One of the concerns in the emerging field of longevity medicine is how we can push the envelope to really change the outcome of aging and age-related diseases without doing more harm than good. The body desires to always restore balance or homeostasis. When we disrupt this process in our attempt to help, we may actually cause more disease than we help prevent.

This lecture will focus on the use of NAD and its precursors, NMN and NR, which are extremely popular right now. However, using these supplements needs to be done in a much more cautious and calculated manner to avoid damaging the delicate REDOX balance in the cell and causing more disease than we help!

Nicotinamide Adenine Dinucleotide (NAD+) is the crucial coenzyme found in all living cells, playing a pivotal role in redox reactions, metabolism, and cellular signaling. The NAD+ redox pathway is fundamental to energy production and homeostasis. NAD+ functions as an electron carrier in metabolic processes, alternating between its oxidized (NAD+) and reduced (NADH) forms. This ability to accept and donate electrons makes NAD+ essential in various biochemical pathways, particularly those involved in the production of ATP, the cell’s primary energy currency.

In glycolysis, NAD+ is reduced to NADH as glucose is broken down into pyruvate, generating ATP in the process. Subsequently, in the mitochondria during the citric acid cycle (also known as the Krebs cycle), NAD+ is again reduced to NADH. These NADH molecules then donate electrons to the electron transport chain, a series of protein complexes located in the inner mitochondrial membrane. As electrons pass through these complexes, a proton gradient is established, driving the production of ATP via oxidative phosphorylation.

Beyond its role in energy metabolism, NAD+ is integral to cellular signaling and DNA repair, it serves as a substrate for sirtuins, a family of NAD+-dependent deacetylases that regulate gene expression, aging, and stress resistance. NAD+ is also a substrate for poly (ADP-ribose) polymerases (PARPs), which are involved in DNA repair and genomic stability. Moreover, NAD+ influences calcium signaling through its role in the production of cyclic ADP-ribose, a molecule that mobilizes calcium from intracellular stores.

The cellular NAD+/NADH ratio is a critical indicator of cellular redox state and metabolic health. High NAD+ levels are associated with enhanced cellular repair and longevity, while a decline in NAD+ levels is linked to aging and various metabolic disorders. Consequently, NAD+ replenishment strategies are extremely popular today. However, is more always better? Are we actually simply feeding degradative enzymes such as CD38 and NNMT by giving NAD and its precursors, which propagate rather than inhibit disease states? By the end of this unique lecture topic, the audience will have a much clearer understanding of the safe use of these compounds, the intricate balance at play inside our cells, and how we can best raise NAD+ levels in the safest way possible using unique peptide modalities and supplements that work in a much more physiologic fashion to restore healthful NAD levels.

Session Learning Objectives:

As a result of attending this lecture, participants will:

1.) Review the importance of redox – specifically to the NAD+pathway.

2.) Discuss how and why the NAD+pathway is crucial to cellular and metabolic health. 

3.) Establish how to optimize the NAD+redox pathway with practical and safe strategies for your clients and patients.