Liposomal NAD+ Complete Nasal Spray by Renue by Science

POSSIBLY EFFECTIVE

• Chronic fatigue syndrome (CFS). Several small clinical studies suggest that oral NADH, taken alone or in combination with coenzyme Q10, modestly improves symptoms of CFS. Details: One small clinical study in patients with CFS shows that taking NADH 10 mg daily for 4 weeks leads to a favorable response in around 31% of patients, compared with around 8% of those taking placebo (8267). Another small clinical study in patients with CFS shows that taking NADH 5-10 mg daily for 24 months reduces symptoms by 42% when compared to baseline in the first 3 months, with symptom scores maintained for the rest of the study. These results were similar to patients receiving conventional treatment with nutritional and psychological interventions (93687). NADH has also been evaluated in combination with other ingredients. A small clinical study in patients with CFS shows that taking a specific product (ReConnect, Vitae Natural Nutrition) containing NADH 10 mg plus coenzyme Q10 100 mg twice daily for 8 weeks reduces fatigue index scores by about 6%, compared with about 3% in those taking placebo (93686). A larger clinical study also shows that taking NADH 20 mg plus coenzyme Q10 200 mg daily for 8 weeks improves some measures of fatigue, sleep quality, and quality of life when compared with baseline. No improvements in these measures were reported with placebo (107448). It is unclear if these findings are due to NADH, coenzyme Q10, or the combination.

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging. Although there has been interest in using oral NADH for aging, there is insufficient reliable information about the clinical effects of NADH for this purpose.
• Alcohol-related liver disease. Although there has been interest in using oral NADH for alcohol-related liver disease, there is insufficient reliable information about the clinical effects of NADH for this purpose.
• Athletic performance. Although there has been interest in using oral NADH for improving athletic performance, there is insufficient reliable information about the clinical effects of NADH for this purpose.
• Cognitive function. Although there has been interest in using oral NADH for improving various measures of cognitive function, including memory and mental alertness, there is insufficient reliable information about the clinical effects of NADH for this purpose.
• Dementia. It is unclear if oral NADH is beneficial in patients with dementia. Details: A small clinical study in patients with mild to moderate dementia of the Alzheimer, vascular, or fronto-temporal type shows that taking NADH 10 mg daily for 12 weeks does not improve measures of memory, cognition, or behavioral function when compared to baseline (8275).
• Depression. Although there has been interest in using oral and parenteral NADH for depression, there is insufficient reliable information about the clinical effects of NADH for this purpose.
• Hypertension. Although there has been interest in using oral NADH for hypertension, there is insufficient reliable information about the clinical effects of NADH for this purpose.
• Jet lag. Although there has been interest in using oral NADH for jet lag, there is insufficient reliable information about the clinical effects of NADH for this purpose.
• Parkinson disease. Small, low-quality studies have yielded conflicting findings regarding the effects of oral or parenteral NADH in patients with Parkinson disease. Details: A very small, double-blind, placebo-controlled clinical trial in patients with Parkinson disease shows that administering intravenous NADH 25 mg daily for 4 days followed by intramuscular NADH 25 mg at weeks 2 and 4 does not improve Unified Parkinson Disease Rating Scale (UPDRS) scores when compared with placebo (3090). However, a large, open-label clinical study in patients with Parkinson disease shows that taking NADH 5 mg by mouth or administering intravenous NADH 12.5 mg over 30 minutes every other day for 14 days reduces disability scores by between 30% and 50% in around 19% of patients and reduces scores by between 10% and 30% in around 59% of patients when compared with baseline (3089). Also, a smaller, open-label clinical study in patients with Parkinson disease shows that administering intravenous NADH 10 mg over 30 minutes once daily for 7 days improves symptoms as measured by the UPDRS and increases the bioavailability of levodopa when compared with baseline (3086). The validity of the findings in these open-label studies is limited by a lack of placebo control. More evidence is needed to rate NADH for these uses.

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INSUFFICIENT RELIABLE EVIDENCE to RATE

• Age-related macular degeneration (AMD). Although there is interest in using oral nicotinamide riboside for AMD, there is insufficient reliable information about the clinical effects of nicotinamide riboside for this condition.
• Alzheimer disease. Although there is interest in using oral nicotinamide riboside for Alzheimer disease, there is insufficient reliable information about the clinical effects of nicotinamide riboside for this condition.
• Ataxia telangiectasia. It is unclear if oral nicotinamide riboside improves ataxia telangiectasia. Details: Preliminary clinical research in adults and children with ataxia telangiectasia shows that taking nicotinamide riboside orally 25 mg/kg daily for 4 months improves ataxia scores by 11% to 17% when compared with baseline. Ataxia scores also worsened after treatment withdrawal. The validity of this study is limited by the lack of a comparator group (107703).
• Athletic performance. It is unclear if oral nicotinamide riboside improves athletic performance in healthy adults. Details: One small study in young, healthy males shows that taking a specific nicotinamide riboside product (NAD+ Cell Regenerator, Life Extension) 500 mg two hours before exercise does not improve measures of muscle strength, muscle fatigue, or oxygen consumption when compared with placebo (102036). Given the small sample size, this study is limited by a lack of adequate power to detect significant differences between groups.
• Diabetes. Although there is interest in using oral nicotinamide riboside for diabetes, there is insufficient reliable information about the clinical effects of nicotinamide riboside for this condition.
• Heart failure. It is unclear if oral nicotinamide riboside is beneficial for heart failure. Details: Preliminary clinical research in patients with heart failure and a left ventricle ejection fraction of less than 40% shows that taking nicotinamide riboside 250 mg orally twice daily, titrated weekly by 250 mg to a final dose of 1000 mg orally twice daily, for 12 weeks does not improve 6-minute walk test distance or quality of life scores when compared with placebo. However, the study may have been inadequately powered to detect a difference between groups (110506).
• Hyperlipidemia. It is unclear if oral nicotinamide riboside improves lipid levels. Details: One small clinical study in sedentary males with obesity and elevated blood lipids shows that taking nicotinamide riboside (Niagen, ChromaDex) 1000 mg twice daily for 12 weeks does not improve total cholesterol or low-density lipoprotein (LDL) cholesterol when compared with placebo (94745).
• Hypertension. It is unclear if oral nicotinamide riboside reduces blood pressure. Details: One small clinical study in patients with and without hypertension shows that taking nicotinamide riboside (Niagen, ChromaDex) 500 mg twice daily for 6 weeks non-significantly reduces systolic and diastolic blood pressure by around 4 mmHg and 2 mmHg, respectively, when compared with placebo. The effect seems to be more pronounced in patients with elevated blood pressure at baseline (94744).
• Nonalcoholic fatty liver disease (NAFLD). Oral nicotinamide riboside has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in adults with NAFLD shows that taking a combination product containing nicotinamide riboside 125 mg and pterostilbene 25 mg (Basis, Elysium Health), 2-4 tablets orally daily for 26 weeks does not improve liver function test levels or liver fat content when compared with placebo (110508).
• Obesity. It is unclear if oral nicotinamide riboside improves weight loss. Details: Two small clinical studies in adults with obesity shows that taking nicotinamide riboside (Niagen, ChromaDex) 1000 mg once or twice daily for 6-12 weeks does not reduce body weight or improve insulin sensitivity, glucose metabolism, or lipid levels when compared with placebo (94745,104935).
• Parkinson disease. It is unclear if oral nicotinamide riboside improves Parkinson disease. Details: Very preliminary clinical research in adults with newly diagnosed Parkinson disease shows that taking nicotinamide riboside 500 mg orally twice daily for 4 weeks does not improve Parkinson disease scores when compared with placebo. However, the study may have been inadequately powered to detect a difference between groups (110504).
• Physical performance. It is unclear if oral nicotinamide riboside improves physical performance in older adults. Details: One small clinical study in healthy, elderly males shows that taking a specific nicotinamide riboside product (NAD+ Cell Regenerator, Life Extension) 500 mg two hours before exercise seems to improve some measures of muscle strength and fatigue, but not oxygen consumption, when compared with placebo. Additionally, muscle strength, as measured by isometric peak torque, was improved in these older patients when compared with younger males taking the same product (102036). More evidence is needed to rate nicotinamide riboside for these uses.

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POSSIBLY SAFE ...when used orally and appropriately. NADH has been safely used at doses up to 10 mg daily for up to 12 weeks and 20 mg daily for up to 8 weeks (8267,8275,93686,107448).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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POSSIBLY SAFE ...when nicotinamide riboside chloride is used orally and appropriately. The European Food Safety Authority has set a tolerable upper intake level (UL) of 300 mg daily for nicotinamide riboside chloride (104937,107706). In clinical research, higher doses have been used for up to 12 weeks (110504,110506). A specific nicotinamide riboside branded ingredient (Niagen, ChromaDex) 1000 mg has been used twice daily for 12 weeks with apparent safety (94744,94745,94746,102035).

PREGNANCY AND LACTATION: POSSIBLY SAFE
when nicotinamide riboside chloride is used orally and appropriately. The European Food Safety Authority has determined that taking nicotinamide riboside chloride in doses of up to 230 mg daily is safe when pregnant or breastfeeding (104937,107706).

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ANTIHYPERTENSIVE DRUGS Interaction Rating = Minor Be watchful with this combination. Severity = Mild •  Occurrence = Possible •  Level of Evidence = D Theoretically, nicotinamide riboside may have additive effects with antihypertensive drugs, potentially increasing the risk for hypotension.  Details One small clinical study suggests that nicotinamide riboside can modestly reduce blood pressure in hypertensive patients (94744). However, other clinical research did not find a reduction in blood pressure when compared with control (104935).

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General ...Orally, NADH seems to be well tolerated. No adverse effects have been reported in clinical research.

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General ...Orally, nicotinamide riboside seems to be well tolerated.
Most Common Adverse Effects:
Orally: Bloating, muscle pain, nausea, pruritus, sweating, and transient changes in stools.

Dermatologic ...Orally, mild cases of flushing, skin rash, pruritus, and excessive sweating have been reported in clinical trials for some patients taking nicotinamide riboside (Niagen, ChromaDex) (94744,94745). However, flushing and skin rash were reported at the same rate in patients receiving placebo (94744).

Gastrointestinal ...Orally, mild cases of nausea, bloating, and transient changes in stools have been reported in clinical trials for some patients taking nicotinamide riboside (Niagen, ChromaDex) (94744,94745,102035).
Other gastrointestinal adverse effects such as abdominal discomfort, diarrhea, and dyspepsia have been reported with oral use of a combination product (Basis, Elysium Health) containing nicotinamide riboside and pterostilbene (94747). It is unclear if these effects were due to nicotinamide riboside, pterostilbene, or the combination.

Hematologic ...Orally, increased bruising was reported in one clinical trial for one patient taking nicotinamide riboside (Niagen, ChromaDex) (94744).

Musculoskeletal ...Orally, leg cramps were reported in one clinical trial for one patient taking nicotinamide riboside (Niagen, ChromaDex) (94744). Some patients taking this specific nicotinamide riboside product in another clinical trial have reported mild muscle pain or soreness (102035).

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