NAD Intracellular Assay

The NAD Intracellular Assay by AgingSOS™ is a blood-based test that targets age-related levels of NAD and empowers you to make decisions that most benefit your health. Nicotinamide adenine dinucleotide (NAD) is a coenzyme that is essential to life and is found in every cell of all living things.  NAD facilitates hydrogen transfer...
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The NAD Intracellular Assay by AgingSOS™ is a blood-based test that targets age-related levels of NAD and empowers you to make decisions that most benefit your health. Nicotinamide adenine dinucleotide (NAD) is a coenzyme that is essential to life and is found in every cell of all living things.  NAD facilitates hydrogen transfer through its two forms: NAD+ and NADH. NAD is required to catalyze reactions for more than 400 enzymes, more than any other vitamin-derived coenzyme.

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What is NAD?

Nicotinamide adenine dinucleotide (NAD) is a coenzyme that is essential to life and is found in every cell of all living things.  NAD facilitates hydrogen transfer through its two forms: NAD+ and NADH. NAD is required to catalyze reactions for more than 400 enzymes, more than any other vitamin-derived coenzyme. It is one of the top essential molecules for life because it is involved in many physiological and pathological functions including energy (ATP) production in the mitochondrial TCA cycle and oxidation of fatty acids and amino acids, DNA damage repair, oxidative stress, inflammation, cellular senescence, and others.

  • Energy production: NAD is necessary for major pathways for cellular energy (ATP) production such as glycolysis, the Krebs cycle, and oxidative phosphorylation. When NAD is too low, cells cannot produce enough ATP to sustain important biological processes, leading to suboptimal health including chronic fatigue.
  • DNA repair and anti-cancer activity: Our DNA can be damaged by environmental pollutants such as radiation and toxins as well as toxic molecules produced by our cells such as reactive oxygen metabolites (ROM). Damaged DNA is usually repaired by a group of enzymes called PARP which relies on NAD+ for its function and in the process degrades NAD+ into a metabolite known as NAM. Without the proper function of PARPs, our DNA accumulates damages and becomes unstable, leading to the development of cancer. Another group of enzymes called sirtuins also help prevent genomic instability by increasing, together with FOXO transcription factors, the expression of antioxidant enzymes which to protect cells from damages by oxidative stress.
  • Aging and age-related diseases: NAD declines with age, and this decline is associated with loss of function and vitality and many age-related diseases.  These roles of NAD are mainly related to sirtuins that require NAD for their activation. Sirtuins are involved in six hallmarks of aging: epigenetic alterations, mitochondrial dysfunction, deregulated nutrient sensing, genomic instability, cellular senescence, and inflammation. Restoration of NAD+ levels promotes health and extends lifespan.
  • Infectious diseases and COVID-19: NAD support immune health and accelerates recovery from COVID-19.
  • NAD can also protect the brain, improve glucose intolerance, insulin sensitivity, and blood plasma lipid profiles, and support bone density and neurogenesis, improve endurance and strength, regulate circadian rhythm (sleep), and sleep intracellular calcium release.

What are the causes of NAD deficiency?

  • NAD is synthesized by cells from the building blocks (precursors) of NAD contained in the diets. Vitamin B3 (niacin) and tryptophan are natural building blocks for NAD. The low dietary intake of these precursors is a major risk factor of low NAD levels.
  • NAD declines with age, probably due to reduced ability to synthesize new NAD and to recycle NAD.  A high percentage of middle age and older people as well as a lower proportion of children have low levels of NAD.
  • NAD is deficient in a very high percentage of patients with age-related diseases, including cancer, diabetes, and many others like a wide variety of cardiovascular and metabolic diseases such as atherosclerosis, endothelial dysfunction, acute cardiac syndromes, cardiomyopathy, hypertrophy, and heart failure, arrhythmias, hypertension, metabolic syndrome, obesity and fatty liver, diabetes mellitus, and dyslipidemia.
  • High levels of NAD degrading enzymes may be responsible for fast NAD turnover and low levels: Three important enzymes, CD38, PARP, and Sirtuins, have great effects on NAD degradation.  CD38 is increased in aged immune cells and maybe a critical risk factor for NAD decline in aged persons.
  • NAD deficiency appears to cluster in some families, suggesting that genetic factors may influence levels of NAD, at least partially or in some families.

Intervention tips

  • NAD precursor supplements such as niacin (vitamin B3), nicotinamide riboside (NR), and nicotinamide mononucleotide (NMN) have been shown to raise AD levels in humans. NAD+ infusion and patches, the RealNAD buccal lozenge is also used to boost NAD in humans.
  • Lifestyle factors can affect NAD levels.  Obesity is associated with reduced expression of NAD, whereas weight loss increases NAD. Exercise has been shown to increase the activity of a NAD-synthesizing enzyme called NAMPT.
  • Inflammation (TNF-alpha) may cause a decline in NAD and reducing inflammation may promote NAD levels.
  • Testing your NAD level is important for general health and age management, and especially for those who have NAD-related diseases and who are taking any form of NAD therapy. JPM offers the first commercially available test that measures blood NAD levels in serum/plasma.

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