What the New Kidney Disease Study Says About NR and CoQ10

Key Points:

• Supplementing with either NR (nicotinamide riboside) or CoQ10 increased gene activity related to metabolism and immunity.
• CoQ10 supplementation significantly reduced protein markers of inflammation in the blood.
• NR improved the functional capacity of the cell powerhouse—mitochondria—as suggested with a measurement called the bioenergetic health index (BHI).

Up to now, very little evidence exists suggesting that nicotinamide adenine dinucleotide (NAD+) precursors like NR and the supplement CoQ10 enhance metabolism and enhance immunity in humans. Now, published in a non-peer reviewed article, Roshanravan and colleagues from the University of California, Davis present findings from a human trial of patients with chronic kidney disease (CKD) showing that NR or CoQ10 supplementation increases gene activity related to metabolism and immunity. Moreover, in the study, CoQ10 supplementation was associated with reduced proteins related to inflammation, such as IL-13 and C-reactive protein, in the blood. What’s more, NR supplementation was associated with an increase in bioenergetic health index (BHI), a measure of mitochondrial function. These findings are some of the first to support the idea that these two supplements may improve metabolism and immunity in humans.

NR and CoQ10 Promote Gene Activation Associated with Enhanced Metabolism and Immunity

To get an idea of what physiological pathways supplementing with either NR or CoQ10 may influence, Roshanravan and colleagues analyzed gene activity profiles in patients with CKD. NR supplementation changed gene activity to suggest that it promotes the metabolism of carbohydrates and fats (lipids) and enhances immunity. In a similar way, CoQ10 altered gene activity profiles in line with enhancing lipid metabolism and immunity. These findings suggest that either NR or CoQ10 may improve these two aspects of physiological wellbeing in patients with CKD.

The California-based researchers then sought to analyze whether either of the two supplements has an effect on inflammation, so they measured inflammation-associated proteins after six weeks of supplementation. Interestingly, CoQ10 significantly reduced two proteins associated with inflammation: IL-13 and CRP. At the same time, NR did not significantly affect either of these proteins. These findings support that CoQ10 may alleviate systemic inflammation in patients with CKD, while more studies are required to confirm or refute whether NR reduces systemic inflammation.

Finally, Roshanravan and colleagues assessed mitochondrial function in a type of white blood cell called a monocyte. The research team ran analyses on monocytes since there is some data suggesting that monocyte mitochondrial health can predict mitochondrial function in muscle and heart tissue. Intriguingly, NR, but not CoQ10, was associated with an increase in BHI in monocytes, suggesting potential improvements in mitochondrial function. These results provide some of the first evidence that NR may indeed enhance cell energy generation in patients with CKD by improving mitochondrial function. Furthermore, while more studies are necessary for confirmation, improvements in monocyte mitochondrial function suggest that NR may improve mitochondrial function in skeletal muscle and the heart.

Testing the Combination of NR and CoQ10

Roshanravan and colleagues’ study provides some of the first evidence suggesting that supplementing with either NR or CoQ10 improves metabolism and immunity in patients with CKD. Furthermore, CoQ10 reduced protein markers associated with inflammation, and NR improved monocyte mitochondrial function.

Future studies should examine whether combining NR and CoQ10 additively enhances metabolism and immunity and whether the combo additionally improves inflammation and mitochondrial function in patients with CKD. Moreover, researchers could perform the same study design in aged individuals without an age-related condition to see whether these two supplements improve their metabolism and immunity.

What’s more, since NR and CoQ10 may improve metabolism, future studies could examine whether these supplements improve the body’s fitness after undergoing an exercise regimen for an extended period. Such a study could examine whether NR and/or CoQ10 improves strength, endurance, and muscle recovery time. Other measurements of fitness could include body composition and weight.