Standard Dosing for NAD+ Supplementation
There is no established standard dose for NAD+ supplementation as current clinical guidelines do not specifically recommend NAD+ supplementation for general health maintenance due to lack of sufficient evidence. 1
NAD+ Precursors and Their Dosing
NAD+ itself is not typically supplemented directly, but rather through precursors that can increase NAD+ levels in the body:
Niacin (Nicotinic Acid)
- Standard treatment dose for niacin deficiency: 15-20 mg/day of nicotinic acid 1
- Upper limit: 10 mg/day (due to flushing risk) 1
- Therapeutic dose in mitochondrial myopathy: 750-1,000 mg/day (shown to increase blood NAD+ up to 8-fold) 2
Nicotinamide
- Standard treatment dose for niacin deficiency: 300 mg/day 1
- Upper limit: approximately 900 mg/day for adults 1
Nicotinamide Riboside (NR)
- Research doses:
Nicotinamide Mononucleotide (NMN)
- No standardized dosing in clinical guidelines
- Research suggests it may improve mitochondrial function 3
Factors Affecting Dosing Decisions
When considering NAD+ precursor supplementation, several factors should be considered:
- Form of supplement: Different NAD+ precursors (niacin, nicotinamide, NR, NMN) have different potencies and side effect profiles
- Purpose of supplementation: Higher doses may be needed for therapeutic purposes versus prevention
- Individual tolerance: Side effects like flushing with niacin may limit dosing
- Existing conditions: Mitochondrial disorders may require higher doses
Safety Considerations
- Niacin at doses >10 mg can cause flushing 1
- Nicotinamide appears safer at higher doses (up to 900 mg/day) 1
- NRPT (nicotinamide riboside with pterostilbene) was well-tolerated in an 8-week trial with no serious adverse events 5
- High-dose niacin (750-1,000 mg/day) may cause anemia tendency in some patients 2
Monitoring
For therapeutic use of NAD+ precursors, monitoring may include:
- Blood NAD+ levels (if available)
- Complete blood count (to monitor for potential anemia)
- Liver function tests
- Clinical response
Dietary Sources
The American Academy of Nutrition and American College of Nutrition recommend obtaining niacin (vitamin B3) from dietary sources 1:
- Recommended daily intake:
- Men over 14 years: 16 mg/day
- Women over 14 years: 14 mg/day
- Pregnant women: 18 mg/day
- Lactating women: 16 mg/day
Rich sources include meat, poultry, fish, nuts, legumes, and whole grains 1.
Research Context
While research on NAD+ precursors is promising, it's important to note that most studies are small and of short duration. The 2020 study showing significant benefits with niacin at 750-1,000 mg/day in mitochondrial myopathy patients represents one of the more compelling therapeutic applications 2, but this dosing is specific to that condition and not recommended for general use.
Human studies have demonstrated that NR can increase NAD+ levels by approximately 40% at recommended doses and 90% at double doses after 4 weeks of supplementation 5, but long-term benefits and optimal dosing remain to be established.
Human Metabolism Clinics
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Standard Dosing for NAD+ Supplementation
There is no established standard dose for NAD+ supplementation as current clinical guidelines do not specifically recommend NAD+ supplementation for general health maintenance due to lack of sufficient evidence. 1
NAD+ Precursors and Their Dosing
NAD+ itself is not typically supplemented directly, but rather through precursors that can increase NAD+ levels in the body:
Niacin (Nicotinic Acid)
- Standard treatment dose for niacin deficiency: 15-20 mg/day of nicotinic acid 1
- Upper limit: 10 mg/day (due to flushing risk) 1
- Therapeutic dose in mitochondrial myopathy: 750-1,000 mg/day (shown to increase blood NAD+ up to 8-fold) 2
Nicotinamide
- Standard treatment dose for niacin deficiency: 300 mg/day 1
- Upper limit: approximately 900 mg/day for adults 1
Nicotinamide Riboside (NR)
- Research doses:
Nicotinamide Mononucleotide (NMN)
- No standardized dosing in clinical guidelines
- Research suggests it may improve mitochondrial function 3
Factors Affecting Dosing Decisions
When considering NAD+ precursor supplementation, several factors should be considered:
- Form of supplement: Different NAD+ precursors (niacin, nicotinamide, NR, NMN) have different potencies and side effect profiles
- Purpose of supplementation: Higher doses may be needed for therapeutic purposes versus prevention
- Individual tolerance: Side effects like flushing with niacin may limit dosing
- Existing conditions: Mitochondrial disorders may require higher doses
Safety Considerations
- Niacin at doses >10 mg can cause flushing 1
- Nicotinamide appears safer at higher doses (up to 900 mg/day) 1
- NRPT (nicotinamide riboside with pterostilbene) was well-tolerated in an 8-week trial with no serious adverse events 5
- High-dose niacin (750-1,000 mg/day) may cause anemia tendency in some patients 2
Monitoring
For therapeutic use of NAD+ precursors, monitoring may include:
- Blood NAD+ levels (if available)
- Complete blood count (to monitor for potential anemia)
- Liver function tests
- Clinical response
Dietary Sources
The American Academy of Nutrition and American College of Nutrition recommend obtaining niacin (vitamin B3) from dietary sources 1:
- Recommended daily intake:
- Men over 14 years: 16 mg/day
- Women over 14 years: 14 mg/day
- Pregnant women: 18 mg/day
- Lactating women: 16 mg/day
Rich sources include meat, poultry, fish, nuts, legumes, and whole grains 1.