From the Guidelines
NAD injection, or Nicotinamide Adenine Dinucleotide injection, is a treatment where NAD+ is administered intravenously or through injection to potentially replenish declining NAD+ levels with age, supporting mitochondrial function and cellular energy production. NAD+ is a coenzyme found naturally in all cells that plays a crucial role in cellular metabolism and energy production. These injections are typically offered at specialized clinics and wellness centers, with proponents claiming benefits such as increased energy, improved cognitive function, anti-aging effects, and assistance with addiction recovery.
Key Points
- The typical protocol involves IV infusions lasting 1-4 hours, with dosages ranging from 500-1500mg per session, as seen in studies such as 1.
- Treatment schedules vary from single sessions to multiple infusions over several days or weeks.
- While NAD+ is essential for cellular function, scientific evidence supporting these injections for health enhancement remains limited, with some studies suggesting potential benefits, such as 1.
- The treatment works by potentially replenishing NAD+ levels, which naturally decline with age, thereby supporting mitochondrial function and cellular energy production.
- Side effects may include flushing, nausea, headache, and discomfort at the injection site.
Mechanism of Action
- NAD+ is a cofactor for poly (ADP-ribose) polymerases (PARP), which carry out DNA base excision repair processes and/or mediate cell death in response to oxidative damage, ischaemia and excitotoxicity, as noted in 1.
- Maintenance of cellular NAD+ seems warranted, given its role in energy metabolism and the potential consequences of low NAD+ levels, including mitochondrial dysfunction and cellular energy crisis.
Clinical Considerations
- Symptoms associated with vitamin B3 deficiency, which can lead to low NAD+ levels, include neuromuscular deficits such as muscle weakness and wasting, gait and truncal ataxia, peripheral neuritis, limb areflexia and myoclonus, as described in 1.
- Potential mechanisms for neuromuscular damage can be discerned from experimental depletion of cellular NAD+, which induces oxidative damage and mitochondrial instability, as seen in 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Definition and Function of NAD
- NAD (Nicotinamide adenine dinucleotide) is an essential pyridine nucleotide cofactor present in cells, involved in various biological processes such as oxidative phosphorylation, DNA repair, and gene expression 2, 3, 4.
- NAD+ levels have been reported to decline during aging and age-related diseases, making it a potential therapeutic target for age-associated degenerative diseases 4.
NAD Injection and Supplementation
- Studies have investigated the efficacy of NADH supplementation in patients with chronic fatigue syndrome (CFS), with results showing a decrease in anxiety conditions and maximum heart rate after a stress test 2, 3.
- NADH supplementation has also been associated with an increase in general quality of life and improvement in health parameters, such as a decrease in inflammatory cytokines and improvement in sleep quality 3, 5.
- However, the use of NAD+ precursors, such as NAM, NR, and NMN, has also been shown to have a favorable outcome on several age-related disorders, with a limited acute toxicity profile 4.
Therapeutic Potential of NAD
- NAD+ treatment has been shown to alleviate symptoms of experimental autoimmune encephalomyelitis (EAE) by activating autophagy and inhibiting the NLRP3 inflammasome 6.
- The therapeutic potential of NAD+ administration has also been investigated in other diseases, such as multiple sclerosis (MS), with results indicating that regulation of autophagy by NAD+ treatment may be an effective therapeutic strategy 6.
- Further studies are needed to recapitulate the preclinical benefits in human clinical trials and to explore the underlying pathomechanisms of NAD+ administration in various diseases 3, 5, 4.