Could it be helpful for FSHD?
BY AMANDA HILL, HIGHLANDS RANCH, COLORADO
In the current absence of a treatment for FSHD, many patients experiment with a variety of lifestyle or diet changes, supplements, naturopathic medicine, or other types of treatments to help alleviate and cope with disease symptoms. In recent years, several laboratory studies have shed light on one such supplement that may have a variety of positive effects across multiple types of muscular dystrophies: nicotinamide adenine dinucleotide (NAD+) or one of its precursors, nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN).
You may have seen NAD+ supplements touted as anti-aging molecules in mainstream media channels, and there is a significant body of science supporting this idea. NAD+ plays an important role in the generation of mitochondria, the cellular machinery responsible for producing your body’s energy supply from the nutrients you eat.
Numerous laboratory studies have shown that NAD+ has beneficial effects on a diverse range of physiological processes, including energy production, inflammation, oxidative stress, insulin resistance and weight gain, memory and cognition in Alzheimer’s disease, cardiac function, and more. Interestingly, it is fairly well established that NAD+ levels decline with age.
In the case of muscular dystrophies in general, one study looked at gene expression patterns across multiple mouse models of different types of muscular dystrophies, including FSHD. The researchers found that as expression of genes involved in the pathogenesis of disease went up, expression of genes involved in the generation of mitochondria and NAD+ synthesis went down. Although we must be careful to understand that correlation does not show causation, this is an interesting result to explore further.
The same group then went on to evaluate the therapeutic impact of supplementation with NR in a mouse model of Duchenne muscular dystrophy (DMD). They found that NR supplementation improved mitochondrial energy dynamics, improved running capacity, protected animals from and reversed muscle damage, and decreased muscle inflammation. These results were obtained in a mouse model of DMD, but all of these effects would theoretically also be beneficial in FSHD.
Although more studies are needed to better understand the effects of NAD+ supplementation in muscular dystrophies generally, and in FSHD specifically, the early evidence shows some therapeutic potential. NAD+ supplementation would not cure FSHD, but there is a scientific rationale for thinking it may improve some symptoms, such as muscle damage, muscle pain, and fatigue.
NAD+, NR, and NMN supplements are all available for purchase over the counter and without a prescription. Although laboratory studies sound promising, it’s important to emphasize that there is no clinical data yet that these supplements provide patients with any benefits.