7 Medications and Supplements Not To Mix With NAD+

Nicotinamide adenine dinucleotide (NAD+) is a natural compound in your body. It plays a role in several important processes, including metabolism, immunity, and DNA repair.

Studies reveal that the level of NAD+ in your body declines as you age. Researchers have found a relationship between low NAD+ levels and aging-related diseases like diabetes, heart disease, fatty liver, neurodegenerative diseases like Alzheimer’s disease, and muscular diseases like myasthenia gravis.

Potential benefits of NAD+ supplements include boosting muscular strength, improving heart and metabolic health, reducing premature skin aging, and reducing food addiction or substance abuse cravings and withdrawal symptoms. However, use NAD+ supplements with caution, particularly if you have any chronic diseases. NAD+ levels can affect how some medications work.

NAD+ supplements can interact with medications to manage diabetes, like insulin and other blood sugar-lowering medicines such as Fortamet (metformin).

• Some studies suggest that high doses of nicotinamide (NAM), a compound your body uses to make NAD+, may decrease insulin sensitivity, leading to insulin resistance. This means that your body can become less responsive to insulin, which could lead to a spike in blood sugar.
• Animal studies also suggest that NAM can contribute to glucose intolerance (a group of conditions resulting in higher-than-normal blood sugar levels). This could affect the effectiveness of drugs that lower your blood sugar, like metformin.
• NAD+ supplements may also increase blood sugar, which might block the action of medications that lower blood sugar.

NAD+ boosters may increase the effects of blood medications that lower blood pressure. Some studies suggest that higher doses of NAD+ supplements (more than 2 grams daily), can reduce blood pressure.

This means that NAD+ can significantly lower your blood pressure if you take blood pressure-lowering medications. Monitoring your blood pressure while using NAD+ supplements is important, especially if you are at risk of developing hypotension (low blood pressure).

Studies suggest that NAD+ can fuel cancer cells, so they may not be suitable for people receiving cancer treatment. Increased levels of NAD+ can also lead to resistance to cancer treatment.

NAD+ supplements may also bind to sites where some cancer medications act, which can interfere with treatment effectiveness.

If you receive chemotherapy, it’s best to avoid NAD+ supplements, since some cancer medications work by reducing NAD+ levels. Talk to a healthcare provider first if you must use NAD+ supplements while receiving cancer treatment.

Some studies have found that NAD+ boosters like niacin can affect the metabolism of anticoagulants (medications that prevent or reduce blood clots) like Coumadin (warfarin). You should avoid taking NAD+ boosters with anticoagulants if you have pre-existing blood clotting conditions. Your healthcare provider may consider spacing them at least two hours apart to minimize potential interactions.

If you use NAD+ boosters and anticoagulants together, you may need to monitor the International Normalized Ratio (INR). This test helps measure how long your blood takes to clot and informs you of any bleeding risk. Ask your healthcare provider how to monitor the INR.

Antioxidants like quercetin and resveratrol can increase NAD+ levels in your body. One study showed that resveratrol can increase NAD+ levels by up to five times.

While antioxidants can boost the effect of NAD+, they can also increase the side effects of NAD+ supplements. These side effects include hot flashes, nausea, calf cramps, skin itching or burning, headaches, abdominal discomforts, and fatigue.

NAD+ boosters may also interact with medications used to manage depression. Antidepressants affect how some NAD+ boosters are produced, which can affect how much NAD+ is produced.

Studies have shown that low levels of NAD+ can lead to depression, anxiety, and mood-related symptoms. Some researchers believe taking NAD+ supplements can reduce the development of these conditions. However, there is limited and inconclusive research on how antidepressants affect oral NAD+ supplements, so it’s best to talk to your healthcare provider before combining them.

Studies show that NAD+ supplements may affect your circadian rhythm (sleep-wake cycle). Since melatonin also affects the sleep-wake cycle, taking both supplements at night can amplify sleepiness, making you feel extremely groggy, brain-fogged, and fatigued.

Due to the limited number of human clinical trials, little is known about the safety, side effects, and drug interactions associated with NAD+ supplementation. It is also unclear how NAD+ will affect the body decades from now.

Children and pregnant or breastfeeding people should avoid NAD+ supplements, as there are not enough safety studies done in humans. For example, NAD+ affects DNA repair, and how it affects fetal development is unknown.

Talk to your healthcare provider before combining NAD+ boosters with any medication or supplement, especially if you have underlying health conditions such as hypertension (high blood pressure), cancer, or hyperglycemia (high blood sugar). NAD+ supplements can interfere with how these medications work.

NAD+ boosters may help support heart health, reduce the effects of aging, and enhance muscle strength. However, they can interact with certain medications, such as insulin, anticoagulants, and chemotherapy.

More human studies are needed to understand how NAD+ supplements work or affect other medicines. Therefore, it’s better to avoid taking NAD+ boosters with some medications, especially chronic disease medications. Always talk to a healthcare provider first.