonly available form (and tends to be more affordable).

What is NAD+?

Like CoQ10, NAD+ is a central player in energy production in your mitochondria and is involved in protecting against oxidative stress. In addition, NAD+ plays a role in maintaining normal genes (protecting DNA and also RNA) and a healthy inflammatory response.

But it works in the body in a different way. While CoQ10 is a coenzyme, NAD+ is an essential molecule for your body that can be made from various forms of vitamin B3, usually the niacinamide/nicotinamide form (though it can also be made from the common niacin form of B3).

You need NAD+ for every system in your body to function properly. (Actually, you need it to function at all.) Lately, NAD+ has been receiving increasing attention among longevity enthusiasts for age-related matters, healthy aging, and for those seeking peak performance.

How do you increase NAD+?

If you're thinking there's a "but" in there somewhere, this is it: you can't find a bottle of NAD+ on the shelf. To boost your NAD+, you're going to have to take advantage of its precursors, which are the different forms of vitamin B3. The most efficient way to make NAD+ is to start with a supplement containing nicotinamide riboside, which has been demonstrated to support NAD+ levels in people (meaning, in good clinical studies).

You can certainly get plenty of niacin from your diet from foods like chicken, turkey, tuna, salmon, and enriched flour or rice to promote NAD+ synthesis, though your body doesn't necessarily make NAD+ from all of that. You can also take niacin as a supplement, though be warned that too much causes unpleasant flushing that is also very unpleasant. Niacinamide is also available, and doesn't cause flushing, but it's not the most direct source of NAD+.

Should you take CoQ10 or NAD+?

This question is a bit like asking "should I eat plenty of broccoli and salads, or should I make sure I get enough cold-water fish like halibut and cod three times a week?" You can't really compare them. You want your veggies and phytonutrients, but you also want healthy protein and omega-3 fatty acids. So it's not really an "or" question. (Let's leave aside that you can't actually take NAD+, you have to take NAD+ precursors.)

If you have to choose one or the other, and your main focus is heart health, supporting your kidneys, keeping already healthy blood pressure in a healthy range, and having a generally smart preventive approach to maintaining your cardiovascular system, you probably want to opt for CoQ10.

Of course, plenty of people opt for CoQ10 to keep their mitochondria humming generally, and for an excellent intracellular antioxidant, and because they want to optimize their energy production.
If your main focus is getting on the healthy-aging train, and helping to ensure healthy DNA, you ought to consider nicotinamide riboside. As a bonus, you'll also be helping your body's energy metabolism and supporting your antioxidant defenses.

Though really, you don't have to choose one or the other. Both CoQ10 and NAD+ precursors are optimal health superchargers!

Can you take NAD+ with CoQ10?

Glad you asked! The answer is yes, absolutely. They play different and complementary roles as antioxidants in protecting against free radicals and oxidative stress, in producing cellular energy, and in ensuring optimal nutrition. Look for nicotinamide riboside to optimize your NAD+, and consider the ubiquinol form of coenzyme Q10 for greater absorption.

What are the benefits of taking CoQ10 with NAD+?

From a strict scientific point of view, this is a very difficult question to answer, because they haven't been studied as a combination. However, we know the benefits of coenzyme Q10, and we know the critical role of NAD+ in the body.

Based on that, we can feel confident that both have different but complementary benefits for a wide range of essential body functions: energy metabolism, heart health, antioxidant activity, protecting DNA, responding to immune challenges, and much, much more.

Also, both supplements are very safe at recommended dosages and are unlikely to cause problems. Of course, if you have a health condition or are taking medications, or plan to try to use any nutrient to address a health goal, check with your health care practitioner first.

What do NAD+ and CoQ10 have in common?

NAD+ and CoQ10 have their differences, but there's a reason both are "hot" nutrients, particularly when it comes to maximizing energy. We're going to dive into a bit of technical information here, because it's necessary to explain why both NAD+ and CoQ10 have reputations for promoting energy levels.

NAD actually exists in two forms: NAD+ and NADH. NAD+ is in what is known as an oxidized state, which is a way of saying that it can accept electrons, which carry a whole bundle of energy. NADH exists in what is known as a reduced state, meaning it has an electron it can give up. (Cue jokes about NADH being a giver and NAD+ being a taker!) When NAD+ accepts electrons, it becomes NADH. And then NADH delivers those electrons into the mitochondria's energy generation pathways.

The mitochondria use all of this energy to make ATP (adenosine triphosphate). ATP is one of the basic energy storage molecules in the body. This electron shuttle between the two NAD forms, and other molecules, is one of the most important ways the body makes its energy. You can think of it like an energy production assembly line inside your mitochondria.

Interestingly, CoQ10 in involved in this exact same energy pathway in your mitochondria. And its role is similar: CoQ10 is necessary at a different point in the production line (production cycle is actually a better description of it) for transporting high-energy electrons and making ATP.

Like NAD+ and NADH, CoQ10 exists in two forms, one of them oxidized (an electron taker) and one reduced (a friendly, generous electron giver). For CoQ10, ubiquinone is the oxidized form and ubiquinol is the reduced one. This electrochemical difference serves the same purpose as we just described for NAD+: it allows CoQ10 to carry and shuttle electrons that feed into the mitochondria's energy production cycle.

For taking CoQ10, the ubiquinone form is more readily available, while ubiquinol has the reputation of being more easily absorbed into your bloodstream.

What else to boost your energy?

You can complement a nutrition regimen that includes nicotinamide riboside and coenzyme Q10 with a number of different lifestyle tweaks to optimize your energy levels.

• Listen to your body. Although sometimes you have to power through fatigue, it also helps to be gentle with yourself.
• Rest and sleep are non-negotiable. Yes, our modern world tells us we need to go-go-go constantly. But that's a recipe for crashing later. Get seven to nine hours of sleep every night, and sleep in as dark a room as possible. Use natural sleep support options if you need help with sleep.
• Exercise, or be physically active. This is also non-negotiable. Your body needs to move to be healthy. If you're mostly sedentary now, remember that small steps matter. Start with a walk around the block every day. Next week, walk around the block two times. If you have access to a park or outdoor trails to move your body in the fresh air, so much the better. Getting started is sometimes half the battle. For some people classes work best, and they don't have to be full-throttle aerobics: yoga and Pilates are excellent and can be low-key.
• Another non-negotiable? Yep, a healthy diet is essential to fuel your body and maximize your energy. It's not rocket science that hitting the donuts and chips on the regular will sap your energy levels, while adding in more plant foods and healthy proteins is a great way to stay on your game.
• Consider including the full complement of vitamins and minerals in your nutrition regimen. Covering all the basics helps ensure you're getting everything you need for your body and mind to operate at peak efficiency.
• Manage stress. Easier said than done, right? We may not be able to control all the external stressors, like job and family demands and interpersonal dynamics. All the factors in the list above can help with stress, but so can trying to learn to not mentally "beat ourselves up." Our minds can be pretty exhausting!

References

• Barcelos IP, Haas RH. "CoQ10 and Aging." Biology (Basel). May 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627360/
• Pallotti F, et al. "The Roles of Coenzyme Q in Disease: Direct and Indirect Involvement in Cellular Functions." Int J Mol Sci. December 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745647/
• Xie N, et al. "NAD+ metabolism: pathophysiologic mechanisms and therapeutic potential." Signal Transduction and Targeted Therapy. October 2020. https://www.nature.com/articles/s41392-020-00311-7
• "Coenzyme Q10." Linus Pauling Institute. May 2018. https://lpi.oregonstate.edu/mic/dietary-factors/coenzyme-Q10
• "Niacin." Linus Pauling Institute. August 2018. https://lpi.oregonstate.edu/mic/vitamins/niacin