The link between NAD+, energy production, and chronic illness really couldn’t be clearer. Low NAD+ results in low ATP levels.
Low ATP levels quickly deplete your cell’s energy reserves. When a cell’s energy supply isn’t replenished, the cell ages and can die.
Depending on the types of cells that are affected by the low NAD+ levels, different diseases might develop over time. If nerve cells are affected, depression, anxiety, fatigue or a lack of focus may show up as the symptoms of this cellular lack of energy. In other cases, one might experience tremors, spasms, tingling, numbness, and blurred vision. Symptoms can be transient or, in more extreme cases, lead to neurodegenerative conditions such as Parkinson’s disease or Multiple Sclerosis.
All of the knowledge of the role NAD+ plays in energy metabolism and anti-aging has led to therapeutic applications of NAD supplements in a variety of cases. A 2015 review article recommends NAD+ supplementation as a therapy for a wide range of neurodegenerative disease including:
- Multiple Sclerosis
- Parkinson’s disease
- Alzheimer’s disease
- Chronic fatigue
- Mitochondrial dysfunction (Source 11)
Because of the importance NAD+ for both energy metabolism and sirtuins, research is looking at its use for metabolic disease. There is growing evidence in animal models of this connection, but human trials are still scarce. (Source 12) It will be interesting to follow the science as the use of NAD+ evolves for diabetes, obesity, heart disease and other metabolic conditions.
I’ll talk more about how to supplement with NAD at the end of the article, as far as the form and dosages, but first, let’s take a look at some of the ways NAD is being used clinically, with the most compelling human research for chronic fatigue syndrome, Parkinson’s disease and athletic performance.
Chronic Fatigue Syndrome (CFS):
A few strong clinical trials show that NAD+ may reduce symptoms of CFS including fatigue, muscle pain, weakness, headaches and others. In an early (1999) randomized crossover trial, 31 percent responded favorably to the supplement, compared to only 8 percent of placebo in just 4 weeks of use. (Source 13)
Since that time, larger trials have shown similar results. In a study of NAD+ and Coenzyme Q10, an important mitochondrial antioxidant, showed that those receiving the supplements had a significant reduction in fatigue, along with improved levels of NAD+, CoQ10, ATP and Citric Acid Cycle enzymes. (Source 14) In an 8 week study of NAD+ and CoQ10, symptoms of fatigue also improved using an exercise test. (Source 15)
The use of NAD+ supplements may increase dopamine production in the body, leading to various clinical applications from Parkinson’s disease to improvements in mental health. (Source 16) The enzyme, tyrosine hydroxylase, is diminished in the brains of people with Parkinson’s Disease and NAD+ has been shown in animal models to increase this enzyme activity along with dopamine levels. (Source 17) In a small, 7-day trial, Parkinson’s patients showed a significant response to supplementation in terms of both dopamine production and decrease in symptoms. (Source 18)
In a study of healthy individuals between the ages of 55 and 79, participants received either nicotinamide riboside (a precursor to NAD+) or placebo. The study found that those in the treatment group tolerated the supplements well and they showed a 60 percent increase in NAD+ levels, with a potentially greater response in those with lower levels to begin with. In addition, the study looked at a variety of metabolic markers and although authors suggest more research is needed, there is evidence that the supplementation may help to improve blood pressure and the health of the arteries. (Source 19)