From the Guidelines
NAD+ supplements, in the form of nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN), may be considered for boosting NAD+ levels, but their use should be approached with caution and under the guidance of a healthcare provider, especially considering the current limited clinical evidence in humans 1.
Key Considerations
- NAD+ plays a crucial role in energy metabolism, DNA repair, and activating sirtuins, which are involved in cellular health and longevity 1.
- The current evidence suggests that NAD+ supplements may offer potential benefits for metabolic health, cognitive function, and age-related decline, but more research is needed to confirm these findings 1.
- Side effects of NAD+ supplements are generally mild and may include flushing, nausea, fatigue, and headaches 1.
- It is essential to purchase NAD+ supplements from reputable manufacturers, as the supplement industry is not strictly regulated 1.
Dosage and Safety
- The optimal dosing of NAD+ supplements remains unclear, but typical doses range from 250-1000mg daily 1.
- The upper intake level (UL) for nicotinamide is 12.5 mg/kg body weight/d or approximately 900 mg/d for adults, with no adverse effects observed at doses up to 25 mg/kg body weight/d in prolonged studies 1.
- Nicotinic acid has a UL of 10 mg/d, due to the risk of flushing and transient hypotensive episodes, especially in the elderly 1.
Clinical Recommendations
- Before starting NAD+ supplementation, patients should consult with a healthcare provider, especially if they have existing health conditions or take medications, as interactions are possible 1.
- NAD+ supplements should complement, rather than replace, healthy lifestyle practices such as proper nutrition, exercise, quality sleep, and stress management 1.
- In cases of clinical symptoms, such as diarrhoea, dermatitis, and dementia (Pellagra disease), blood or tissue NAD levels may be measured to guide treatment 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Role of NAD as a Dietary Supplement
- NAD (Nicotinamide adenine dinucleotide) is a key coenzyme in the production of adenosine triphosphate or cellular energy, and its precursors have been investigated for potential neuroprotective effects in cellular, animal, and human studies 2.
- Nicotinamide, a precursor of NAD(+), has been shown to be beneficial in preserving and enhancing neurocognitive function, and is non-toxic, inexpensive, and widely available 2.
- NAD(+) precursors, such as nicotinamide riboside and nicotinamide mononucleotide, have been found to boost intracellular NAD levels, preventing or ameliorating metabolic and mitochondrial diseases in mouse models 3.
- The regulatory role of NAD in human and animal cells is crucial, as it serves as a substrate for several families of regulatory proteins that control vital cell processes, including gene expression, DNA repair, and apoptosis 4.
- Administration of NAD precursors has been demonstrated to restore NAD levels in tissues, producing beneficial therapeutic effects in preclinical models of various diseases, such as neurodegenerative disorders, obesity, diabetes, and metabolic syndrome 4.
- Dietary supplementation with NAD+ precursors, classically known as vitamin B3, has received attention as a therapeutic strategy for the treatment of metabolic and age-related diseases 5.
- Targeted nutritional supplementation with NAD precursors, including vitamin B3 precursors nicotinamide and nicotinic acid, is likely to have beneficial effects in various diseases, while inhibition of NAD synthesis promotes cell death and has emerged as a therapeutic concept for cancer treatment 6.