NAD
Additional Information
What is NAD+ Therapy and how can it benefit me?
Nicotinamide adenine dinucleotide (NAD) is a coenzyme found in all living cells. It plays a crucial role in cellular energy metabolism and redox reactions, acting as a key molecule in processes such as:
- Energy Production: NAD is essential for converting food into ATP, the body’s main energy currency, via glycolysis, the citric acid cycle, and oxidative phosphorylation.
- DNA Repair: NAD is a cofactor for enzymes like PARPs (poly ADP-ribose polymerases), which repair damaged DNA.
- Gene Expression and Longevity: It regulates sirtuins, a group of proteins linked to aging, metabolism, and stress resistance.
- Neuroprotection and Brain Function: NAD is vital for neuron survival and cognitive function, helping to prevent neurodegenerative diseases.
- Immune System Modulation: It influences inflammatory pathways and mitochondrial function in immune cells.
Why might NAD+ supplements be needed/recommended?
NAD+ levels decline with age, leading to decreased mitochondrial function, increased oxidative stress, and a higher risk of age-related diseases. NAD+ is in essence a form of Vitamin B3 and naturally not in the normal food-chain of humans and hence not easy to supplement. Hence NAD+ is regarded as a dietary or food supplement, like other vitamins and classified as a Food Supplement for Health and Wellbeing, and therefore not a prescription drug.Â
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However, like any other vitamin or food supplement, this should be used with care and ideally under supervision of your Health Care Provider, as like all other supplements, NAD+ might have side effects, especially when used incorrectly.
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Supplementation may be recommended for:
- Anti-aging and longevity support: Boosts mitochondrial function and reduces cellular aging.
- Cognitive health and neuroprotection: Supports brain function and may help with neurodegenerative diseases like Alzheimer’s and Parkinson’s. There are significant evidence that links declining NAD+ levels with Neurodegenerative diseases including Alzheimer’s, Parkinson’s, Dementia and accelerated Cognitive decline.
- Metabolic and cardiovascular health: Improves insulin sensitivity, reduces inflammation, and supports heart health. A large amount of studies are conducted linking abnormal levels of NAD+ with Diabetes, Obesity and other metabolic disorders.
- Energy and athletic performance: Enhances endurance and muscle recovery by optimizing ATP production.
- DNA repair and cellular health: Assists in the repair of oxidative damage and reduces cellular stress.
- POST-COVID or Post-Viral Chronic Fatigue Syndrome: Covid-19 and similar viruses are known to target the Mitochondria and disrupt mitochondria and energy function within the cell. Significant studies highlighted the use of NAD+ in the treatment of Long-Covid and similar diseases.
How does NAD supplements work?
NAD supplements work by increasing intracellular NAD+ levels, which enhances metabolic processes and cellular repair mechanisms. They do so through various precursors:
- Nicotinamide Riboside (NR): A highly bioavailable precursor that converts efficiently into NAD+.
- Nicotinamide Mononucleotide (NMN): Another potent precursor that rapidly raises NAD+ levels.
- Nicotinamide (NAM) and Nicotinic Acid (NA): Older forms of vitamin B3 that also contribute to NAD+ biosynthesis.
- Direct NAD+ IV therapy: Bypasses digestion and enters cells directly but has limited bioavailability compared to precursors.
Well Nurse Clinic encourages clients to also supplement with oral precursors of NAD+ along with your NAD+ IV such as Nuchido which is sold in our clinic.
Can you explain the difference between oral and IV NAD supplements?
Oral NAD supplements:
- Typically come as NR, NMN, or NAD+ capsules or powders.
- Are convenient, cost-effective, and can be taken daily.
- Require conversion in the body to increase NAD+ levels gradually. In the Krebs’s or ATP cycle, NAD+ is converted to NADH and this complex system is critical for energy production in animals and humans. This is exactly why a trusted, researched and published NAD+ supplement should be selected. These options comes typically at a higher cost and the buyer should be vigilant selecting a product that actually converts correctly. It is not about taking NAD+ or NMN or any other form of NAD+. It is about making sure that the conversion is completed correctly to make the active ingredient Bioavailable for the tissues of the body.
- Absorption may be limited due to digestion and first-pass metabolism.
- NAD+ is an unstable molecule, and its oral bioavailability is limited due to several biochemical factors.
1. Instability of NAD+
NAD+ is highly unstable in the bloodstream because:
It is hydrolyzed rapidly by enzymes like CD38 and NADase, breaking it down into nicotinamide (NAM) and ADP-ribose.
It is not membrane-permeable, meaning it cannot efficiently cross cell membranes in its intact form.
2. Poor Oral Bioavailability
Oral NAD+ supplementation is often ineffective due to:
Gastrointestinal degradation: NAD+ is broken down into nicotinamide (NAM) and other metabolites before absorption.
Limited transport across cells: Even if absorbed, NAD+ itself does not readily enter cells; instead, it must be recycled intracellularly through salvage pathways.
Considering the above it is critical that a well-researched product with published NAD+ Bioavailability, should be selected.
IV NAD therapy:
- Delivers NAD+ directly into the bloodstream for immediate effects.
- Bypasses digestion, and particularly the liver, leading to higher bioavailability.
- Used for rapid benefits in fatigue, detox, neurological conditions, and anti-aging therapy.
- More expensive and requires administration by a healthcare professional.
- Some patients report side effects like flushing, nausea, or discomfort during infusion.
Both methods increase NAD+ levels, but IV therapy is more immediate, while oral supplementation is more sustainable for long-term use.
What research is there to support NAD as an anti-aging intervention?
Nicotinamide adenine dinucleotide (NAD+) has been extensively studied for its role in aging and longevity.
Numerous studies have demonstrated that NAD+ levels decrease with age, and the deterioration of NAD+ metabolism promotes several aging-associated diseases.
Additionally, research in model organisms, such as yeast, worms, and mice, has shown that boosting NAD+ levels can extend lifespan. These findings suggest that NAD+ metabolism plays important roles in aging and longevity.
NAD+ (Nicotinamide Adenine Dinucleotide) is a critical coenzyme involved in cellular metabolism and energy production. It plays a direct role in regulating sirtuins—a family of NAD+-dependent protein deacetylases that influence aging and longevity.
NAD+ and Sirtuin Activation:
The following facts are well researched and published.
- Sirtuins (SIRT1–SIRT7) require NAD+ to function. Higher NAD+ levels enhance sirtuin activity, leading to several beneficial effects on cellular health:
- Mitochondrial Function: SIRT1 and SIRT3 improve mitochondrial efficiency and reduce oxidative stress.
- DNA Repair: SIRT6 promotes DNA repair, maintaining genomic stability.
- Inflammation Reduction: SIRT1 suppresses pro-inflammatory pathways, reducing chronic low-grade inflammation linked to aging.
- Metabolic Regulation: Sirtuins enhance insulin sensitivity and improve lipid metabolism.
NAD+ Decline and Aging:
NAD+ levels naturally decrease with age, leading to reduced sirtuin activity. This decline contributes to mitochondrial dysfunction, increased DNA damage, and chronic inflammation—hallmarks of aging.
Longevity Implications: Published Evidence
Restoring NAD+ levels via precursors (e.g., NMN or NR) or lifestyle interventions (e.g., fasting, exercise) enhances sirtuin activity, improving metabolic health, delaying aging-related diseases, and potentially extending lifespan. Studies in model organisms show that boosting NAD+ and sirtuins mimics some effects of caloric restriction, a well-known longevity intervention.
In summary, NAD+ is essential for sirtuin function, and maintaining optimal NAD+ levels may promote longevity by preserving cellular function, reducing inflammation, and enhancing metabolic resilience.
Several peer-reviewed studies support NAD+ supplementation for mitochondrial
function, cellular repair, and longevity.
Is there anyone NAD supplements may not be suitable for?
While NAD+ supplementation is generally considered safe, there are some potential contraindications:
Cancer patients: NAD+ plays a role in cell growth and repair, so there is concern that it might promote tumor growth in certain cancers. However, on the contrary a number of publications confirmed the role of optimal NAD+ levels to improve and enhance innate Immune and anti-cancer cell response in studies. More research is needed before recommending it for individuals with active malignancies.
Pregnant or breastfeeding women: There is limited safety data, so caution is advised.
People with low blood pressure: NAD+ can enhance vasodilation, potentially lowering blood pressure too much.
Individuals on blood thinners: Since NAD+ affects blood vessel function, it may interact with anticoagulant medications.
Autoimmune conditions: There is some evidence that NAD+ modulates immune responses, which may not be ideal for individuals with autoimmune diseases like lupus or rheumatoid arthritis.
