Nicotinamide adenine dinucleotide as a therapeutic supplement
Nicotinamide adenine dinucleotide (NADH) is a crucial cofactor in the body that aids in energy production and the synthesis of dopamine, a key neurotransmitter. There is growing interest in NADH as a potential therapeutic supplement, especially for age-related conditions, though scientific research on its efficacy is limited. NADH is primarily produced in the body from vitamin B3 and is found in high concentrations in muscle tissues, but dietary sources are often insufficient due to degradation during food processing. Research suggests that NADH levels decline with age, which may correlate with diminished positive effects in health.
While NADH has been explored for various applications, including jet lag, Alzheimer's disease, chronic fatigue syndrome, and depression, only preliminary evidence supports its use, particularly for jet lag. Typical supplemental dosages range from 5 to 50 mg daily, often administered sublingually. Some studies indicate that NADH may enhance cognitive function under sleep-deprived conditions, but more robust clinical trials are needed to establish its safety and effectiveness comprehensively. Although generally considered safe at lower doses, the long-term safety profile and effects on vulnerable populations remain unclear.
Nicotinamide adenine dinucleotide as a therapeutic supplement
Definition: Natural substance of the human body used as a supplement to treat specific health conditions.
Principal proposed use: Jet lag
Other proposed uses: Alzheimer’s disease, chronic fatigue syndrome, depression, Parkinson’s disease, sports performance enhancement
Overview
Nicotinamide adenine dinucleotide (NADH) is an important cofactor, or assistant, that helps enzymes work throughout the body. NADH particularly plays a role in the production of energy. It also participates in the production of L-dopa, which the body turns into the important neurotransmitter dopamine. NADH, sometimes referred to as NAD, is believed to have potential as a remedy for age-related diseases. This hypothesis is, however, tempered by the small amount of scientific research on the subject.
Based on these basic biochemical facts, NADH has been evaluated as a treatment for jet lag, Alzheimer’s disease, Parkinson’s disease, chronic fatigue syndrome, and depression, and as a sports supplement. However, only the first of these uses has any meaningful scientific evidence behind it, and even that is highly preliminary.
Requirements and Sources
Healthy bodies make all the NADH they need, using vitamin B3 (also known as niacin or nicotinamide) as a starting point. The highest concentration of NADH in animals is found in muscle tissues, which means that meat might be a good source, were it not that most of the NADH in meat is destroyed during processing, cooking, and digestion. In reality, people do not get much NADH from their food.
Scientific research suggests that NADH levels decline with age. The positive impacts supplied by NADH likewise diminish. In the 2020s, more clinical trials have been conducted to establish whether NADH can serve as a therapeutic intervention for conditions such as immunity decline and chronic inflammation. The body’s responses to these may rely on elevated cellular activity that may reduce with age.
Therapeutic Dosages
The typical dosage for supplemental NADH ranges from 5 to 50 milligrams (mg) daily, often taken sublingually (under the tongue). Products said to be stabilized are available.
Therapeutic Uses
Two small double-blind, placebo-controlled trials suggest that NADH may be useful for enhancing mental function under conditions of inadequate sleep, such as jet lag.
Supplemental NADH has also been proposed as a treatment for Alzheimer’s disease, chronic fatigue syndrome, depression, and Parkinson’s disease. Additionally, it has been tried as a sports performance enhancer. However, although a few studies have been performed to evaluate these potential uses, none were designed in such a way as to produce scientifically meaningful results.
Scientific Evidence
In a double-blind, placebo-controlled trial, thirty-five individuals taking an overnight flight across four time zones were given either 20 mg of NADH or a placebo sublingually (under the tongue) on the morning of arrival. Participants were twice given wakefulness and mental function tests: first at ninety minutes and then at five hours after landing. Individuals given NADH scored significantly better on these tests than those given a placebo.
The only other supporting evidence comes from an unpublished double-blind, placebo-controlled, crossover study funded by the makers of an NADH product. In this study, twenty-five people were kept awake all night and their cognitive function was tested the following day. People given NADH performed significantly better on various measures of mental function than those given placebo. NADH did not, however, reduce daytime sleepiness or enhance mood.
Safety Issues
NADH appears to be quite safe when taken at a dosage of 5 mg daily or less. However, formal safety studies have not been completed, and safety in young children, pregnant or nursing women, and those with severe liver or kidney disease has not been established.
Bibliography
Chen, Allison. “Dietary Supplement May Delay Physiological Aging.” The Johns Hopkins Newsletter, www.jhunewsletter.com/article/2018/04/dietary-supplement-may-delay-physiological-aging. Accessed 6 Sept. 2023.
Forsyth, L. M., et al. “Therapeutic Effects of Oral NADH on the Symptoms of Patients with Chronic Fatigue Syndrome.” Annals of Allergy, Asthma, and Immunology 82 (1999): 185-191.
Radenkovic, Dina, and Verdin, Eric. “Clinical Evidence for Targeting NAD Therapeutically.” Pharmaceuticals, 13 Sept. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7558103. Accessed 6 Sept. 2023.
Tiner, Sara. “From Fasting to a Pill? Mayo Clinic Scientists Explore the Biology of Caloric Restriction.” Mayo Clinic, 28 Mar. 2022,mcpress.mayoclinic.org/research-innovation/from-fasting-to-a-pill-mayo-clinic-scientists-explore-the-biology-of-caloric-restriction. Accessed 6 Sept. 2023.