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NADH study reports long-term gains

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A nutritional supplement, NADH may be a valuable adjunctive therapy for CFS, according to a published report by a team of researchers at Georgetown University Medical Center in Washington, D.C. In a double-blind, placebo-controlled, cross-over study of 26 patients with CFS, Dr. Joseph Bellanti and colleagues reported that eight patients improved during the four weeks they were on NADH, while only two patients improved while on placebo. In a continuation of the study in which all the volunteers were knowingly taking the supplement, 72% (18 of 25 patients) reported significant improvement of their fatigue with no severe adverse effects from the supplement..

NADH (the reduced form of nicotinamide adenine dinucleotide) is a co-enzyme that triggers energy production in cells by generating ATP (adenosine triphosphate), which stores energy in cells. If cellular levels of NADH are depleted, brain and muscle cells lose their ability to function effectively. The theory is that as NADH levels rise in the body, the cells become more energized, making the body feel stronger and more energized.

This trial used a dosage of 10 mg per day (two tablets, taken 45 minutes before breakfast) of a patented, oral form of NADH manufactured under the brand name Enada by the European company Menuco.

This study was small, with just 26 patients, but it does appear to have been carefully controlled. The study protocol was approved by the Food and Drug Administration (FDA), which does not regulate the distribution of nutritional supplements but does regulate medical claims made for such products. This was the equivalent of a Phase II safety and efficacy trial.

Subjects were 17 women and nine men, ranging in age from 26 to 57, and they had experienced fatigue for an average of seven years (ranging from one to 16 years). One patient was African-American; 25 were Caucasian. All had fatigue, neurocognitive difficulties and sleep disturbances, and nearly all experienced postexertional malaise, headaches, muscle weakness, arthralgia, myalgias and a history of allergy. Eighteen had swollen or tender lymph nodes. There was no correlation between a specific symptom pattern or laboratory test results and response to treatment. Response was measured primarily by a subjective questionnaire, with at least a 10% improvement required to be considered a favorable response.

One of the subjects reported being overly stimulated, and the researchers suggested that patient’s dosage could have been decreased. Other non-responders may have benefited from an increased dosage. Dosages were not adjusted for weight in this study.

The study was published in the February 1999 issue of Annals of Allergy, Asthma and Immunology. A larger open-label study is planned at Georgetown. NADH also is being studied as a potential treatment for persons with Alzheimer’s disease and Parkinson’s disease.

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