Overlooked Companion Therapies: NAD+ and Photobiomodulation.

I’m diving deep into the science of NAD+ Supplement, Photobiomodulation, and I end this article with exactly why they are resoundingly good together. This is exciting and very relevant in the optimal health revolution.

Reaching and Achieving.

This is biochemistry. It’s a dense subject. As I go along I’ve explained things in common terms without dumbing down the science. But if you’d like a simpler, just click here and skip right to the conclusion and my personal review of Tru Niagen®.

Biohacking Optimized

The ongoing medical research of Nicotinamide adenine dinucleotide, or NAD+ is dramatically reshaping our understanding of NAD+ as an all-important part of our optimal health. NAD is found in every cell, specifically in the mitochondria of our cells, and is crucial to the most essential reactions that keep us alive: ATP production. Photobiomodulation is a light therapy using lasers or LEDs to improve tissue repair, reduce pain and inflammation wherever the beam is applied. And photobiomodulation also works through the mitochondria and in a complementary manner.

Can these two health-optimizing therapies, NAD+ and Photobiomodulation, combined to deliver superior results than if they are used separately?

Getting the optimal results from your NAD+ supplement is the whole point, right?

As of this writing, I’ve been using NAD+ for over seven months and this is the narrative of my personal investigation and use.

Let’s start off by explaining more about…

  • NAD+ precursor Nicotinamide Riboside (NR).
  • Optimal NR dose sizes.
  • Photobiomodulation (Red Light Therapy).

Understanding how each of these therapies work and the bioscience backing up my reason for using them together, will lock this powerful idea into place. Once you see how they work together, combining these two therapies will be plainly obvious to you, too.

From here you can investigate this topic further. This, in turn, could update your own use of NAD+ precursor supplements while opening up a powerful new combination of therapies anyone can do at home.

NAD+ Vs. Niacin B3

A comprehensive 2008 article published in the Journal of Pharmacology and Experimental Therapeutics explains that NAD+ is a form of Niacin (Nicotinic Acid). The author, Anthony A. Sauve, explains that while NAD+ is a molecular cousin to another form of niacin, vitamin B3 (nicotinamide and nicotinic acid), which induces flushing, NAD+ works a bit differently.

To start with, it’s good to know that NAD+ is actually the oxidized end-point of Nicotinamide Riboside (NR)1.

Sounds technical, doesn’t it. It’s not that bad.

  • Take NR by mouth.
  • NR → Stuff Happens → NAD+  Growth, DNA Repair, Energy Occur.

Essentially…

  • NR pushes NAD+ production inside our bodies.
  • NAD+ makes Energy.
  • Energy drives growth, DNA repair, and power.

How does this happen?

This all happens by taking a NAD+ supplement by mouth, through the usual process of digestion and chemical changes that happen in your stomach and your liver, and voilà! NR is changed into the end-point product called NAD+.

FYI: A precursor is something that must be present before another thing can be made. NR must be present in the body before the liver can convert it to NAD+.

Here’s a simple example. Apples must be present before apple pie can be made. Apples are the precursor to apple pie. No apples; no apple pie. Likewise no Nicotinamide Riboside, no NAD+. Easy peasy.

And yes…there are other NAD+ precursors, but I’m only talking about NR here since this is the most widespread form people are supplementing with. All NAD+ supplements on the US market are not actually NAD+, but the biologically active precursor to NAD+, which is Nicotinamide Riboside Chloride, which is a ChromaDex product.

Naming of the Terms

  • Throughout this article, I will refer to:
  • NAD+ supplement
  • NAD+ precursor
  • NAD+ precursor vitamin
  • Nicotinamide Riboside Chloride (Niagen®)
  • NR

They’re all describing the same thing, Nicotinamide Riboside, naturally occurring or lab made.

I will also refer to Photobiomodulation as:

  • PBMT
  • Red Light Therapy
  • LLLT (Low Level Light / Laser Therapy)
  • Photomedicine

Again, these terms are nearly interchangeable.

While Red Light Therapy is not strictly accurate, its commonly understood meaning in photomedicine is what I’m striking at here.

The scientific literature uses all of these terms and you may be into the nerdy stuff. If you’re not, no worries.

Science loves nomenclature.

NAD+ Affects More Than it Appears

Not having enough NAD+ is the source of many diseases, cellular dysfunctions, and of course premature cell death. It is the ignition and source of many global actions in our bodies.

If I was talking nerdy to you I’d explain that…

“NAD+ is a coenzyme for hydride transfer reactions and a substrate for sirtuins and other NAD+-consuming enzymes.  NAD+-dependent processes are essential to how our bodies use and metabolize food, in gene regulation, advancing DNA repair, in protein modification, and in the internal “call and response” of cell signaling events. NAD+ is the key hydride transfer coenzyme for a wide variety of oxidoreductases and is also the consumed substrate of sirtuins, poly adenosine diphosphate ribose (ADPr) polymerase, mono ADPr transferases, and cyclic ADPr synthases.2, 3  NAD+ produces its beneficial effects by targeting at multiple pathological pathways, including attenuating mitochondrial disorders, DNA damage, and oxidative stress, by modulating such enzymes as sirtuins, glyceraldehyde- 3-phosphate dehydrogenase, and AP endonuclease.4

NERDY TALK: Sirtuins are part of the hormetic, heat shock protective response which Vitagenes encode for. This Integrated response exists to detect and control diverse forms of stress. This is accomplished by a complex network of the so-called longevity assurance processes, which are composed of several genes termed vitagenes. Vitagenes encode for heat shock proteins (Hsps), thioredoxin and sirtuin protein systems.

 

Simply Speaking…the measurable levels of NAD+ and NR act as snapshots of our current health and physiological resilience. The more NAD+ we have in our mitochondria the more resilient and robust our health is. Not enough, and we are in deep sh*t. The health implications are vast! 

We are discovering so much of how this all ties into many pathologies. The study of NAD+ is continuing to demonstrate its potential to treat many of our greatest health issues.5

Connected to Everything

An abundance of NAD+ in our cells’ mitochondria ensures all growth, physiological resilience, and healing. NAD+ is essential in vast areas of biological well being, including but not limited to…

  • Vascular health, metabolism, and preventing muscle atrophy.
  • Slowing and reversing of aging-related disorders, protecting the heart, and increasing cognitive health, induced neural plasticity and potential Alzheimer’s treatment.6
  • As well as restoring hormonal youth, insulin regulation, and energy for resilience and repair.

The big takeaway is that NAD+ is a crucial part of cellular respiration which is the very essence of biological life.

All growth, repair, protective response to stressors, and a myriad of vital responses in the body and the brain, are driven by NAD+.

 

In a 2015 article titled, NAD+ Metabolism and the control of energy homeostasis7 published in Cell Metabolism, Carles Cantó, Keir Menzies, and Johan Auwerx, write,

“In mammals, the enhancement of NAD+ levels has been linked with improved mitochondrial function under stress8,9,10,11 leading to protection against dietary12,13, and age-related14,15, metabolic complications.”

 

In their conclusion they state…

“The association between metabolism, health and lifespan have long been proposed based on similarities, between metabolic dysfunction and disease (e.g. obesity, diabetes, neurodegeneration, cancer) and the aging process. Only recently have these processes been linked so tightly by multiple proteins, including the sirtuins and PARPs, all of which are tightly controlled by the regulation and subcellular balance of the metabolite NAD+. As such, we have never been so close to solving the ancient question of how we age and what we can do to slow this process, while simultaneously not compromising on our quality of life.”

 

Carles Cantó, Keir Menzies, and Johan Auwerx add here that,

“Despite these insights, several aspects of NAD+ metabolism remain obscure. On one side, the complex detection and quantification of NAD+ metabolites and fluxes has not yet allowed us to obtain a clear picture of how different NAD+ precursors are metabolized to feed cells and tissues. We also speculate that additional proteins controlling the supply or salvage of NAD+, along with proteins that are controlled by NAD+levels, will be identified. Furthermore, the potential preventive and therapeutic use of NAD+ boosting strategies requires an assessment of the bioavailability and effectiveness of various precursor doses in human therapy. In addition, new NAD+ boosters are welcomed since the side effects of niacin generally lead to poor compliance, despite its known efficacy in a myriad of diseases.”

Supplementing with NAD+ precursor is not cheap. It’s a conscious investment into our health and resilience, with an intended future of superior health, longevity, and a robust response in the face of disease and stress.

The Patent, Production & Pricing

In 2004, Dr. Charles Brenner discovered nicotinamide riboside (NR) could increase levels of NAD+ in yeast cells. You see, NAD+ itself is not stable outside of the mitochondria. Taken orally, NAD+ is metabolized in the stomach and the liver. It does nothing. The only effective means of delivering NAD+ is intravenously which limits widespread, daily use by most people. Dr. Brenner’s discovery that Nicotinamide Riboside (NR) pushes up NAD+ levels in the mitochondria, by the use of daily oral supplements, has made the leap of accessibility for the rest of us. As a lab-made NR supplement, Niagen® is stabilized with the addition of Chloride. Dr. Brenner’s patents and established NR production techniques are licensed to ChromaDex.

 

From a 2018 interview with a well known fitness guru, Dr. Brenner was asked if all NR is Niagen?

He responded,

“Is NR that is called Niagen or Tru Niagen the same as a product that contains NR that is not called Niagen. Easy question. Absolutely not. Only one company licensed the Dartmouth IP for human nutritional uses of NR. Only one company has obtained FDA notifications for the means by which NR chloride is produced, crystallized and for material that, on the basis of its lack of toxicity in animals and people, is designated as a new dietary ingredient and generally regarded as safe. If you are buying a product with Niagen as an ingredient or a finished product called Tru Niagen, you are getting material that has a legal, regulatory and safety pedigree. If you are buying a product that says it has NR in it that is not Niagen, I truly don’t know what is in it or what safety data supports its human use.”

 

Currently ChromoDex Corporation, out of Irvine, CA, holds the sole patent on the production of Nicotinamide Riboside Chloride, which has been demonstrated through hundreds of research studies to drive up the biological levels of NAD+ when taken orally or intravenously in specific concentrations. All NAD+ supplements source their NR from ChromoDex despite the many different brands out there. This current monopoly on production keeps the price of NAD+ precursor supplements, NR, high.

Are You Benefiting From NAD+ in the Way That You Think?

This has been the black box question for many years.

As it turns out, the answer is yes. But, we still don’t know the how it gets into the mitochondria.

While the exact way that cells pull NAD+ into their mitochondria is not yet known, the ongoing research is indicating something good is happening even if the exact way this is happening is not yet understood.

FYI: You may be surprised to learn that the exact way in which hundreds of pharmaceutical drugs work is not known, either. It doesn’t stop the Food and Drug Administration (FDA) from recognizing its effectiveness and allowing it to be prescribed. While NR is not a controlled pharmaceutical drug, I mention this gold standard of the FDA as a way of reassuring you that the current and ongoing research is based on its effectiveness despite the need for further discovery.

Anecdotally many people, myself included, who are dosing with Tru Niagen®, NAD+ supplement, and other brands, swear we are seeing and feeling results. With so much science behind this, we’re pretty sure it’s working the way we think it is.

NERDY TALK: In contrast to yeast and plants, no human mitochondrial NAD+ transporter has been identified in humans or other mammals. A 2015 study published in the Journal of Biological Chemistry demonstrated increased levels of NAD+ within the mitochondria of human cells that had been experimentally induced to express the plant NAD+ transport proteins. Science has already found these transport proteins in yeast cells, which are eukaryotic cells and biologically similar to human cells, which are also eukaryotic cells. The presence of NAD+ in the mitochondrial matrix was the result of diverse expression of mitochondrial NAD+ transport proteins which pulled the NAD+ from the cytosol of the cell into the inside area of the mitochondria. While this plant-mammal NAD+transport protein mashup resulted in some less-than-optimum outcomes for the cell, namely reduced mitochondrial it served to the site of the conversion of NMNAT3 into NAD+ was in Glycolysis.

Optimizing NAD+ By Lower and Longer Dosing

So, how much NAD+ precursor vitamin is best?  Not as much as you might think.

A 2016 study published in Nature Communications reported the results of mouse trails undertaken together with the first human trial.

The investigators studied three NAD+ precursor vitamins and their effects on NAD+ blood levels; NA, NAM, and NR.16  The purpose of the study was to determine the time and dose-dependent effects of these three NAD+ precursor precursor vitamins, in a side-by-side comparison, in the metabolism of mice and humans. The three NAD+ precursor vitamins were taken by mouth, including NR. The results showed that blood NAD+ levels can rise as much as 2.7-fold with a single oral dose of NR.

Furthermore, this study found that at 4.1 hours after ingesting NR the measured NAD+ levels increased by 230%.

This was a pilot study of one individual, and that oral NR elevates mouse hepatic NAD precursor with distinct and superior pharmacokinetics to those of nicotinic acid and nicotinamide.

This study validated that NR is the favored NAD+ precursor vitamin for increasing NAD+ and NAD+-consuming activities in liver.

NERDY TALK: This study showed that nicotinic acid adenine dinucleotide (NAAD), which was not thought to be en route for the conversion of NR to NAD þ, is formed from NR and discover that the rise in NAAD is a highly sensitive biomarker of effective NAD þ repletion.

Too much NR too fast triggers the body to lower the resulting NAD+ levels.

 

But here’s the kicker, too high of levels of NAD+ can trigger our body’s ability to maintain balance.  Homeostasis, is our body’s drive to a maintain balance by adjusting something up or down. Our bodies are amazingly responsive to change. By increasing something that’s run low or decreasing another thing that has become too abundant, this is our homeostasis at work. And it’s this homeostatic response to too much NAD+ that will lower the NAD+ levels that you worked so hard to push up.

This apparent contradiction in the homeostatic balancing response is well known.

Boutique health clinics that provide NAD+ by IV, require the patient to be hooked up to a drip IV for 8 hours so the NAD+ levels are slowly dispensed into the bloodstream without triggering a NAD+-lowering response. This is the homeostatic response of balancing too much of something can trigger.

Our bodies are endlessly resilient and responsive to so much of what we throw at it.

You see, when our bodies received too much NAD+ too quickly, such as 500 – 1000 mg daily, over a short period of time, our body’s balancing act kicks in and lowers the NAD+ levels in our blood. This defeats our original purpose and ultimately wastes our efforts.

A Note on NAD+ supplements: Tru Niagen® is the only NAD+ Precursor supplement I’m aware of that accounts for this homeostatic response by breaking their recommended daily dose into smaller dose sizes. Tru Niagen® is encapsulated into 125 mg capsules to make small incremental increases easy. For safety, the minimum dose of 250 mg is stated as recommended daily. This is a safety baseline.

Side Effects?

None…if you don’t go crazy off-the-charts with your dosing.
Use some common sense and do your research.

Start with this study.

A 2016 study published in Human & Experimental Toxicology21, a side-by-side toxicology study of Nicotinamide riboside (NR), which is a naturally occurring form of vitamin B3, was compared against Niagen™, a synthetic form of NR (Nicotinamide Riboside Chloride). This was determined in three ways: 1.) using a bacterial (Ames) assay, 2.) an in vitro chromosome aberration assay, and 3.) in live rats using a micronucleus assay. The live rats had high dose (acute) 14-day and 90-day toxicology studies.

The results were encouraging. NR wasn’t toxic to the rats’ DNA and none of the rats died from the highest (acute) oral dose of 5000 mg/kg.

It’s the methodology of studies to go for extremes. But don’t you do this to yourself.

Based on the results of this 14-day study, a 90-day study was performed comparing NR at 300, 1000, and 3000 mg/kg/day to an equimolar dose of nicotinamide at 1260 mg/kg/day as a moderate (positive) control.

Results from this study showed that NR had a similar toxicity profile to nicotinamide at the highest dose of 5000 mg/kg. This was seen in the target organs of toxicity which are the liver, kidney, ovaries, and testes.
The lowest observed adverse effect level for NR was 1000 mg/kg/day, and the no observed adverse effect level was 300 mg/kg/day.

Dose / Amount?

Suppose you decided to increase your daily NAD+ supplement intake to 500 mg daily. With Tru Niagen® you could easily titrate four evenly spaced 125 mg doses throughout the day so your body shouldn’t experience that spike. This will prevent the body’s homeostatic response from lowering the resulting too high levels of NAD+.

Steady and low is the way to go.

You see, Tru Niagen® , like the other NAD+ Precursor supplements, like the other NAD+ precursors, has their standard recommended dose of 250 mg, but this is in divided between two (2) capsules. This way you can spread this amount throughout your day without triggering that NAD+-lowering, homeostatic response.

Because of this handy dosing size, you could even increase your dose up to 500 or 1000 mg daily in tiny increments of 125 mg each. It will increase your costs, but you’re aware of this already.

The Working Bits: Mitochondria and ATP Production

Here are some slides that show the mitochondria’s structure and the detailed function of the Electron Transport Chain within the mitochondrial membrane where all of this happens.  So you get NAD+ is essential for the energy of living. In order to draw a picture for you, these educational slides show where the mitochondria is in the cell and where the electron transport chain is.

 

Image from unacademy.com

Mitochondrial Dysfunction

So, this is a bit technical, but I’ll try to break it down. Stay with me and you’ll be impressed by how easily you’ll understand the big ideas despite all of the details.

When we get sick, injured, stressed, chronically sleep-deprived, etc., the mitochondria in our cells can produce excess Nitric Oxide (NO). We need NO, but too much stuck in one place is a problem. To understand why this is bad, let’s go back to that critical enzyme in the Electron Transport Chain of the Mitochondria, called, Cytochrome C Oxidase (CCO).

During the creation of ATP synthase, Nitric Oxide (NO) competes with oxygen and binds to CCO. This bottleneck of NO on CCO stops the production of ATP and thereby increases oxidative stress. If this state doesn’t change, this NO-driven ATP stoppage can lead to Mitochondrial Dysfunction and eventual cellular death.

Nothing in, nothing out.

In the middle of all of this research-validated goodness we are overlooking a strong ally that has the potential to amplify how your body uses NAD+: Photobiomodulation.

Photobiomodulation: The Electron Transport Chain is Where the Action Is!

So back to the mitochondria of the cell and Electron Transport Chain.

The Electron Transport Chain, which is literally on and inside the membrane of the mitochondria, is significant because of these three actions:

  • ATP Production.
  • Mitochondrial Dysfunction.
  • Photobiomodulation.

Understanding Photobiomodulation requires first understanding of Mitochondrial Dysfunction.

We’ve covered the ATP production pretty well. So let’s go on to the remaining two.

Photobiomodulation

Now, Photobiomodulation, also known as Red Light Therapy or LLLT, is using LED light within specific wavelengths that are biologically active. In this case, it’s the biologically active Red Light wavelengths of 660 nm and 850 nm.

When the light is absorbed into the tissues, this causes the Nitric Oxide that’s bound to the Cytochrome C Oxidase to simply pop off. This reverses the mitochondrial dysfunction, allows ATP production to start back up resume all of the ATP-driven processes. Yeah!

And because NAD+ levels have been elevated from supplementing with the NAD+, Nicotinamide Ribose which has been converted to NAD+ by this time, is primed and ready to work at optimal rates.

But when doesn’t supplementing with Nicotinamide Riboside Chloride work optimally?  When this happens the Electron Transport Chain in the mitochondria shuts down. This is called Mitochondrial Dysfunction17 and it essentially means that a particular mitochondria just stopped working.18  Kaptuz! Nada!

Too much nitric oxide binding in the Electron Transport Chain is the culprit.

If this happens, no amount of NAD+ will jump start it.

So now what?

Reversing Mitochondrial Dysfunction

As you recall from the many, many times I’ve mentioned it here, the location of NAD+-driven energy production occurs in a small organelle of the cell called the mitochondria. As you have gathered from this article, mitochondria function like nano energy generators within the cell and each cells has upwards of 100+ mitochondria. Some high-functioning muscle cells, like cardiac cells that make up the heart, will have many more.

Inside the mitochondrial membrane, during the Citric Acid Cycle (aka the Kreb’s Cycle) is where ATP is produced. ATP is often referred to as the currency of life. NAD+ is what drives the H+ electron gradient, which in turn drives the binding of Oxygen to Cytochrome C Oxidase (CCO) and the end production of ATP.

Are you getting a bit dizzy from all of this? Yes, biochemistry can seem like a Rube Goldberg Machine, where overly complex machinery does a simple action, and in essence it is.

When everything is going right…!

  • NAD+ picks up H+ = NADH.
  • NADH donates H+ electrons that drive the Electron Transport Chain (ETC) process forward.
  • ETC leads to Cytochrome C Oxidase binding to Oxygen.
  • Cytochrome C Oxidase + Oxygen = ATP!

When everything turns to sh*t… (Mitochondrial Dysfunction)19

  • ETC + Nitric Oxide = NO ATP.
  • NAD+ accumulates in the cell unused.
  • Loss of function in mitochondria.
  • No NAD+ = No ATP = No Life!

From a peer-reviewed journal, this description of about mitochondrial dysfunction is a bit technical, but I think you can still get some of this.

 

NERDY TALK: From a 2014 paper on Mitochondrial Dysfunction, published in Integrative Medicine, Garth L. Nicolson writes,“Mitochondrial dysfunction, characterized by a loss of efficiency in the electron transport chain and reductions in the synthesis of high-energy molecules, such as adenosine-5′-triphosphate (ATP), is a characteristic of aging, and essentially, of all chronic diseases. These diseases include neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis, and Friedreich’s ataxia; cardiovascular diseases, such as atherosclerosis and other heart and vascular conditions; diabetes and metabolic syndrome; autoimmune diseases, such as multiple sclerosis, systemic lupus erythematosus, and type 1 diabetes; neurobehavioral and psychiatric diseases, such as autism spectrum disorders, schizophrenia, and bipolar and mood disorders; gastrointestinal disorders; fatiguing illnesses, such as chronic fatigue syndrome and Gulf War illnesses; musculoskeletal diseases, such as fibromyalgia and skeletal muscle hypertrophy/atrophy; cancer and chronic infections.”

And this is why we fight so hard with everything we have got!

Kickstart ATP Back Into Production

This image, from a 2018 paper by Dr. Michael Hamblin, one of the foremost authorities in the world on Photobiomodulation, shows the Nitric Oxide-driven Mitochondrial Dysfunction. With the absorption of Red and Near Infrared (NIR) light into the chromophores of the mitochondria, this kicks out the Nitric Oxide from the Cytochrome C Oxidase. When this occurs, oxygen can again bind to the Cytochrome C Oxidase, restarting the production the production of ATP21.

Conclusion and How to Use this Article

Use both NAD+ and Photobiomodulation together!

Because the biochemical responses triggered by the photobiomodulation continue for hours, and sometimes weeks after a single exposure. The window of opportunity to combine these two therapies for optimized impact is focused to within a few hours of using each one. But if you miss this optimal window, all is not lost, even if there may be diminishing returns.

By combining our current understanding of how best to use NAD+ supplement (NR), and consistently using Nicotinamide Riboside (NR) in low doses throughout our day, while adding in photobiomodulation as part of our daily health habits, we are throwing everything science has discovered is good for us and applying this to our health, youth, and longevity. This is like a massive home run with the bases loaded; we’re giving our absolute, maximum effort for a maximum payoff.

My Experience with Tru Niagen®

Using NAD+ (Nicotinamide Riboside) & Red Light Therapy Together.

If you’re here for a video review of Tru Niagen, please view below:

In the Beginning

Seven months ago I started off using LifeExtension® NAD+ (Nicotinamide Riboside Chloride) only. I took this with food in the morning. I used the recommended dose of 250 mg as indicated on the bottle.

It started working. I felt really energized and just good. I also noticed an increase in my libido without me using any testosterone gel or other antigen-driven supplements. I’m a 55 year old female, in great shape. I’m well maintained hormonally and physiologically. However, getting back my 20-something and 30-something mojo is still a strong desire. Lol. While this wasn’t my primary focus, this increase in my libido was a happy accident.

How I noticed this enhancement to my libido was subtle at first. It wasn’t a jolt of excitement like the pressing of the “on button”, but a steady increase that coincided with an overall increase in my physical and mental resilience that led to this feeling of well being. I would say there was about a two-week lag time between initially dosing with NR and noticing my overall enhanced well being, then the increased libido kicking in.

I did indeed notice an enhanced mental focus and cognitive capacity. I write for a living, so staying focused and creative, while diving into deep research while remaining focused on the subject is my job. This became noticeably easier and downright enjoyable.

My sleeping through the night was also back on track. Not sleeping well had become a problem because of a injury that caused neurological damage resulting in Complex Regional Pain Syndrome (CRPS). CRPS has an impact on the whole being of the patient, including the circadian sleep-wake cycles. As a result of taking NR, I was feeling more like my younger self, getting better sleep, and feeling well rested when awake. I noticed my skin looked smoother, responded better to my many skin tools, and products. I also noticed my hair and my nails were growing faster.

However, after about two months I was feeling less of this. It was confusing to me.

I hadn’t yet read the research on the homeostatic response where, after six to eight weeks of high NAD+ levels, this triggers our body to lower the NAD+ levels, thereby lowering our benefits, too. As I stated before, at the time I was taking LifeExtension® NAD+ supplement at the recommended daily does of 250 mg in a single capsule. It seems I was inadvertently tripping that homeostatic balancing wire.

Turns out, my experience coincided exactly with the clinical trials. This research showed that after six to eight weeks of increased NAD+ levels in the body, trial participants went from riding high on the results only to experience a decline in these gains. It wasn’t a complete loss, just a reduction.

A Refinement to My Protocol

Then I was introduced to Tru Niagen® and they have the same quality product delivered in a 250 mg daily dose that is divided into two capsules per day. By this time I’d read the research on the homeostatic response and this seemed worth a shot.

I have since switched over to Tru Niagen® and have been on it for nearly four months. What I noticed was a bit of a drop in my libido and a slight drop in mental focus, but it wasn’t huge. I stuck with Tru Niagen®. Over the next several months I noticed a steady albeit subtle gain that I can definitely feel.

It didn’t have that strong and powerful feeling like I had before, yet it was most definitely improving my overall mental clarity, physical well being. I have steadily gained back the results I initially had with the higher single dose and I’ve kept these gains as of this writing.

Maximized Ignition

I’m a creature of habit, and I’ve been faithfully using my Tru Niagen® NAD+ everyday at 250 mg in equally divided doses taken with food, morning and night. My libido slowly has risen back to nearly the same increased level I had previously noticed without any homeostatic-triggered drops. The same with my cognitive and physical well being.

Low and steady is the rule when using NAD+ supplement.

Two months ago I got my Joovv® Red Light Red & NIR full body unit and started incorporating this into my daily regime. I knew that these two therapies, photobiomodulation and NAD+ therapy, both work by optimizing the mitochondrial function and they seemed like natural go togethers. I hadn’t read any literature regarding using them together and I wasn’t sure why this was. This seemed entirely nature to me, so I did just did it.

I experienced a slight burst of healing and even more cognitive focus and creativity.

Everything responded so well and so quickly! I kept thinking to myself, “Am I imagining all this?”

I use the Joovv Red and NIR Light over my kidneys for up to 20 minutes and I get a powerful response! I literally feel an significantly increased and happy flow of blood throughout my lower pelvic region. My urine output is higher with more full voids. Look it up. My skin looks even smoother with this airbrushed appearance I couldn’t believe when I first noticed it. It’s still amazing to me. No way do I look my age, feel my age, or respond to life as if I’m 55 years old. My age feels like it’s inconsequential to my energy, focus and life.

Now, of all times, is when I wished I had access to researching NR and photobiomodulation, used together, in mammal and human test subjects.

Again, while it wasn’t like the jolt you get when taking three shots of espresso, it was yet again an uptick in my overall physical performance and response. And…I noticed my greatest gains cognitively. Why this is, I have no idea. Nothing changed except the addition of the Red and NIR light therapy.

I use microcurrent lifting for my face and I noticed an uptick on how good my skin looked and how long it lasted in between treatments.

To this I add in facial exercises to enhance the microcurrent lifting and properly shape my face. These exercises are typically short-lived in their effects, usually lasting only one day. I had noticed by adding in NAD+ this gave my exercise sessions more staying power; up to two days after a session. But when I added in the Red and NIR Light, these facial exercises can have an effect for up to three days between sessions.

The skin on my body seems more dense and even in color with a silky feeling I don’t recall having for a very long time. I’m not a tri-athlete or a weightlifter, but I imagine I’d have more to report if I was.

So there you have it.

My Best Practices

AM – Protocol

  • Take 125 mg NR with food.
  • Four (4) Hours later I use Red & NIR Light Therapy a minimum of 10 minutes on each side, both front and back.
  • NOTE: At four hours the NAD+ is at maximum bioavailability.16
  • You can add in an additional 10 minutes to each side of your body, the left and right, go for it! I do this frequently.

PM – Protocol

  • Take 125 mg NR with food.

I still continue to monitor my progress and note any changes, for or against. NAD+ and NR taken orally is still a black box in many ways and our knowledge is just beginning to show glimpses of how it works. While purely anecdotal, my personal investigation has been science backed.

If you’re interested in Red Light Therapy…

You can read about my review on the Joovv Red Light Therapy system.

For Your Further Research

1 NAD+ and Vitamin B3: From Metabolism to Therapies – Anthony A. Sauve, Journal of Pharmacology and Experimental Therapeutics March 2008, 324 (3) 883-893

2 Belenky P, Bogan KL, Brenner C. (2007) NAD+ metabolism in health and disease. Trends Biochem Sci32: 12–19, [PubMed]

3 Bogan KL, Brenner C. (2008) Nicotinic acid, nicotinamide, and nicotinamide riboside: a molecular evaluation of NAD+ precursor vitamins in human nutrition. Annu Rev Nutr 28: 115–130 [PubMed]

4 Mingchao Zhang and Weihai Ying. (2018). Antioxidants & Redox Signaling. Mary Ann Liebert, Inc. Online Ahead of Print: February 7, 2018. Online Ahead of Editing: January 2, 2018

5 Mingchao Zhang, Weihai Ying (2018); NAD+ Deficiency Is a Common Central Pathological Factor of a Number of Diseases and Aging: Mechanisms and Therapeutic Implications Published Online: 7 Feb 2018

6 NAD+ supplementation normalizes key Alzheimer’s features and DNA damage responses in a new AD mouse model with introduced DNA repair deficiency Yujun Hou, Sofie Lautrup, Stephanie Cordonnier, Yue Wang, Deborah L. Croteau, Eduardo Zavala, Yongqing Zhang, Kanako Moritoh, Jennifer F. O’Connell, Beverly A. Baptiste, Tinna V. Stevnsner, Mark P. Mattson, Vilhelm A. Bohr Proc Natl Acad Sci U S A. 2018 Feb 20; 115(8): E1876–E1885. Published online 2018 Feb 5. doi: 10.1073/pnas.1718819115 PMCID: PMC5828618

7 NAD+ metabolism and the control of energy homeostasis – a balancing act between mitochondria and the nucleus. Carles Cantó, Keir Menzies, Johan Auwerx Cell Metab. Author manuscript; available in PMC 2016 Jul 7. Published in final edited form as: Cell Metab. 2015 Jul 7; 22(1): 31–53. Published online 2015 Jun 25. doi: 10.1016/j.cmet.2015.05.023 PMCID: PMC4487780

8 NAD(+)-dependent activation of Sirt1 corrects the phenotype in a mouse model of mitochondrial disease. Cerutti R, Pirinen E, Lamperti C, Marchet S, Sauve AA, Li W, Leoni V, Schon EA, Dantzer F, Auwerx J, Viscomi C, Zeviani M. 2014 Cell Metab. 2014 Jun 3; 19(6):1042-9.

9 Effective treatment of mitochondrial myopathy by nicotinamide riboside, a vitamin B3. Khan NA, Auranen M, Paetau I, Pirinen E, Euro L, Forsström S, Pasila L, Velagapudi V, Carroll CJ, Auwerx J, Suomalainen A. EMBO Mol Med. 2014 Jun; 6(6):721-31.

10 The NAD(+)/Sirtuin Pathway Modulates Longevity through Activation of Mitochondrial UPR and FOXO Signaling. Mouchiroud L, Houtkooper RH, Moullan N, Katsyuba E, Ryu D, Cantó C, Mottis A, Jo YS, Viswanathan M, Schoonjans K, Guarente L, Auwerx J Cell. 2013 Jul 18; 154(2):430-41.

11 Pharmacological Inhibition of poly(ADP-ribose) polymerases improves fitness and mitochondrial function in skeletal Muscle. Pirinen E, Cantó C, Jo YS, Morato L, Zhang H, Menzies KJ, Williams EG, Mouchiroud L, Moullan N, Hagberg C, Li W, Timmers S, Imhof R, Verbeek J, Pujol A, van Loon B, Viscomi C, Zeviani M, Schrauwen P, Sauve AA, Schoonjans K, Auwerx J. Cell Metab. 2014 Jun 3; 19(6):1034-41.

12 PARP-1 inhibition increases mitochondrial metabolism through SIRT1 activation. Péter Bai, Carles Canto, Hughes Oudart, Attila Brunyánszki, Yana Cen, Charles Thomas, Hiroyasu Yamamoto, Aline Huber, Borbála Kiss, Riekelt H. Houtkooper, Kristina Schoonjans, Valérie Schreiber, Anthony A. Sauve, Josiane Menissier-de Murcia, Johan Auwerx Cell Metab. Author manuscript; available in PMC 2012 Apr 6. Published in final edited form as: Cell Metab. 2011 Apr 6; 13(4): 461–468. doi: 10.1016/j.cmet.2011.03.004 PMCID: PMC3086520

13 The NAD+ precursor Nicotinamide Riboside Chlorideenhances oxidative metabolism and protects against high-fat diet induced obesity Carles Cantó, Riekelt H. Houtkooper, Eija Pirinen, Dou Y. Youn, Maaike H. Oosterveer, Yana Cen, Pablo J. Fernandez-Marcos, Hiroyasu Yamamoto, Pénélope A. Andreux, Philippe Cettour-Rose, Karl Gademann, Chris Rinsch, Kristina Schoonjans, Anthony A. Sauve, Johan Auwerx Cell Metab. Author manuscript; available in PMC 2013 Apr 4. Published in final edited form as: Cell Metab. 2012 Jun 6; 15(6): 838–847. doi: 10.1016/j.cmet.2012.04.022 PMCID: PMC3616313

14 Declining NAD+ Induces a Pseudohypoxic State Disrupting Nuclear-Mitochondrial Communication during Aging. Ana P. Gomes, Nathan L. Price, Alvin J.Y. Ling, Javid J. Moslehi, Magdalene K. Montgomery, Luis Rajman, James P. White, João S. Teodoro, Christiane D. Wrann, Basil P. Hubbard, Evi M. Mercken, Carlos M. Palmeira, Rafael de Cabo, Anabela P. Rolo, Nigel Turner, Eric L. Bell, David A. Sinclair Cell. Author manuscript; available in PMC 2014 Jun 30.

15 Nicotinamide mononucleotide, a key NAD+ intermediate, treats the pathophysiology of diet- and age-induced diabetes in mice Jun Yoshino, Kathryn F. Mills, Myeong Jin Yoon, Shin-ichiro Imai Cell Metab. Author manuscript; available in PMC 2012 Oct 5. Published in final edited form as: Cell Metab. 2011 Oct 5; 14(4): 528–536. doi: 10.1016/j.cmet.2011.08.014 PMCID: PMC3204926

16 Nicotinamide riboside is uniquely and orally bioavailable in mice and humans Samuel A.J. Trammell , Mark S. Schmidt, Benjamin J. Weidemann, Philip Redpath, Frank Jaksch, Ryan W., Dellinger, Zhonggang Li, E Dale Abel Marie E. Migaud & Charles Brenner Nature Communications volume 7, Article number: 12948 (2016).

17 Nitric Oxide and Mitochondrial Signaling From Physiology to Pathophysiology Jorge D. Erusalimsky, J. D., S. Moncada Originally published 20 Sep 2007 Arteriosclerosis, Thrombosis, and Vascular Biology. 2007;27:2524–2531

18 Reversible inhibition of cytochrome c oxidase, the terminal enzyme of the mitochondrial respiratory chain, by nitric oxide. Implications for neurodegenerative diseases M.W.J. Cleeter ,J.M. Cooper, V.M. Darley-Usmar, S. Moncada, A.H.V. Schapira First published: May 23, 1994

19 Mitochondrial Dysfunction and Chronic Disease: Treatment With Natural Supplements Garth L. Nicolson Integr Med (Encinitas) 2014 Aug; 13(4): 35–43. PMCID: PMC4566449

20 Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation Michael R. Hamblin Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 2 Department of Dermatology, Harvard Medical School, Boston, MA 3 Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA Received 21 September 2017, accepted 31 October 2017, DOI: 10.1111/php.12864

21 Safety assessment of nicotinamide riboside, a form of vitamin B3 DB Conze, J Crespo-Barreto, CL Kruger First Published January 20, 2016