From the Guidelines
Oral nutritional supplements should be offered to patients with lung cancer undergoing concurrent chemotherapy and radiotherapy (CCRT) to prevent malnutrition and cachexia, with a recommended intake of at least 30 kcal and 1.0-1.5 g protein per kg body weight, as well as the recommended daily allowance for all micronutrients 1. When considering oral nutrition, it's essential to assess the patient's nutritional risk and provide counseling by trained professionals to improve energy and protein intake, body weight, and quality of life. Some key points to consider include:
- Nutritional assessment should be performed by a nutrition expert and includes calculating body mass index, estimating food intake, determining the presence and degree of weight loss, muscle mass, anorexia, and other nutritional impact symptoms 1.
- Prevention of nutritional deficits should include early counseling on potential stressors, options to improve food intake and physical activity, and seeking professional help early in case of developing symptoms 1.
- If oral intake is inadequate despite meticulous care, resulting in progressive weight loss of 5% from the initiation of CCRT, tube feeding should be initiated promptly 1. It's also important to note that while other studies discuss the management of chemotherapy-induced nausea and vomiting 1, the most recent and highest quality study relevant to oral nutrition in patients with lung cancer undergoing CCRT is the 2020 study published in the Annals of Oncology 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Oral NAD+ Supplementation
- NAD+ depletion has been proposed to promote aging and degenerative diseases in rodents, and studies have shown that NAD+ deficiency occurs in patients with degenerative disorders 2.
- Oral administration of NAD+-booster niacin, a vitamin B3 form, has been shown to increase blood NAD+ levels and improve muscle performance in adult-onset mitochondrial myopathy patients 2.
- Niacin supplementation has also been shown to prevent congenital malformations in mice by preventing NAD deficiency during gestation 3.
Niacin and NAD+ Relationship
- Niacin is required for the synthesis of coenzymes, nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) 4, 5.
- Niacin deficiency can cause pellagra, a photosensitivity dermatitis, and has been shown to be mediated through prostaglandin E₂-EP4 (PGE₂-EP4) signaling via reactive oxygen species (ROS) production in keratinocytes 4.
Clinical Applications
- Niacin and its derivatives have been recognized as key mediators of neuronal development and survival, and have been investigated as a therapy for neurodegenerative diseases such as Alzheimer's, Parkinson's, and Huntington's diseases 5.
- Supplementation with NAD+ precursors, including niacin, has been identified as a promising treatment strategy for age-related cognitive decline, diabetes, stroke, and traumatic brain injury 6.