What’s With the Buzz Around NAD+ Injections?

— Ubiquitous enzyme becomes a health and wellness trend, without much evidence behind it

by
Jennifer Henderson, Enterprise & Investigative Writer, MedPage Today
May 31, 2023

Welcome to Culture Clinic, MedPage Today‘s collaboration with Northwell Health to offer a healthcare professional’s take on the latest viral medical topics.

These days, everyone wants to age in reverse. But are NAD+ injections really the key to the fountain of youth?

NAD+ is the oxidized form of nicotinamide adenine dinucleotide, which is found in all living cells, and is involved in metabolism and other cellular functions. A number of companies market NAD+ injections or supplements as a boon to staving off or improving age-related impacts on physical and cognitive function, as well as appearance.

So, do NAD+ injections really come doctor-recommended? And what are their potential benefits — and risks? MedPage Today asked Marzena Gieniusz, MD, who specializes in geriatric and internal medicine at Northwell Health in New Hyde Park, New York, to weigh in.

“Essentially, it’s just an enzyme that is present naturally in the body,” Gieniusz said.

There have been formulations made to be administered in various ways, such as injectable and oral routes, she noted, and companies have been selling injections or supplements that promise certain health-related benefits.

However, there is not necessarily strong evidence behind them, she cautioned.

“This is not really something we utilize in general practice,” Gieniusz said. “We don’t recommend this to our patients.”

That decision is based in part on the fact that supplements are not as stringently regulated as prescription medications, she explained. Often, what is made available can have impurities, and there can be other ingredients present that are not listed on the packaging.

Additionally, if clinicians or other professionals with certain degrees or licenses are associated with or administering a product, “it almost gives a false sense of security that it is safe,” she added.

Though Gieniusz said she hasn’t yet heard of any severe side effects reported with NAD+ injections, she reiterated her belief in the need for more robust research.

Some of the buzz surrounding NAD+ injections or supplements has centered on their use in potentially improving physical strength and function, as well as cognitive function, in addition to their supposed anti-aging properties, she noted. Though there is some evidence that they may have a role in maintaining health, or improving or maintaining skeletal muscle activity or skin condition, this remains speculative in her view.

Ultimately, Gieniusz said she wants to see more high-quality studies showing clinically significant benefits.

For now, while she and her colleagues are not regularly hearing from patients inquiring about NAD+ injections or supplements, “we do occasionally come across patients who are using supplements.”

Most concerning is when patients “don’t even tell us that they’re on them,” she added.

Patients often may not realize that a supplement can have side effects or potentially interfere with other medications they’re already taking, she said. Some pursue supplements “kind of like an easy fix” for something that may be troubling them, like chronic fatigue or muscle weakness, while others believe that taking a supplement is an easy alternative to living a healthy lifestyle.

However, that’s simply not the case, Gieniusz noted, pointing out that she’s not sure the evidence will ever show NAD+ injections or supplements are comparable to eating a healthy diet and staying active.

Regardless, it’s critically important for people to maintain an open dialogue with those providing their medical care, she stressed.

“It is very, very important to discuss, with a primary care physician, at least, if anyone is taking these supplements, because again, it may not be a benign thing,” she said. “It’s important for the clinical team to know exactly what patients are taking.”