NAD - The Youth Capsule?

People hear of a “new product” or a “scientific discovery” in the context of purported “miracle” and the buzzing begins.

Such has been the case with NAD (NAD+, NADH).

The buzz leads to the emergence of evangelists armed with nothing more than a catch phrase.

“NAD is great for anti-aging.”

And from said catch phrase, sellers of supplementceuticals find revenues and new profitability as long as they can ride the wave of intrigue and mystery.

I’d like to provide a bit of baseline clarity about this intriguing compound as the research continues to unfold.

Let’s begin with this. 

We don’t really want “anti-aging.” 

Chronological aging represents longevity and we all want long lives.  So while we understand the intention, anti-aging refers not to fighting chronological continuance, but rather to combatting biological breakdown.

We want our lives to move forward, not as an invitation for limitation and disease, but rather as experiential visits in this human body filled with joy, reward, fulfillment, vitality, and a series of celebrations and victories.

In that we really seek “healthy aging,” or better yet “preservation of youth.”

THE BIOCHEMISTRY OF YOUTH

When we begin to explore the typical biochemistry of “youth” as compared with the biochemistry of “aging degeneration,” we’re bound to come across hormonal differences, cellular differences, and biomolecular differences, and NAD offers a marker for a very significant biochemical difference, one that impacts the health and action of literally every single cell in a living being.

The idea of using some variation of exogenous NAD to preserve youth is perhaps a viable strategy, one that may help to maintain or even “restore” youthful biochemistry, but before you run out and swallow handfuls of NAD capsules, there are a few things you should know.

WHAT IS NAD?

Let’s get the long name of the NAD compound, define it, and then get into strategies for optimizing your body’s availability and use of this “secret” to “youth preservation.”

NAD stands for Nicotinamide Adenine Dinucleotide (nicotinamide is more commonly known as Vitamin B3, or Niacin).

OK, SO WE NOW KNOW THE LONG NAME . . . BUT WHAT IS IT???

NAD is a coenzyme, which means, it assists or facilitates the action of enzymes responsible for human metabolism, cellular processes, performance, sustenance, and survival mechanisms.  That sounds important.

It is.

As all enzymes and coenzymes responsible for a massive amount of cellular work, we (humans) produce (synthesize) it within our own molecular biology.  NAD is formed from Vitamin B3 and ATP (a metabolic cellular energy substrate, the cellular fuel for human energy expenditure).

When the human machine is young, powerful, balanced, healthy, and systemically fueled, NAD is abundant.  Conversely, when NAD diminishes (as it does with age), performance, health, and youthful energy will show signs of decline or degeneration.

As we try to discern and assemble the strategies and nutrients that can help us preserve the gifts of youth, the question becomes, “Is NAD supplementation, or exogenous infusion of NAD (IV), an important factor?”

It appears the answer is yes!

With that question on the table, can we see NAD as a valuable supplemental aid to delay disease onset, prevent disease onset, or better yet, reverse disease?

There’s a lot to unpack in answering that question, but we might start fielding answers by considering The World Health Organization’s decision to declare “aging” itself as a disease (2018). 

While that classification has a broad scope, it allows us to see anything that delays or reverses neurodegeneration, vascular oxidation, chronic inflammatory issues, and chronic hormonal disruptions (maladaptations) as a true “anti-aging” (youth preserving) aid.

An excerpt from The World Health Organization’s 2018 International Classification of Diseases defined “age-related diseases” as:

“conditions caused by pathological processes which persistently lead to the loss of organism’s adaptation and progress in older ages.” 

We can debate whether that translates to “aging is a disease” but the bottom line is, viewing our population clearly reveals “more senior populations” have significantly greater degeneration and disease diagnoses than their younger counterparts.  

If reducing the onset of these diseases in later years could be accomplished by lifestyle shifts and heightened by altering NAD levels, this is exciting news.

WHAT DOES THE SCIENCE SAY?

The research is unfolding at a rapid clip, and while “the best way” to “increase cellular NAD” may still be in debate, there’s no question that facilitating that increase can have a profound effect on a number of those diseases that have historically been considered inevitabilities of aging.

Considering the observations I shared in comparing “senior populations” to youthful groups, we can draw a clear line between “increased disease incidence” and “reduced NAD levels.”

By the age of 45, you are likely producing 50% or less of the NAD you were as a young teen.  Theoretically, if we can restore the NAD levels of a 45-year-old to his or her pre-adult volume, the impact should be palpable.

So, let’s consider the options in hopes of determining “the best way” for you to begin integrating NAD elevation into your youth preservation strategy.

The most obvious way to increase NAD would be “take NAD in capsule form,” but in the opening paragraphs I hinted this may not be the magic route to youthfulness.  There are three primary reasons the obvious route is a flawed one. 

Firstly, the NAD molecule degrades quickly and variants that speed its degradation include exposure to heat and light.  Even in a dark bottle at room temperature, NAD is not very stable.  That means storing bottles of NAD under “normal” storage situations may destroy the  potential efficacy of the capsules within.

While for decades now scientists have demonstrated that NAD injection and IV application facilitate quantifiable change and offer significant promise in treating conditions such as Parkinson’s,* depression, and chronic fatigue, future studies with oral applications showed lesser outcomes and far less consistent results, likely in part because of the instability of the molecule.

*Birkmayer JG, Vrecko C, Volc D, Birkmayer W. Nicotinamide adenine dinucleotide (NADH)--a new therapeutic approach to Parkinson's disease. Acta Neurol Scand Suppl. 1993;146:32-5.

The second variable that makes oral administration of NAD far less preferred than other options is the need to pass through the digestive tract where the digestive process and stomach acids destroy the integrity and structure of the NAD molecule.

The third obstacle to swallowing NAD and hoping for youth preservation is simply the size of the NAD molecule.  Even if it makes it to the cell intact, it’s too large to easily permeate cell walls (toward the end of the article I'll share insight related to a "liposomal" system that might allow for NAD in capsules to be effective).

WHAT ARE THE BEST OPTIONS

A complete review of the science would conclude that “the best” option for increasing cellular NAD would be a slow infusion intravenously.  It may be a bit costly, but beyond price, the larger inconvenience may be devoting several hours to sitting in a chair allowing it to slowly drip into your vein.  If you have the luxury of money and time, this is the option to consider.

Intramuscular injections are quick (a quick shot into the gluteus medius), and while some people feel what they describe as “a rush,” or “a spike in alertness and energy,” much is lost in the journey from muscle tissue to bloodstream and then bloodstream to cell.

Worthwhile?  Lots of my friends and colleagues do IM NAD shots weekly.  Not a one of them has examined long-term impact on cellular NAD so I’d still have to call this method questionable, at least when seeking to determine “the best option.”

MUST THERE BE NEEDLES INVOLVED?

Now we get to the really good news.  There may be some oral, or at least non-injectable options that can do the trick.  There is some strong evidence to indicate:

1. Sublingual, liposomal, and intransal applications of NAD may deliver promising outcomes
2. Swallowing precursors of NAD may result in increased synthesis and ultimately greater availability of NAD at a cellular level

The two snippets of good news are leading to continued research and continued indication of promise that oral supplementation may do the trick, not of the actual NAD molecule, but of the precursor(s).

If I were to attempt to explore every option, this would be a very lengthy review, so for the sake of brevity and relative conciseness, I’m going to only discuss “oral” use of the NAC precursors.  I will, however, before I move toward a conclusion, explain that the vast difference between “oral” and a non-injectable transport into the bloodstream is “first pass.”  

When you swallow any compound or nutrient, it must “pass through” digestion and filtration which may  reduce absorption and may prompt reactive liver response.  When that same compound is absorbed into the little vessels in the nasal passage and under the tongue it finds its way into the bloodstream without “first pass.”

With that stated, let’s look at oral use of NR and/or NMN.

THE PRECURSORS

A molecule of NR (nicotinamide riboside) is less than half the size of the NAD molecule, so transport into the cell can be far greater.  As a result, research continues to explore NR’s viability in treating “aging.”

CLICK HERE FOR A LISTING OF SOME OF THE MORE RECENT STUDIES
ON NR AND METABOLISM

NR can convert to another NAD precursor and vice versa.  The enzymatic chemistry is complex, but with the right factors lining up, the oral ingestion of either precursor appears to be a viable strategy for restoring youthful levels of NAD.

There is some evidence that supplemental NMN (Nicotinamide mononucleotide) alone can increase cellular NAD. 

Shade C. The Science Behind NMN-A Stable, Reliable NAD+Activator and Anti-Aging Molecule. Integr Med (Encinitas). 2020 Feb;19(1):12-14.

Several papers have raised questions as to whether NMN has the propensity to enter the cell, but a 2019 paper reveals there is a reliable and proven transport mechanism.

Wu LE, et al. The elusive NMN transporter is found. Nat Metabo 2019;1(1):8-9

I see this promising, and while the jury is still out since there are conflicting study outcomes, NMN oral supplementation combined with a non-oral NAD delivery system is a sound and sensible strategy.

Okabe K, Yaku K, et al. Oral Administration of Nicotinamide Mononucleotide Is Safe and Efficiently Increases Blood Nicotinamide Adenine Dinucleotide Levels in Healthy Subjects. Front Nutr. 2022 Apr 11;9:868640.

There is one other challenge with NMN.  One of availability.  The FDA has targeted NMN as a compound that should not be sold as a dietary supplement (because of its consideration as a drug).  Interpret that was you will.  As I said earlier, there’s a lot to unpack.

LIPOSOMAL DELIVERY

As discussed, the challenge with simply "taking" NAD is capsule form is fostered by the question "will it make it into the cell," and with standard encapsulation of powders, the overriding conclusion appears to be no.  That, however, might be changed if the NAD molecule is "protected" in a "phospholipid bubble," facilitating "liposomal delivery."

There is some solid research to indicate a Liposomal Delivery System can much enhance the effectiveness of an oral spray application (not subject to first pass), or even the cellular delivery of "Lipo" NAD powder in capsule form.

He H, Lu Y, Qi J, Zhu Q, Chen Z, Wu W. Adapting liposomes for oral drug delivery. Acta Pharm Sin B. 2019 Jan;9(1):36-48. 

This is highly encouraging as "capsules" have long been the preferred vehicle for delivering supplemental nutrients to the body.

I wish I could conclude this article with a definitive “best.”

I can’t.

The science is still unfolding.  Based on science, time, and the newest research, I’ll do the best I can to wrap this up knowing I’ll write far more about NAD and its precursors in weeks and months to come (share your thoughts and experiences).

IN CONCLUSION

Existing data will point to IV slow-drip as the most effective way to increase active NAD at a cellular level.

Weighing out all of the research and data, and acknowledging the inconvenience of a slow-drip, I personally have used sublingual NAD and a nebulized form (nasal spray) in conjunction with oral NMN supplementation.

I am presently switching to a Liposomal product combining an oral spray and capsules (with a combo of NAD and precursors).

I discourage anyone from making this single compound “all-important” as the data I’ve already shared on C60, NAC, Bovine Colostrum, and other nutritionals are all effective strategies for extending youthful health.  If you opt to give NAD a try, I invite you to share your experiences and trust that I’ll keep you posted as more definitive insights emerge.

We do offer NAD IV's at Infinite Impact so feel free to stop by and give it a try.

Explore other Nutritional Aids and Compounds Discussed in the Younger Better Stronger Program