NMN and NAD+ — Miracle Molecules or Cancer Fuel?

By Manoj K. Sharma, DO, Board Certified Internal Medicine, Elite Medical Associates

In the quest for longevity, few molecules have garnered as much attention as NAD+ and NMN. These molecules are at the core of cellular metabolism and DNA repair, processes essential for energy production and healthy aging. With the rise of biohacking, countless people now turn to NMN and NAD+ supplements, hoping to tap into their potential to extend healthspan, enhance cognitive function, and improve physical performance.

But amid all the excitement, there’s a growing concern: could these miracle molecules unintentionally support cancer growth?

As a physician at the forefront of longevity medicine, this question has made its way into many of my patient consultations. Let’s dive deeper into this controversy and separate what we know from what we theorize.

The Science Behind NAD+ and NMN

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in all living cells. It plays a crucial role in metabolism by helping turn nutrients into energy, and it’s also involved in maintaining healthy DNA by repairing damage.

As we age, our levels of NAD+ decrease, leading scientists to speculate that boosting NAD+ might reverse some of the signs of aging. Enter NMN (nicotinamide mononucleotide), a precursor to NAD+ that can increase its levels in cells when taken as a supplement.

It sounds straightforward, but the complexities of how our cells operate make this picture far more intricate.

Can NAD+ Promote Cancer Cell Growth?

The potential downside of NAD+ supplementation lies in its very function. NAD+ doesn’t just help healthy cells—it also supports cells that divide rapidly, such as cancer cells.

Some studies, particularly in animal models, have suggested that boosting NAD+ may give an advantage to cancer cells. Dr. David Sinclair, a renowned researcher in the field of aging and longevity, has been one of the leading voices advocating for NAD+ boosters, but even he acknowledges that caution is warranted. “We need more data, especially in humans, to fully understand whether NAD+ boosters could be dangerous in the context of cancer,” Sinclair said in a recent interview.

The Mechanism of Concern: PARP, Sirtuins, and Cellular Repair

To understand why NAD+ might support cancer, we need to look at how it interacts with PARP (Poly ADP-Ribose Polymerase) enzymes. These enzymes use NAD+ to repair damaged DNA. In healthy cells, this is beneficial. But in cancer cells, enhanced DNA repair can allow them to survive when they might otherwise be destroyed.

Additionally, NAD+ activates sirtuins, proteins involved in regulating cellular metabolism and longevity. While sirtuins can suppress tumors in some cases, they might also enhance survival pathways in certain cancer types, making the relationship between sirtuins and cancer complicated.

Dr. Peter Attia, a longevity expert, has highlighted this complexity. “Sirtuins and PARP are double-edged swords. In healthy individuals, they promote longevity by maintaining DNA integrity. But in cancer, these same mechanisms might help tumor cells evade destruction,” Attia warns.

The Current Evidence: What We Know and What We Don’t

While it’s important to note that much of the concern is still theoretical, some evidence does exist to support caution:

• Animal Studies: A few preclinical trials have demonstrated that enhancing NAD+ can promote the growth of cancerous cells in mice. However, translating these findings to humans remains a significant challenge.

• Context Matters: It’s not just about whether NAD+ can fuel cancer growth—it’s about whether the individual has cancer or is at high risk of developing it. Healthy cells benefit from NAD+ by repairing damaged DNA and improving metabolism. But in the presence of cancer cells, those same benefits could backfire.

So, what does this mean for those taking NMN and NAD+ supplements?

My Take as a Longevity Physician

At Elite Medical Associates, we practice evidence-guided medicine, focusing on maximizing healthspan while avoiding unnecessary risks. Based on the current evidence, I continue to recommend NMN and NAD+ boosters to healthy individuals, particularly those seeking to enhance energy levels and protect against age-related decline. The data strongly supports their role in improving cellular metabolism and reducing the burden of age-related diseases, from neurodegeneration to cardiovascular disease.

However, for patients with a history of cancer or those at high risk due to family history or genetic predisposition, I recommend a more cautious approach. Until more human studies are conducted, it’s wise to avoid taking NMN or NAD+ precursors if there is any concern about pre-existing neoplastic conditions.

What the Future Holds

We are on the cusp of understanding how these molecules interact with the intricacies of human health and disease. As more human trials are conducted, I believe we’ll have clearer answers. For now, it’s essential that we practice personalized medicine. What works for one person might not be ideal for another, especially when cancer is part of the equation.

In the coming years, I expect more research to fine-tune our understanding of NAD+ and NMN, potentially revealing ways to selectively boost their levels in healthy cells without feeding cancerous ones. Until then, we must stay informed, cautious, and forward-thinking.

Ready to Partner with Us on Your Health Journey?

At Elite Medical Associates, we offer personalized, evidence-based concierge medicine that combines the latest in longevity research with a holistic approach to health. If you’re interested in exploring how NMN, NAD+, and other cutting-edge therapies could fit into your health strategy—or if you have concerns about your cancer risk—don’t hesitate to reach out.

We’re here to help you take control of your health and partner with you on your journey to a longer, healthier life. Contact us today to schedule a consultation and discover how we can support you in achieving your health goals.

References:

1. Sinclair, D. A. (2020). Lifespan: Why We Age – and Why We Don’t Have To. Atria Books.

2. Attia, P. (2021). The Drive podcast, Episode on Longevity and Cancer Risk.

3. Rajman, L., Chwalek, K., & Sinclair, D. A. (2018). “NAD+ metabolism as a therapeutic target in aging and cancer.” Nature Reviews Drug Discovery, 17(6), 375-394.

4. Belenky, P., Bogan, K. L., & Brenner, C. (2007). “NAD+ metabolism in health and disease.” Trends in Biochemical Sciences, 32(1), 12-19.

5. Vander Heiden, M. G., Cantley, L. C., & Thompson, C. B. (2009). “Understanding the Warburg effect: the metabolic requirements of cell proliferation.” Science, 324(5930), 1029-1033.

6. Verdin, E. (2015). “NAD+ in aging, metabolism, and neurodegeneration.” Science, 350(6265), 1208-1213.

7. Jacobson, E. L., & Jacobson, M. K. (1993). “NAD+ and cellular responses to DNA damage.” Molecular and Cellular Biochemistry, 122(1), 3-20.

8. Imai, S., & Guarente, L. (2014). “NAD+ and sirtuins in aging and disease.” Trends in Cell Biology, 24(8), 464-471.

Disclaimer:

This article is for informational purposes only and does not constitute medical advice. While Dr. Sharma and Elite Medical Associates strive to provide the latest in longevity medicine, always consult with a healthcare professional before starting any new supplement, particularly if you have a history of cancer or other significant health concerns.