Is Nicotinamide adenine dinucleotide (NAD) supplementation safe during pregnancy?

Safety of NAD Supplementation During Pregnancy

There is insufficient evidence to support the safety of NAD supplementation during pregnancy, and it should be avoided unless specifically recommended by a healthcare provider for a diagnosed deficiency.

Current Evidence on NAD in Pregnancy

The safety and efficacy of Nicotinamide adenine dinucleotide (NAD) supplementation during pregnancy has not been adequately studied in humans. While NAD is a critical coenzyme involved in numerous cellular reactions and metabolic processes, there are no clinical guidelines specifically addressing its supplementation during pregnancy.

What We Know About NAD

• NAD is synthesized from tryptophan or vitamin B3 (niacin/nicotinamide) and is involved in over 400 enzymatic reactions in the body 1
• NAD deficiency during pregnancy has been associated with congenital NAD deficiency disorder (CNDD) in animal models, characterized by multiple congenital malformations and/or miscarriage 2
• Genetic mutations affecting NAD synthesis pathways can lead to adverse pregnancy outcomes in mouse models 3

Safety Concerns

Several important safety considerations exist:

1. Lack of human studies: There are no clinical trials evaluating NAD supplementation safety specifically during pregnancy
2. Unknown optimal dosing: Without pregnancy-specific guidelines, appropriate dosing remains unclear
3. Potential metabolic effects: NAD influences numerous metabolic pathways that could affect fetal development

Recommendations for Specific Situations

For Women with Suspected NAD Deficiency

• Dietary sources of NAD precursors (niacin/vitamin B3) should be prioritized first
• The European Food Safety Authority has established an upper limit (UL) for nicotinic acid at 10 mg/day and for nicotinamide at 900 mg/day for adults 1
• If supplementation is deemed necessary, nicotinamide (a form of vitamin B3) may be safer than nicotinic acid during pregnancy, as it doesn't cause flushing effects that could potentially affect maternal blood pressure 1

For Women Taking NAD for General Health

• Discontinue NAD supplementation during pregnancy unless specifically prescribed
• Focus on obtaining adequate vitamin B3 through diet (meat, poultry, fish, nuts, legumes)
• Consider standard prenatal vitamins that contain appropriate amounts of B vitamins

Potential Benefits Being Studied

Some emerging research suggests potential benefits of niacin/vitamin B3 supplementation:

• Animal studies have shown that nicotinamide supplementation may help alleviate preeclampsia symptoms and improve fetal growth in mouse models 4
• Maternal nicotinamide riboside (NR, another NAD precursor) supplementation during lactation has shown benefits for postpartum weight loss and offspring development in animal models 5

Important Considerations

• Prioritize established supplements: Focus on supplements with established safety profiles during pregnancy, such as standard prenatal vitamins
• Consult healthcare providers: Any supplementation beyond standard prenatal vitamins should be discussed with healthcare providers
• Monitor for side effects: If NAD supplementation is deemed necessary, careful monitoring for adverse effects is essential

Conclusion

Until more human research is available, NAD supplementation during pregnancy should be approached with caution. Women should focus on obtaining nutrients through a balanced diet and standard prenatal vitamins unless specifically advised otherwise by their healthcare provider.