Continued….

Increasing Levels of NAD⁺ to Enhance Immunity

The role that mitochondria play in immunity and the fact that viruses can deplete NAD⁺ levels indicate that increasing NAD⁺ concentrations may be a potential way to support immunity both before and during exposure to the SARS-CoV-2 virus. The scientific literature and results in my clinical practice and those around the country indicate that supplementing with nicotinamide riboside (NR), a unique and naturally occurring precursor to NAD⁺, is highly effective at raising NAD⁺ levels and improving mitochondrial health.

In humans, NR supplementation is well known to increase blood NAD⁺ levels.^23,24  NR also boosts NAD⁺ levels in mice and leads to mitochondrial biogenesis.²⁵ In animal studies, NR was beneficial in mitochondrial myopathy.²⁵NR’s ability to strengthen the mitochondria may make it a useful tool for ensuring these organelles stay healthy during viral infections such as SARS-CoV-2.

Supporting the Health of People with Underlying Conditions

Cardiovascular concerns are known to be associated with worse outcomes during COVID-19. Furthermore, some patients with COVID-19 present with cardiovascular symptoms without typical fever and cough.^26,27 In about 7% of people who have a confirmed diagnosis of COVID-19, the SARS-CoV-2 virus causes damage to the heart.^26,27  This is thought to be the result of either a direct attack of the virus on the heart or a cytokine storm that leads to the death of heart cells. ^26,27   

Restoring mitochondrial health with nicotinamide riboside may support heart health and provide a strong cardiovascular foundation. A randomized, double-blind, controlled cross-over study of 30 middle-aged and older healthy male and female adults were given 500 mg NR orally twice a day for six weeks.²⁸ NR significantly increased average NAD⁺ levels by 60%. Additionally, in individuals with elevated/stage I hypertension, NR supplementation was associated with a mean 9 mmHG decrease in systolic blood pressure (SBP) compared with the placebo. This reduction was not observed in participants with initial SBP in the normal range. NR supplementation also increased ATP levels. 

In animal models, nicotinamide riboside has been shown to have cardiovascular benefits. For example, in one mouse model of dilated cardiomyopathy, NR reduced the development of heart failure.²⁹

Diabetes is another underlying condition that may lead to a worse outcome in COVID-19. Preclinical studies in rodents indicate NR supplementation may be supportive in this condition. In a mouse model of type 2 diabetes, NR significantly lowered non-fasting and fasting blood glucose and led to reduced weight gain.³⁰

Case Studies

Female with COVID-19 Pneumonia. A 40-year-old female patient had tested positive for COVID-19. Her primary symptom was pneumonia. She also had co-morbid factors of diabetes, obesity, and sleep apnea. Dr. Meletis ordered an Organic Acid Test (OAT), which pointed to diminished citric acid cycle efficiency. The citric acid cycle is a series of reactions that lead to the generation of ATP, the body’s cellular fuel. There were two specific areas of what Dr. Meletis terms “bioaccumulation” of substrates that were NAD⁺ dependent, which included pre- and post- alpha ketoglutarate. Dr. Meletis provided the patient with 1,000 mg of a form of nicotinamide riboside that has been shown to increase NAD⁺ levels in a clinical trial of 140 healthy overweight adults by 142%.³¹ Without any other prescription medications and simply using oral zinc, vitamin D, vitamin C, and nicotinamide riboside, this patient with full-blown COVID-driven pneumonia made a full recovery.

General Clinical Observation of Several Cases. As a clinical educator for US BioTek Laboratories, Dr. Meletis has consulted with numerous health care practitioners across the country and observed several cases of COVID-19 in the field via other clinical practices. One of the common denominators was that the patients’ citric acid cycle was notably dysfunctional per their urinary OAT test. NAD⁺ plays a critical role in the citric acid cycle, indicating that supplementing with nicotinamide riboside as an NAD⁺ precursor may lend support in this group of patients.

Conclusion

The mitochondria are involved in immunity and the body’s response to viral invasion. Although any discussion of the role of mitochondrial support and COVID-19 is partially theoretical, there is good rationalization for such an approach both in clinical practice and in the scientific literature. Raising NAD⁺ levels through the use of nicotinamide riboside can rejuvenate the mitochondria, support immunity, and maintain a healthy citric acid cycle, thus potentially inhibiting viruses like SARS-CoV-2. Nicotinamide riboside may also have a role to play in supporting the health of people with underlying cardiovascular or diabetic conditions that can increase the threat of poor outcomes with COVID-19.  

Dr. Chris D. Meletis is an educator, international author, and lecturer. His personal mission is “Changing World’s Health, One Person at a Time.” He believes that when people become educated about their bodies is the moment when positive change begins.

He is widely recognized as a world-renowned expert on the science of CBDs and has authored 16 books and over 200 national scientific articles in such journals and magazines as Natural Health, Alternative and Complementary Therapies, Townsend Letter, Life Extension, and The Journal of Restorative Medicine.

Dr. Meletis served as Dean of Naturopathic Medicine and Chief Medical Officer for seven years at NUNM (Portland, Oregon), the oldest naturopathic medical school in North America. He has received numerous awards, including the prestigious Physician of the Year Award by the American Association of Naturopathic Physicians; Excellence Award for his work in treating and advocating for the medically underserved; and most recently, the NUNM Hall of Fame Award.

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