Can NMN help in mitigating Post COVID-19 symptoms?

The global COVID-19 pandemic has had a significant impact on public health, causing substantial mortality and morbidity. Among individuals affected by the virus, approximately 80% experienced mild to moderate disease, while around 5% developed severe illness. Interestingly, a subset of those who recovered from COVID-19 continues to experience persistent or new symptoms that last for weeks or even months. This condition is commonly referred to as "long COVID," "Long Haulers," or "Post COVID syndrome."  In this discussion, we will explore the various factors contributing to Long COVID and emphasise the potential role of NMN treatment in alleviating its symptoms and improving immunity with real-life examples.

What is Long Covid

Long COVID is a term used to describe a wide range of health problems that persist for an extended period, sometimes lasting for weeks or even years, following a COVID-19 infection. Diagnosing it is complex and typically relies on several factors, including a person's medical history, confirmed COVID-19 diagnosis, and the presence of specific symptoms or exposure details related to the initial infection.

People with Long COVID often experience a variety of ongoing health issues that can significantly impact their daily lives. These symptoms can affect different parts of the body and include:

1. Fatigue: Persistent tiredness and extreme fatigue that can make it challenging to perform everyday activities.
2. Respiratory and Cardiovascular Issues: Symptoms such as difficulty breathing, persistent cough, chest pain, and heart palpitations can continue long after the initial COVID-19 infection.
3. Neurological Symptoms: These can manifest as difficulties with concentration, often referred to as "brain fog," frequent headaches, sleep disturbances, dizziness upon standing, altered sense of smell or taste, and mental health issues like depression or anxiety.
4. Digestive Problems: Some individuals with Long COVID experience gastrointestinal issues like diarrhea and stomach pain.
5. Musculoskeletal Symptoms: Joint or muscle pain may persist, causing discomfort and reduced mobility.

These diverse and persistent symptoms make COVID a complex and challenging condition to manage and treat. Treatment for Long COVID typically involves a multidisciplinary approach, including consultation with healthcare professionals who can provide evidence-based treatments and recommendations based on an individual's specific symptoms and needs. Recently, NMN has been effective in addressing Covid, and post-COVID symptoms and boosting immunity.

How does NMN improve immunity?

The immune system relies on nicotinamide adenine dinucleotide (NAD) for responding to stress, inflammation, and infections. This involves activating NAD-dependent repair enzymes like sirtuins and PARPs, along with other immune cell functions. Studies in animals have shown that when NAD metabolism is disrupted, it impairs immune function and increases inflammation. Conversely, using NAD precursors, such as NMN, has been found to enhance immune function and reduce the expression of inflammatory markers.

Activation and Differentiation of T cells

T-cells play a vital role in our immune defence by initiating the body's response to infections, targeting infected cells, releasing crucial cytokines (chemicals), and coordinating other immune cells. During their development, T cells undergo differentiation into various subtypes and mature, equipping them with the ability to combat different pathogens. This differentiation process, essential for generating diverse T cell types capable of fighting various invaders, relies on proteins like Sirtuin, specifically Sirt-2, which is activated by NAD+. Therefore, ensuring sufficient NAD+ levels is critical for activating Sirt-2 and ensuring a robust immune response, including the formation of memory T cells. Memory T cells, as the name suggests, store information about past invading pathogens. This memory enables a faster and more potent immune response upon encountering the same antigen again.

Activates Macrophages

Macrophages are central components of the immune system, identifying and eliminating harmful bacteria and pathogens while releasing cytokines to recruit other immune cells. The activation and effectiveness of macrophages are influenced by the levels of NAD+. In studies involving rats, boosting NAD+ levels with supplements rescued them from lethal doses of bacterial toxins. Additionally, Interferon Gamma (IFN-γ), produced by activated macrophages, plays multiple roles in enhancing immune responses. Nicotinamide treatment can increase IFN-γ secretion, further strengthening the immune response.

NAD+ metabolism to viral infections

Viral infections are known to deplete the NAD+ levels of the body. In cases of severe COVID-19, individuals have exhibited lower levels of the NAD+ precursor NMN in their blood compared to healthy individuals. Alterations in NAD+-related gene expression have also been observed in lung tissue of deceased COVID-19 patients and pulmonary fluid of SARS-CoV-2-infected individuals, emphasising the potential role of NAD+ in influencing COVID-19 disease progression and outcome.

Certain enzymes that rely on NAD+, such as PARPs and Sirtuins, act as powerful antiviral agents by breaking down the genetic material of viruses and inhibiting their replication. Messenger-like enzymes also use NAD+ to assist immune cell activation. Understanding the interactions between these enzymes and viruses provides insights into ways to combat infections.

Consistently consuming NMN (nicotinamide mononucleotide) can effectively increase NAD+ levels in the body, significantly enhancing the immune system's ability to resist infections and bacteria. This elevation in NAD+ supports the immune system's effectiveness in responding to illnesses and infections, reinforcing the body's immune defences.

NMN in Treatment of COVID

The utilization of Nicotinamide Mononucleotide (NMN) in the treatment and management of COVID-19 patients has gained attention through various studies and doctors' reports. Here are some examples of such reports. 

Study 1: NMN Cocktail Treatment in Elderly COVID-19 Patients

A non-peer-reviewed study by Dr. Huizenga involved treating elderly COVID-19 patients with an NMN cocktail, observing rapid and dramatic improvements in clinical parameters. The treatment led to decreased inflammation markers and increased white blood cell counts, suggesting an enhanced immune response. The NMN cocktail, mixed with water and consumed twice daily, included over-the-counter NMN and three boosters aimed at optimizing the activity of NAD+-dependent sirtuins, crucial for cellular health. Patients treated with the cocktail experienced significant improvements, including fever resolution within a few days, without the need for intensive care unit admission. This study underscores NMN's potential to improve clinical outcomes in COVID-19 patients, especially those with comorbidities and severe symptoms (Huizenga, 2020b).​ 

Study 2: Mice Models of COVID-19

A study investigated the effects of NMN in two mouse models infected with SARS-CoV-2, which mimics some immune features present in human patients. The study found that NMN supplementation led to significant improvements in pneumonia symptoms, such as reduced inflammation, RBC destruction, and clots in the lungs. Moreover, NMN was able to protect a portion of aged mice from death caused by the infection. The treatment appeared to modulate the immune response and cell death pathways triggered by the virus, suggesting a potential therapeutic role for targeting the NAD+ pathway in COVID-19 treatment (Jiang et al., 2022d).

Study 3: Long Covid Clinics 

A healthcare professional, writing for The BMJ, has highlighted the potential role of NAD+ precursors, such as NMN, in addressing the energy depletion problem associated with Long COVID. The argument suggests that NAD+ depletion, a common consequence of viral infections like COVID-19, may play a significant role in the fatigue and organ dysfunction experienced by Long COVID patients. The viewpoint supports the use of NMN supplements, particularly in a liposomal form for enhanced absorption, as a means to restore NAD+ levels and potentially alleviate Long COVID symptoms.

This perspective aligns with the understanding that COVID-19, especially in severe cases or among individuals with underlying health conditions, can lead to a reduction in NAD+ levels, potentially worsening clinical outcomes. The recommendation to consider NMN is based on its established safety profile in humans and promising results observed in animal studies. These findings suggest that NMN may hold the potential to alleviate Long COVID symptoms by addressing the underlying issue of NAD+ depletion and cellular energy deficits (Dean, 2023).

Conclusion

NMN supplementation presents a promising avenue for managing COVID-19 and Long COVID symptoms. Clinical trials and studies demonstrate its potential to reduce inflammation, boost immunity, and improve clinical outcomes. Further research is needed to explain optimal dosages and long-term effects, but current evidence suggests NMN as a viable option for mitigating COVID-19 and Long-term COVID symptoms, offering hope for improved patient outcomes and recovery.

 

FAQs

1) Can NAD+ help for COVID?

Indeed, boosting the levels of substances like NAD+ seems pivotal in addressing severe COVID-19 by inhibiting both viral replication and inflammation. Studies in animal models suggest that raising NAD+ levels in endothelial cells may be able to undo dysfunction in the vascular and endothelial systems.

2) Is NMN toxic to the kidneys?

NMN presents no risk of kidney toxicity; instead, it serves to prevent kidney diseases. For individuals with pre-existing health conditions, NMN helps reduce kidney damage and supports the restoration of kidney function.

3) Is NMN just vitamin B3?

NMN differs from vitamin B3, despite their association. Although NMN is derived from vitamin B3 (niacin), it is not precisely labelled as "a type of vitamin B3." NMN is a naturally occurring compound originating from B3 but should not be categorized as B3 in its own right. This anti-ageing supplement comes in different forms, including NMN powder, liquid, or capsules.

4) What treatments are there for Covid?

Available treatments for COVID include antiviral drugs, monoclonal antibodies, immunomodulators, corticosteroids like Dexamethasone, convalescent plasma therapy, COVID pills such as Paxlovid and Molnupiravir, and vaccination against the coronavirus.

5) Can NMN supplements help fight COVID?

Supplements containing NMN, including the NMN cocktail, exhibit the potential to ease symptoms associated with COVID-19 and Post COVID. Specific research suggests a decrease in both lung damage and inflammation, highlighting the effectiveness of NMN in mitigating the severity of the disease and improving patient outcomes.

 

References

1. Huizenga, R. (2020). Dramatic Clinical Improvement in Nine Consecutive Acutely Ill Elderly COVID-19 Patients Treated with a Nicotinamide Mononucleotide Cocktail: A Case Series. Available at SSRN 3677428.
   https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3677428 
2. Jiang, Y., Deng, Y., Pang, H., Ma, T., Ye, Q., Chen, Q., ... & Xu, Z. (2022). Treatment of SARS-CoV-2-induced pneumonia with NAD+ and NMN in two mouse models. Cell Discovery, 8(1), 38.
   https://www.nature.com/articles/s41421-022-00409-y 
3. Dean, E. (2023). What happens inside a long covid clinic?. BMJ, 382.
   https://www.bmj.com/content/382/bmj.p1791/rr-0