The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
as far as we know right okay yeah it's sort of like an ATP problem like it's really hard to quantify ATP in a cell by the way does nad p do any of this as well well it it's important no doubt it's part of this whole problem that we were working on but if you add n ADP or even NADH which is only different by 100 yes they don't those don't work too activates which ones only in a d-plus will do that
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it's generally well regarded that cells can't take up free nad they have to make their own nad Josh and Rabinowitz and colleagues actually published a paper in June of this year that demonstrated that the nad must be made in the cytoplasm not in the mitochondria and it's actually transported from the cytoplasm to the mitochondria
you have to appreciate the central role of the liver in controlling the flux throughout the entire body the livers not just making an ad for itself it's making nad because it carries all of the reserves for the rest of the body as nad so the liver doesn't just have nad that's immediately being used in respiration and is immediately being used in search ones and parts it has a reserve pool of nad that it holds on to for the specific purpose of a slow release of nicotinamide to the rest of the tissues
pretty much every and every molecule of nad is ultimately derived from circulating nicotinamide that the liver put out
overwhelmingly if you're talking about a tissue other than the liver what's happening is that supplement gets converted into nicotinamide reaches the other tissues as nicotinamide and increases tissue ad nad by that tissue taking the nicotinamide and making the nad
so nicotinamide is circulating as the circulating form in the blood but intracellularly you don't let it hang out there you do something with it
pretty much every and every molecule of nad is ultimately derived from circulating nicotinamide that the liver put out
we can make some nice and from tryptophan and about 95 percent of that happens the liver in the liver five percent happens in the kidney
and then almost everything that comes out of the liver into the circulation is nicotinamide so the overwhelming thing that gets niacin out of the liver to any other tissue is nicotinamide that's the transport form
nicotinamide is the is the physiological circulating form of niacin that all cells will use to make nicotinamide
and then those tissues will convert that into nad
then it goes into the liver and the liver is the main site that's really metabolizing all these forms for the entire body and what the liver is going to do is it's going to try to convert as much of those forms into nad as possible not even just for itself but because it's going to hold a reserve of nad for the rest of the body