NAD+: Getting Serious About Anti-Aging Therapy

We’re living in a time of major, worldwide breakthroughs when it comes to understanding how we age and also the steps we can take to not only slow down aging, but to all appearances reverse the process.

Over history, the fountain of youth seekers came, literally and figuratively, to dead ends, but back then Ponce de Leon had no internet in Florida. I do and after a few clicks, I’m reading solid anti-aging research from universities around the world including in Japan, Israel, and the US.

Some of the most interesting work is coming out of a place you’ve likely never heard of, the Wistar Institute at the University of Pennsylvania, whose website describes itself as “a world leader in early-stage scientific discovery.”

The big scientific publications–Nature, Science, and Aging Cell–accept only peer-reviewed scientific research, quality over hype. If you get lost in too much scientific jargon, graphs, and tables, the well-known Life Extension Foundation’s magazine presents very accessible prose, though admittedly it’s a bit prone to hyperbole.

NAD+

The most significant news of the past couple years has centered on a substance produced in our bodies called nicotinamide adenine dinucleotide, NAD+ for short. It’s classified as a co-factor, meaning that it helps all parts of your metabolism run efficiently. Imagine your metabolism as billions of gears running 24/7, from conception to your final breath. NAD+ lubricates everything. Without NAD+ you’d be dead, instantly.

Scientists have spent decades trying to figure out exactly how we age, researching why some people become old before their time and die quite young even as others are mentally and physically fit as they near 100, sometimes even enjoying a daily cigar and martini.

The current thinking is that, over the years, we age because we’re exposed to a variety of harmful substances (free radicals, for example) that slowly but relentlessly damage our cells. When we’re young, we’ve got plenty of NAD+ to handle damage control. But with the passage of time our bodies simply don’t make enough NAD+ to keep up with the harm to important things, like our DNA and our mitochondria (the “power plants” inside every cell).

At 50, you have only half the NAD+ you enjoyed as a callow youth. At 80, you’re lucky if you have 5% left.

Here’s how NAD+ acts as an anti-aging agent

It’s a little complicated, but you’ll follow.

• NAD+ is needed to maximize the efficiency of certain proteins called sirtuins that contribute to longevity by maintaining the length of your telomeres. Telomeres are lengths of DNA at the ends of your chromosomes—like the plastic tip of a shoelace. Telomere shortening is the key marker of cellular aging. When telomeres reach a critically short length, cell renewal stops, leading to accelerated aging and cell death. NAD+ appears to extend telomere length.

• On a cellular level, whenever DNA is damaged, it activates PARP-1, an enzyme necessary
  for prompt and efficient DNA repair. PARP-1 requires large amounts of NAD+ to function. As you age, however, because of declining NAD+ your ability to repair DNA declines. Your immune system falters, making you more vulnerable to infection and cancers, and you accumulate waste products, with the result that your arteries harden or plaque accumulates in your brain. There’s a new group of cancer chemotherapy drugs called PARP inhibitors, an idea that seems counterintuitive, since we need PARP. It turns out that cancer cells have particularly weak DNA, so if you block the DNA repair mechanism by inhibiting PARP, the cancer cell dies.

• NAD+ regulates your otherwise aging immune system, allowing it to steer a midcourse between overactivity (which can cause autoimmune disease) and underactivity (which can lead to susceptibility to infection and cancer).

• NAD+ maximizes how we get energy from food. As we get older our energy levels can decline. Watching a group of children at play, you wonder aloud where they get all of that energy. Basically, they have far more NADH+ than their parents and can extract a lot of energy from just several bites of food. What’s happening is that our cells extract energy from the food we eat via a pathway every medical student must memorize: the electron transport chain. NAD+ promotes energy extraction and increases the capacity of your cells to work efficiently.

• NAD+ was recently discovered to not only restore nervous system neurotransmitters but to act as a neurotransmitter itself. Here’s a very unscientific but enthusiastic article about having a “brain reboot” with intravenous NAD+.

Raising your NAD+

The fastest and most efficient way to raise your NAD+ is to begin a series of intravenous (IV) treatments, usually a total of five to seven, over a period of ten days, followed by a combination of maintenance IVs (one a month) and nutritional supplements you take by mouth.

There are two NAD+ IV potencies, regular strength and high strength. For people looking for an anti-aging therapy, the regular is fine. If you have a chronic health issue of virtually any kind, however, the higher-strength NAD+ IV treatment is probably a better choice.

NAD+ delivered via IV is offered worldwide and you can find treatment centers near any urban area.

Lifestyle changes can boost NAD+ as well. The process will be slower and the results less dramatic than with IV infusions, but considering the benefits of healthy NAD+ levels, you might as well get started on all of these, which have been shown to raise NAD+.

• Regular exercise. In fact, recent research confirms that exercise itself had very intensive anti-aging capabilities. The key researcher also believes that the current drugs being recommended for “anti-aging” like Metformin, actually block the positive effect of exercise on muscles. This is a tough for doctors interested in anti-aging medicine because researchers on both side of the metformin issue are basing their recommendations on mice studies, not people. The conclusion to be reached might be this: if you exercise regularly don’t consider metformin as an anti-aging ‘add-on’ as it might do more harm than good. Conversely, if chess is your main sport and you want an add-on ‘something,’ then read about metformin and ask your doctor about it.
  • At any rate, it’s estimated only 25% of the population are getting an adequate amount of exercise (even less in rural areas). Here’s my Health Tip on how much exercise makes a difference.
• Following a low-carb ketogenic diet. Being in ketosis, in which your body uses fat instead of glucose for energy, increases your NAD+. Here’s a keto meal plan for beginners.
• Practicing intermittent fasting. Click here for a guide to intermittent fasting.
• Eating foods high in NAD+ including milk, fish, chicken, yeast, green vegetables, crimini mushrooms, and fermented foods like kombucha and sauerkraut.
• Supplementing with an NAD+ precursor (building block) called nicotinamide riboside, a variation of vitamin B3. Click here for a review of these supplements. NAD+ itself isn’t available as a supplement because the delicate molecule is destroyed during digestion.

You might have already guessed that we offer NAD+ IV infusions at WholeHealth Chicago. We’ve priced our NAD+ series competitively, but two advance warnings: the infusions are not covered by insurance and you need to allow three hours for each session, so bring your phone, laptop, or book or just plan a long meditation. We offer two different doses in IV form.

You don’t have to be a WHC patient to schedule IV NAD+. You can buy online.

Be well,
David Edelberg, MD