From the Guidelines
Nicotinamide adenine dinucleotide (NAD+) supplementation is beneficial for maintaining cellular energy metabolism, preventing mitochondrial dysfunction, and potentially reducing the risk of age-related diseases, but its use should be approached with caution due to potential side effects and contraindications.
Benefits of NAD+ Supplementation
- Maintaining cellular NAD+ levels can prevent mitochondrial dysfunction and cellular energy crisis, which may contribute to age-related diseases such as sarcopenia 1
- NAD+ supplementation may help prevent neuromuscular deficits, such as muscle weakness and wasting, associated with vitamin B3 deficiency 1
- NAD+ is essential for the function of over 400 enzymes, including those involved in energy metabolism, DNA repair, and antioxidant effects 2 ### Side Effects of NAD+ Supplementation
- High doses of nicotinic acid (≥30 mg/day) may cause flushing, hypotensive episodes, and other adverse effects 3
- Nicotinamide is generally considered safe at doses up to 900 mg/day, but high doses may cause adverse effects in some individuals 3 ### Contraindications of NAD+ Supplementation
- Niacin deficiency can be caused by inadequate oral intake, poor bioavailability from grains, defective tryptophan absorption, carcinoid tumors, metabolic disorders, and long-term use of chemotherapeutic treatments 4
- Certain populations, such as the elderly, pregnant women, and cancer patients, may be at risk of niacin deficiency and require careful consideration of NAD+ supplementation 4 ### Recommended Dosage and Measurement
- The recommended daily intake of niacin is 40 mg/day, and supplementation with nicotinic acid (15-20 mg/day) or nicotinamide (300 mg/day) may be effective in treating traditional pellagra 4
- Measurement of blood or tissue NAD levels may be recommended in cases of clinical symptoms, such as diarrhea, dermatitis, and dementia (Pellagra disease) 5
From the Research
Benefits of NAD+ Supplementation
- NAD+ supplementation may influence the aging process and associated metabolic sequelae by increasing NAD+ status 6
- NAD+ precursors, such as nicotinamide mononucleotide (NMN), may mitigate aging-related disorders, including oxidative stress, DNA damage, neurodegeneration, and inflammatory responses 6, 7
- Supplementation with NADH and precursors has been observed to decrease anxiety conditions, maximum heart rate, and increase muscle insulin sensitivity, insulin signaling, and quality of life 8
- NAD+ precursors, such as nicotinamide (NAM), nicotinic acid (NA), nicotinamide riboside (NR), and nicotinamide mononucleotide (NMN), may attenuate NAD+ decline in degenerative disease states and physiological aging 9
Side Effects of NAD+ Supplementation
- Common side effects associated with NAD+ supplementation include muscle pain, nervous disorders, fatigue, sleep disturbance, and headaches 8
- High-dose nicotinamide administration may exert negative effects through multiple routes, including inhibition of poly(ADP-ribose) polymerases (PARPs), alteration of cellular energy metabolism, and changes in cellular methyl metabolism 10
- Chronic use of high-dose nicotinamide may lead to epigenetic alterations and potential risks 10
Contraindications of NAD+ Supplementation
- There is limited information available on the contraindications of NAD+ supplementation, but it is recommended to consult with a healthcare professional before taking any supplements, especially for individuals with pre-existing medical conditions or taking medications 8, 10
- High-dose nicotinamide administration may not be suitable for everyone, and individual tolerance and sensitivity should be considered 10