NAD Supplements Show Promise for Anti-Aging But Raise Cancer Concerns

The Double-Edged Promise of NAD+ Boosters

A growing body of research is revealing that popular anti-aging supplements designed to boost cellular energy may have an unexpected dark side. NAD+ supplements, which have gained popularity for their energy and anti-aging benefits, raise concerns about potentially supporting the growth of cancer cells because cancer cells use a lot of energy to grow .

These supplements, including nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR), work by increasing levels of NAD+, a crucial molecule that accepts electrons when we break down food and carries them to places throughout the cell, including the mitochondria, which are the powerhouse of the cell . NAD+ levels naturally decline as people and animals age, and studies show that boosting NAD+ levels can extend life span in yeast, worms and mice .

The appeal is clear. Fans of NAD+ supplements say they can help boost energy levels and ward off signs of aging . But emerging research suggests the relationship between NAD+ and health may be more complex than initially understood.

Cancer Cells' Hunger for Energy

Cancer cells have high metabolic needs, including processes requiring NAD+, and many types of cancer cells boost NAD+-making enzymes and then die when those enzymes are blocked by drugs . This creates a troubling scenario where the same supplements meant to energize healthy cells could potentially fuel malignant ones.

Recent animal studies have provided mixed but concerning signals. Mice genetically predisposed toward pancreatic cancer developed more precancerous and cancerous growths when they consumed the NAD+ precursor NMN, with Zhang's study being one of the first to directly show that providing supplemental NAD+ was associated with increased cancerous growths in mice .

However, the picture isn't uniformly negative. In one study, NMN supplementation reduced inflammatory cytokine levels and oxidative tissue damage in a colitis-associated cancer model, with mice treated with NMN developing fewer colon tumors than untreated animals . Other long-term studies found that without increasing tumor counts or severity in any tissue, NMN treatment increased activity and reduced overall frailty, showing that chronic NMN treatment delays frailty without increasing cancer burden .

The Scientific Divide

The scientific community remains split on the implications. Some experts argue there isn't sufficient evidence to say that raising NAD+ levels would favor cancer, noting that the idea that elevating NAD+ levels could fuel cancer growth remains a hypothesis that has attracted considerable attention .

As one researcher put it, "It might still slow down the aging part, but it might fuel the cancer part" . This encapsulates the central dilemma facing both scientists and consumers interested in anti-aging interventions.

Animal studies report no carcinogenicity or tumorigenicity associated with prolonged NMN exposure for increasing NAD levels, but during cancer progression, NAD boosting has shown deleterious effects by promoting cell survival, growth and propagation resulting in resistance to typical treatments .

Navigating the Uncertainty

For now, experts recommend caution, particularly for certain populations. While no direct evidence has shown NAD+ supplements cause cancer in humans, until more is known, people with active cancer or at high risk should avoid NAD+ boosters .

The regulatory landscape adds another layer of complexity. In 2022, the FDA ruled that NMN could not be marketed as a dietary supplement because it had been investigated as a drug first, leading major retailers like Amazon and PayPal to restrict its sale .

While research continues to unfold, the safest approach may be focusing on proven strategies for healthy aging rather than relying on supplements with uncertain long-term effects. Scientists believe it may be possible to carefully modulate the NAD+ pathway to suppress cancer without accelerating aging, with researchers asking "How do we make an NAD+ strategy that is specific for cancer?" Until those answers emerge, the promise of NAD+ supplements remains tempered by legitimate safety concerns.