Key Points:
- Dr. Shah explains the importance of NAD+ and its role in maintaining energy levels and DNA repair.
- Symptoms of NAD+ deficiency include brain fog, pain, and poor sleep, he says.
- Ways to raise NAD+ besides supplements include diet and exercise.
Dr. Darshan Shah is a Mayo Clinic-trained surgeon, now the CEO and owner of NextHealth — “The ‘Apple Store’ Of Next Generation Health.” In an interview with Dr. Oz, he discusses the importance of NAD+ (nicotinamide adenine dinucleotide) and one of its precursors NR (nicotinamide riboside). He also reveals how he knows when to recommend NAD+ precursors to his patients.
Dr. Shah Explains NAD+
Dr. Shah says we have 23 trillion cells in our body and each cell has many mitochondria, which make energy with the help of NAD+. He says that after we turn 30, there is a steep decline in NAD+ that makes us feel like we have less energy. He adds that it’s not just age that causes a decline in NAD+ but also toxins, consuming processed foods, and not getting adequate sleep. Furthermore, NAD+ fuels enzymes called sirtuins to repair DNA and play a role in turning genes on and off through a process called epigenetic regulation.
While NAD+ precursors — molecules that are converted into NAD+ in the body — are found in foods, Dr. Shah says we cannot get enough NAD+ precursors from food to boost NAD+ levels. He further explains that the reason for supplementing with NAD+ precursors instead of NAD+ itself is that NAD+ is not easily absorbed into our cells. Still, he says that NAD+ itself can be taken directly if injected intravenously (IV), but this comes with unwanted side effects.
Dr. Shah Explains How He Diagnoses NAD+ Deficiency
Dr. Shah believes that NAD+ deficiency is one of the root causes of many problems he sees in clinical practice. These problems include:
- Brain fog
- Inability to lose weight
- Low energy
- Poor sleep
- Pain
For this reason, an NAD+ precursor is one of the core supplements Dr. Shah gives to patients. He says he prefers NR (nicotinamide riboside) because it gets into cells better than other precursors. He has found 1000 mg of NR each morning to be the most beneficial for patients. However, he has patients taper up from 300 mg to 600 mg and if they feel better, he will increase the dose. Nevertheless, some patients have trouble sleeping because they have too much energy, he says, and he will taper their dose back down. Importantly, it is advisable to consult with your own personal healthcare provider to determine whether taking an NAD+ precursor is safe.
Other Ways to Raise NAD+
As always, supplements should not be the first plan of action if feeling any of the symptoms mentioned above. Maintaining adequate NAD+ requires a healthy diet, consistently exercising, and sleeping well.
Dr. Shah says the standard American diet (SAD) is almost designed to lower NAD+ levels because it does not contain enough good quality vegetables and meats but instead consists of ultra-processed foods that are not dense in nutrients. Also, the microbiome plays a critical role in nutrient absorption, and eating fermented foods can help improve gut microbiome health. Other ways to improve gut microbiome health include eating lots of fiber, reducing intake of sugars, and avoiding high-carbohydrate diets.
When asked about other ways to increase NAD+ levels, Dr. Shah says that anything that stresses our mitochondria will boost NAD+ levels. As such, he says that cold plunges and infrared saunas will increase NAD+ levels. However, there no human studies showing that this is true. Continuing, he emphasizes that getting enough sleep will also help NAD+ levels go up. Furthermore, high-intensity exercise is a good way to boost NAD+. Overall, maintaining a healthy lifestyle can work wonders in maintaining NAD+ and potentially slowing down the aging process.
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