NAD Supplements for Transgender Health

While access to gender-affirming care has expanded for many transgender people, many still feel the need to seek treatment outside of the care of a physician. NAD+ may be a helpful supplement for LGBTQ+ patients who need to seek nonprescription therapy.

Key takeaways:
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    Nicotinamide adenine dinucleotide (NAD) and nicotinamide mononucleotide (NMN) are essential components to creating NAD+, which has several health benefits.
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    NAD+ may be an excellent supplement for transgender people to help with the physical and mental aspects of their gender affirmation.
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    Cross-sex hormone therapies should be prescribed by and overseen by a physician if one is available.

What is NAD+?

Nicotinamide adenine dinucleotide (NAD) is a coenzyme that is present in everyone's body. It is comprised of NMN and vitamin B3. NAD works as an oxidizing agent known as coenzyme 1, which accepts electrons from other molecules and gives power to other chemical reactions in the body.

The two main functions of NAD are to create energy from the nutrients you consume and to help protein regulate cellular functions. NAD helps to transport this energy to the mitochondria, which is considered the "battery" of our cells.

Nicotinamide mononucleotide (NMN) is a vitamin B3 metabolite found naturally in our bodies. NMN and NAD are the precursors to NAD+. Both NMN and NAD are necessary for creating energy (ATP) in the Krebs Energy Cycle. The Krebs Energy Cycle is the chemical reaction in the body that releases energy from our nutrients.

NAD and NMN are different from NAD+ since they are both the precursors to NAD+, even though NAD+ contains both NAD and NMN.

NMN is slightly easier to absorb in the body and has more physical effects than NAD+. NMN has been shown to absorb within a few minutes and becomes absorbed into the tissue within 15 minutes. Once absorbed, it becomes NAD+ and is stored in the liver, skeletal muscles, and other tissues.

Can NAD+ help transgender people?

For female-to-male transformation NAD+ and NMN supplements help to increase lean muscle, muscle mass, and strength. While transitioning, it will also help to support cartilage and joint functions.

NAD+ and NMN supplements may also improve mental health. Transgender people often suffer mental health issues while struggling to fit in and feel comfortable in their own bodies.

The supplements can help to support mood, reduce feelings of stress, help with sleep cycles, improve mental clarity, increase and maintain memory, and increase mental alertness.

NAD+ may be increased naturally in the body, making the supplements more effective. Following a healthy diet and exercise routine can help naturally increase NAD+. Foods such as milk, tuna, salmon, chicken, mushrooms, and green veggies like asparagus have higher levels of NAD+.

Other benefits of NAD+

NAD+ and NMN supplements can be helpful for many people. They have been known to increase energy, help provide a youthful look, and provide emotional and mental benefits.

These supplements have also been shown to help improve thyroid health, increase DNA repair, decrease free radicals, and maintain healthy mitochondria.

The mood and mental health benefits of NAD+ and NMN are also beneficial to anyone to takes these supplements. They may also assist in cognitive performance and training.

How to take NAD+ or NMN

The amount may vary based on the manufacturer's guidelines. It is safest to follow the instructions given with the supplements. Consult a physician before the use of any supplements to see if they are suitable for you and your transition. If you are unsure of the dosage, speak with your doctor first.

Some places suggest starting at 250 mg two to three times daily and gradually increasing to 1 gram per day. Some supplements may suggest starting off at 1 gram immediately. However, not everyone can tolerate this dosage upfront.

Some supplements may come in powder to be absorbed under the tongue, and others may come in pill or capsule form. The sublingual powder has been shown to have better absorption action in the body than the other versions.

NAD+ is also available in intravenous (IV) form; however, this requires a medical professional, such as a nurse, to place an IV catheter and infuse it for you. This route is the most effective route, but it is considerably more expensive.

NAD+ and NMN supplements are unregulated, like most supplements. When buying and using any supplement, perform proper research to ensure quality.

Side effects of NAD+ and NMN

NAD+ and NMN were discovered in 1906. Since then, most studies have been conducted in Japan.

Studies have shown that there are very few side effects related to these supplements. As with most over-the-counter supplements, there are potential mild side effects.

These side effects include:

  • Digestion issues
  • Stomach cramps
  • Nausea

Cross-sex hormones

When it comes to taking cross-sex hormones to assist in transitions, whether it is a male-to-female or female-to-male transition, it is safest to do so under the supervision of a medical professional. Many over-the-counter supplements claiming to assist in transitioning are often unregulated and may cause health problems.

Often when people self-medicate to help with their transition, it is because there is a lack of appropriate care and treatment available to them. Over-the-counter supplements are not regulated and often are not approved for use by the Federal Drug Administration (FDA). There is also a lack of medical peer-reviewed studies regarding the self-administering of gender-affirming hormones.

Feminizing gender-affirming therapy includes estrogen supplements and anti-androgen supplements. The common anti-androgen that is prescribed is spironolactone, which works to block testosterone. Estrogen can be prescribed as an ointment, gel, patch, injection, or pill.

Dosing can vary based on hormone levels in your body and could be adjusted periodically. Your blood levels will need to be checked to make proper adjustments if needed. During this time, you may notice physical changes such as breast development and testicular shrinkage.

Masculine gender-affirming therapy involves taking testosterone supplements. Testosterone can be taken as an injection, gel, or patch. Testosterone hormone levels need to be monitored and adjusted as needed to be in a particular range. While on testosterone treatment, you may notice physical changes of increased muscle definition and face structure changes.

Risks to taking cross-sex hormones

All medications, including supplements, have some sort of side effects or adverse effects. When taking hormones, there can be an increased risk of developing cardiovascular conditions such as heart attack and stroke.

Risks of taking testosterone include high red blood cell counts and excess acne.

Risks of taking estrogen and anti-androgen include blood clots, stroke, dehydration, excess urination, and elevated potassium levels.

Overall, NAD+ has not shown any adverse reactions with other medications; however, more research needs to be done. If you are taking hormone treatments and would like NAD+ or NMN, consult with your physician to see if it could further benefit your treatment plan.


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