NAD+ supplements may fuel treatment-resistant cancer cells, researchers warn

New research cautions that popular nicotinamide adenine dinucleotide (NAD+) precursor supplements might be doing more harm than good for cancer patients. Scientists warn that these vitamin B3 derivatives could be helping cancer cells survive treatment by suppressing DNA damage and cell death, which chemotherapy depends on to work. 

The study authors at Case Western Reserve University’s School of Medicine, US, explain that NAD+ is a molecule that healthy and cancerous cells need to function and survive. They say taking an NAD+ supplement essentially “floods the body’s cells with fuel.”

The study does not suggest these supplements are dangerous for healthy people. However, for cancer patients the risks are “serious and demand immediate attention.”

“Our findings highlight a potentially concerning role for NAD+-boosting supplements in the context of an active cancer, especially when used in conjunction with chemotherapy,” says study lead author Jordan Winter, a professor at Case Western Reserve School of Medicine.

“Our discovery is a call to action for the medical community.”

Fuel for cancer cells

NAD+ precursor supplements include nicotinamide mononucleotide (NMN), nicotinamide riboside (NR), and nicotinamide (NAM). These are often marketed to boost energy, slow aging, and protect the heart and brain.

Published in Cancer Letters, the study investigates how NAD+ precursor supplements affect pancreatic cancer, which is one of the deadliest cancers. The American Cancer Society reports it has a five-year survival rate of just 13%.

The authors explain that cancer cells hijack the same NAD+ “fuel” that healthy cells use to “power up” energy systems, repair DNA damage from chemotherapy, and avoid the cell death that chemotherapy triggers.

NAD+ precursor supplements are often marketed to boost energy, slow aging, and protect the heart and brain.They learned that a combination of these factors allows tumors to survive doses of medicine that should be lethal. The supplements were found to reduce oxidative stress in tumors, neutralizing one of chemotherapy’s key mechanisms for destroying cancer cells.

In both laboratory cell culture experiments and mouse models, the supplements — particularly NMN — shielded pancreatic cancer cells from three standard chemotherapy drugs: oxaliplatin, 5-fluororouracil, and gemcitabine.

“This research is a critical reminder that ‘natural’ doesn’t always mean safe, especially in the complex biology of cancer treatment,” Winter cautions. For now, he advises cancer patients to discuss the potential risks with their oncologist and medical team immediately.

The researchers call for routine screening of supplement use in all cancer patients and further clinical research about the interaction between NAD+ supplements and cancer therapies.

Genuine benefits for healthy individuals

In healthy people, the study authors note NAD+ supplements may offer genuine benefits across broad areas. This has been backed by recent Nestlé-led clinical research demonstrating that NAD+ booster supplements promote health in “unexpected” areas of gut health by enhancing beneficial bacteria in the digestive system.

Access to these supplements is also widening. Earlier this year, Niagen Bioscience’s direct-to-consumer website partnered with payment platform Truemed to offer eligible US-based customers the option to purchase its NAD+ booster, Tru Niagen, for a lower cost using pre-tax health care dollars.

Meanwhile, nutrition scientists are continuously innovating new ways to more efficiently harness the body’s own production of NAD+. NXT USA’s herbal blend, BluNADBooster, recently outperformed a popular NAD+ precursor, nicotinamide riboside, in raising NAD+ levels in a clinical study.