NAD+, a coenzyme derived from vitamin B3, is gaining attention for its critical role in energy production, DNA repair, and cell signaling within the human body. As people age, levels of this essential molecule decline, potentially contributing to various pathologies and the aging process itself. Researchers from the University of Bergen have highlighted mitochondria as "reservoirs" for NAD+, emphasizing its integral involvement in hundreds of metabolic reactions. This discovery holds promise for addressing age-related diseases and conditions linked to mitochondrial dysfunction.
NAD+ stands out due to its multifaceted functions in the body. It plays a crucial role in converting nutrients into energy, repairing damaged DNA, and facilitating communication between cells. Dr. Manisha Parulekar, a renowned expert, underscores its significance:
“NAD+ (the oxidized version of NAD) is a crucial coenzyme involved in hundreds of metabolic reactions, particularly those related to energy production, DNA repair, and cell signaling.” — Manisha Parulekar, MD, FACP, AGSF, CMD
The decline in NAD+ levels with age has sparked interest in potential supplementation approaches. These methods might not cure underlying pathologies but could slow disease progression and alleviate symptoms.
Mathias Ziegler, a leading researcher at the University of Bergen, elaborates on the promising outcomes of NAD+ supplementation:
“Our study has made an important contribution towards understanding the mechanistic basis for positive outcomes of various preclinical and some clinical studies of NAD supplementation approaches. Even though it is unlikely that such supplementation approaches will be able to cure the pathology, they could have positive effects on disease progression (i.e., slowing down progression) and dampening the symptoms.” — Mathias Ziegler, MD, PhD
Despite its benefits, the method of delivering NAD+ requires caution. Intravenous (IV) infusions, commonly used for vitamin and supplement delivery, pose significant infection risks. Clifford Segil, DO, advises against these procedures outside hospital settings:
“Anytime you get a supplement infusion, which is an IV done outside of a hospital, there are large risks for infections, so I discourage any patient to get an IV or an infusion of any supplement. I think it’s safer just to continue oral supplements with vitamins and minerals. IV infusions of vitamins and supplements carry the risk of infection, and the risks of infection outweigh any potential benefits.” — Clifford Segil, DO
Before starting any NAD+ supplementation regimen, individuals should consult healthcare professionals. This is particularly crucial for those with existing health conditions. Dr. Parulekar emphasizes the importance of professional guidance:
“It is important to consult with a healthcare professional before starting any NAD+ supplementation regimen, especially if you have any underlying health conditions. They can help you interpret the existing research and determine whether NAD+ supplementation is appropriate for you.” — Manisha Parulekar, MD, FACP, AGSF, CMD
Research also explores how different factors such as age, sex, genetics, and health conditions affect responses to NAD+ precursors. In neurology, mitochondrial problems often manifest as muscular issues. While this connection is well-accepted in muscle-related conditions, its impact on dementia remains under investigation. Dr. Parulekar points out the need for further research in this area:
“Part of what they said was that NAD in the study is related to mitochondrial problems. In neurology, mitochondrial problems are usually neuromuscular or muscle problems, so (it’s) pretty much accepted mitochondrial problems affect muscles in neurology. It’s not accepted that mitochondria affect dementia in neurology.” — Manisha Parulekar, MD, FACP, AGSF, CMD
Dietary changes may also influence NAD+ levels as people age. Dr. Parulekar advocates for exploring such lifestyle modifications:
“I’d like to see them say what dietary changes could try to increase NAD as we age. I’d also like to see them do NAD research on mitochondrial or muscle diseases because in neurology, mitochondrial diseases are most prevalent in muscular neurological problems.” — Manisha Parulekar, MD, FACP, AGSF, CMD
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