Therapeutic oral NADH on the symptoms of patients with chronic fatigue syndrome

CFS is a disorder of unknown etiology, consisting of prolonged, debilitating fatigue, and a multitude of symptoms including neurocognitive dysfunction, flu-like symptoms, myalgia, weakness, arthralgia, low-grade fever, sore throat, headache, sleep disturbances, and swelling and tenderness of lymph nodes. No effective treatment for CFS is known.

Objective: The purpose of the study was to evaluate the efficacy of the reduced form of nicotinamide adenine dinucleotide (NADH) ie, ENADA the stabilized oral absorbable form, in a randomized, double-blind, placebo-controlled crossover study in patients with CFS. Nicotinamide adenine dinucleotide is known to trigger energy production through ATP generation which may form the basis of its potential effects.

Methods: Twenty-six eligible patients who fulfilled the Center for Disease Control and Prevention criteria for CFS completed the study. Medical history, physical examination, laboratory studies, and questionnaire were obtained at baseline, 4, 8, and 12 weeks. (as shown in table 1)

Table 1 

Subjects were randomly assigned to receive either 10 mg of NADH or placebo for a 4-week period. Following a 4-week washout period, subjects were crossed to the alternate regimen for a final 4-week period.(see details on Table 2 )

Table 2 

Results:
1. Oral NADH can significantly improve the fatigue symptoms of patients with chronic fatigue syndrome and improve their quality of life.
2. Oral NADH did not have adverse effects on the immune function and viral infection status of patients.
3. The success rate for the drug is 31% and for the placebo 8% based on the arbitrary symptom scoring system.
4. 72% of the study patients enrolled in a longer open label follow-up study reported significant improvement in clinical symptomatology and energy levels.
5. The study suggests that NADH may play a role in the treatment of chronic fatigue syndrome.
No severe adverse effects were observed related to the study drug after NADH oral intaking. Within this cohort of 26 patients, 8 of 26 (31%) responded favorably to NADH in contrast to 2 of 26 (8%) to placebo. Based upon these encouraging results we have decided to conduct an open-label study in a larger cohort of patients. 

Conclusion: The study found that oral NADH can significantly improve the fatigue symptoms of patients with chronic fatigue syndrome and improve their quality of life. In addition, the study found that oral NADH did not have adverse effects on the immune function and viral infection status of patients. Collectively, the results of this pilot study indicate that NADH may be a valuable adjunctive therapy in the management of the chronic fatigue syndrome and suggest that further clinical trials be performed to establish its efficacy in this clinically perplexing disorder.