Can Nicotinamide adenine dinucleotide (NAD) contribute to cancer growth?

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Last updated: April 15, 2025View editorial policy

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From the Guidelines

NAD supplementation should be approached with caution in individuals with active cancer or high cancer risk, as it may potentially provide metabolic support for existing cancer cells, although the current evidence does not conclusively show that NAD directly "feeds" cancer in humans. The relationship between NAD and cancer is complex, and NAD plays a critical role in cellular metabolism and energy production, which cancer cells heavily rely on for their rapid growth and proliferation 1. Some laboratory studies suggest that certain cancer cells may utilize NAD pathways to support their growth, and theoretically, increasing NAD levels through supplementation could potentially provide metabolic support for existing cancer cells.

Key Considerations

  • Cancer cells often have altered metabolism and may be more dependent on NAD than normal cells for survival and growth 1.
  • This metabolic difference is why some cancer therapies actually target NAD metabolism pathways.
  • If you have cancer or significant cancer risk factors, it would be prudent to discuss NAD supplementation with your oncologist before use, as the effects may vary depending on cancer type, treatment protocols, and individual factors.
  • The scientific understanding in this area is still evolving, and what shows effects in laboratory studies doesn't always translate directly to clinical outcomes in humans.

Evidence Summary

The provided evidence does not directly address the question of whether NAD feeds cancer, but it highlights the importance of NAD in cellular metabolism and energy production 1. Another study discusses the effects of nutritional support on tumor growth, suggesting that while nutritional support may promote tumor metabolism, it does not necessarily lead to disproportionate or excessive tumor growth compared to stimulation of body cells 1. However, these findings do not directly relate to NAD supplementation and its effects on cancer.

Clinical Implications

Given the potential for NAD to support cancer cell growth and the complexity of cancer metabolism, it is essential to prioritize caution and consult with an oncologist before using NAD supplements, especially for individuals with active cancer or high cancer risk. This approach ensures that any potential benefits of NAD supplementation are weighed against the risks, considering the individual's specific cancer type, treatment protocols, and overall health status.

From the Research

NAD and Cancer

  • NAD is a crucial metabolite for cellular activities, and its biosynthesis mainly occurs through the salvage pathway using the nicotinamide phosphoribosyl transferase (NAMPT) enzyme 2.
  • Cancer cells have a unique energy metabolism, and NAD levels are significantly affected due to the shift in energy production pathways 3.
  • Increased NAD levels can enhance glycolysis and fuel cancer cells, making NAD metabolism a promising therapeutic target for cancer treatment 3, 4.

Role of NAD in Cancer Cell Biology

  • NAD serves as a substrate for various enzymes, including poly(ADP-ribose) polymerase (PARP), sirtuin, and NAD glycohydrolase, regulating DNA repair, gene expression, and stress response 3, 5.
  • NAD(+)-dependent signalling pathways regulate fundamental events such as transcription, DNA repair, cell cycle progression, apoptosis, and metabolism, many of which are linked to cancer development 4.
  • Depletion of NAD+ results in depletion of energy levels, sensitization of cancer cells to oxidative damage, decreased cell proliferation, and initiation of cell death through manipulation of cell signaling pathways 5.

Therapeutic Targeting of NAD Metabolism

  • Inhibition of the NAD+ salvage pathway causes cancer cell cytotoxicity in vitro and in vivo, making it a potential therapeutic target for cancer treatment 5.
  • NAMPT inhibition, alone or in combination with other cancer therapies, results in decreased cell viability and tumor burden for many cancer types 2.
  • A novel NAMPT inhibitor, KPT-9274, is a promising, low-toxicity option currently in clinical trials 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

NAD Metabolism in Cancer Therapeutics.

Frontiers in oncology, 2018

Research

NAD+ salvage pathway in cancer metabolism and therapy.

Pharmacological research, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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