Everything You Need to Know About NAD+ and NAD+ Therapy

Forms of NAD+

Discovered in 1906 by William John Young and Sir Arthur Harden, nicotinamide adenine dinucleotide exists in two forms, oxidized NAD+ and reduced NADH. Although some differences exist, NAD+ and NADH  are two sides of the same coenzyme critical to many metabolic processes in the cell mitochondria.

The two NAD+ forms participate in a redox reaction, in which one form of NAD+ loses an electron (oxidation), and the other form obtains an electron (reduction). In this type of reaction, NADH transfers its obtained electron to the mitochondria, where it is used to produce ATP, the energy-carrying molecule in your cells. With one less electron, NADH is transformed back to NAD+, and the cycle begins again.

Reduces Genomic Instability

Genomic instability⁶ occurs when our DNA sustains damage and is unable to be repaired. It is proposed as one of the causes of accelerated aging and plays a key role in genetic mutations or cancer development.

NAD+ plays a vital role in decreasing the occurrence of genomic instability by aiding in damaged DNA repair and also fixing faults made during replication. This crucial role allows efficient transmission of genetic information  from one generation to the next via germline cells.

Inflammation and Immunity

Research⁷ has shown that NAD+ levels in the body are directly related to the intensity and duration of an immunological response to infection. During an infection, macrophages benefit from elevated levels of NAD+ because it enhances their ability to neutralize the invading pathogen.

Crucial in Energy Metabolism

Human cells need energy and if NAD+ levels are low, the body’s ability to make and use energy is hindered. The reactions(Glycolysis, Krebs cycle, oxidative phosphorylation, and fatty acid oxidation) by which the body produces and utilizes energy all depend on NAD+ and low amounts of this cofactor interferes with energy metabolism.

Gene Expression

Genetic expression refers to the process by which the instructions contained in the DNA of cells are translated into the proteins and other substances that the body needs. The successful expression of genes is achieved through NAD+-dependent modification of histone⁹. Since NAD+ is required for this reaction, low amounts of this cofactor may interfere with this process and, in turn, reduce the efficiency with which genes are expressed.

Cardiovascular Function

Due to its continual contraction and expansion, the heart is the body’s most metabolically active organ. Heart metabolic activity must be kept at a healthy state at all times, and studies have shown that appropriate levels of NAD+¹⁰ are crucial in maintaining healthy levels and healing after a severe heart disease.

Improves Renal Function

It is widely known that renal function declines with age, and diminishing NAD+ levels may have a part to play. Studies¹¹ have shown that supplementing with NAD+ can help reduce the risk of acute renal damage by triggering the production of prostaglandin E2. This prostaglandin E2 production aids in repair of kidney damage and improves renal function.

Crucial in Liver Function

Maintaining healthy levels of NAD+ in the body is crucial for the liver to do its job properly. Several studies suggest supplementing with NAD+ can improve liver function, protect it against toxic diseases, and speed up recovery after hepatic damage.

Important in the Circadian Rhythm

The circadian clock controls the sleep-wake cycle, called the biological clock or the circadian rhythm. The body’s internal clock facilitates adaptation to seasonal or diurnal changes. Studies¹² show that NAD+ levels in cells determine circadian clock precision and performance.

Also, according to studies, sleepiness during the day, insomnia at night, hormone disruptions, and mental state changes are some potential side effects of a deficit of NAD+. This study highlights how low NAD+ levels disturb the body’s natural circadian cycle.

Improves Neurological Function

Maintaining enough NAD+ levels is crucial for the health and survival of brain cells. This was reinforced by studies that showed that after a severe neurological event, NAD+ was important in regenerating the brain’s neurons.

NAD+ decreases the progression of neurodegenerative disorders by enhancing the body’s natural capacity to repair damaged cells. Also, If NAD+ levels are increased, it leads to the accumulation of proteins that help with cellular communication and improved cognitive function.

How do NAD+ Levels Drop in the Body

NAD+ is produced naturally by our bodies; however, the available levels vary depending on the individual’s state of health. There is mounting evidence linking low NAD+ levels to a wide range of illnesses and physiological stressors.

Natural occurring aetiological causes of decline in NAD+ include:

• Aging,
• Stress,
• Environmental factors

The following factors can also bring on NAD+ depletion:

Excessive Alcohol Intake

To metabolize alcohol intake, the body uses NAD+ to produce acetaldehyde, a toxic substance that triggers hangovers and alcohol-related malignancies. Therefore heavy drinking reduces NAD+ levels and has been linked to liver damage and other harmful consequences.

Impaired Circadian System

According to studies¹², oxidative stress is higher in people who sleep less than those who sleep longer at night. It is believed that suppressing melatonin through nighttime activities like staying up and working contributes to low levels of NAD+.

Effects of Low NAD+ Levels

A deficiency in NAD+¹⁴, or a disruption in NAD+ homeostasis in the body, may impair healthy physiologic processes, resulting in different illnesses or disease conditions. Low NAD+ levels can be linked with some health problems like

• Fatigue
• Hypoxia
• Weight gain
• Cardiovascular diseases
• Multiple sclerosis
• Oxidative stress
• Decreased brain function
• Sunburn and skin damage
• An accelerated rate of aging
• Dermatitis
• Dementia
• Diarrhea

Decreases Rapid Aging

Restoring and supplementing NAD+ in the body helps improve one’s looks, health, and quality of life by preserving DNA, which might otherwise deteriorate with age due to mechanical stress, faulty replication, or free radical damage.

Enhances Weight Control

When NAD+ levels are restored intravenously, they accelerate the conversion of food into energy, which is subsequently recycled to burn calories, resulting in measurable weight reduction. Also, increasing our resting metabolism through NAD+ is important for keeping fat stores low after a major weight reduction.

Keeping your NAD+ levels in check helps you avoid metabolic disorders contributing to weight gain and destroying your health.

Improves Cognitive Function

How exactly exogenous NAD+ supplementation improves cognitive function is still being researched; however, It has been established that NAD+ has a dual role in the brain, providing both neuroprotection and neurogenesis.  IV NAD+ treatment boosts cognitive abilities, including learning, remembering, focusing, and regenerating the brain, as well as general neurological health.

Alleviates Pain

Some people use intravenous NAD+ therapy to alleviate pain, a relatively innovative treatment. Since inflammation is often associated with pain, NAD+, which is known to exert considerable anti-inflammatory activities inside the body, may be utilized to alleviate at least part of the pain experienced by patients.

Improves Mood

When someone is worried or depressed, taking supplemental IV NAD+ therapy can help them create normal quantities of “feel good” neurochemicals in the brain. The brain uses NAD+ to generate mood-regulating neurotransmitters like serotonin, which can improve one’s disposition and reduce the impact of depressive and anxious feelings.

Enhances Athletic Performance

Athletes may benefit from IV NAD+ supplementation in energy, cognition, and response time during games and other sporting activities. In addition, research suggests that NAD+ supplementation can help build muscle and repair damaged muscle, resulting in muscular hypertrophy and muscle hyperplasia.

What NAD+ Treatment is Right for Me?

NAD+ is generally recommended for everyone and can provide great results.

If this is your first time receiving NAD+ or if you haven’t received a treatment in awhile the general recommended protocol is:

Initial treatments:

• 2,000 mg total broken up into 4 sessions of 500 mg each.
• Each session takes on average 2-3 hours for infusion.
• The first 4 sessions should be completed within 7-10 days.

Follow up treatments:

• Once the initial protocol is complete the frequency and dosage of your follow up infusions will depend on lifestyle factors and goals of treatment.
• The most common frequencies of treatment are once every other month, once a month and once a week.

Exceptions:

• Some may not tolerate infusions as well as others, or may need to follow a protocol at slower rate and frequency.
• Patients over the age of 65 may be required to receive approval from their primary care physician or specialty doctor, depending on medical history.

Recommendations and Tips for Infusions:

Prior to Infusion:

• Eating a light digestible meal. Eating too much or too little beforehand may increase uncomfortable symptoms during infusion.
• Avoiding alcohol consumption 24 hours prior to treatment is recommended for the best experience.

During the Infusion:

• Keeping legs elevated and choosing a comfortable spot will maximize comfortability. Make sure to chose a nice set up with pillows or a blanket.
• Although you may work during your infusion, we recommend doing something relaxing like watching your favorite TV show or reading.

Post Treatment Tips and Tricks

• Wait 1-2 hours after your infusion to workout since NAD+ is a vasodilator.
• You do not need to wait to eat a meal.
• It’s common for patients to have difficulty sleeping after infusions and sleep less hours. However they also report feeling more rested in spite of the sleep issues.
• For a better night’s sleep post infusion try the following:

–  No screens 2-3 hours before bed. Screens emit blue light which keeps you up.

– Take a Melatonin before bed. Melatonin is an over the counter sleep aid.

– Incorporate something relaxing into your bedtime routine such as taking a bath, drinking tea or reading book.

How Soon will I Start to Notice Benefits?

• Results may vary from immediately after your 1st infusion to after your 4th. Many notice the largest difference after their last infusion of their protocol.

Are There any Side Effects?

• Some experience no symptoms at all.
• Some experience symptoms like nasal congestion, headache, butterflies in the stomach, nausea, or a “weighted blanket” feeling.
• During infusion experiencing one or more of these symptoms is common, but our nurses are trained to make sure that it is given at a rate that alleviates these symptoms or resolves them completely.

Please contact us to speak to one of our Nurse Practitioners if you have any further questions.

 

References:

[1] NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752291/

[2] Cell Metabolism: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(12)00192-1

[3] NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053056

[4] Science Direct: https://www.sciencedirect.com/science/article/abs/pii/S1043661816311434

[5] Research Gate: https://www.researchgate.net/figure/NAD-is-synthesized-through-de-novo-Preiss-Handler-and-salvage-pathways-NAM_fig2_333027019

[6] Pubmed: https://pubmed.ncbi.nlm.nih.gov/31779194

[7] NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082456/

[8] Pubmed: https://pubmed.ncbi.nlm.nih.gov/33353981

[9] Pubmed: https://pubmed.ncbi.nlm.nih.gov/29309893/

[10] Pubmed: https://pubmed.ncbi.nlm.nih.gov/33485900

[11] Pubmed: https://pubmed.ncbi.nlm.nih.gov/33099633/

[12] Pubmed: https://pubmed.ncbi.nlm.nih.gov/32369735/

[13] NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5469033

[14] Pubmed: https://pubmed.ncbi.nlm.nih.gov/29295624/

[15] NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558103/