From the Guidelines
NAD+ supplementation, specifically through its precursors nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN), is recommended to lower inflammation, with suggested doses of 250-500mg daily for NR or 250-1000mg daily for NMN, based on the most recent evidence 1. When considering NAD+ for inflammation reduction, it's crucial to understand its role in energy metabolism and its impact on mitochondrial function, as highlighted in the study by Aytekin et al. 1. NAD+ plays a significant role in transferring hydride ions within dehydrogenase–reductase systems, which is essential for maintaining cellular energy homeostasis. The depletion of NAD+ can lead to a 'cellular energy crisis' caused by mitochondrial dysfunction, which in turn can result in increased oxidative stress and inflammation 1.
Key Considerations for NAD+ Supplementation
- Dosing: The recommended doses are based on the premise of maintaining or increasing NAD+ levels to support mitochondrial function and reduce oxidative stress.
- Administration: Taking NAD+ precursors in the morning with food may enhance absorption and efficacy.
- Duration: A consistent regimen of 3-6 months is suggested to evaluate the effectiveness of NAD+ supplementation in reducing inflammation, as benefits may take time to manifest.
- Lifestyle Integration: Combining NAD+ supplementation with anti-inflammatory lifestyle practices such as regular exercise, adequate sleep, stress management, and an anti-inflammatory diet rich in omega-3 fatty acids and antioxidants is likely to enhance results.
Mechanism of Action
NAD+ works by supporting mitochondrial function, activating sirtuins (proteins that regulate cellular health), and reducing oxidative stress—all processes that help combat chronic inflammation 1. The maintenance of cellular NAD+ levels is crucial for preventing the depletion of NAD+, which can lead to apoptotic events and increased inflammation.
Potential Side Effects and Precautions
Some individuals may experience mild side effects like flushing, fatigue, or headaches when starting NAD+ supplementation. Therefore, beginning with a lower dose and gradually increasing as needed is advisable. It's also important to consult with a healthcare professional before starting any new supplement regimen, especially for individuals with underlying health conditions or those taking medications.
From the Research
NAD+ and Inflammation
- There is no direct evidence in the provided studies that links NAD+ to lowering inflammation in the context of rheumatoid arthritis or other inflammatory conditions.
- The studies primarily focus on the efficacy of various disease-modifying antirheumatic drugs (DMARDs) and biologic agents in treating rheumatoid arthritis, without mentioning NAD+ as a potential therapeutic agent for reducing inflammation 2, 3, 4, 5.
- One study discusses the efficacy of synthetic and biological DMARDs, but does not mention NAD+ as a factor in reducing inflammation 5.
- Another study is unrelated to the topic of NAD+ and inflammation, as it discusses COVID-19 vaccines and their efficacy and safety 6.
Treatment of Inflammation
- The provided studies suggest that various DMARDs and biologic agents, such as methotrexate, sulfasalazine, and tumor necrosis factor (TNF)-alpha antagonists, can be effective in reducing inflammation and treating rheumatoid arthritis 2, 3, 4, 5.
- Combination therapies, such as triple therapy with methotrexate, sulfasalazine, and hydroxychloroquine, have also been shown to be effective in controlling disease activity and reducing inflammation 4.
- However, these studies do not provide evidence on the use of NAD+ as a therapeutic agent for lowering inflammation.