Are NAD (Nicotinamide adenine dinucleotide) supplements of any help?

NAD+ Supplements Are Not Recommended Due to Lack of Clinical Evidence

NAD+ supplements are not recommended for any medical condition due to lack of established clinical evidence supporting their effectiveness, according to current clinical guidelines. 1

What is NAD+ and Why It's Being Studied

• NAD+ (Nicotinamide adenine dinucleotide) is a coenzyme required by more than 400 enzymes in the body, helping convert nutrients into energy, create and repair DNA, and exert antioxidant effects 1
• NAD+ levels naturally decline with age, which has led to interest in supplementation as a potential anti-aging intervention 2, 3
• NAD+ plays central roles in mitochondrial energy metabolism and is involved in cellular processes related to aging 4

Current Evidence on NAD+ Supplementation

• No established clinical guidelines recommend NAD+ supplements (in any form) for any medical condition 1
• The American Academy of Physical Medicine and Rehabilitation does not recommend NAD+ patches due to insufficient clinical evidence 1
• While some small clinical trials show NAD+ precursors like nicotinamide riboside (NR) can increase NAD+ levels in humans, clinical benefits remain unproven 5
• A systematic review found that while NAD+ supplementation appears safe with low incidence of side effects, more research is needed to establish clinical benefits for specific conditions 6
• A study specifically examining cognitive effects found no evidence for cognitive improvement from oral NADH in patients with dementia 7

Nutritional Recommendations for NAD+ Precursors

• The American College of Nutrition recommends daily intake of niacin (a precursor to NAD+): 16 mg/day for adult males, 14 mg/day for adult females, 18 mg/day for pregnant women, and 16 mg/day for lactating women 4
• For enteral nutrition: 18-40 mg per day of niacin in 1500 kcal is recommended 2
• For parenteral nutrition: at least 40 mg of niacin per day is recommended 2, 4
• Dietary sources of niacin are preferred: meat, poultry, fish, nuts, legumes, and fortified foods 1, 4

Safety Considerations and Potential Risks

• Upper intake limit for nicotinic acid (a form of niacin) is 10 mg/day due to flushing effects 1, 4
• Upper intake limit for nicotinamide is approximately 900 mg/day for adults 1, 4
• High doses of nicotinic acid can cause flushing, nausea, vomiting, liver toxicity, blurred vision, and impaired glucose tolerance 1
• Common side effects reported with NAD+ supplementation include muscle pain, nervous disorders, fatigue, sleep disturbance, and headaches 6

Special Considerations

• There is no evidence that vitamin or mineral supplementation benefits people without underlying deficiencies 2
• Routine supplementation with antioxidants and micronutrients is not advised due to lack of efficacy evidence and concerns about long-term safety 2
• For specific populations (pregnant/lactating women, older adults, vegetarians, and people on very low-calorie or low-carbohydrate diets), a multivitamin may be necessary 2
• Age-related decline in cellular NAD+ levels has been documented, but current evidence doesn't support supplementation beyond recommended dietary intake 2

Conclusion

While NAD+ supplementation shows theoretical promise based on preclinical research, current clinical evidence does not support its use for any specific health condition. Individuals should focus on obtaining adequate niacin through dietary sources rather than supplements unless specifically indicated for a diagnosed deficiency.