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Supplements

NADH

What Is It?
Health Benefits
Forms

Dosage Information

Guidelines for Use

General Interaction

Possible Side Effects

Cautions

References

Evidence Based Rating Scale
 

What Is It?

NADH, is the reduced form of the coenzyme nicotinamide adenine dinucleotide (NAD+, or NAD “plus”), hence the addition of “H” tat the end. Coenzymes are molecules that link to enzymes and are essential to the activity of the enzyme.  Many coenzymes are derived from vitamins, and the body needs good amounts of them for optimal energy production. The coenzyme, NAD+, is no exception. Present in all living cells, it combines with Vitamin B3 (niacin) with the help of an enzyme. As a coenzyme, NAD+ helps start chemical reactions that result in changes in other substances.  In the process, NAD+ is converted to NADH  

NADH stimulates the production of ATP (adenosine triphosphate), a compound that regulates the release of energy from glucose in cells. The more NADH a cell has the more chemical energy it produces. (1)

NAD and NADH work together by adding and releasing hydrogen atoms in cellular energy production. NADH is formed when the reaction adds a hydrogen atom to NAD. The formed NADH donates its hydrogen in the cellular respiratory chain, reverting to NAD. As a coenzyme, NAD and its reduced form NADH serve an important role in cellular energy production and in the production of dopamine, a neurotransmitter (messenger) necessary for motor skills and brain focus.

Health Benefits

Oral NADH supplementation has been used to combat simple fatigue as well as such mysterious and energy-sapping disorders as chronic fatigue syndrome and fibromyalgia. Researchers are also studying the value of NADH supplements for improving mental function in people with Alzheimer's disease, and minimizing physical disability and relieving depression in people with Parkinson's disease. One animal study indicated NADH supplements may prevent age-related hypertension. (2)

Some healthy individuals also take NADH supplements orally to improve concentration and memory capacity, as well as to increase athletic endurance. However, to date there have been no published studies to indicate that using NADH is effective for these purposes.

Specifically, NADH may help to:

  • Improve Alzheimer's symptoms. Some European studies of NADH have shown promise for treating people with Alzheimer's disease. In one well-designed double-blind, placebo-controlled study, twenty-four patients with probable Alzheimer's Disease were given either 10 mg per day of NADH supplements or placebo for six months. At the end of the study, patients who received NADH showed no evidence of progressive cognitive deterioration and had higher scores on the Mattis Dementia Rating Scale (MDRS) than those who received placebo. The MDRS is designed to assess the level of cognitive function in individuals with brain dysfunction. The results of the study suggest NADH supplementation may slow the progression of Alzheimer's Disease. (1)

  • Relieve symptoms of chronic fatigue syndrome. Results are mixed for the efficacy of NADH in chronic fatigue syndrome (CFS). In a 2010 study, seventy-seven patients with CFS were given 20 mg of oral NADH or placebo for the first two months. In the results, NADH supplementation was associated with reduced maximum heart rate and anxiety compared to placebo. However, NADH did not affect the symptoms of CFS. (3) A 2011 review of complementary and alternative medicine (CAM) for CFS found NADH was one of only two supplements that indicated efficacy in improving symptoms of CFS. (4)

  • Relieve depression. Imbalances in brain chemicals are a primary cause of certain types of depression. Because NADH stimulates the production of many key chemicals called neurotransmitters, it may have a role to play in relieving the symptoms of depression. No clinical trials to demonstrate this effect have been conducted so far, however.

  • Lift general fatigue and exhaustion in fibromyalgia. Because NADH increases energy in cells, some researchers speculate that it may also boost energy in people with fibromyalgia, a disorder characterized by muscle pain and fatigue. NADH may also keep simple, daily fatigue at bay by helping to supply muscle cells with energy. Large-scale studies are needed to confirm this potential benefit.

  • Complement Parkinson's therapy. People with Parkinson’s disease have dwindling supplies of the neurotransmitter dopamine. There is early evidence that NADH supplements may raise levels of dopamine, which is crucial to slowing the physical symptoms of Parkinson's disease and relieving the depression that often accompanies them. However, clinical trials in humans are limited and none are recent. In a 1996 trial of 15 patients, intravenous treatment with NADH in addition to L-dopa for seven days led to significant improvements in Unified Parkinson’s Disease Rating Scale (UPDRS) scores. Perhaps more significantly, NADH seemed to stimulate the  biosynthesis of levodopa in the brain, thus increasing efficacy of the conventional drug in treating PD. (5) In a 1993 open-label trial of 885 patients with PD receiving NADH either intravenously or orally, both forms of the coenzyme led to significant improvement in disability. However, the effect of NADH was related to duration of disease and age of the patient. In the study, younger patients and patients with a shorter duration of disease had a better chance of marked improvement in disease symptoms than did older patients and patients with longer duration of disease. (6) Conflicting studies have shown no benefits in PD patients after short-term treatment with NADH. (7) More studies are needed to determine efficacy.  

Forms 

  • Intravenous
  • Tablet

Dosage Information

Special Tip:

-- Some people recommend taking the disodium salt form of NADH with water either thirty minutes before or two hours after meals.  

· For Alzheimer's disease, 10-15 mg daily or every other day.

· For chronic fatigue syndrome, 10-15 mg daily or every other day.

· For fatigue, 2.5-5 mg daily or every other day.

· For fibromyalgia, 10-15 mg daily or every other day.

· For Parkinson's disease, 10-15 mg daily or every other day.

Guidelines for Use

Take NADH with water thirty minutes before or two hours after meals.

General Interaction

There are no known drug or nutrient interactions associated with NADH.

Possible Side Effects  

There are no reported side effects of NADH. 

Cautions

The safety of long-term treatment with oral NADH remains unclear. Most sources recommend using it for periods of no more than four months, then taking a month off before starting again. An alternative is to take it only two or three times a week, rather than daily. 

References 

1. Demarin V, Podobnik SS, Storga-Tomic D, Kay G. Treatment of Alzheimer's disease with stabilized oral nicotinamide adenine dinucleotide: a randomized, double-blind study. Drugs Exp Clin Res. 2004;30(1):27-33.
2. Bushehri N, Jarrell ST, Lieberman S, et al. Oral reduced B-nicotinamide adenine dinucleotide (NADH) affects blood pressure, lipid peroxidation, and lipid profile in hypertensive rats (SHR). Geriatr Nephrol Urol 1998;8:95-100.
3. Alegre J, Rosés JM, Javierre C, Ruiz-Baqués A, Segundo MJ, de Sevilla TF. Nicotinamide adenine dinucleotide (NADH) in patients with chronic fatigue syndrome. Rev Clin Esp. 2010 Jun;210(6):284-8.
4. Alraek T, Lee MS, Choi TY, Cao H, Liu J. Complementary and alternative medicine for patients with chronic fatigue syndrome: a systematic review. BMC Complement Altern Med. 2011 Oct 7;11:87.
5. Kuhn W, Müller T, Winkel R, et al. Parenteral application of NADH in Parkinson's disease: clinical improvement partially due to stimulation of endogenous levodopa biosynthesis. J Neural Transm.
1996;103(10):1187-93.
6. Birkmayer JG, Vrecko C, Volc D, Birkmayer W. Nicotinamide adenine dinucleotide (NADH)--a new therapeutic approach to Parkinson's disease. Comparison of oral and parenteral application. Acta Neurol Scand Suppl. 1993;146:32-5.
7. Dizdar N, KÃ¥gedal B, Lindvall B. Treatment of Parkinson's disease with NADH. Acta Neurol Scand. 1994 Nov;90(5):345-7.

Evidence Based Rating Scale

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies and what our clinical advisors have found to be efficacious in their personal practice into a visual and easy to interpret format. This tool is meant to simplify the information on supplements and therapies that demonstrate promise in the treatment of certain conditions.

 

Condition

Rating

Explanation

 

Alzheimer's Disease

   

One small study suggests supplementation may slow the progression of the disease; larger studies are needed. (1)

Chronic Fatigue Syndrome  


Conflicting evidence for NADH's benefit; more studies needed. (2, 3)

 

Parkinson’s disease  
Small preliminary studies indicate potential efficacy, but conflicting studies exist. More research is needed. (4-6)
 


Date Published: 04/19/2005
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