NAD+ in a Pill
We know that intravenous infusions of specific stable forms of NAD+ have an impact on NAD+ levels, and some supplements are utilizing the precursor, Nicotinamide Riboside (NR), which has shown promise in raising NAD+ levels in plasma, but how can we introduce NAD+ in a pill format and get it to where it needs to go – in this case the brain. That’s the challenge Innovative Medicine along with Thomas K. Szulc, MD and a team in pharmaceutical and nutraceutical development accepted.
Absorption & Bioavailability
One of the greatest concerns of ingesting NAD+ versus intravenous or intranasal application is the absorption of NAD+ through the digestive system. It has long been known that taking any supplement orally (by mouth) is a fairly complex and sometimes inefficient process where compounds in the supplement must cross from the small intestine into the bloodstream. This also means that all the compounds in any supplement must first survive the stomach acid that can destroy many ingredients.
NAD+ is considered a delicate molecule, and thus many believe that orally consuming the coenzyme may destroy it. This line of thought stems from a 1983 bioavailability study that indicated that ingested NAD+ was primarily hydrolyzed in the small intestine by brush border cells (Baum et al., 1982; Gross and Henderson, 1983). But other studies since that time seem to show a different story.
One study in 2006 entitled “Comparison of metabolic fates of nicotinamide, NAD+ and NADH administered orally and intraperitoneally; characterization of oral NADH” (J Nutr Sci Vitaminol (Tokyo). 2006 Apr;52(2):142-8.) researched the outcome of mice who were administered nicotinamide (Nam), NAD+ (the oxidized version of nicotinamide adenine dinucleotide) and NADH (the reduced version of nicotinamide adenine dinucleotide) both intraperitoneally (injection to the abdomen) and orally. The results showed “intraperitoneal injection of Nam, NAD+ and NADH produced significant increases in urinary excretion of Nam and its metabolites. Similar results were obtained when Nam and NAD+ were given orally.”
Other’s seem to share in the idea that NAD+ can be orally administered without destroying the molecule as it passes through the digestive system. In the clinical research and experience with various patients by Thomas K. Szulc, MD, he found that NAD+ in specific formulas with other ingredients taken orally had a positive effect relative to NAD+ administered intravenously in small doses. It was this research and compatibility analysis into a formula that would be readily absorbed, bioavailable, and create a synergistic cognitive enhancing effect that led him to formulate an oral nutraceutical supplement with NAD+ as the main ingredient (more on that below).
As mentioned earlier, NAD+ is a delicate oxidizing agent. To simply put any ingredient into a pill and expect positive results would be foolish. In addition, simply raising NAD+ levels in plasma without having that NAD+ enter the brain would prove to be an ineffective supplement. The challenge here is to formulate a oral supplement that consists of compounds that can both provide a synergistic effect (thus requiring less quantity of any ingredient for maximal impact) and help deliver the therapeutic agents to the brain. The ratios, feasability and stability of combining certain ingredients, and quality of each raw ingredient must be meticulously tested to ensure a final product that has a potent therapeutic effect on the brain. This again, was a challenge that took a team consisting of physicians, medical professionals, and experts in compatibility analysis as well as pharmaceutical and nutraceutical development and encapsulation to figure out. The result is a nutraceutical brain formula unlike any other.