In this educational video, Dr. A (a clinician specializing in integrative and naturopathic medicine) answers the six most common questions about nicotinamide adenine dinucleotide (NAD+). He explains NAD+’s biochemical structure and its role as a co‑factor in cellular metabolism, especially mitochondrial energy production. The video contrasts oral NAD precursors—niacinamide (vitamin B3), nicotinamide riboside (NR), and nicotinamide mononucleotide (NMN)—with injectable or intravenous NAD, highlighting differences in bioavailability and the speed of effect. Dr. A outlines therapeutic uses of NAD therapy, including mitochondrial support for long‑COVID, chronic fatigue, fibromyalgia, post‑surgical and athletic recovery, and addiction treatment, noting that higher doses are often used in specialized addiction programs. He discusses safety considerations, particularly the theoretical cancer risk of high‑dose or prolonged NAD supplementation, and recommends dosing strategies that start with intensive periods followed by tapering to maintenance with plain niacinamide. Throughout, he emphasizes the importance of addressing underlying factors such as thyroid health and toxin exposure to optimize mitochondrial function. The video concludes with a call to explore related playlists for deeper dives into integrative medicine topics.
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Why is every clinic telling me I should have some NAD+, et cetera? Well, here's the thing. We get all the way down, get into your cells. Cells aren't working right, or you're trying to, you know, kickstart your cells again. Or maybe you've done some recreational or other things that have really slowed your brain down. You know, you've had some problems with addiction, et cetera. Getting the mitochondria in your cells to wake back up and do their job helps to get the body back online. So, getting NAD+ levels up in the body helps. Because the nutrient NAD, your top six questions answered today. Hey, I'm Dr. A. Welcome to my YouTube channel. I love talking about all things integrative medicine, naturopathic medicine, regular allopathic medicine, any questions you guys like to ask, and I try and answer them here on video because I just do not have the time to type out answers to everything. So let's get into NAD. First off, it stands for a nutrient nicotinamide adenine dinucleotide. We'll just call it NAD. AD from here on out. It's in the news, people are advertising they're using it. I get a lot of questions about, is this just some hype thing or whatever? And so let's just go through the big 6 questions that we see. The first thing is, and this is a legit concern that everyone should have, is if you ever see something promoted, I don't care whether it's a drug from a pharma company or a natural substance or a new type of a car or whatever, and it just seems to do everything correctly and it cures everything, you should really probably look into it. Do it. Do a little due diligence around it. All right. Same with with things in the nutritional world. But I just want to break this down so you kind of know the pluses and minuses of NAD. So first thing is we said it's nicotinamide adenine dinucleotide. What that really means is niacin vitamin B three comes in two forms. There is nicotinic acid, and then there is niacinamide or niacinamide depending on what part of country you've come from. So niacinamide is the piece that is put into NAD+. And so what you have is a stack of 2 niacinamides and then a joining bit of chemistry that has some specific sugars in it. So it's sort of a kind of a U/Y-shaped molecule. Why would we care about that? Well, NAD+ is kind of the final step as a cofactor in most of the operations in the body that vitamin B3, the nicotinamide, you know, family uses. So, if I can get NAD in its fully formed complex molecule instead of just nicotinamide, I'm probably going to get a bigger effect from it. And indeed, that is largely true. Now, a question people will have is, do I have to inject? Because it seems like every place I go looking for NAD, they're going to give me an IV or have me injected subcutaneously or intramuscularly. Well, the reason for that is it is this giant molecule. And if you look, when I teach doctors about, you know, The use of these, these things like NAD and stuff like that. I show a picture of nicotinamide and it's sort of this kind of general molecule here. And then, this big old funky NAD over here. And, it's like, what's going to happen if I eat this big old funky molecule versus I eat this one nicotinamide? Well, nicotinamide is going to go in largely, it's going to be transported into my blood, but then I got to put a bunch of it together to make this funky NAD molecule. If I take NAD orally, most of it is going to get broken down and it's going to be very inefficient. Right now, here's the footnote. There are a couple types of precursors to NAD that you can take orally. And so if nicotinamide, plain vitamin B3, the nicotinamide form is kind of your base, then priming or giving you NAD-producing power goes up a couple of notches with these other oral molecules. So let's say you don't want to go get shots and stuff like that. You can take nicotinamide riboside, often known as NR, or nicotinamide mononucleotide, NMN. Those are 2 of the precursor molecules to making NAD in the body. Well, so is plain old cheap nicotinamide. It's just nicotinamide makes NAD easier than plain niacin. NR and NMN make it even easier. So a lot of times you'll be put on this for whatever the purpose is it will get you. But if you really So, if you want NAD and you want it full force, normally, they're going to give it to you intravenously, maybe as subcutaneous or an intramuscular injection. So then, next question is, okay, well, that's some wonderful nutritional biochemistry there, Paul. Why is every clinic telling me I should have some NAD, et cetera? Well, here's the thing. We get all the way down, get into your cells. Cells aren't working right, or you're trying to kickstart your cells again, or maybe you've done some recreational or other things that have really slowed your brain down. You've had some problems with addiction, et cetera. Getting the mitochondria in your cells to wake back up and do their job helps to get the body back online. So getting NAD levels up in the body helps because it turns out that the major way that the mitochondria, which give you all this energy and make your cells operate, the major way that they get their sort of electrical current to move energy and make ATP so that you have energy for yourself is through the breakdown of the family of NAD. It's not just NAD, but it's the family of NAD. So, if somebody goes and they put some NAD into an IV bag and then they put an IV in your arm and the NAD goes in, you're going to usually feel that. You're going to feel energy, et cetera. Well, that's because your mitochondria are waking up, right? This is a good thing. So, what if I do it the oral way? Well, if you take NR or NMN or even long-term taking niacinamide, but remember it's quite a lot slower, you're going to sometimes feel the same thing. And, I've experimented with all different types And, I can definitely tell you if I inject it, you feel it right away usually. If I take plain old nicotinamide, which is the cheapest of all of them, it's very subtle. If I take NMN or NR, nicotinamide mononucleotide or nicotinamide riboside, I can actually feel an energetic shift, meaning not an external ethereal one, but I mean an actual energy in my body shift. Within a couple hours of taking it orally. So, it really does help. Now, just because something helps doesn't mean it's always the best thing in the world for you, right? Other things that help your mitochondria work are thyroid, right? So, certainly, if you have a thyroid problem, you want to fix that because, you know, NAD+ is going to help, but that's not fixing the thyroid problem. Other things that hurt your mitochondria operating would be toxins. You get rid of that stuff, you won't need as much. We mentioned, you know, drug abuse, alcohol. It's used in drug abuse, alcohol centers. Same thing. Yeah. It's, we're just trying to undo the damage that was done before. So common conditions it's used for tend to operate around or circulate around mitochondrial slowness. So recovery, people with long COVID are using it, seems to work pretty good there. People with chronic fatigue use it, fibromyalgia, people with other post-viral syndromes, people recovering from surgeries, any recovery sort of thing. Anybody who has a long-term chronic illness can be very helpful there. I mentioned in addiction use. Now in addiction use, it's used quite differently. And if you get— if you're going to an addiction center that does NAD therapy, they're usually very specially trained because they're using much higher doses than the average place does. And they're doing it in concert with other types of therapies. Addiction's sort of a different use of it, but you can think of it— addictions often are to toxicants or toxins in the environment, and toxins in the environment literally stop your mitochondria from working appropriately. So again, helping the cells come back online, especially you stop the whatever thing you were toxifying yourself with, the whatever addictive substance. Now you're putting nutrients in, you get mitochondria working again, your brain will start to operate better. And I've known a number of people who use this in addiction and recovery, and it's a very good synergy. It doesn't fix everything. There are many other things you have to do, but that's another reason that it is used. It's also used in people for athletic recovery. Just think about anything where your cells need to turn back on. Now, there's always one little footnote, and this really deserves its own video, and I will I make my own video on it, but that is, should I avoid it if I have cancer? Now, normally, and if you look behind me in the fuzziness, there's some books I've written about cancer and some of them deal with this topic. Normally nutrients are not that much of a danger in cancer unless you're doing, you know, super high amounts, in which case you should be working with someone who does that, right? The concern, now it's a theoretical concern and there are papers on both sides of this, the ledger here, but the concern is if you use it periodically, like let's say you recover from cancer And you also went to a drug treatment center and they used NAD, right? You're not going to be at the drug treatment center forever and ever, right? So, short time to get a job done physiologically or pathologically, it's fine. Okay. So, I'm going to turn your cancer back on. Kind of the same as if I have a long COVID patient and they're somewhere in their cancer journey or they're in remission or whatever. And I'm using NM, nicotinamide mononucleotide, or NR, nicotinamide riboside, or injectable. I'll do it for a particular outcome to get their mitochondria back online. And then I'm going to back off. I'm going to slow down on the, you know, putting the NAD into the body. Remember I said there's papers on both sides. Some are like, no, it can never happen. Some are like, no, we don't know. Some of the best written biochemistry I have ever tried to understand and read, which means it took me a number of readings to go through in papers around cancer, is your body— remember, NAD is in the middle of a family of molecules. Your body uses that family of molecules for mitochondrial function, which is great, but also for a ton of other stuff. And if you don't have a really good, robustly healthy body and there's cancer that might, you know, need a little nudge in one direction, and you put a whole bunch of NAD+ into the person, theoretically, according to some pretty smart biochemists, you could metabolize that NAD+ in a way that might do that. So it's, as I say, as a therapeutic use, again, only do what your doctor tells you. I'm just talking, just telling you my experience. But if, if I see a patient and they have a therapeutic To get this out of NAD therapy, whether it's oral through NR, NMN, or IV through, you know, IV NAD, we're going to do that goal. We're going to do that treatment protocol. If it's a longer-term thing like long COVID, something like that, I'm going to start and give it to them every day. And then if we get past a couple months, I'm probably going to give it to them 5 days a week. And if we're out 6 months later and they're still needing it, which in some long COVID patients is true, you know, I might be like 4 days on and 3 days off, just so it's a nutritional buildup in the body, but I'm not putting more in every single day. So as far as danger goes, that's really— it is an area of contention in the scientific literature whether it would have any effect or not. As someone who's worked with cancer patients for a very long time, I'm very, very comfortable with nutrients and cancer, and most nutrients are not going to make your cancer get worse. I promise you that. But because there is this effect where this is a complex molecule and there's a difference between me putting you through addiction treatment for a couple of months and giving you a bunch of it, or me putting you through post-COVID treatment for, you know, 2, 3, 4, 5 months and give you a bunch of it, or you just taking it forever and ever. Those are 2 different dosing strategies. My approach is use it for when you need it. As your body gets back online and you're getting more strong and everything's working, you can dial back down, use the simple molecule niacinamide, which is just the plain, uh, amide form of vitamin B3. And, uh, that one's not gonna hurt anything. And you can use that as maintenance. I'm really glad someone asked this question. Again, we'll probably do other ones On this, but that gets me to the big 6 on NAD. Please check out the other videos we're going to put up here somewhere on the screen. Check out our playlists on YouTube, uh, and I can't wait to talk to you on the next recording. Thank you.
