Describing NAD+ as a powerhouse is not an overstatement. This small molecule is an antioxidant and electron carrier that is vital to every cell in your body. Low NAD+ levels are associated with chronic fatigue and age-related diseases.1
NAD+ and NADH work as a pair. NAD+ is an oxidizing agent that accepts electrons and, therefore, is called an electron carrier. When NAD+ accepts electrons and a negatively charged hydrogen ion, it becomes NADH. NADH is an electron donor.
NAD+ and NADH work together, accepting electrons from some chemical reactions and donating them in others. Each time electrons are passed between molecules, energy is generated. Your body uses this energy for everything, including building muscles, powering brain activity, seeing, hearing, smelling, and interpreting the world.
After you eat, your food is broken down in the gastrointestinal tract and absorbed through the intestinal lining. It must be completely broken down into simple sugars, glycerides, fatty acids, and amino acids so the intestinal cells can transport them through the membrane and deliver them to your bloodstream.
Once in your bloodstream, these nutrients are processed by the liver and either stored or used by your cells for energy. However, your cells cannot use them in this form. The bonds between the individual carbon, hydrogen, oxygen, and nitrogen atoms are broken and release energy.
It is unsafe for your cells to break bonds and release electrons because these unpaired electrons will bind to body tissues and cause damage. Instead, your body uses NAD+ and NADH to donate and accept these electrons, thereby safely transferring the energy stored in food to adenosine triphosphate (ATP).
ATP is used to power every process in every cell in your body.
Because NAD+ is such an important molecule to your survival, NAD+ production is tightly regulated. It can be produced de novo from tryptophan or via the salvage pathway from precursors and is broken down by NAD+-consuming enzymes. The de novo, Preiss–Handler, and NAD+ salvage pathways catalyze the formation of NAD(H), continuously counteracting the loss of NAD(H) by NAD+-consuming enzymes.2
Aging, oxidative stress, and chronic disease can all increase NAD+ use, causing NAD+ depletion. Researchers are working to better understand these processes and how NAD+ supplementation could potentially slow the aging process or treat chronic diseases.
So far, research suggests that supplementing with NAD+ or NAD+ precursors could treat:1,3-5
NAD+ is involved in over 500 chemical processes in your body. Restoring NAD levels may help with the following:
NAD has poor bioavailability and is quickly broken down in the gastrointestinal tract. Your body overcomes this obstacle by providing several pathways that produce NAD+. As long as there is a balance between NAD+ production and NAD+ use, everything works well. Supplementing with NAD+ can potentially restore NAD+ levels, leading to more efficient metabolic support. There is also the risk that too much NAD+ may have an as-yet-unknown impact.
The effects of NAD+ supplements are not fully understood, but they seem well-tolerated with few side effects.
Side effects reported include:
Research is still early, but it looks promising. Animal studies showed that supplementing with NAD precursors reduced body fat and improved insulin sensitivity.
NAD+ enhances energy metabolism primarily by activating NAD-dependent sirtuins. The currently accepted theory is that by replacing NAD+, especially during times of metabolic stress, your metabolism will function more efficiently. Most of the current research has used NAD+ precursors, not NAD+ injectables.6
“Remarkably, ageing is accompanied by a gradual decline in tissue and cellular NAD+ levels in multiple model organisms, including rodents and humans. This decline in NAD+ levels is linked causally to numerous ageing-associated diseases, including cognitive decline, cancer, metabolic disease, sarcopenia and frailty. Many of these ageing-associated diseases can be slowed down and even reversed by restoring NAD+ levels. Therefore, targeting NAD+ metabolism has emerged as a potential therapeutic approach to ameliorate ageing-related disease, and extend the human healthspan and lifespan. However, much remains to be learnt about how NAD+ influences human health and ageing biology.”Covarrubias et al. Nature Reviews Molecular Cell Biology
Over 1,000 clinical trials are registered on ClinicalTrials.gov investigating the potential health benefits of NAD+ and NADH. New aspects of NAD+ metabolism have recently been discovered. NAD+ can potentially treat many diseases associated with aging and chronic fatigue, but the evidence is lacking until the clinical trials are complete.
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