The Link Between NAD+, Inflammation, and Post-Viral Recovery
As a dietitian, I am always looking for new ways to support my clients' health, especially when it comes to immunity and recovery support. The recent global health landscape has brought post-viral fatigue and long-term recovery to the forefront of many conversations. And exciting emerging science is shedding light on the crucial role of NAD+ (nicotinamide adenine dinucleotide) in these areas, offering a new perspective on cellular health.
Recent findings from a study conducted at Massachusetts General Hospital, particularly around long COVID, suggest that supporting NAD+ levels may be a promising area of focus. Let's explore the science, the distinction between acute and long-term viral effects, and what this means for our practice.
Differentiating COVID-19 and Long COVID
It's important to distinguish between the acute phase of a viral infection like COVID-19 and its long-term consequences. The acute phase is the body's immediate fight against the virus, often involving familiar symptoms like fever, cough, and fatigue. This is part of the typical immune response.
Long COVID, or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), is different. It’s a multi-system disorder where symptoms like profound fatigue, cognitive impairments ("brain fog"), sleep disturbances, and muscle aches persist for months after the initial infection has cleared. This condition points to deeper, lingering dysregulation within the body’s systems.
NAD+ and Its Role in Cellular Resilience
So, where does NAD+ fit into this picture? NAD+ is a vital coenzyme that plays a key role in producing ATP within the mitochondria and activating enzymes like sirtuins and PARPs that are critical for DNA repair and managing inflammation.
During an acute viral infection, the body's demand for NAD+ increases as the immune system works overtime. This can lead to a significant depletion of NAD+ levels. Emerging evidence suggests that this depletion might contribute to the lingering symptoms seen in long COVID, including mitochondrial dysfunction, persistent inflammation, and impaired cellular energy.
Why NAD+ Supplements Aren’t the Answer
While the importance of NAD+ is clear, it’s crucial to understand that taking NAD+ supplements directly isn’t an efficient way to restore levels. NAD+ molecules are too large to be effectively absorbed by the body when taken orally, meaning they won’t reach the cells where they’re needed most. This is where NR (nicotinamide riboside) comes in as a better alternative.
What is NR and Why is it Better?
NR is a precursor to NAD+, meaning it’s a smaller molecule that the body can easily absorb and convert into NAD+. Unlike direct NAD+ or other precursor supplements, NR crosses into the cell directly and has been shown in clinical studies to effectively boost NAD+ levels in humans. It’s a more efficient and scientifically supported way to support cellular energy and recovery.
New Research on NR and Long COVID Recovery
A recent clinical trial published in eClinicalMedicine conducted at Massachusetts General Hospital provides promising insight into the potential benefits of NAD+ augmentation using Niagen (patented NR) supplementation for individuals with long COVID. This 24-week, randomized, double-blind, placebo-controlled study followed 58 non-hospitalized adults suffering from persistent post-COVID symptoms. Participants received Niagen supplementation (2,000 mg/day), and the research team monitored changes in NAD+ levels and tracked outcomes such as cognitive performance, fatigue, mood, and sleep quality.
The trial showed that within 5–10 weeks, NAD+ levels increased by up to 3.1-fold in whole blood. Notably, participants experienced significant improvements within themselves, reporting the following outcomes:
Better executive function
Reduced fatigue
Improved sleep quality
Decreased depressive symptoms
Although differences between the Niagen and placebo groups were not statistically significant (likely due to small sample size and confounding factors), the overall trend suggests NAD+ restoration through Niagen supplementation could help alleviate key symptoms associated with long COVID. The study also found Niagen was well-tolerated, with a safety profile similar to placebo.
The Bottom Line
Larger studies are still needed, but this research on Niagen, patented NR, marks an important step forward for understanding how cellular energy and NAD+ biology may aid recovery from post-viral syndromes.
This blog post was sponsored by Niagen Biosciences. All opinions are my own.