NAD+

Do you have it? Do you need it? How do you get it?

NAD refers to a cellular molecule called Nicotinamide Adenine.  This exists in two forms in cells.  One has been “oxidized” the other has been “reduced.”  In case you did not take chemistry in high school (lucky you!), the term oxidized means it is able to react with other molecules, while reduced means it cannot.  The oxidized or active form is NAD+ and the reduced or inactive form is NADH.

The chemistry lesson is over, let’s move to biology.  NAD+ is regarded as a “co-enzyme” which means it works with other molecules to speed up chemical reactions.  Although it is involved in several reactions, by far and away the most important is creating energy.  Energy becomes available (is created) when a specific element – Phosphorous – is attached to a molecule of adenosine.  When three molecules of phosphorous are attached to one molecule of adenosine, the entire molecule is very unstable.

Try to imagine balancing a plate on a broomstick on your nose, while riding a unicycle.  When the plate falls – and you know it will – there will be a crashing sound when it hits the floor.  That’s energy – biochemically speaking.  This entire fabrication – plate, broomstick, unicycle – is called adenosine tri phosphate.  Energy derived from the separation of one phosphate molecule fuels every aspect of the one hundred trillion cells in the human body.

Now imagine that as soon as one plate falls, you have to restore it to the end of the broomstick balancing on your nose while riding the unicycle.  Quite a feat, huh?  That’s where NAD+ becomes important.

That alone should be enough, but NAD+ does more – much more.  One of those actions is regulation of our sleep cycle, called a circadian rhythm.  As we move through the day, our natural reservoir of NAD+ is depleted which means we become tired and feel the need for sleep.  While we sleep, we create more NAD+ which leads to more ATP which leads to more energy.

Another action of NAD+ is regulation of our stress response(s).  As you may know, stress triggers release of a hormone – correctly called the “Stress Hormone.”  It peaks when we awaken and declines throughout the day.  Obviously, this correlates with NAD+. 

NAD+ is also involved in at least two aspects of metabolic regulation.  One is insulin sensitivity, which refers to the ability of insulin to pass glucose through a cell membrane into a cell.  The other is breakdown and removal of fats.

The last example of the many uses of NAD+ in the body is that it protects nerve cells (neurons).  This neuroprotective aspect plays a role in nerve conduction.  Consider disease conditions such as multiple sclerosis, all forms of neuropathy, even cognitive decline.

As we age, production of NAD+ decreases.  Energy decreases, cognition decreases, metabolism decreases, insomnia increases, and more.  We call this normal aging.

To be clear, as we age many hormones decrease, including testosterone, estrogen, progesterone, and thyroid – not just this co-enzyme we call NAD+.  But, if we are going to fight the aging process, it is important to include NAD+ in our weapons.

NAD+ can be supplemented in some people, but not by everyone.  Those who should not have NAD+ supplementation include:

• People not yet at least 40 years of age. You don’t need it and won’t find a lot of benefit.
• Cancer patients: The purpose of chemotherapy is to prevent cancer cells from replicating. Since NAD+ encourages cells to grow, NAD+ must be blocked in cancer patients.
• Pregnancy and breastfeeding: If an embryo/fetus/newborn grows too quickly, defects and malformations are inevitable. No NAD+ for new or soon-to-be moms.

Some people may have NAD+ supplementation if there is close monitoring: Liver disease, kidney disease.  Frankly, I discourage NAD+ use in these patients.

NAD+ supplementation can be accomplished in three ways:

• Oral – very ineffective, although some companies will eventually start offering it that way. Please don’t be fooled by slick advertising.
• IV administration – very effective, but very inconvenient and very expensive. V.s must be given very slowly – over a period of hours not minutes.  If NAD+ is administered too quickly, we can expect the recipient to have nausea, flushing and anxiety.  When administered this way, we suggest 250 mg of NAD+ in saline over four hours.
• Injection into muscle or the subcutaneous space. To avoid the side effects of too much, too soon, we administer about 25 mg into the hip.  This can be repeated as frequently as 3 times per week, and the dose can be increased as tolerance is established – but never more than 100 mg.

Our program is a series of six injections, either twice or three times per week for two or three weeks.  After that, a weekly maintenance dose is adequate.

If you would like to have more information, please contact us at info@ArizonaNaturopathicMedicine.com.