NADH, Nicotinamide Adenine Dinucleotide dietary supplement

NADH 5mg is an anti-ageing supplementcontaining reduced nicotinamide adenine dinucleotide (NADH). This substance is invaluable for helping the body to function normally, but cellular levels decline inexorably with age, contributing to the ageing process.

What exactly is NADH?

NADH, or nicotinamide adenine dinucleotide, is an important co-factor which supports the work of enzymes throughout the body. It plays a vital role in the production of energy inside each cell (1) and is involved in the production of L-dopa, which is subsequently converted into an important neurotransmitter.

Studies have investigated the benefits of NADH for treating jetlag, premature ageing, cognitive decline and neurodegeneration, chronic fatigue syndrome, and as a nutritional supplement for sportspeople.

Why increase your NAD levels?

With age, there is a decline in the body’s NAD levels due both to a decrease in its production and an acceleration in its deterioration (2-4). This is a significant since NAD is a major coenzyme in the body, involved in very many cellular processes (5).

One of the only solutions to this irreversible decline in production is supplementation, and there are several different supplements available.

Which supplements help to produce NAD in the body?

There are three ways of stimulating NAD production in the body and boosting NAD levels in cells.

1. The de novo synthesis pathway. The body converts tryptophan, an essential amino acid provided by the diet, into NAD via several intermediate reactions, though the mechanism is not very effective.
2. The Preiss-Handler pathway. The body converts niacin (NA) a form of vitamin B3 present in the diet, into niacinamide (NAM), then into nicotinamide mononucleotide (NMN), and finally into NAD. As direct precursors, NMN supplements are thus very popular.
3. The salvage pathway. The body is able to re-form NAD molecules from nicotinamide (NAM) and nicotinamide riboside (NR), two NAD precursors which are also products of its breakdown. This is why this mode of production is called the salvage pathway. NR and NAM are both converted into nicotinamide mononucleotide (NMN) before being finally converted into NAD.

Is direct supplementation with NADH not an option?

Rather than supplement with its precursors, why not just supplement directly with NAD(H)? It’s a good question. Unfortunately, studies show that NAD(H) is unable to cross the intestinal barrier. It is broken down in the small intestine by intestinal epithelial cells (6), then converted into NMN by a number of intestinal enzymes, and then into various metabolites such as NR and NAM. It is these metabolites that cross the intestinal barrier and reach all the body’s cells where they are again converted into NAD.

Supplementing with NADH is by no means useless: it does indeed help to produce NAD in cells. But supplementing more directly with NMN, NR or NAM is usually preferable as it avoids several successive stages of breakdown and reconversion. However, NADH supplementation is still an attractive option price-wise as it is much less expensive than supplementing with its precursors.

How can you increase your NAD levels naturally?

The first step is to take a capsule of NADH every morning on an empty stomach, making sure you wait 30 minutes before eating. In addition, there are two different ways of supporting NAD production.

Promote NAD production through diet

In order to utilise the de novo synthesis pathway, the body needs tryptophan, the best dietary sources of which are wholegrain rice, meat, dairy products, eggs, soy proteins, peanuts, pulses and nuts. You also have the option of nicotinamide riboside (NR), which is found in milk, though the best dietary sources of NAD precursors are raw foods (both plant- and animal-source). The human digestive system, ably aided by its gut flora, breaks down NAD from other organisms into various compounds which can then be used to re-form NAD via the above-mentioned salvage pathway.

In contrast, studies show that over the long term, a diet high in fat (7) accelerates the decline in NADH production. It’s therefore important to ensure you eat a balanced diet.

Promote NAD production through physical activity

It is well-known that exercise stimulates growth of new blood vessels and boosts muscle mass. But researchers have discovered that these effects are associated directly with the activation of certain genes (SIRT1) specific to the increase in levels of NAD (8-9).

Take one capsule a day (or as advised by your therapist) with water, in the morning, on an empty stomach. Wait 30 minutes before eating.

1. Abhirup Das, George X. Huang, Michael S. Bonkowski, Alban Longchamp, Catherine Li, Michael B. Schultz, Lynn-Jee Kim, Brenna Osborne, Sanket Joshi, Yuancheng Lu, Jose Humberto Treviño-Villarreal, Myung-Jin Kang, Tzong-tyng Hung, Brendan Lee, Eric O. Williams, Masaki Igarashi, James R. Mitchell, Lindsay E. Wu, Nigel Turner, Zolt Arany, Leonard Guarente, David A. Sinclair. Impairment of an Endothelial NAD -H 2 S Signaling Network Is a Reversible Cause of Vascular Aging. Cell, 2018; 173 (1): 74 DOI: 1016/j.cell.2018.02.008
2. Yoshino, J., Mills, K. F., Yoon, M. J. & Imai, S. Nicotinamide mononucleotide, a key NAD(+) intermediate, treats the pathophysiology of diet- and age-induced diabetes in mice. Cell Metab. 14, 528–536 (2011).
3. Gomes, A. P. et al. Declining NAD(+) induces a pseudohypoxic state disrupting nuclear-mitochondrial communication during aging. Cell 155, 1624–1638 (2013).
4. Braidy, N. et al. Mapping NAD(+) metabolism in the brain of ageing Wistar rats: potential targets for influencing brain senescence. Biogerontology 15, 177–198 (2014).
5. Ying, 2008 W. Ying NAD+/NADH and NADP+/NADPH in cellular functions and cell death: regulation and biological consequences Antioxid. Redox Signal., 10 (2008), pp. 179-206
6. Gross and Henderson, 1983, C.J. Gross, L.M. Henderson, Digestion and absorption of NAD by the small intestine of the rat J. Nutr., 113 (1983), pp. 412-420
7. Kraus et al., 2014Nicotinamide N-methyltransferase knockdown protects against diet-induced obesity, Nature, 508 (2014), pp. 258-262
8. Costford et al., 2010. Skeletal muscle NAMPT is induced by exercise in humans, Am. J. Physiol. Endocrinol. Metab., 298 (2010), pp. E117-E126
9. Abhirup Das, George X. Huang, Michael S. Bonkowski, Alban Longchamp, Catherine Li, Michael B. Schultz, Lynn-Jee Kim, Brenna Osborne, Sanket Joshi, Yuancheng Lu, Jose Humberto Treviño-Villarreal, Myung-Jin Kang, Tzong-tyng Hung, Brendan Lee, Eric O. Williams, Masaki Igarashi, James R. Mitchell, Lindsay E. Wu, Nigel Turner, Zolt Arany, Leonard Guarente, David A. Sinclair. Impairment of an Endothelial NAD -H 2 S Signaling Network Is a Reversible Cause of Vascular Aging. Cell, 2018; 173 (1): 74 DOI: 1016/j.cell.2018.02.008