NR Supplements debate – Adapted ATTIAInterview format with Dr Peter Attala and Dr. Matt Kaeberlei (credit: https://peterattiamd.com/nr-supplements-and-cancer/)
Question 1: Can NR supplements actually contribute to an increased lifespan or are they merely a waste of money?
Answer 1: Nicotinamide riboside (NR) supplements are often marketed as anti-aging products with the potential to increase lifespan. However, the reality is that we have little to no strong evidence showing their efficacy in extending life. While NR supplements are generally safe from an acute toxicity perspective, their long-term impact on aging and lifespan remains unclear. Some users might consider them a risky but potentially worthwhile investment, hoping for substantial benefits in the future. Yet, it’s essential to stay updated with ongoing research and evidence to evaluate their true effectiveness.
Question 2: Is there a potential risk for cancer progression associated with NR supplementation?
Answer 2: Recent studies, including a notable one by Maric et al., have raised concerns about NR supplementation potentially accelerating cancer progression. Early experiments indicated that in mice with aggressive cancer, NR supplementation increased tumor growth. These findings are biologically plausible since cancer cells often require NAD+, a coenzyme in glycolysis, for their high energy needs, and NR is a precursor to NAD+. Though these studies used dosages far higher than what’s typically found in human supplements, they underscore the need for caution and further research, particularly in individuals with pre-existing cancer or at high risk of cancer.
Question 3: Can NR supplements trigger the development of cancer?
Answer 3: While current research, like the studies conducted by Maric et al. and Dr. Iñigo San Millan, suggests that NR can speed up the growth of existing tumors, there’s no concrete evidence that it can initiate cancer. It’s important to note that these findings primarily concern those who already have cancer. NR supplementation in extremely high doses was shown to accelerate tumor progression, but these doses were much higher than those in typical supplements. So, while NR doesn’t appear to cause cancer, its role in the development or progression of cancer at therapeutic levels still requires more investigation.
Question 4: Despite the risks, do NR supplements offer any therapeutic benefits?
Answer 4: Despite the concerns around aging and cancer, NR supplements might still hold therapeutic value for certain conditions. Research has shown that treatment with NAD+ precursors, including NR, can improve function and survival in specific mouse models of diseases related to DNA repair and mitochondrial function. For instance, NR has shown promising results in improving cognition in Alzheimer’s disease models. While these findings are preliminary and require more extensive clinical trials, they suggest that NR could have beneficial applications beyond its debated role in anti-aging.
Dr. Iñigo San Millan explained some very preliminary data suggesting that, in a very small cohort of mice with an aggressive form of cancer, NR supplementation increased tumor growth by 15% relative to controls
In Closing About NR Supplements
Nicotinamide riboside (NR), a precursor to the crucial cofactor nicotinamide adenine dinucleotide, has garnered significant interest in the scientific community, primarily due to its purported metabolic benefits revealed in several preclinical studies. The journey of NR from intriguing laboratory results to human clinical trials began earnestly in 2016, aiming to validate its safety and effectiveness for human use. Since then, the research landscape has seen an array of trials, each striving to uncover the implications of NR on metabolic health and its potential in combating severe human diseases.
This review takes a deep dive into the existing body of literature—25 published articles on human NR supplementation—to date, with a focus on separating the wheat from the chaff. Our aim is not just to summarize but to critically evaluate these studies, sifting through the evidence to identify overstatements and to guide future research in a more grounded direction.
The collected data on oral NR supplementation, as it stands, shows a somewhat muted picture compared to the initial buzz. While the clinical effects noted are relatively few, it’s important to acknowledge the role NR could play in mitigating inflammation and its emerging potential in treating a variety of severe illnesses.
However, there appears to be a prevailing trend within the literature to overstate the significance and solidity of these findings. In the quest to truly understand and harness the power of NR, it’s crucial for the scientific community to maintain a balanced, evidence-based approach, avoiding the pitfalls of hyperbole and ensuring that claims are firmly rooted in robust scientific inquiry.
NR Supplements May Increase The Risk Of Breast Cancer
A recent investigation by the University of Missouri (MU) suggests potential risks associated with the consumption of nicotinamide riboside (NR), a dietary supplement. Previously thought to be beneficial for various health aspects, including cardiovascular and neurological well-being, this new study indicates NR might elevate the risk of triple-negative breast cancer and its spread to the brain.
MU researchers pointed out an increased likelihood of developing this aggressive form of breast cancer and the potential for brain metastasis in individuals with high NR levels. The grim prognosis for brain-involved cases, mainly due to current treatment limitations, underscores the study’s significance.
Elena Goun, the lead researcher and an associate professor of chemistry at MU, emphasized the common misconception about supplements being exclusively beneficial. She stated, “A general assumption is that vitamins and supplements are always a health-positive choice. However, understanding their precise effects is less clear, which led us to explore how they function in the body.”
The study highlights NR’s role in boosting cellular energy, which inadvertently fuels the high metabolism of cancer cells. With NR’s prevalent use and its examination in numerous human clinical trials, particularly for alleviating cancer treatment side effects, this discovery is crucial.
Goun’s team utilized innovative bioluminescent imaging technology for real-time, non-invasive measurement of NR levels in cancer cells, T cells, and healthy tissues. This method depicts NR presence through emitted light, with brighter light indicating higher NR levels.
Goun remarked on the necessity for thorough research into supplements like NR, particularly regarding potential adverse effects in diverse health scenarios.
The MU research team advocates for more individualized studies in the field, aiming to enhance the effectiveness of cancer treatments, including chemotherapy. Goun noted, “Cancer’s metabolic profile varies significantly among individuals and can even alter its metabolism in response to treatments like chemotherapy.”
This study serves as a reminder of the complexity and individuality of cancer, emphasizing the need for personalized approaches in both understanding and treating this disease.
Study: Popular dietary supplement increases breast cancer risk, brain metastasis. University of Missouri. November 18, 2022. Accessed November 15, 2022. https://showme.missouri.edu/2022/study-new-imaging-technique-in-animal-study-gives-insight-to-popular-supplements-potential-role-in-cancer-progression/
- Cantò et al. (2012): In mice on both a regular and high-fat diet, giving NR increased endurance, improved muscle oxidative profile, and boosted NAD+ levels in muscles. This also enhanced the activity of certain proteins (sirtuins) related to metabolism, but didn’t affect other specific proteins (PARP-1).
- Cerutti et al. (2014): In normal mice, NR increased the ratio of NAD+ to NADH (important molecules in cellular energy processes) and sirtuin activity, but didn’t improve motor performance or affect genes related to fat oxidation and mitochondrial function.
- Zhang et al. (2016): Older mice given NR showed increased muscle strength, running times, and distances. NR also aided muscle healing after damage and improved several cellular markers related to muscle stem cells (MuSCs) and inflammation.
- Kourtzidis et al. (2016): In male rats, NR actually decreased swimming performance under certain conditions.
- Frederick et al. (2016): In mice genetically modified to have a muscle-specific enzyme deficiency, NR helped prevent exercise intolerance, reduced muscle dysfunction, and improved various aspects of muscle health and function.
- Hou et al. (2018): Older mice drinking water with NR showed improved grip strength.
- Diguet et al. (2018): In a particular mouse model, NR increased heart muscle NAD+ levels and affected the heart’s structure but didn’t significantly change heart function or mitochondrial activity.
- Kourtzidis et al. (2018): Another study on male rats found that NR didn’t affect muscle NADPH levels (another molecule involved in cellular processes) but created a more oxidative environment in muscles and decreased blood glucose levels without changing muscle glycogen (a form of stored glucose).
- Crisol et al. (2019): Mice given NR had increased NAD+ in their skeletal muscle but showed no improvement in exercise performance.
While NR Supplementation Shows Promise: NMN Still Hold The Trophy, Even Over Oral NAD+
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