NAD/NADH

What is NADH?

NAD, nicotinamide adenine dinucleotide, is a coenzyme within our cells. It helps enzymes by transporting electrons. NAD, NAD+, and NADH are variations of the same molecule. NAD+ is an oxidized form of NAD. When NAD+ gains an electron, it becomes NADH. When it loses an electron, it turns back into NAD+.[1] 

What does NADH do in the body?

NAD+ is important for energy metabolism, DNA repair, aging of cells, and the immune system. [2] The balance between NAD+ and NADH is called the NAD+/NADH ratio. Ideally, this ratio should favor NAD+, but a good balance is important. This ratio helps regulate the inside of cells, especially in the mitochondria and the nucleus.[3]

How can NADH help alleviate certain Long COVID symptoms and/or pathophysiology? 

NADH helps the body create energy. One study found that patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) experienced less mental fatigue and improved quality of life when they took oral coenzyme Q10 (CoQ10) with NADH. These improvements might also benefit people with Long COVID.[5].

Research shows that while NAD+ levels were only slightly lower in COVID cases, there was a significant increase in how quickly NAD+ was used.[6]

In clinical trials, a team found that using metabolic activators, including NAD+ precursors, helped people recover faster from mild-to-moderate COVID and improved metabolic and inflammatory markers. [7] However, another study found no significant improvement in blood cell counts or clinical outcomes when using nicotinamide for COVID-related low lymphocyte counts. This suggests that the benefits of NAD+ might vary based on individual circumstances and may not work for everyone.[8]