NADH supplement health benefit, side effects 5 mg 10 mg and 20 mg tablets, which medical conditions is this nutrient used for? by Ray Sahelian, M.D.
Feb 14, 2014

NADH, which stands for nicotinamide adenine dinucleotide, is an activated form of the B vitamin niacin. I remember my high school biology class where I first tried to learn the complicated Krebs cycle and how energy in the form of ATP was derived from sugars, amino acids, and fats. I recall coming across NADH, the coenzyme that helps in this complicated process of energy extraction. I never thought that someday it would be available as a supplement.

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Suggested Use: One NADH tablet a few times a week in the morning, on an empty stomach, with water. Wait 10 to 30 minutes before eating. Or, take it as recommended by your health care professional.


Enada NADH Supplement Facts:
ENADA NADH - 5.0 mg
    (B-Nicotinamide Adenine Dinucleotide)

 

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Making energy
The body, just like a car, needs fuel. Our primary source of fuel is through fats, proteins, and carbohydrates in our diet. After digestion in the stomach, foodstuffs are absorbed into the blood and circulate to various tissues and cells where they are broken down into even smaller particles. One of these is a two-carbon molecule known as acetyl. Enzymes help break down these fats, proteins, and carbohydrates into acetyl and they then help extract the final energy from acetyl. Enzymes also need helpers, and these helpers are called coenzymes. Most of the coenzymes are partly made from vitamins, such as vitamins E, C, lipoate, and riboflavin (vitamin B2). NADH, known as nicotinamide adenine dinucleotide, is a coenzyme, partly made from nicotinamide (vitamin B3).
   NADH, through a series of reactions with acetyl and oxygen, is able to produce energy. This energy is in the form of ATP (adenosine triphosphate). Therefore, a good supply optimizes energy production in the body. Another function is its ability to help transform an amino acid called tyrosine into the important brain chemical dopamine. Dopamine is involved in mood, energy, sexual drive, concentration, memory and muscle movement.
   NADH is normally found in meat, fish, and poultry. The content of in fruits and vegetables is minimal.

The claims and promotions
NADH was introduced to the US health market in 1995. There are claims that it can improve memory, athletic performance, slows the aging process, and is helpful in a variety of conditions including Alzheimer's disease, Parkinson's disease, chronic fatigue syndrome, depression, and overall lack of energy.
   A small number of short term studies done with an oral form of NADH have shown slight to moderate benefits in regards to depression, Parkinson’s disease and Alzheimer’s disease. An eight-week double blind study done at Georgetown University Medical Center found thirty percent of patients with chronic fatigue syndrome to benefit from 10 mg of NADH compared to eight percent of the controls. Birkmayer Laboratories of Vienna, Austria who organized all of these studies, are also involved in promoting their trademarked NADH product.

Fatigue and tiredness
Rev Clin Esp. 2010. Nicotinamide adenine dinucleotide (NADH) in patients with chronic fatigue syndrome. Nicotinamide adenine dinucleotide (NADH) may be depleted in chronic fatigue syndrome (SFC). The purpose of the study was to evaluate the efficacy of supplementation with NADH in these patients. A double blind, placebo controlled, 3 month long clinical trial was conducted. The patients were randomized to oral NADH oral 20mg or placebo during the first two months. Administration of oral NADH was associated to a decrease in anxiety and maximum heart rate, after a stress test in patients with CFS. On the contrary, this treatment did not modify other clinical variables and the global functional performance.

Jet lag benefit?
Stabilized NADH ENADA improves jet lag-induced cognitive performance deficit
Wien Med Wochenschr. 2002.
Current remedies for jet lag (phototherapy, melatonin, stimulant, and sedative medications) are limited in efficacy and practicality. The efficacy of a stabilized, sublingual form of reduced nicotinamide adenine dinucleotide (NADH, ENADAlert, Menuco Corp.) as a countermeasure for jet lag was examined. Because NADH increases cellular production of ATP and facilitates dopamine synthesis, it may counteract the effects of jet lag on cognitive functioning and sleepiness. Thirty-five healthy, employed subjects participated in this double-blind, placebo-controlled study. Training and baseline testing were conducted on the West Coast before subjects flew overnight to the East Coast, where they would experience a 3-hour time difference. Upon arrival, individuals were randomly assigned to received either 20 mg of sublingual stabilized NADH or identical placebo tablets. All participants completed computer-administered tests (including Cog Screen) to assess changes in cognitive functioning, mood, and sleepiness in the morning and afternoon. Jet lag resulted in increased sleepiness for over half the participants and deterioration of cognitive functioning for approximately one third. The morning following the flight, subjects experienced lapses of attention in addition to disruptions in working memory, divided attention, and visual perceptual speed. Individuals who received NADH performed significantly better on cognitive test measures and reported less sleepiness compared with those who received placebo. No adverse effects were observed with ENADA  NADH treatment. Stabilized ENADA NADH significantly reduced jet lag-induced negative cognitive effects and sleepiness, was easily administered, and was found to have no side effects. NADH dehydrogenase and NAD.

Dr. Sahelian's Experience
Does NADH really improve energy, concentration, and mood? I have taken it on numerous occasions. Within an hour or two of swallowing a pill on an empty stomach in the morning, I notice an increase in alertness, wellbeing, vitality, visual clarity, and sexual interest. The effects last most of the day. However, I develop a tolerance to NADH if I take it regularly. I understand NADH is available as 2.5 mg, 5 mg, 10 mg, and recently as 20 mg. I don't think the 10 mg and certainly the NADH 20 mg supplements are useful, they may cause fatigue after a few days of use rather than enhancing energy. Too much of a good thing is not so good.

NADH side effects, caution, risk
Reports of NADH side effects from the use of 2.5 mg are rare. Higher dosages can sometimes lead to insomnia, anxiety, fatigue, and overstimulation. George, a 42 year-old lawyer from Philadelphia says, “I like the 2.5 mg dose because of the alertness it provides. However, when I take 5 mg or more, it makes me too stimulated, almost with a panicky feeling.” As more individuals start taking this nutrient, we may come across additional reports of NADH side effects. The risk of NADH adverse reactions increase when this supplement is combined with other stimulants. A few patients have found that high dosages used daily for prolonged periods led to mood swings, anxiety, and sleeplessness which resolved when the NADH was stopped. I do not recommend its use on a daily basis for prolonged periods until we learn more details about its effects when used daily for months and years.
   One user noticed that NADH helped her chronic fatigue, but things didn’t go well when she stopped. Betty, a 36 year-old homemaker from Houston, says, “I have chronic fatigue syndrome (CFS) and was taking 10 mg of NADH daily. I know it really helped my energy level and mood. But I began to have stomach upset from it and stopped for a few days. I then fell quickly into a very bad CFS "crash," the worst one in months.” I recommended that Betty only take 2.5 mg of NADH every other day. I don’t think we should rely on one nutrient to solve CFS.

I have been taking a NADH supplement daily for a week and it has caused me insomnia.
    When sleeping problems occur this means a lower dosage is appropriate or the product needs to be taken less frequently.   

Questions
Is Enada a way of processing NADH and not a synonym?. I looked on the label and in the product description and nowhere was the word Enada used. So -- is Co-E1 an Enada NADH?
    The company that makes ENADA nadh was bought out, and the new owners are still using the name but now they have added a new name CoE1. Both Co-! and Enada are the same exact product.

Interactions with medications
Are you aware of the existence of any interactions with the antipsychotic Seroquel as well as Lithium Carbonate?
   Negative or positive interactions depend on dosages and the overall health of the person. I have not seen such studies with these combinations.

Research and clinical trials
Antioxidant activity of NADH and its analogue--an in vitro study.
J Biochem Mol Biol. 2004.
The antioxidant activities of NADH was evaluated in vitro. These results indicate that NADH can inhibit lipid peroxidation despite being hydrophilic. Nevertheless, membrane penetration is an important factor and limits its antioxidant activity.

Treatment of Alzheimer's disease with stabilized oral nicotinamide adenine dinucleotide: a randomized, double-blind study.
Drugs Exp Clin Res. 2004.
This study was designed to evaluate the effect of stabilized oral reduced nicotinamide adenine dinucleotide on cognitive functioning in patients with Alzheimer's disease (AD). NADH is a coenzyme that plays a key role in cellular energy production and stimulates dopamine production. In previous trials NADH has been shown to improve cognitive functioning in patients with Parkinson's disease, depression and AD. The present trial was a randomized, placebo-controlled, matched-pairs, double-blind, 6-month clinical study. Patients with probable AD were randomized to receive either stabilized oral NADH (10 mg/day) or placebo. Twelve pairs of subjects were matched for age and baseline total score on the Mattis Dementia Rating Scale (MDRS). After 6 months of treatment, subjects treated with NADH showed no evidence of progressive cognitive deterioration and had significantly higher total scores on the MDRS compared with subjects treated with placebo. Analysis of MDRS subscales revealed significantly better performance by NADH subjects on measures of verbal fluency, visual-constructional ability and a trend to better performance on a measure of abstract verbal reasoning. There were no differences between groups in measures of attention, memory, or in clinician ratings of dementia severity. Consistent with earlier studies, the present findings support NADH as a treatment for AD.

Distributor information
Birkmayer USA, the largest distributor of NADH tablets in the USA and the world, has released a new formula which has Chlorophyll in all NADH size tablets – 2.5mg , 5.0mg and the 10mg. Birkmayer USA markets NADH as ‘CO-E1 NADH’ as NADH is co-enzyme #1 and is vital in the support of the energy system of the body.
“By combining both NADH and Chlorophyll we have a truly brilliant and real product to help many people, and we are truly excited to be able to provide this product” said Rachel Chandler, the Manager of Birkmayer USA.
   Dr. Sahelian says: I really don't know why chlorophyll was chosen. Not that chlorophyll is a bad supplement, it may have some health benefits, but I really don't see the rational for combining NADH and chlorophyll. It's a puzzle to me.


Emails
Q. I have been taking 50 to 300mg of 5-HTP for about 2 months at bedtime to help my sleep and depression. It definitely improved my mood but I still felt tired and achy so I added 5 mg of NADH first thing in the morning to my regime for one week so far. I've had a few serious bouts of depression after adding the NADH but a lot more energy. I find it's better if I alternate between the two. Also, I've become very constipated after taking the 5-HTP.
Reading your website, and from experience of reducing the amount and consistency of 5-HTP, the grogginess is less. For your info, I found that taking 5-HTP actually increased my libido but that I've already become tolerant to that benefit. I find it relaxes me and reduces my negative thinking greatly. Reading your website, I'm pretty amazed at some of the horrific negative affects it has had on some people.

How soon does a NADH tablet have an effect after ingesting?
   I personally notice a sense of alertness and wellbeing within an hour or two of taking a tablet on an empty stomach in the morning. Most people notice the effects within hours.

Thanks so much for originally introducing me to NADH through your literature. I last took NADH 2 years ago. I am now trying to find the same form - 2.5mg NADH sublingual tablets. Do you know who manufactures it? (apparently, not Menuco). I'd prefer not to take the source naturals tablet, due to a very sensitive stomach -also, I had such a good prior experience with the sublingual. Thanks very much for your help, and I wish you continued success.
    You could do a google search for NADH 2.5 mg sublingual and find out, it is likely that there are many online stores that sell it.

I understand that Source Naturals NADH 20 mg is available. Do you think 20 mg is helpful?
    I don't see the need to take more than 5 or 10 mg of NADH supplement a few times a month. I'm concerned about side effects with a 20 mg dosage. Sometimes a lesser dosage of a supplement product works better than a higher dosage.

I am 72 years old and was having pretty difficult time hearing clearly for quite a while. My friend found me this article by you on hearing loss and NADH help forit. Instead of running for $5000 hearing aid i decided to try. Only 4 days back WOW what a change. I was myself amazed if i am making it in my head or it is real. I am experiencing so alive energy and improvement in hearing. I had been practicing singing my scales (Indian Music) since Jan.2013. I could hear the chords but not the in between notes clearly in my ears. But after 2 days of taking this NADH 5mg. one a day, third day as i sang the notes I could clearly hear all the notes in the same three strings of Tanpura (drone instrument looks like Sitar) i had been practicing so long. I could hardly hold my self down, Am so very very happy with this divine change that i can hear my swars (notes on the scale). This makes a sky and earth apart difference in progress of my vocal Indian classical music. Once again my heartfelt thanks for your article. One question how long can i take this tablet. I am taking only 5mg a day to begin with.
   As with many supplements whose long term use is not known well, it is preferable to take a break once in a while for a few days.