Supplement isn’t ‘fountain of youth’

Dear Dr. Roach: I read a recent article on the benefits of the supplement NAD+, which describes its antiaging benefits. It appears that there are quite a few. I am very interested in your take on this.

K.R.

Answer: NAD+ is a coenzyme that is critical for basic function of the cell.

ATP is the basic energy currency of the cell. A certain amount of NAD+ is needed for the system to work, and adding more is not necessary. However, NAD+ and NADH have many more jobs, in and out of the mitochondria.

It is true that as animals age — both mice and humans have been studied — NAD+ levels tend to decrease. This seems to relate to increased destruction of NAD by the cell. Raising NAD+ directly requires intravenous supplementation, but there are NAD+ donors, such as nicotinamide riboside, that will increase NAD+ levels when given orally. Trials in mice have shown some benefits in cellular function, such as improved ability to metabolize sugar. There is not yet any good evidence that NAD+ supplementation in humans leads to any clinical benefit. Studies are ongoing.

However, there is evidence that while NAD+ may help mitochondria in our cells, it may also increase cancer cell growth. Studies in mice have shown increased rates of developing pancreatic cancer in mice genetically predisposed to do so.

Finally, supplements are not regulated by the Food and Drug Administration to the same levels that pharmaceutical drugs are, and there is no guarantee that any supplement you are taking has an accurate amount listed on the bottle.

Although I would love to be proven wrong, I don’t think that NAD+ is the “fountain of youth” as some of its supporters have touted.

I don’t recommend taking the supplement until much more information is available about the benefits and risks of long-term use.

When a person is taking a drug or supplement to prevent disease, and they have no symptoms to treat, the evidence needed to prove benefits outweigh risks needs to be very strong.