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Nicotinamide Adenine Dinucleotide

Our NAD+ Clinical Therapy Program

With its growing popularity, NAD+ supplementation is quickly becoming widely available throughout the US. However, while most clinics only provide intravenous infusion, our protocol involves strategic oral supplementation in addition to a proprietary infusion cocktail of NAD+ with mitochondria-boosting infusions. This provides for dramatically higher levels of energy-boosting ATP available to the body’s cells — a protocol developed by Dr. Joseph Purita, PUR-FORM by The Institute’s founder and Medical Director.

What is NAD+?

Nicotinamide Adenine Dinucleotide, or NAD+, is an essential coenzyme in the body that we can not live without. It boosts the mitochondria in the cells and is involved in metabolism, neurologic and muscular function, cardiometabolic health, cellular repair, and scientists believe the loss of NAD+over time plays an important role in the aging process.

NAD+ stores naturally decrease in the body as we age which result in many of the common symptoms of aging (cognitive decline, slowing metabolism, heart health issues, etc.). Therefore, replenishing NAD+ stores can lead to slowing this process of aging and revitalizing our hard working organs.

Many patients report feeling noticeably different for months following NAD+ treatments, as it can be an effective solution for lessening feelings of fatigue, brain fog, slowing metabolism, anxiety, and inflammation. The most common feedback we receive from patients post treatment are feelings of increased energy, improved focus, and less recovery time needed.

You can go deeper into the importance of mitochondrial health with Dr. Purita and anti-aging supplements to stack with our Nurse Manager, Bella Sannasardo.

Who Can Benefit from NAD+?

Considering NAD+ counteracts the effects of aging and stress, it is safe to say that almost everyone can benefit from an NAD+ treatment to some degree. Below are the conditions that NAD+ has been shown to be especially effective in treating.

  • Addiction
  • Aging
  • Alzheimer’s disease
  • Anxiety
  • Chronic Fatigue
  • Cognitive decline
  • Depression
  • Diabetes
  • Fibromyalgia
  • Heart disease
  • Internal Inflammation
  • Memory / concentration issues
  • Multiple sclerosis
  • Parkinson’s disease
  • Slowing metabolism

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NAD+ and Coronavirus

An article in Nature Metabolism reveals the importance of NAD+ supplementation in the fight against COVID-19.

With an estimated 250 million people worldwide contracting COVID-19 or one of its variants, you are likely familiar with the symptoms, ranging from fever and loss of taste or smell to severe fatigue. One of the potential reasons for such debilitating symptoms may be due to coronavirus’s relationship with NAD+ in our bodies.

In layman's terms, as the coronavirus replicates, it depletes our stores of NAD+, effectively turning the infection into a biological war zone. The article states, “cellular NAD+ becomes a battlefield in which the innate immune system and the virus struggle for the upper hand”.

What we have found is that COVID-19 will induce the transcription of several genes, which result in the increased consumption of NAD+ by our bodies. Even worse is that viral infections may lead to a "bioenergetic crisis" in the body. Patients with severe cases of COVID-19 even have lower levels of NAD+ metabolites in the blood.

One conclusion that we can draw from this article is that it is very important to maintain one’s levels of NAD+ by both oral supplementation and via an intravenous route.

This is one regimen that I faithfully follow.
- Dr. Joseph Purita

To read the entire study, click here: Nature Metabolism Article

How Does NAD+ Affect Aging?

NAD+ is present in the mitochondria of each cell and has been shown to decline steadily over time, reaching about 50% decline by ages 40-60. The mitochondria are known as the powerhouse of the cell and make ATP or energy within the cell. Without sufficient NAD+ our mitochondria struggle to make sufficient energy, which can be very taxing to our vital organs and causes many of the symptoms of aging.

With NAD+ modulation, we are able to stimulate a group of anti-aging genes called sirtuins, which activate mitophagy and mitochondrial biogenesis, enhancing the quality of the mitochondria and creating an age reversal effect. Because of this, NAD+ stores can lead to improved performance, slow the process of aging, and revitalize our hard working organs.

NAD+ plays a key role in metabolism and DNA repair, which is very important in the prevention of chronic illnesses and even cancer. The organs with the highest concentrations of NAD+ are the heart and brain, so the lack of NAD+ can put these organs at risk for degenerative conditions (ie. Alzheimers). For this reason, NAD+ can potentially be very effective in preventing dementia, Parkinsons, and even multiple sclerosis.

For many, the early signs of aging include periods of brain fog, forgetfulness, reduced athletic performance, fatigue, and changes of the skin. Supplementation of NAD+ has been shown to revitalize the body from the inside out, which results in reducing each of these symptoms and much more.

Can NAD+ Increase Brain Health?

There continues to be increasing evidence that suggests NAD+ and NADH play an important role in multiple biological processes in the brain such as neurotransmission, learning, and memory. It may also mediate brain aging and the tissue damage in various brain illnesses. This means that NAD+ may be able to signal the growth, repair and development of brain/nerve tissue. In other words, NAD+ may be able to virtually help the brain regenerate and reverse aging to some degree, allowing patients to feel like they did before the brain tissue was damaged either from injury, stressful events, brain disease or the regular aging process.

It has been shown that reduced NAD+ levels play a pivotal role in brain aging and neurodegenerative disorders. Therefore, NAD+ replenishment improves mitochondrial function and mitochondrial biogenesis and reduces accumulation of damaged mitochondria in both premature aging and Alzheimer’s disease.

Lautrup S, Sinclair DA, Mattson MP, Fang EF. NAD+ in Brain Aging and Neurodegenerative Disorders. Cell Metab. 2019;30(4):630-655. doi:10.1016/j.cmet.2019.09.001

Ying W. NAD+ and NADH in brain functions, brain diseases and brain aging. Front Biosci. 2007 Jan 1;12:1863-88. doi: 10.2741/2194. PMID: 17127427.

How should I expect to feel during an NAD+ treatment?

NAD+ is administered via intravenous infusion and takes about two to four hours depending on each patient's tolerance of the drip. During the drip, most patients experience some symptoms of chest tightness and/or butterflies in their stomach, but everyone is different. These symptoms are completely benign, and will go away within 20 seconds of slowing the drip. We like to think of the sensation of these symptoms as our cells getting the boost of energy that they'd been working so hard for! Typically, our areas of issue or disease are the areas of the body in which NAD+ is lacking, thus we typically feel the symptoms in those areas. In short, you'll feel it where you need it!

How long does an NAD+ treatment take?

Treatment time varies depending on the person. Generally speaking, NAD+ takes about 2 hours per 250mg. So if you are getting a 500mg dose it can take up to 4 hours. In order to speed things along, we give patients some oral supplementation to take prior to treatment which helps increase absorption rates.

How should I expect to feel after an NAD+ treatment?

Most patients report increased mental clarity as well as feeling energized, happier, more focused, and relaxed for the following days, weeks and months following NAD+ treatments.

How many NAD+ treatments do you need?

As with all treatments, everybody is different and has different needs based on their health status and lifestyle. We highly recommend booking a consultation to get one of our providers’ professional recommendations based on your condition.

With that said, for those generally healthy individuals who are starting to see early signs of aging, degeneration, or just feeling like they could use a boost, our recommendation is to start with a “loading dose”, 3-4 consecutive days of 500mg of NAD+. After this, we typically recommend coming in for one treatment every 4 weeks. In our experience, this is how our patients receive optimal results with NAD+ therapy.

However, if you are interested in just trying one treatment, we encourage you to do so as you will likely still feel a difference.

Are there any side effects associated with NAD+?

As stated in “How should I expect to feel during an NAD+ treatment?”, some patients feel temporary symptoms of chest tightness and/or stomach discomfort during treatment. These symptoms are completely benign, and will go away within 20 seconds of slowing the drip.

After the treatment, there have been no negative side effects reported.

Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD + in healthy middle-aged and older adults

Can NAD+ help with addiction?

Generally speaking, as a person abuses drugs or alcohol, they deplete the natural stores of NAD+ in their body, making it more difficult for them to break down energy from food and creating a dysregulation of endocrine factors, circadian rhythms, dopamine neurotransmitters, and oxytocin signaling. It is also known to increase neuroinflammation and impair mitochondrial function. Unsurprisingly, it is also speculated that people who naturally produce less NAD+ are more likely to develop addictions or co-occurring disorders (anxiety, depression, neurodegenerative diseases, etc.).

Because of this, there have been many studies conducted to determine if intravenous NAD+ supplementation can aid in addiction recovery. While much more research needs to be done, studies show that raising intracellular NAD+ levels may be a potential solution for managing and treating addictive behavior, as well as reducing cravings, and withdrawal symptoms.

By flooding the brain with NAD+ via IV to replenish stores of the co-enzyme, the below key effects may be provided.

  1. Substances can be flushed out of the user’s system more efficiently.
  2. Difficult and uncomfortable withdrawal symptoms can be reduced.
  3. Physical and mental cravings for alcohol or substances can be reduced.
  4. The body’s ability to produce energy more naturally can be restored, without the need for stimulants or other substances like caffeine.
Braidy N, Villalva MD, van Eeden S. Sobriety and Satiety: Is NAD+ the Answer?. Antioxidants (Basel). 2020;9(5):425. Published 2020 May 14. doi:10.3390/antiox9050425

Why do I have to take supplements as part of the NAD+ IV?

The supplements we provide and instruct patients to take before, during and after infusion are to increase the absorption rate and effectiveness of the NAD+ IV. All documentation with nutritional information will be provided to you upon receiving the supplementation for transparency.

What role does NAD+ play in cellular respiration?

NAD+, is the oxidized form of the coenzyme. When a molecule is in an oxidized state, it means it can accept the tiny negatively charged particles, called electrons, from another molecule. After it receives the electrons, it has a negative charge, so it also picks up a hydrogen atom from the surrounding environment, because hydrogen atoms are positively charged. Now, it is turned into the reduced form, also known as NADH.

The molecule acts as a carrier for electrons during cellular respiration. At various chemical reactions, the NAD+ picks up an electron from glucose, at which point it becomes NADH. Then NADH, along with another molecule known as flavin adenine dinucleotide (FADH2) will transport the electrons to the mitochondria, where the cell can harvest energy stored in the electrons. One can think of the NADH as a cargo truck, transporting electrons like trucks transport goods to a factory. Once at the factory, the workers, or in our case proteins in the mitochondria, take the raw goods and make something useful, in our case, ATP. For this reason, many biologists refer to ATP as the 'energy currency of life.'

By providing more ATP to the cells as they differentiate, we are able to increase the efficiency of regenerative cells in the body.

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