What You NEED TO KNOW About Oral NAD Supplements | You Could Be Taking it the Wrong Way

If you think about it and you have somebody, take example of long COVID, they're really fatigued and they're kind of crawling out of the hole and they're starting to feel a little better and we want to get some more energy priming in them. We give them nicotinamide riboside orally, for example, and a B complex and minerals during the process. They may also have some— Hey, it's Dr. A. Welcome to my YouTube channel. I've been doing research and teaching in the naturopathic and integrative medical communities for 30 years now, and I've been a clinician practicing with cancer and chronic illness patients for a very long time. Use this YouTube channel to answer questions, and a big question that came up after an original video we did was, could you break down a little bit more about NAD, nicotinamide adenine dinucleotide, the nutrient, how it works in the body, and are supplements effective if I take them by mouth to help me with my NAD levels? Also, would I want to do that? So let's get at it right now. First off, nicotinamide adenine dinucleotide, the long name for NAD+, is a primer that's used in a lot of cofactor processes in the body. So I'm going to talk about non-mitochondrial processes and then mitochondrial processes. Non-mitochondrial uses of NAD+ are literal cofactor operations where you are generally using NAD+ to help an enzyme go from a substrate to a product or making something that you need. Now, that might be a neurotransmitter in your brain, might be part of an enzyme formation system, or another enzymatic type of a system in your liver or elsewhere in your body. So NAD is used all over the body. The brain uses a ton, the liver uses a ton, et cetera. The part most people focus on when doing NAD supplementation or augmentation is generally the mitochondrial part, which is, if we think about mitochondria, which make the energy for your cells, that's a good thing. If low energy is literally low mitochondrial rate, In the body. So if we think about those mitochondria, we have multiple inside of our cells. You can have a few hundred in your muscle cells. You can have 5,000 in your heart muscle cells. Brain has a bunch, et cetera. NAD happens to be at the beginning of running the mitochondrial energy production system. So this is why NAD is used so much as a supplement or a support to try and help return energy to somebody. What NAD does is at the very beginning of the mitochondrial electron transport chain, which runs oxidative phosphorylation and helps out with cell respiration, et cetera, is NAD donates the initial chemistry to help run the chain. Now, the faster the chain runs, the more energy is produced. So that's why NAD has such a big focus. That and the fact that people have developed supplements and IV therapies and stuff to support NAD function. So what's NAD made of? Well, nicotinamide adenine dinucleotide tells you a little bit about the structure, but vitamin B B3, you also might see supplements called niacinamide. So there's 2 different chemical forms of B3. If you take a niacin supplement, you may get flushed. That's pretty common with niacin supplements. Niacin at high dose has been used in cardiovascular disease to lower triglycerides, things like that. And niacin also has been used in psychiatry and other things for a long time. Niacinamide, if you take that, you could take hundreds of milligrams, grams, you, you will not flush from that because the chemistry is a bit different. Well, which one would your body prefer to make NAD, which is more complex? So if we take niacinamide and we take another niacinamide and put them next to each other, and then the adenine dinucleotide is a bunch of other chemistry at the top that holds these 2 niacinamide tails together, what you will see if you look at biochemistry is niacinamide, the amide form, is going to be closer to making NAD than plain niacin, the flushing kind, would be. So if we're trying to use the least expensive way to promote NAD formation in the butt, because your body has the enzymes to do this, we give people niacinamide. Okay, the supplement. So that's the least expensive way to do it. It often takes a long time. And if you're really fatigued, if you're recovering from surgery, if there's any other reason you need NAD kind of cranked up, sometimes it's a little bit slow. So what are other ways to do it? Well, there are precursors. Now, could I take NAD orally? Well, you could, but your digestive system will break that molecule down and you won't get much efficacy out of oral NAD. You You can use a sublingual cousin called NADH, and that will absorb. We used to use that a lot with people. And then there are 2 oral forms that are precursors to make NAD that do absorb through the GI tract. One is NMN, nicotinamide mononucleotide. The other is NR, nicotinamide riboside. Now, currently in the United States, the FDA has shut down most people who make NMN because NMN has an investigational new drug application with the FDA for a drug purpose. And the FDA's contention is you cannot have an IND for a new drug and a supplement at the same time. So if you make NMN— now, I just went online and looked, and there's still companies you can buy NMN from, but as the FDA finds them, they're going to tell them to stop selling it. So that's one thing. But NMN is a precursor. I've used it with lots of people. The other one that you see more commonly is NR, nicotinamide riboside. And this has the most research behind it. It also probably has the most developmental money behind it as far as a, you know, supplement to prime NAD+, et cetera. And so NR is commonly used. So the way I look at it is if money is no object, which of course it always is, you really need NAD+, nicotinamide riboside is going to be a faster way to get there. If you just want chronic long-term support beyond your diet to form NAD+, take supplemental niacinamide, which is much less expensive but takes a lot longer to work. The difference, for example, is I can take 1,000 milligrams of niacinamide and I won't really feel, you know, any energy change perceptibly. But if I take it over time, you know, I probably will. If I take nicotinamide riboside, NR, and I take 100, 200, 300 milligrams, I will often feel an energy shift that day, sometimes within an hour. So nicotinamide riboside, you do feel more. So that's what NAD+ is. And that is kind of what's behind the different types of supplementation. Now, I don't know the status in Canada or any other country. You can probably still get NMN. If I'm looking clinically at nicotinamide riboside and NMN, the nicotinamide riboside does tend to give me a clinical response a little faster than NMN, but both of them do work. So if you're in a country you can get either one, will work. Nicotinamide riboside, NR, will work faster, generally speaking. Quick interruption from the regular video. If you are a healthcare practitioner, practitioner and you have an interest in this topic, we're going to put a link in the description below to my CE website and specifically the webinar that is about this topic. So see you over there. Thanks. So then there's a bunch of questions about what can I expect from taking these things? Well, like I said, with niacinamide, the simple one, that's one part of the whole tree there of NAD, it's going to be subtle. You're going to take 500 milligrams, 1,000 milligrams, maybe more every day along with your diet and the B complex and other stuff. And it's going to help you with energy, but it's going to be Over time. If you take NMN or N-acetyl nicotamide riboside, NR, you're going to notice it much more quickly as far as the energy shift. Now, energy shifts depend on how worn out you are. Sometimes people are really worn out, notice it right away, and it's almost disturbing to them. So, you know, we start them and we say, look, just take, you know, 100 to 150 of nicotamide riboside milligrams and let us know how you do. And they say, ooh, that's You know, almost too much. Felt overcaffeinated, etc. We may have them take less. Might have them take it every other day, something like that. And then what they'll notice is a certain point their energy starts to regroup because they're doing other things to support this, and then they are able to shift the dose, take it every day or whatever. The other thing is you take it and you're two weeks in, and you get back with your provider, and you're like, maybe I noticed something, but I'm not sure. And you're taking 100-150 milligrams of nicotinamide riboside. At that point, the practitioner might say, well, you. You know, you're either, you have a lot of need or, you know, maybe you got inhibition or whatever's going on. Why don't we try more? And so then they might go, you know, from 200 to 300 or something like that, milligrams of nicotinamide riboside, about the same for NMN too. So there's sort of a faster effect, a slower effect, and most people it's somewhere in the middle. Now, another question that comes up with what to expect is, do I have to take this forever? Because it's expensive. Well, the answer is no. You don't have to take anything forever generally, but as a supplement, it's supposed to be on top of what you're eating and getting in your body. So, once we have people recovering their energy and their diet is tuned up and they're feeling better and all of that, we usually have them start to wean off of the nicotinamide riboside and take less over time. Now, some people still will take a little bit every week. Some people just don't need it because they're healthier and they're kind of on the other side of the illness. A lot of it depends on why you are doing it. And then beyond what to expect, we got a lot of questions about, well, is there a way to like optimize the supplementation I'm doing? And the answer is of course yes. So the first thing is, because this is getting to core levels of your body's function, so there's the non-mitochondrial functions, which are enzymatic pathway manipulation, stuff like that your body does millions of times a day. And then there's the mitochondrial part that your body does millions of times a day. And what you feel usually is the mitochondrial part. So we might want to optimize it. Well, the first thing is, is that you Never use any nutrient alone. Okay? It always does something to other nutrients around it. With B vitamins, which remember nicotinamide is vitamin B3, so NAD+ is considered active B3, but it's actually a downstream metabolite, very active. So anytime you use one B vitamin, you're going to use other B vitamins generally because you will speed up the pathway, your B vitamin, say it's NAD+ that you're taking, and that pathway has other pathways it speeds up that use other B vitamins. So for example, in the mitochondria, you might have a couple of other B vitamins getting involved in the act. And when you speed it up with NAD+, those other B vitamins become more necessary. So we are always gonna first off give the NAD+ primer or the nicotinamide along with other B vitamins. Now you might take more. Let's say you're doing the simple, cheap way and it's nicotinamide. You're gonna take probably like a B complex. That's fine. It's gonna have a bit of nicotinamide in it probably. And then you're gonna, on top of that, take extra niacinamide, nicotinamide, same thing. And And that might be 500, 1,000, or even more milligrams to augment the B vitamins, but you're getting extra B vitamins. The base of this, of course, is eating a nutrient-rich diet, which is going to give you lots of B vitamins and minerals and stuff. Beyond the B vitamins, other things you're going to speed up the use of would be vitamin C. Humans don't make their own vitamin C, so they're going to need a little bit of extra of that. And then minerals, including trace minerals and non-trace minerals. So magnesium is going to be used faster because of cofactor activity, trace elements, some things you've heard of like zinc or selenium, et cetera. And generally for those things, I just have people use clinically a multi-mineral supplement that has some magnesium, potassium, and stuff, and then the trace minerals in it. So you're sort of getting a balance, kind of like using a B complex as a base. And again, your diet's first and then supplements come after that. So optimizing that, first off is diet, second off is other supplements to round it out, and then third is doing things that would be generally supportive if you have other issues. So if you think about it and You have somebody, take example of long COVID, and they're really fatigued and they're kind of crawling out of the hole and they're starting to feel a little better and we want to get some more energy priming in them. And so we give them nicotinamide riboside orally, for example, and a B complex and minerals. Well, they may also, during the process of long COVID and whatever else is going on, they may also have some infections they're cleaning up. They, other infections beyond COVID, they may have some inflammatory things that they're dealing with. They may have discovered that the methylation issues they have genomically are really bothering them. Of course, you want to treat the other collateral problems that the energy— really the reason the energy was in deficit from— and then the whole ship is going to get better overall. All right. Well, I hope this answered the questions that we triggered through NAD+. I'm Dr. A. Thank you so much. Thanks to all you new subscribers, all you present subscribers. Please like, share, subscribe, do the notifications, and I'll see you on the next video.