Niacin Cures Systemic NAD + Deficiency and Improves Muscle Performance in Adult-Onset Mitochondrial Myopathy.
Level 3 - non-randomized controlled study
Non-randomized prospective trial with matched control group
PubMed 32386566 · doi:10.1016/j.cmet.2020.04.008
What was done
Adult-onset mitochondrial myopathy patients and matched controls were treated with escalating doses of niacin (vitamin B3, up to 750–1,000 mg/day; NCT03973203). Patients were treated for 10 months and controls for 4 months. Investigators measured blood and muscle NAD+ levels, muscle strength, mitochondrial biogenesis markers, muscle metabolome shifts, and liver fat.
What was found
Blood NAD+ increased in all participants by up to 8-fold, and patient muscle NAD+ reached control levels. Muscle strength and mitochondrial biogenesis increased in all participants. In patients, the muscle metabolome shifted toward the control profile, and liver fat decreased by up to 50%. Anemia tendency was noted in some patients.
Why it matters
This paper provides human evidence of systemic NAD+ deficiency in adult-onset mitochondrial myopathy and shows that oral niacin can replete NAD+ pools, improve muscle performance, and reduce hepatic fat.
Limits
The abstract omits sample size, variance metrics, and exact baseline numbers. The trial was non-randomized and open-label, lacked a placebo comparator, used different treatment durations for patients and controls (10 months vs. 4 months), and identified anemia tendency as a potential adverse effect.
Cited by
- supports Exercise, cold therapy, sauna, niacin (vitamin B3), and a low-carbohydrate diet increase mitochondrial biogenesis, whereas refined sugars and starches destroy mitochondria.