What You Don’t Know About NAD-IV (and Why It Matters)

So we did a couple of videos on the YouTube side about NAD, nicotinamide adenine dinucleotide, and got a lot of questions about NAD in the intravenous form. Why would we do it? Does it help more? Why is it so expensive? All those questions. I'm going to answer those questions in this YouTube today. Hey, I'm Dr. A. Welcome to my YouTube channel. I've been researching and teaching in the integrative and naturopathic medicine world for 30 years at this point. Been seeing people with Cancer and chronic illness for a very long time. I use this channel to answer questions. So let's get at it. The first thing I want to do to kind of segue from the other video that we did is just a quick recap. So NAD is an active downstream metabolite of vitamin B3 nicotinamide. And so some people say it's the active form of nicotinamide, but it's actually 2 nicotinamides put together with some other chemistry in between. So it's a, it's a very complex molecule. So keep in mind it's vitamin B3 and then it becomes NAD+. And NAD+ is used all over the body and lots and lots of chemical reactions. Your brain uses a ton of it, et cetera. But one of the things it's most famous for is being the inciting nutrient chemical in the electron transport chain, running oxidative phosphorylation and cell respiration in the mitochondria, which of course we know make all the energy for your cells. So NAD equals mitochondrial function, mitochondrial energy. We see NAD being used therapeutically a lot of times specifically to try and get the mitochondria operating. Now, another big picture thing which we went over in the other video is all of your cells pretty much have some level of mitochondrial activity. Some kind of borrow it, but most of your cells that you know about do. NAD is used on top of what's already in your body as a therapeutic to stimulate mitochondrial activity. And so it's gonna hit the more mitochondrially dense tissues first. Who are those? Don't all the cells have the same amount of mitochondria? No. The biggest users of mitochondria are going to be the brain, the heart, the reproductive organs. Those are gonna be your highest density mitochondria per cell. For example, skeletal muscle that you use to move your body around has 200 to 500 mitochondria per skeletal muscle cell. Cardiac muscle has 5,000 mitochondria per cell. Brain, a little bit higher. Reproductive organs, et cetera. Your digestive organs have a lot. The liver has a lot, and on and on. So this is the good and bad of NAD therapy. So one of the things, question that came from the first video that we did about this was, well, if I get it intravenously, does it make a big difference? And what would the side effects be? So let's go through that. So in the other video, we talked about oral forms and oral digestion and assimilation of NAD or NAD precursors and how you could get Potentially a little bit even shaky if you took too much or feel like you were overcaffeinated. Some people take it too late in the day and they don't sleep very well. That's because the mitochondria are taking the marching orders from the NAD precursors you took orally and trying to work. In the case of intravenous NAD, one of the things that we have to be the most careful with is seeing what your tolerance is to it. And that's different for everybody. So we normally will give lower doses of NAD to somebody intravenously, make sure they don't get those overcaffeinated kind of feelings, and then And they can ramp up. Now, there's kind of 2 big uses for NAD intravenously. One is the more global chronic illness recovery, cellular recovery, you're recovering from surgery, recovering from long COVID, any, you know, anything else that's chronic. And then the other, which uses higher doses, is used in addiction medicine. And the really high doses of NAD have to be done in a highly controlled manner. But also, if you're somebody who's in an addiction program and they're doing intravenous therapies with you, And they're ramping up to higher doses of NAD+, your biochemistry has more challenges than somebody who's not, say, detoxing drugs, et cetera. So a lot of times the tolerance is higher in those situations. So that's why you see higher dose NAD+ there. Quick plug here, if you're a healthcare practitioner working with patients with these issues, I have a CE website and I do webinars on this topic and others. So we're going to put a link in the description below to the CE website link and the particular webinar of interest. Thank you. But what about every other, you know, person. Let's say, you know, you're recovering, you're trying to get over a fatiguing illness, you have a post-viral syndrome, long COVID, you have some other, you know, chronic fatigue or something. Would intravenous NAD+ be helpful for you? And the answer is yes, usually so, because it's going to go right into your body and it's going to be available to the mitochondria. And if you give it with a proper test dose to make sure you don't have, you know, too much excitation or overcaffeinated kind of feeling, you're going to able to find out the type of benefit that you get from it. Now, are there multiple forms of NAD that can be intravenously given? Well, right now there's 2 primary forms. One is the actual molecule NAD, nicotinamide adenine dinucleotide, and that is the most common one used. And the other one is nicotinamide riboside, which we mentioned in the oral NAD primer course. And so we talked about that as an oral supplement to increase NAD levels. Well, it turns out that the nicotinamide riboside used intravenously is also useful. And in some instances, in a little bit of research done about it, it actually is taken up by the cells more efficiently sometimes to get in the mitochondria than NAD itself. But they're both very useful. Now, your pharmacies— these generally are made by compounding level pharmacies, the 503 class of pharmacy. And so sometimes there are availability issues and can't ship to certain states and all of that. But let's say it's available. Both of them are going to be helpful. You may find a difference between one or the other, or your practitioner may prefer one or the other because of availability, cost, et cetera. How is it often used? So we're not going to talk about in addiction medicine because that's its own sort of thing. But normally when I am ordering NAD IV or, or NRID IV types of therapies, we do a couple of things. One is the test dose, and then you ramp up. The next thing is what we did So I was using NAD intravenously long before it was cool and anyone ever heard about it with chronic fatigue patients. We had it available, you know, 20+ years ago, and then it kind of went away and then it made a resurgence and super popular now. What we used to do and we still do is if I order it, I'm always going to have the person get nutrients as cofactors. So the other B vitamins, tiny bit of vitamin C, some minerals, maybe some trace minerals, and then they're going to get some glutathione separately. And the NAD will either be with the IV bag with all the nutrients, or if If it's not compatible, it'll be given separately. Why do we do that? Because when you put the NAD in, it's not just gonna work on its own. It's gonna use up a bunch of other cofactor and conutrients. And so what we find is we get less side effects if we give the nutrients and NAD and then glutathione, and it just kind of helps the whole system work better together. The other thing that we do is decide how much they need from the IV versus oral. So normally we give IV, we'll give oral stuff in between the IVs because of the expense. Sometimes people can do it once a week. You know, they're really, really sick, maybe twice a week. And we'll do that for a short period of time. So we might do, let's say someone's really, really sick and they can do twice a week. We do that for 4 weeks, see how they do. And then we might go to once a week for another 8 weeks after that. In between, we're going to have them taking the oral NAD supports that we talked about in the previous YouTube video. And those are going to be things like either plain niacinamide, also known as nicotinamide, or nicotinamide riboside, or another precursor-like substance. So we're going to always be supporting what we do with the IV with oral supplementation. Now, you might say, well, what happens if somebody comes in at 2 weeks, they're doing twice a week, they're like, I feel, you know, like 80% of my energy's returned. Can I just do once a week for a little bit? Sure. You always adjust intravenous therapies to the response of the patient. Same thing would be if they get to 4 weeks and they're doing it twice a week and they say, I do feel better, feel maybe I've recovered 15%, 20% of my energy. Is there any reason I can't do twice a week for a little bit longer? The answer is no, there's no reason that you can't. So you can always adjust it as you go. So these ideas of X number of treatment for a certain amount of time, then X number of treatment that's less for a longer time, those are adjusted based on your personal response. Well, I hope this answers the questions that we stirred up, obviously, with our original NAD videos. And I hope to see more questions. You can put 'em in the comments below. We're gonna put some other links here at the end that you can take a look at as well. Thank you very much.