What are the optimal levels of Nicotinamide adenine dinucleotide (NAD+) for cellular rejuvenation and autoimmune disease reversal?

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Last updated: May 29, 2025View editorial policy

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From the Guidelines

To rejuvenate healthy cells, NAD+ supplementation of 250-500mg daily is recommended, typically through precursors like NMN or NR, as it plays a crucial role in energy production, DNA repair, and sirtuin activation, as evidenced by the importance of NAD in various bodily functions 1. When considering NAD+ supplementation for autoimmune reversal, it is essential to adopt a comprehensive approach that includes dietary changes, stress management, exercise, sleep quality, and vitamin D supplementation.

  • An anti-inflammatory diet that eliminates processed foods, gluten, and dairy can help reduce inflammation and promote immune system balance.
  • Stress management techniques like meditation and yoga can help mitigate the impact of stress on the immune system.
  • Regular moderate exercise, such as walking or cycling, can help reduce inflammation and improve overall health.
  • Quality sleep, aiming for 7-9 hours nightly, is crucial for immune system function and overall health.
  • Vitamin D supplementation, in the range of 2000-5000 IU daily, can help support immune system function and reduce inflammation. NAD+ supplementation should be started at a lower dose and gradually increased while monitoring for side effects like flushing or headaches, as advised in clinical practice. It is crucial to consult with a healthcare provider before beginning this regimen, especially if you have existing health conditions or take medications, to ensure safe and effective implementation. The importance of NAD in various bodily functions, including energy production and DNA repair, is highlighted in the espen micronutrient guideline 1, which supports the use of NAD+ supplementation for cellular health and longevity.

From the Research

Autoimmune Reversal and NAD+ Rejuvenation

  • There is no direct evidence in the provided studies regarding the amount of NAD+ required to rejuvenate healthy cells or its role in autoimmune reversal.
  • The studies primarily focus on the use of rituximab, a monoclonal antibody, in the treatment of autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and others 2, 3, 4, 5.
  • Rituximab has been shown to be effective in depleting B cells and re-establishing immune homeostasis and tolerance in various autoimmune diseases 3, 4.
  • However, the use of rituximab is not directly related to NAD+ rejuvenation, and its efficacy varies among different autoimmune diseases 3, 5.
  • Another study discusses the use of CAR T-cell therapy in autoimmune diseases, which has shown promise in targeting autoreactive B cells and inducing clinical and serological remission in refractory systemic lupus erythematosus and dermatomyositis 6.
  • Overall, there is no clear evidence to support the use of NAD+ for autoimmune reversal or cell rejuvenation in the provided studies.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Rituximab in autoimmune diseases.

Australian prescriber, 2016

Research

A review of the current use of rituximab in autoimmune diseases.

International immunopharmacology, 2009

Research

CAR T-cell therapy in autoimmune diseases.

Lancet (London, England), 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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