What is the recommended use of Nicotinamide adenine dinucleotide (NAD) supplementation in medical treatment?

From the Guidelines

NAD supplementation is recommended for patients with chronic oxidative stress or malabsorption at a dose of 200-500 mg/day, as supported by a strong consensus of 92% in the espen micronutrient guideline 1. When considering the use of Nicotinamide adenine dinucleotide (NAD) supplementation in medical treatment, it's essential to prioritize the most recent and highest quality evidence. The espen micronutrient guideline, published in 2022, provides a clear recommendation for NAD supplementation in specific patient populations 1.

Key Points to Consider

• Patients with chronic oxidative stress, including those with diabetes mellitus, smoking, heart failure, alcoholism, severe COPD, and chronic dialysis, may benefit from NAD supplementation.
• A dose of 200-500 mg/day is recommended for these patients, based on a strong consensus of 92% in the espen micronutrient guideline 1.
• The evidence supporting NAD supplementation for other conditions, such as mitochondrial disorders, neurodegenerative diseases, and metabolic syndromes, is limited and requires further validation through larger, well-designed clinical trials.
• Common precursors used to boost NAD+ levels include nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), but optimal dosing remains unclear.

Potential Benefits and Risks

• NAD+ plays crucial roles in cellular metabolism, energy production, and DNA repair, and its decline with aging may contribute to various diseases.
• However, the long-term safety and efficacy of NAD supplementation have not been fully established, and potential interactions with medications or effects on conditions like cancer need to be considered.
• A study published in 2018 highlights the importance of maintaining cellular NAD+ concentrations to prevent SIRT2-mediated apoptosis and suggests that supraphysiological doses of vitamin B3 may be beneficial in preventing age-related sarcopenia 1.

Clinical Implications

• Patients interested in NAD supplementation should consult healthcare providers to discuss the potential benefits and risks and determine the best course of treatment.
• Healthcare providers should be aware of the latest evidence and guidelines, such as the espen micronutrient guideline, to make informed decisions about NAD supplementation for their patients.

From the FDA Drug Label

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL NDC: 63776-880-15Item: VN0280 Viatrexx Bio Incorporated Viatrexx-NAD + Box of 1 X 10 mL vial For Oral Use Expiry date: Lot #: Manufactured for: Viatrexx Bio Incorporated Newark, DE, USA, 19713 www.Viatrexx.com Ingredients, homeopathic See insert or www.viatrexx.com

The FDA drug label does not answer the question.

From the Research

NAD Supplementation in Medical Treatment

• NAD (Nicotinamide adenine dinucleotide) supplementation has been studied for its potential benefits in various medical conditions, including chronic fatigue syndrome, addiction, and cognitive decline 2, 3, 4.
• A study published in 2010 found that oral NADH supplementation was associated with a decrease in anxiety and maximum heart rate in patients with chronic fatigue syndrome, but did not modify other clinical variables or global functional performance 2.
• Research has also implicated NAD+ in the neurobiology of addiction, suggesting that raising intracellular NAD+ levels may be a potential target for managing and treating addictive behavior 3.
• Additionally, NAD+ precursor supplementation has been identified as a promising treatment strategy for preventing cognitive decline in conditions such as age-related cognitive decline, Alzheimer's disease, and vascular dementia 4.

Administration and Guidelines

• There is limited information available on the recommended use of NAD supplementation in medical treatment, and further research is needed to provide definitive answers regarding its impact on human health 4.
• The Infusion Nurses Society provides updates on infusion therapy standards of practice, which may include guidelines for NAD supplementation, but these guidelines are subject to change and may not be directly applicable to all patients 5.
• When interpreting and using clinical practice guidelines or recommendations, clinicians must consider the trustworthiness of the development process, the extent to which the recommendations are applicable to their patients, and the potential for conflicts of interest 6.