Dr. Sandra Kaufmann is Chief of Pediatric Anesthesia at Children’s Hospital in Hollywood, FL. On the side, she founded an Anti-Aging Institute and is author of The Kaufmann Protocol: Why We Age and How to Stop It. She recently wrote a post on NAD — but left lots of questions on NAD boosters unanswered. Fortunately, thanks to her many podcast appearances we can piece together what she really thinks.

Dr. Kaufmann on the Sex and Happiness Podcast — Health and Super Longevity (Link) (Discussion starts at 25:20 in podcast embedded below)

“Most people that come to me……as you said I’m a pediatric anesthesiologist…my office is in the operating room….

No one comes to see me as an anti-ager because I just don’t have an office.

However, the entire hospital at this point — they sneak into my office at some point and ask me questions — what can I do about this nut…

And the most frequent questions are:

#1 — I just don’t have the energy I used to.

#2 — I’ve got aches and pains.

When we get rid of those, people just seem to be more themselves.

So, whereas I’ve pushed the idea you have to not age in seven categories, those two are the big ones.

Therefore, most people over the age of 40 are Nicotinamide deficient.

And Nicotinamide, not the kind you get from cigarettes or anything of that nature….

Nicotinamide is important in your body for 4 reasons.

And the biggest reason is because it’s a rate limiting step in energy production in the mitochondria in the electron transport chain.

So if your transport chain doesn’t work you’re not making ATP — and you’re TIRED.

And unfortunately as you age you need more Nicotinamide and you have less….

The key is that you need it for ENERGY production.

So if you’re deficient you’re just not making energy.

So after 10 days — plus or minus depending on how old you are — after being on it orally people just feel better.

And when they feel better they’re more like themselves and then they’re just happy.

….Nicotinamide….there’s only TWO molecular agents that you can take right now.

There’s Nicotinamide Riboside and Nicotinamide Minoxide….

…They’re probably equivalent in terms of mode of action and all that.

…But, however you decide to take your Nicotinamide, it’s going to make you feel better in about 10 days.“

Dr. Kaufmann on the Rational Wellness Podcast with Dr. Ben Weitz: (Link) (Discussion starts at 28:20 in podcast embedded below)

Dr. Weitz:                          ….So, another substance that you highlight is Nicotinamide Riboside, to stimulate NAD production

Dr. Kaufmann:                   So, Nicotinamide is important, because number ONE, it is very active in the electron transport chain in the mitochondria.

So, as you get older and you have less nicotinamide, and we’ll talk about why that happens in a sec, you make less energy. You just do.

Your mitochondria just don’t function efficiently, which is why a lot of older people just don’t have the energy they should have. So, that’s problem number one.

Problem number TWO is that it is a necessary co-factor for sirtuins (proteins that regulate cellular health). So, the aging, or not aging pathways, the seven mammalian sirtuins, do not function without nicotinamide. So, you can take as much resveratrol or pterostilbene as you want, but without nicotinamide, you’re not doing anything. So, that’s number two.

Number THREE is that, when you have DNA damage, you’ve got a big glob missing in your DNA chain, your body takes the nicotinamide molecule, chops it into pieces, and puts part of it back into the DNA so it fixes it.

So, again, if you don’t have enough nicotinamide, you don’t repair your DNA, then you get CANCER.

And then, lastly, and this one’s hard to sort of quantify, serves as a communication device between your nucleus and your mitochondria.

So, FOUR reasons that you need more, because you have more damage, you need more energy, blah, blah, blah.

So, as you get older and you have less, you, by definition, need more…

NAD…..what I think you do need is slowly filling the deficiency, which you could do obviously, with oral supplementation, which then, boils down to, you’re right. Is it nicotinamide riboside or the NMN?

And the answer is, we don’t know that either.

There’s never been any head-to-head testing.

There’s been a lot of studies that show that NR is very efficacious. They’re catching up on the other side.

I think this is a war of companies. Because they both have their trademark compounds. We know that you need it in some form, and someone ultimately, is going to win. I wish they would do a head-to-head study, because people asked me all the time which is better.

And the answer is, “I really don’t know. I wish I had an answer. But taking one of them, I think is crucial.”

Dr. Weitz:                          So, if you take nicotinamide riboside, what dosage do you like?

Dr. Kaufmann:                   That’s a good question. I think it depends on how old you are. I think it depends on how deficient you are. Just many, many things.

For example, if you’re already 50, you’ve got some catching up to do. So, I recommend a higher dose. You probably would take maybe, two weeks to three weeks to catch up. When your energy levels sort of level off-

Dr. Weitz:                          What would would that higher dose be?

Dr. Kaufmann:                   I would say, it just depends on the bottle, too. I think it’s … They usually come in 250’s, I believe.

Dr. Weitz:                          Right, I think they do.

Dr. Kaufmann:                   So, I tell people, “Take two of them. Spread it out, ONE in the morning, ONE at night, for two to three weeks, until you feel like your energy levels are good. Back down to once a day. And if you still feel good after a month or so, take it every other day.”

Because having too much isn’t good, either. This is not a, “who gets to have the most in their body wins” sort of thing. You need the right amount, but not too much. And the only way to do that is judge it by energy levels.”

Dr. Kaufmann on the Ben Greenfield Fitness Podcast (Link) (Discussion starts at 22:40 mark in podcast embedded below):

“NAD…does four essential things in your body. The biggest thing that it does is it’s obviously in the electron transport system. It shuffles protons, right? NAD, NADH.

When you have a deficiency in NAD, your mitochondria are just not as efficacious, so you get less energy production.

So, the first thing people notice when they supplement with NAD is their energy comes back. It takes about 10 days with an oral supplementation plan, and that’s the most important.

But it also falls into other categories because it is a necessary cofactor for the sirtuin family. For example, if you augment your sirtuins but you’re NAD deficient, you’re going to see absolutely no effect. So, that’s number two thing that it does. Number three thing it does is the actual molecule gets taken apart, and they use it to patch holes in your DNA. So, that’s very important. So, without NAD, your protein repair mechanisms aren’t going to work. And then lastly, it serves as a communication device between the nucleus and the mitochondria via the OXPHOS system.

So many things fall apart with an NAD deficiency….

Recommended by Dr. Kaufmann: Nicotinamide Riboside – 250~500 mg/day”

Dr. Kaufmann writing online about her Kaufmann Protocol (Link)

Question: I would love to hear the group’s opinion on good sources for NAD. Also, is there a difference between NMN, and NR. Sinclair says NMN better but does not mention a source.

Dr Kaufmann: You can either get the NAD from NR or NMN- I really don’t think it makes a difference.

Dr. Kaufmann writing on the NAD booster Niagen Blog (Link):

“The physical changes that you see in your body as you age reflect what’s happening within your cells. I recommend taking NAD+ boosters to improve your cellular energy, support cellular repair, and promote a healthy cellular metabolism.

A product that I personally recommend is Tru Niagen, which is the most well-studied form of the NAD+ precursor nicotinamide riboside. Nicotinamide riboside is proven to safely increase the NAD+ levels by up to 40-50% with daily supplementation.

While some aspects of aging are outside our control, there are still many within our grasp. If we really want to age better, we have to work towards it every day. Start today by monitoring your diet and what you consume.”

RELATED:

  • FAQs on taking NAD boosting vitamin supplement Nicotinamide Riboside (NR) can be found HERE.
  • NR supplementation may have helped sufferers of these diseases & conditions (Consumer Reviews)

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