What Is NAD+ & Does It Help With Fertility?

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When scrolling through social media, among content about the best hacks to get your perfect night’s sleep and other wellness fads, you’ve probably seen videos about “discovering the fountain of youth.” Influencers and celebrities alike are talking about using NAD+, a key cellular coenzyme, in both supplement and IV form to nourish their cells and promote longevity. You may have also come across videos of celebrities like Hailey Bieber and Kendall Jenner hooked up to vitamin IV’s containing NAD+ and testimonials of other stars including Jennifer Aniston and Gwyneth Paltrow singing its praises.

If you’re in the process of planning to start a family, you’re likely inundated with even more of this type of wellness advice everywhere you turn. NAD+ is essential to the life of cells, and can potentially benefit egg cells and therefore reproductive health. However, there is more you need to know about what forms are best so that you can harness its effectiveness with the least amount of side effects.

Fertility specialists explain how to boost your levels of NAD+ in the healthiest way possible, below.

What is NAD+ and What are NAD+ Precursors?

NAD+, or nicotinamide adenine dinucleotide, is a molecule that exists in every living cell in your body and promotes energy production within the mitochondria, the powerhouse of the cell, and also supports cell defense and repair. Without NAD+, cells can’t survive, explains Aimee Eyvazzadah, MD, an OB/GYN and reproductive endocrinologist also known as “The Egg Whisperer” and a Tru Niagen® partner. Over time, NAD+ levels in the cells naturally decline with age or other stressors: such as high fat, high sugar diets, too much sun exposure, and other environmental factors, she adds.

The key to upping levels of NAD+ as time goes on is not necessarily by supplementing pure NAD+, but by taking an NAD+ precursor or “booster” such as nicotinamide riboside, or NR, according to Dr. Aimee. NR is a form of vitamin B3 that has been clinically proven with research to boost the body’s natural production of NAD+.

Why wouldn’t NAD+ supplements or an NAD+ IV directly into your bloodstream give you the purest, most efficient form of NAD+? It has to do with the size of the molecule. “NAD+ molecules are too large and must be broken down before entering the cell, while NR is the most efficient NAD+ booster because it is smaller and can enter the cell directly,” says Dr. Aimee.  By supplementing with an NAD+ “booster” or “precursor,” such as nicotinamide riboside (NR), there might be a solution to supporting  the cellular energy levels of all the cells in your body, including your egg cells, and potentially your reproductive health as a result.

Are NAD+ Precursors Good for Reproductive Health?

“Although there’s predominantly only preclinical research looking at NAD+ and reproductive health, we know cell aging prominently affects all cells in the body, including egg cells. The quality of egg cells decreases after age 30, and requires significant energy to thrive,” says Dr. Aimee. Part of this may have to do with a decrease in NAD+ with age; there’s some evidence that supplementing the production of NAD+ can support egg quality and support the healthspan of those cells, which can help your reproductive health, adds Leyla Bilali, BSN, RN, Chief Clinical Officer and Registered Fertility Nurse at Dandi Fertility.

The predominantly preclinical results suggest that supplementation with NAD+ precursors, like NR, may reduce egg cell damage over time, which may support reproductive health. A human clinical study published in 2021 found that women with PCOS (polycystic ovary syndrome) had lower NAD+ levels and reduced mitochondrial function in ovarian cells called granulosa cells. These cells play a key role in regulating hormones, producing progesterone, and developing the right environment for immature eggs. This study suggests that by supporting granulosa cells with NR supplementation may help support other aspects of reproductive health beyond fertility.

In her practice, Dr. Aimee  recommends both her female and male patients take between 300mg and 1,000mg of Tru Niagen, which features patented NR because it can nourish both egg and sperm cell health. It’s the highest quality, well-researched NAD+ booster, and is proven to be safe.

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What are the risks for NAD+?

The risks and side effects of NAD+ supplementation tend to come from IV NAD+. The NAD+ molecule is large and is thought to cause inflammation when the body detects it outside of the cell, which is what happens during intravenous administration of NAD+, explains Dr. Aimee. This can contribute to uncomfortable side effects, such as headaches, bloating, nausea and vomiting, dizziness, or skin rashes. These are primarily associated with high dose NAD+ IV treatments, which may have adverse effects on the liver and kidneys (and shouldn’t be used in anyone with kidney or liver disease), adds Bilali.

NR, what’s in Tru Niagen, doesn’t have known risks or interactions with medications, says Dr. Aimee. Before starting on any new supplement, you should check in with your healthcare provider, and the same goes for any fertility supplements: Run this decision by your OB/GYN or fertility specialist, who can help tailor a specific protocol to your needs. If patients are particularly sensitive to supplements, Dr. Aimee recommends they start with 300mg of Tru Niagen, and monitor how they feel before increasing the serving, advises Dr. Aimee.   

Are NAD+ Precursors Recommended During Pregnancy?

Some NAD+ precursor supplements haven’t been studied during pregnancy, so it’s best to avoid those during pregnancy to be safe, explains Bilali.

Some preclinical research in animals suggests that smaller doses of NAD+ boosters could be helpful with development during pregnancy. It’s important to know that this has not been shown in  humans yet.

In general, supplementing with NR  before pregnancy may help  your body cope with everyday stressors, says Dr. Aimee. “Pregnancy is the most energetically expensive activity the human body can maintain for nine months, and maintaining NAD+ levels can help support health pre, during, and post-pregnancy.” For example, one report in Science Advances shows that the amount of energy required to sustain a pregnancy is the equivalent to running a 40-week marathon.