What is NAD⁺ and how is it administered?

NAD⁺ (nicotinamide adenine dinucleotide) is a coenzyme essential for cellular energy production and metabolic processes. At Lambert Medical Practice, NAD⁺ is administered intravenously over 2-4 hours, allowing direct delivery into the bloodstream. Oral NAD⁺ precursors are also available but achieve lower blood concentrations than IV administration.

Who is it suitable for?

NAD⁺ therapy may be considered for adults experiencing persistent fatigue despite normal medical investigations, those seeking cellular health optimisation, athletes during heavy training periods, or individuals with specific conditions where NAD⁺ depletion is documented. It is not suitable for everyone and requires clinical screening before treatment.

What are the risks or side-effects?

The most common side effect is abdominal cramping or nausea during infusion, typically managed by slowing the infusion rate. Other potential effects include chest tightness or anxiety (uncommon), headache, and flushing. Serious adverse events are rare but possible with any IV therapy. All treatments occur under clinical supervision with continuous monitoring.

NAD⁺ Therapy in Surbiton: What to Expect and Medical Oversight

Nicotinamide adenine dinucleotide (NAD⁺) has emerged as a focus of longevity and wellness medicine due to its fundamental role in cellular metabolism and energy production. At Lambert Medical Practice in Surbiton, we offer NAD⁺ therapy with appropriate medical oversight, realistic expectations, and evidence-based protocols. This article provides a balanced examination of NAD⁺ therapy—what the science shows, who may benefit, potential risks, and how it's administered safely. Serving patients across Kingston upon Thames and South-West London, we ensure NAD⁺ treatment is delivered with clinical rigour rather than unfounded hype.

What is NAD⁺? Understanding the Science

Nicotinamide adenine dinucleotide (NAD⁺) is a coenzyme found in all living cells. It plays essential roles in fundamental biological processes including energy metabolism, DNA repair, cellular signalling, and gene expression. NAD⁺ exists in two forms: NAD⁺ (oxidised) and NADH (reduced), which interconvert during metabolic reactions.

NAD⁺'s Biological Functions

NAD⁺ is critical for multiple cellular processes:

Energy Production: NAD⁺ is essential for glycolysis, the citric acid cycle, and the electron transport chain—the primary pathways by which cells generate ATP (cellular energy). Without adequate NAD⁺, cellular energy production is impaired.

DNA Repair: NAD⁺ is a substrate for enzymes called PARPs (poly-ADP-ribose polymerases) that repair DNA damage. Cells with inadequate NAD⁺ may accumulate DNA damage, potentially accelerating ageing.

Sirtuin Activation: NAD⁺ activates sirtuins, a family of proteins involved in cellular health, inflammation regulation, and metabolic homeostasis. Sirtuins have been linked to longevity in animal studies, though human evidence remains preliminary.

Cellular Communication: NAD⁺ participates in calcium signalling and other communication pathways between cells.

NAD⁺ Decline with Ageing

Research demonstrates that NAD⁺ levels decline with age across multiple tissues. By middle age, NAD⁺ concentrations may be 50% lower than in youth. Proposed mechanisms for this decline include increased consumption by DNA repair enzymes in response to accumulated damage, reduced synthesis due to declining precursor availability and enzyme activity, and increased breakdown by enzymes called CD38 (which increases with age).

This decline has led researchers to investigate whether restoring NAD⁺ levels might counteract aspects of ageing or improve metabolic health. Animal studies show promising results, but human clinical evidence is still emerging.

The Evidence Gap: Animal Studies vs Human Clinical Trials

Most NAD⁺ research has been conducted in mice and cell cultures. These studies suggest potential benefits including improved mitochondrial function, enhanced insulin sensitivity, neuroprotection, increased lifespan in some models, and improved muscle function.

However, extrapolating animal findings to humans is problematic. Mice have vastly different metabolisms, lifespans, and disease susceptibilities. Human clinical trials of NAD⁺ therapy are limited, generally small-scale, and show mixed results. Whilst some studies suggest metabolic improvements or subjective energy increases, others find minimal effects.

Lambert Medical Practice acknowledges this evidence gap. We do not claim NAD⁺ therapy definitively treats disease or reverses ageing. Instead, we offer it as an emerging therapy with theoretical rationale and some supportive evidence, administered under medical supervision for patients who understand the current limitations of the science.

Potential Benefits: What the Current Evidence Suggests

With appropriate caveats about evidence quality, current research suggests NAD⁺ therapy may offer benefits in specific contexts:

Energy and Fatigue

Given NAD⁺'s role in ATP production, it's biologically plausible that increasing NAD⁺ could improve cellular energy. Some patients report subjective improvements in energy levels and reduced fatigue following NAD⁺ therapy. However, placebo effects are substantial in fatigue studies, and objective evidence from controlled trials is limited.

NAD⁺ therapy should never replace proper investigation of fatigue causes. Before considering NAD⁺, we assess for anaemia, thyroid dysfunction, sleep disorders, depression, and other treatable conditions via comprehensive GP evaluation and blood testing