To Your Health

Q. I recently heard about a product called NADH that can help people with chronic fatigue syndrome. I don't have that problem, but I certainly get tired sometimes and wish for something safe that would give me an energy boost. Would NADH help and at what amount?

A. NAD stands for nicotinamide adenine dinucleotide, and the "H" is to indicate that it is chemically "reduced," which is important for its function in the body. NADH is the primary form of activated vitamin B-3 (niacin) in the body. NADH is present in all living cells and is involved in the complicated enzymatic process of extracting energy from food and storing it as ATP (adenosine triphosphate, the universal energy resource for cells).

The NADH content of fruits and vegetables is minimal, so the only practical way to obtain it is in pill form. Until 1995, NADH was considered too fragile to use as an oral dietary supplement but George Birkmayer, M.D., Ph.D., developed a stable form of NADH that is now clinically effective. He and others have published several scientific papers on the possible use of NADH to treat Parkinson's disease, Alzheimer's disease, depression, and chronic fatigue syndrome. There is also "case history" of it helping Tourette's syndrome.

Parkinson's disease is one of the most common neurological diseases of aging, and traditional medical therapies have serious drawbacks. A lack of the neurotransmitter dopamine leads to the most common physical symptoms of Parkinson's disease and to the depression that often accompanies them. There is evidence that NADH supplements raise brain levels of dopamine.

Because many Parkinson's patients often suffer dementia as well as Parkinson's symptoms, NADH has been tried on Alzheimer's dementia patients. NADH supplements halted the progression of cognitive and behavioral problems and sometimes even reversed them. When NADH supplements were halted briefly to determine if the improvements would last without it, deterioration began after several weeks but benefits were regained once NADH was restarted.

Depression may result in part from a lowered energy level in the brain. The human brain uses about 20% of the body's total energy, and tests on depressed people frequently show reduced brain energy production. Thus, NADH might be expected to literally energize the brain and relieve the chemical depression that seems to be more and more common today.

Chronic fatigue syndrome is a clinically perplexing disorder without a known cause, characterized by prolonged fatigue along with many other debilitating symptoms. In a double-blind crossover research study, supplements of NADH produced favorable response in eight of 26 patients, compared to two in the placebo group. NADH may be a valuable accessory therapy in the management of chronic fatigue syndrome.

The safety of long-term oral NADH supplements remains unclear. Over 10 mg per day may cause anxiety and insomnia, so one option is to use it for a few months then discontinue it for a month, or take it only two or three days of the week. Most studies started with 2.5 mg per day with gradual increase to a maximum of 10 mg per day.

NADH does have brain-stimulating properties and some healthy individuals take NADH supplements to improve concentration and memory. However, to date there have been no published studies using NADH for these relatively minor problems. It seems most useful for people with serious maladies.