THE ACCRESCENT™ PODCAST EPISODE 233

Leigh Ann Lindsey (00:01.154)
Well, Jari, welcome to the show. I’m so excited to have you on. NAD is a very refined topic that we haven’t had any guests on to talk about really, really specifically. So I’m super excited to share everything you have to give us with the audience today.

Jari Narhi (00:17.356)
Thank you for having me and great to be here.

Leigh Ann Lindsey (00:20.886)
I think it’ll be so fun. I always start here. I don’t know that we’ll spend too much time here, but can you give us a little bit of a personal introduction into how did you get into the world of NAD testing? know your background is more mechanical engineering.

Jari Narhi (00:36.364)
That’s right, that’s my education. have a master’s in mechanical engineering, which is not, of course, something you would expect one to have in this position. But then my pathway here, it’s kind of a…

Interesting but logical in many ways. So I’ve been involved with medical technology, medical services, starting with MRI scanners way back in the 90s. And from there, I’ve been running a chain of hospitals at one point, and now the past decade with working with startup companies in the space, and past five years we’ve not met.

Leigh Ann Lindsey (01:18.154)
Mm-hmm. I love it. Sometimes it’s fun to just hear a little bit of the progression of what got us to where we are today. For some of us, it’s a very roundabout, twisty, turvy road. So with that said, we’re going to be talking with you about NADMED’s NAD testing, how it’s different, how it’s so different from what is going on conventionally. But I do think we need to backtrack and start with a little bit of the basics for all of us of…

What is NAD? What is it doing in the body? Essentially, why should we even really be that concerned with NAD testing? But let’s start with just the basics of what is NAD?

Jari Narhi (01:55.668)
Right, NID is actually a molecule that is…

the more numerous molecules in our bodies. And it is something that every living cell on this planet requires to live. mean, the basic function of NAD or one of the basic functions is to provide the energy for mitochondria to produce ATP, which is the source of energy for cells. So without NADs, the cells would not have any energy and therefore

you know, things would go off pretty quickly. Exactly, yeah. And actually without the NADs there would be no life on this planet. mean, viruses, yes, but nothing that is cell-based.

Leigh Ann Lindsey (02:32.75)
Nothing gets done.

Leigh Ann Lindsey (02:44.268)
Wow.

Jari Narhi (02:44.46)
In addition to that, NADs regulate some 300 different metabolic processes in our bodies. They are necessary in DNA repair, for example, in fighting inflammation, and the list goes on. So they are really associated with just about anything that happens in our bodies.

Leigh Ann Lindsey (03:07.542)
Mm-hmm.

Jari Narhi (03:08.304)
The funny thing is that while NAD has been known to science for about a century, measuring them has been very problematic and partially impossible. Until recently, NAD measurement was really restricted to research laboratories.

Leigh Ann Lindsey (03:28.578)
Mm-hmm.

Jari Narhi (03:29.45)
You could reliably measure one form of NADs with mass spectrometer, which is a million dollar device, and it takes days, if not weeks, to get the results, which means that then accurate knowledge of NADs you could obtain from a small set of samples, but nothing like a clinical trial or anything resembling that. And this is where NADMED comes in. We are from…

a mitochondrial disease research laboratory at the University of Helsinki. It’s one of the leading institutions in that field globally.

When you study mitochondria, you need to and you want to measure in ADEs continuously and in large quantities. That, as I said, used to be so difficult and partially impossible that the team thought that there just has to be a better way. And then our current CSO, skilled protein chemist, then took up the challenge and developed the method that we have now.

Leigh Ann Lindsey (04:18.114)
Hmm.

Jari Narhi (04:40.174)
What that provides is an ability for any clinical laboratory with the basic equipment to measure all forms of NADs in high quantities. now clinical trials are now possible and investigations as you would measure any other common metabolite or

is now possible for an Aedes as well.

Leigh Ann Lindsey (05:10.386)
Mm-hmm. We’re gonna get into how it’s different than some of the other conventional NAD testing methods. What I wanna understand a little bit better, so NAD is this foundational cellular enzyme, nutrient. What starts to go wrong? And you already spoke to, if the cells can’t produce the mitochondria, which then produces the ATP, in essence,

everything starts to down regulate. But are there signs and symptoms that you might have low NAD or are these more generalized?

Jari Narhi (05:50.252)
Yeah, first of all, I have to say that most healthy people in places where there’s no nutritional problems or I mean there’s no lack of food, typically people’s NAD levels are just fine. But if they are…

I mean, if your NAD levels are too low, then problems start to occur. And that could manifest itself as being tired, lack of energy. Now there’s hypothesis that chronic fatigue syndrome

may be partially, at least partially NAD related. NADs are known to have a role in lung COVID and that mechanism is somewhat more complicated so it’s not quite that straightforward.

Leigh Ann Lindsey (06:44.014)
Hmm.

Jari Narhi (06:44.748)
And then of course the deficiency in NADs typically will happen if you have an acute injury, inflammation, be it acute or chronic or a chronic disease. That’s when your NAD resources in your body may be depleted. And that’s where supplementation, for example, then becomes medically necessary. Yeah.

Leigh Ann Lindsey (07:11.542)
relevant and necessary. Yeah, I think something I want to try to understand better is in my world and integrative medicine, we talk a lot about root cause. something’s going on in the body. What is ultimately contributing to this? And there can be multiple contributing factors. It sounds to me like in some of the research I was trying to do that it’s not that any D levels just start

dropping randomly on their own and then this causes illness or chronic illness. It seems like maybe it’s more the reverse. Chronic inflammation might start to affect NAD levels, NAD production, NAD usage, which then can contribute to maybe even more chronic illness. Is that accurate?

Jari Narhi (08:00.909)
I think it is. Yes, I think you’re right on track there.

Like I said, the most typical reason for an NAD depletion would be a chronic disease or an acute inflammation. that actually, the causality is probably that way around. And then what the NAD deficiency then causes, then of course your body’s resources are going to be depleted and your body’s ability to respond to a therapy or heal itself is going to be compromised.

Leigh Ann Lindsey (08:15.342)
Mm.

Leigh Ann Lindsey (08:33.822)
Yeah, this feels important to note for the audience because it could be easy for them to go, well, okay, if NAD isn’t the root cause, quote unquote, of my chronic illness, why do I need to focus on it? But…

I think what we need to understand this downstream effect, maybe there’s maybe the ultimate root cause is chronic inflammation and we need to go figure out what’s going on with chronic inflammation. But once it’s starting to affect these NAD levels, that is then creating a fire of its own. That is rippling out into just about every function of the body because it’s affecting the cell.

at that very minute level. And so I was really thinking about this in preparation for today’s conversation, especially with cancer and chronic illness patients, because when you’re in that severe a state of illness, being able to boost your cellular energy can have massive implications for your health and your ability to recover when we’re in such a state of depletion.

Jari Narhi (09:37.612)
Yeah, I think that you’re again right on track there. In simple terms, is actually the active form of vitamin B3. So it’s nothing more complicated than that from that perspective.

Leigh Ann Lindsey (09:51.083)
Okay.

Jari Narhi (09:57.396)
compared to other vitamins, NADs serve quite a few functions that vitamins typically do not. And beyond this energy generation, the signaling function, the regulation of the different metabolic processes, those are really important. And now there are

this starts to get a little bit technical, there are four different forms of NADs and their ratios are also important, which means that if your metabolism is in balance, then those ratios are typically fine, but if one or the other one of these metabolites is…

Leigh Ann Lindsey (10:21.613)
We love technical.

Jari Narhi (10:42.052)
Outer range, then their ratios also try to start to go off-kilter and that may cause then problems in the body’s internal signaling and other functions where these metabolites play a role. It gets complicated and we still know very little about that.

Leigh Ann Lindsey (11:05.963)
Yeah, I think that’s the essence of science, right? Is the more you learn, the more you realize you don’t know. And keeping that humility is so important. What are, I know this isn’t technically your field, so thank you so much for asking all these questions, because you guys are in the testing, not necessarily the treatment side of this. But as much as you feel comfortable to answer, it’s so helpful as we then move into all of the testing around NAD. But

Jari Narhi (11:13.075)
Yeah.

Leigh Ann Lindsey (11:36.053)
What are ways that people are commonly supplementing NAD? And maybe it’s different too in the US versus over in European countries or different areas of the world. But what does supplementation with NAD look like? Let’s go there just for a second if you feel comfortable speaking to that.

Jari Narhi (11:54.188)
Sure. Well, I can tell you what we know and then I can tell you what we don’t know. what we do know, vitamin B3 or niacin is the kind of the basic form where all starts and supplementation with niacin will get your inady levels up. That we know for a fact.

Leigh Ann Lindsey (12:01.348)
Perfect.

Jari Narhi (12:19.782)
Inconvenient thing there is that the high doses of niacin will have side effects on some people. It depends on the person, flushing, tingling and that sort of things. And very high doses, and that we know from the days when niacin was used as a cholesterol drug, that the very high doses may start to then cause liver problems.

Leigh Ann Lindsey (12:34.179)
Okay.

Leigh Ann Lindsey (12:46.412)
Okay.

Jari Narhi (12:46.516)
Therefore, supplementation for the sake of supplementation is probably not a good idea unless you know that you need it. Then the other supplements that we know that work maybe a little bit differently are the

intermediate forms from niacin to NAD, which are NMN and NR, which are commonly used. And they work, yes, again, they may work a little bit differently for you and I. So again, knowing what you do is important.

Leigh Ann Lindsey (13:12.459)
Mm-hmm.

Jari Narhi (13:25.42)
There’s been lots of safety studies, especially in NR, so they are not poisonous as far as we know. But then again, the history is a little bit short there that we still there are open questions, but certainly nothing that you should be too concerned about. Again, elevating your NAD levels for the sake of elevating them really has no known benefits.

Leigh Ann Lindsey (13:53.443)
Hmm.

Jari Narhi (13:54.14)
beyond where the normal healthy range is. There are hypotheses or

Some people think that they may have adverse effects. For example, it is hypothesized that some types of cancer are very fond of NADs. So if you happen to have some type of cancer, then that might not be a good idea to elevate your NADs because that might accelerate the growth of the cancers.

Leigh Ann Lindsey (14:16.271)
Mmm.

Jari Narhi (14:26.89)
That is unproven, but a kind of a critical hypothesis that is being investigated. And again, the signaling function between our cells, of course, may suffer if one kind of this NADs is artificially elevated to beyond where it normally should be. So there’s a lot we don’t know.

Leigh Ann Lindsey (14:51.777)
Mm-hmm.

Jari Narhi (14:56.872)
certainly your reasons to, you know, be careful.

Leigh Ann Lindsey (15:02.217)
Yeah, absolutely. You know, I’m over here in Southern California where it’s like, you know, wellness junkies, biohackers, and that’s fantastic. But I know a lot of people who are in peak health who do NAD IVs on a weekly basis and they will report, you know, some kind of increase the first couple of days after doing it. But to your point, I think, and this is, think something that science is going to start to show us more and more.

Jari Narhi (15:30.538)
Yeah.

Leigh Ann Lindsey (15:30.911)
even quote unquote good things in excess can become bad.

Jari Narhi (15:35.244)
Yeah, and IV, NAD-IV, there it is unclear what the function or mechanism of action there is. We know for a fact that NAD put in your bloodstream will be cleaved into something else. And nobody knows exactly what else. I NAD molecule is too large to enter the cell.

Leigh Ann Lindsey (15:55.903)
interesting.

Jari Narhi (16:03.122)
And NAD is inside your cells, not extracellular. I mean, there are trace amounts, they really, as far as we know, have no function. And therefore, all the NAD is actually created inside your cells. So injecting NAD… Yep, it certainly does something, but nobody… We don’t know what.

Leigh Ann Lindsey (16:20.482)
Wow, so when you’re taking NAD directly…

Leigh Ann Lindsey (16:29.272)
We don’t understand how, because it’s technically too big to get into the cell.

Jari Narhi (16:33.724)
Yeah, so the mechanism is not that, you know, getting NADV IV in your bloodstream that would elevate your NADs in your blood cells. Not going to happen directly. Whether there’s a pathway that we don’t know yet that may cause that to happen through another mechanism or something else, totally something different happens that we don’t know.

but certainly the assumption that injecting NAD in your bloodstream will directly raise your NAD is not.

Leigh Ann Lindsey (17:07.348)
Yeah, yeah. And long term raise it either. This brings me to the question about precursors versus supplementing NAD directly. And maybe you already answered this because now I think there’s a lot of NAD supplements on the market. Everything from NAD IVs like we just talked about to NAD nasal sprays, sublinguals, supplements that are NAD directly. Then there’s some of these precursors that we’ve talked about like the NMN.

And from the research I’ve done, seems like the NMN is a little bit more coherent with our body’s natural process, which is we’re providing the precursors so that our own body can produce more of this NAD itself. But the premise that you just gave for the IVs, does that hold true for any form of NAD supplementation? OK.

Jari Narhi (18:00.724)
We don’t know. I’m not saying at all that the NAD-IV does not work. We just don’t know how it works and what the exercise is. There’s plenty of anecdotal evidence that people feel better after taking them. That probably is the case, but we don’t know why.

Leigh Ann Lindsey (18:11.522)
Yeah, yeah.

Leigh Ann Lindsey (18:26.176)
Right, because just from a biological perspective, that NAD is not able to actually get into the cell. So it is causing benefit, but not through that mode of mechanism. Yeah.

Jari Narhi (18:38.358)
precisely. And then what comes to NR and NMN, then, you know, that is the natural pathway that V3 or niacin is converted into NR and then onto NMN and that cycle goes on and that is not the work. that certainly works. But again, variation from one individual to another may be substantial.

Leigh Ann Lindsey (19:08.4)
Absolutely right. And this is where conversations like these are meant to provide a baseline of information that the audience can then go talk to their medical professional about, not give them the one kind of treatment for themselves specifically. So this is where I do want to ask now about glutathione and how does this play a role?

Jari Narhi (19:26.739)
Mm-hmm.

Jari Narhi (19:31.636)
The glutathione then is a main antioxidant, as I’m sure you know, in our bodies and serves an important role in that. And that then has to do with your NAD, the phosphorylated NADs, which is NADP and NADPH. They then tie back to glutathione and there’s a pathway to how that works. And glutathione is then…

also are turning out to be really interesting biomarkers in oncology in neurodegenerative diseases and that sort of things. But again the research is still pretty sketchy but certainly there is lots of interest in that space and we expect that you know there will be interesting findings in the coming years in regarding glutathione as well.

Leigh Ann Lindsey (20:28.792)
Yeah.

Jari Narhi (20:29.116)
They of course also have a central role in our muscles function. So muscular dystrophies and that sort of things then involve glutathione as to your basic function of the muscles. They control the calcium channels and all the rest of it there so that they have a known central role in those functions.

Leigh Ann Lindsey (20:46.405)
Mm-hmm.

Leigh Ann Lindsey (20:55.737)
And so how might supplementing with glutathione impact NAD directly or indirectly?

Jari Narhi (21:04.204)
I’m not aware, and now I have to plead ignorance, but I’m not aware of glutathione affecting NAD levels directly, so I’m not sure if there’s a cycle that way or not, but the other way, yes, there is a connection.

Leigh Ann Lindsey (21:13.115)
Okay.

Leigh Ann Lindsey (21:18.383)
Yeah. So before we actually, I do have one question here, which is, is it true that our NAD levels just naturally decline as we age? I feel like that’s a common adage about NAD, which then could lead us to go, well, at some point we all should be supplementing with NAD as we age.

Jari Narhi (21:40.244)
Yeah, what we find in our own research is that yes and no, meaning that age, aging alone will not.

cause decline in NADs. But then if you take a kind of a population level point of view, then yes, as people age, they will have more chronic diseases, other kinds of health problems that do deplete your NAD levels. So in a population level, certainly you can find that older populations in NAD levels tend to be lower. But it’s not the age itself. If you’re healthy,

Leigh Ann Lindsey (22:18.661)
Yeah.

Jari Narhi (22:19.18)
through your life then your probably, and maybe others probably are just fine.

Leigh Ann Lindsey (22:23.909)
This was gonna be, this was my thought, which is, I think we’ve made it a little too binary just with age. In general, even though you look at populations and you see older people have less, but is it just because they’re older or is it because they’re older so they’ve had a lot more chronic inflammation stack up and illnesses stack up that are kind of going unaddressed, that is then really like the core motive mechanism for why it’s decreasing.

Jari Narhi (22:49.43)
That is what the research now indicates, that that would be the case.

Leigh Ann Lindsey (22:52.897)
Mm-hmm. Yeah, I just think it’s powerful. And again, coming from the like biohacking holistic health world where I think even in and over on our side of the street, we can be doing too much, you know, and AD levels drop. Let’s supplement and AD. Let’s supplement this. Let’s supplement that. Let’s do all these treatments. And we’ve got to go through some of this with a fine tooth comb and go, is this really necessary? More is not always better.

And even on our side of the street, being able to ask those questions and go, why are we really doing this? What does the research say? And is this just fluff that’s not really necessary if you’re actually a healthy person?

Jari Narhi (23:36.82)
Yeah, with NADs like with most everything else, maximizing your levels should not be the objective. Keeping them in the healthy range, which has a lower and upper limit, that’s what you should be doing. And again, for most healthy individuals, urinary deltas probably are within that range.

Leigh Ann Lindsey (23:58.896)
Right. And this is where it leads me to, and I’ll make two kind of points here then we’ll move into the testing. What I will say is for someone with cancer or chronic illness with medical approval, if they don’t have cancers that actually like an AD, this is where we’re kind of in this in-between place of ultimately we want to address the chronic inflammation. And at the same time,

to give yourselves the immediate energy boost of being able to have more NAD available could be really impactful in treatment when you’re in such a depleted state. it’s not either or, it’s when we’re in such a state of depletion, yes, maybe over here we’re doing some treatments and things to support the root cause of chronic inflammation. Maybe that’s mold toxicity, dormant pathogens that have become active again.

whatever it might be. And we’re also going to support NAD in the meantime, just to get the cells able to function better to get us through this really, really intense state of depletion.

Jari Narhi (25:04.652)
Yeah, and again, the old boring advice I talked to your doctor. They are increasingly knowledgeable about this cell level metabolism. Not all are comfortable yet to say much about it, but I think that’s the direction we’re headed. So it’s becoming more and more mainstream medical practice. That’ll take some time, but we’re headed that way.

Leigh Ann Lindsey (25:27.675)
Yeah.

Yeah. And I think in the integrative world, NAD is being talked about a lot more than the conventional world, at least over here in the USA. But the last point I wanted to make to that end is again, when there’s cancer, when there’s chronic illness, and when we’re looking to support these with maybe Western medicine and integrative medicine combined, what I see so often with patients is it’s so hard to decide.

what supplements to take, what markers to pay attention to. There’s a hundred things we could, more than a hundred, mean, thousands of things we could test, thousands of things we could take. So what makes NAD a marker worth paying attention to?

Jari Narhi (26:06.966)
Yep.

Leigh Ann Lindsey (26:14.616)
more so than maybe others. What makes NAD a marker worth supporting with supplementation more so than others? Again, in something like cancer or chronic illness. And to me, where my mind goes, but correct me if I’m wrong, NAD is affecting the cell or the precursors to NAD when we’re supporting it, are affecting the cell directly. It’s not an indirect support. I think of something like vitamin C.

which is a great antioxidant, maybe like glutathione as well. And so that might indirectly support NAD levels by cleaning up some of the inflammation in kind of the landscape of your cells, you know, of your body, but it’s not directly supporting NAD production. Whereas when we’re doing things to support NAD directly, that is affecting the cell directly. And it seems like when we’re working with such fragile states of health, the more we can go straight to the cell,

rather than some of the fluff in the landscape, that is what is gonna be most impactful.

Jari Narhi (27:20.166)
Yeah, as long as you know what the issue is. NADs are, and that is again comes back to the signaling functions that the NADs also direct whether the resources are used for building or repair functions. And that’s where the NAD plus NAD age ratio then is important that that is correct because that tells the cells what to do, how to behave.

Leigh Ann Lindsey (27:48.838)
Mm-hmm.

Jari Narhi (27:50.865)
And again, I would…

Keep in mind that the NAD, the source of NAD, really is a vitamin, and now there is a range where you want to hold it. And NAD +, which is the thing that people usually talk about as a diagnostic biomarker, it is a very blunt instrument, because it is involved in so many things that if your NADs are depleted,

Leigh Ann Lindsey (28:16.338)
Okay, so let’s get into this.

Jari Narhi (28:25.696)
the cause could be, the list is very, very long. So that alone won’t tell you anything specific. It will tell you that, okay, something is not right. And then you should go find out what that something is. And in the meantime, it probably makes sense to fix your inedible back to where they should be. that, but.

Like we said over and over again, that in itself is easy with either Niacin or NMN or NR. Those are not going work.

Leigh Ann Lindsey (28:58.124)
Yeah, I don’t know if I don’t know even here in the States is NAD plus something that is a part of standard blood tests or that’s something that you’re going to have to ask for. And even when you ask for it, it’s still just an AD plus.

Jari Narhi (29:14.636)
Yeah, and the why it is not part of a standard blood test panel is that measuring it reliably has been largely impossible or I mean so elaborate that that’s not getting done and that is now changing and we’re now getting the first US laboratories to use our tests and then you know from those laboratories you can get reliable NAD testing

Leigh Ann Lindsey (29:28.505)
Yeah.

Jari Narhi (29:45.194)
easily. There’s of course other entities out there and now if we’re getting to why are how are we different? There’s testing entities is difficult and there are certain innovations in our method that are

proprietary and they have to do with the extraction of the metabolites. So because NADs are inside the cells and they are wrapped in multiple layers of proteins and they’re difficult to get out from there. And then you have in blood, which is the accessible matrix, it is somewhat easier to measure from cells.

Leigh Ann Lindsey (30:19.804)
Mm-hmm.

Okay.

Jari Narhi (30:32.508)
or tissues, but then you’re talking about biopsies and again, it’s a non-starter for screening. Blood is especially difficult for NADs. So you need to do a number of things to first of all, the NADs, them out from where they’re hiding, and then they are very unstable bugger. So then you need to stabilize them very quickly and know doing that in a way that

Leigh Ann Lindsey (30:38.779)
Yeah.

Jari Narhi (31:01.47)
it is controlled and then you need to actually, if you’re measuring the different types, typically an AD plus and an ADH, you need to extract them and stabilize them differently and measure them separately. that’s there. It is easy once you have the method, which is something that, you know,

Leigh Ann Lindsey (31:21.51)
Sounds like, that sounds easy. Come on, Yari.

Jari Narhi (31:31.372)
has been worked on by a number of people for some time, it seems like we are first ones who crack it to the degree that you can get equally reliable and accurate measurements as you can get with mass spec with a standard enzymatic reaction covariometric detection assay.

Leigh Ann Lindsey (31:49.691)
Yeah.

Leigh Ann Lindsey (31:54.948)
Yeah, so to your point, and I’m just teasing you, I have to give you a hard time because that obviously is a very complex process. It’s very complex. It probably takes a lot of money, which is why this is not something that’s a standardized process. In most, know, when you go in for your yearly checkup, they’re not looking at your NAD.

Jari Narhi (31:57.494)
Yep.

Jari Narhi (32:01.58)
you

Jari Narhi (32:12.896)
Yeah, correct, but I would add the word yet. think it will in not too distant future, it will be part of your standard blood pattern.

Leigh Ann Lindsey (32:19.133)
Hopefully. Yeah.

Leigh Ann Lindsey (32:26.139)
And so say a little bit more about now specifically what NADMED is doing. And can we talk about why it’s so important to test the four different types of NAD? What are they? What information does that give us when we understand the levels of each type?

Jari Narhi (32:44.94)
Yeah. Whenever you test NADHs, would be important to measure NAD plus and NADH because their ratio is what, excuse me, what

some people say that that is the language that the cells understand. And again, it comes back to if that ratio is one way or the other, then the cells are instructed to behave differently. And then the resources are directed again to fighting inflammation or doing other kinds of repair things or just, you know, the…

Leigh Ann Lindsey (33:15.091)
Okay.

Jari Narhi (33:27.36)
building your body, so your normal energy production and producing whatever the cells do. And that is the reason why you should measure both NAD plus and NADH. Again, NAD plus alone is a very blunt marker. And I like to say that whenever there is reason to draw

Leigh Ann Lindsey (33:48.498)
Mm-hmm.

Jari Narhi (33:57.288)
blood from a patient, you should measure NADs.

Leigh Ann Lindsey (34:02.291)
Hmm.

Jari Narhi (34:02.788)
The simple reason, I mean, if you compare it to, for example, hemoglobin, that’s what doctors want to know every time if you take a blood sample that’s measured, no matter what you’re looking for. Because if your hemoglobin is declined, then you need to fix it and of course find out why it is. And that’s usually fairly straightforward. The same is true for the NADs. That if your NAD levels are depleted, then it would be a good

Leigh Ann Lindsey (34:12.498)
Yeah.

Jari Narhi (34:32.652)
idea to fix that. And it’s equally easy to fix as with hemoglobin that you take a supplement that has a known effect. In case of NADs then you probably need to control that your dose is just about right and you get where you want to go and not too high.

Leigh Ann Lindsey (34:34.225)
Mm-hmm.

Leigh Ann Lindsey (34:54.341)
Yeah. Can you, you spoke to this really briefly. I’d love if you could expand on it just a little bit though, which is NAD, just measuring NAD plus is not that insightful. tells us NAD might be low. It doesn’t tell us anything more than that. What is it about understanding the ratios of NAD and then NADH that gives you more information? If that ratio is off, what, what does that tell you?

or how does that aid in further inquiry?

Jari Narhi (35:24.492)
And again, this is now something where the science is just developing. But from our, you know, the scientists who work on the mitochondrial diseases have established that the NADH, NAD plus NADH ratio is really important for the signaling function that we have now talked about.

Leigh Ann Lindsey (35:45.544)
Mm-hmm.

Jari Narhi (35:47.568)
if it’s high or low, that will determine what the cells are instructed to direct their resources to. that information is something that clinicians who are familiar with the field can already now use in their…

Leigh Ann Lindsey (35:55.278)
Okay.

Jari Narhi (36:11.412)
not so much in diagnostic, but in therapeutic decisions and a follow-up of the success of the therapy. So that is the reason. there we still have some work to do before, you you come up with the standard medical practice guidelines. They’re not there yet, but they are in fairly near future.

Leigh Ann Lindsey (36:19.951)
Okay.

Leigh Ann Lindsey (36:31.144)
Right.

Jari Narhi (36:38.506)
they will start to be developed and applied.

Leigh Ann Lindsey (36:42.906)
Yeah, and standardized guidelines meaning when the NADH NAD NADH ratios are off by this amount, here’s what it means, here’s the standardized treatment we’re going to use for that. That hasn’t been developed yet. Is that what I’m hearing? Okay.

Jari Narhi (36:57.74)
Yeah, and then of course that will be done in the context of other diagnostic information that what is it that you’re looking for and so on and so forth. And there’s still some work to be done in research and clinical trials to get all that right.

Leigh Ann Lindsey (37:04.25)
Exactly. Yeah.

Leigh Ann Lindsey (37:14.002)
Yeah. Now this might be an oversimplification, but just to help all of us understand what you’re saying here. this ratio, depending on what the ratio is between these two forms of NAD tells us when the ratio is this, when it’s X, the body is diverting more resources to the immune system versus the digestive system. Again, I’m making stuff up and oversimplifying.

versus when the ratio is maybe flipped and it’s why that tells us that cells are diverting more resources to the digestive system versus the immune system. Is that the essence of it?

Jari Narhi (37:53.164)
Yeah, I guess it’s probably not exactly like that, but I think again you’re on the right track that that is the type of a decision that or information that can be obtained from that. But now we’re getting into a field where you you really need to have doctors who know that to say anything more specific about that, but that is the new direction we’re heading.

Leigh Ann Lindsey (38:00.606)
Okay.

Leigh Ann Lindsey (38:15.118)
Right. Right. And I guess, I guess the point of that is when you have that additional information, not just NAD is low, so we need to boost it, it’s low and here’s where the body is sending or not sending resources. That tells us more about where we need to look next.

Jari Narhi (38:35.476)
Yeah, exactly. Yes.

Leigh Ann Lindsey (38:39.302)
And so that feels like a crucial piece of the puzzle. Yeah.

Jari Narhi (38:41.612)
Yeah. Then the other forms of NAD and ADP, that then is more complicated and even less understood right now. But that then ties back to at least in oncology. That is an interesting point of research also.

seems like in several neurodegenerated diseases, DNA to EPs and luvath ions and their ratios are an untapped source of information.

Leigh Ann Lindsey (39:13.108)
Hmm.

Jari Narhi (39:16.766)
And this is actually something that we do know already, which we have had the opportunity to measure all these six metabolites from a number of large number of different patients with different diagnosis from the Central University Hospital.

When you map these ratios between these six metabolites and compare it to known diagnoses, you get what we call a metabolic fingerprint. And that is dramatically different for different diagnoses.

Leigh Ann Lindsey (39:49.779)
Wow.

Jari Narhi (39:50.944)
We don’t have, I these are still two small patient groups that we have been measuring, but it certainly tells you that there is a promise of diagnostic value from all these six metabolites, which is the reason why, for example, pharmaceutical companies developing drugs for neurodegenerative diseases, ALS and others who…

They are then interested in all these six metabolites as markers for the efficacy of their drugs that they’re developing. And that actually is the biggest market for our test right now. But the clinical part certainly will take over in your future.

Leigh Ann Lindsey (40:28.02)
Hmm.

Leigh Ann Lindsey (40:40.474)
Yeah, what I think is interesting is you’re saying that you guys as a company decided we want to be able to measure all of these forms of NAD, even though some of them aren’t even that well researched yet. It is important for us to include this in here.

That’s impressive to me just because the amount of financial resources it takes to figure all that out must be immense. And so you guys were like, we don’t care. And we don’t care if people don’t even really understand this NADP, I think is what you said, but we want to be able to measure it.

Jari Narhi (41:16.428)
Yeah, and it is actually the same technology that

can be used for measuring NAD+. So then with little tweaks can be used to measure all the rest of them. So the financial resources needed to establish that are not immense. mean, so it’s not huge, but certainly you do need to have the financial resources to do that. Where the effort will be financially immense then is the clinical trials and establishing the clinical

Leigh Ann Lindsey (41:35.559)
Okay, okay.

Okay.

Jari Narhi (41:52.015)
medical practices that tie back to how do you use this information and that’s where I mean money starts to burn in serious fashion.

Leigh Ann Lindsey (41:57.959)
Mm-hmm. Completely.

Leigh Ann Lindsey (42:03.205)
Yeah. Well, to your point, it’s what is the standardized use of this information? In the integrative world, we might use it for a lot more than that. But of course, in Western medicine, there has to be all of the approved standardized ways to when we get this information, here is the bucket of standard of care options we might use for it.

Jari Narhi (42:27.668)
Yeah, and even apart from this standardized or approved dissemination of the information, I somebody will have to figure it out in a way that we know it’s correct. And then let the world know that this is what we know. that is just the nature of that process is that it takes a long time and it really is resource intensive.

Leigh Ann Lindsey (42:40.766)
Yeah.

Leigh Ann Lindsey (42:46.25)
Mm-hmm.

Leigh Ann Lindsey (42:55.824)
Yeah, absolutely.

Jari Narhi (42:57.344)
Therefore, is not us as NADMED who will do that. It is researchers in universities and pharma companies who will carry that burden. We provide the tool and the capability for them to do that.

Leigh Ann Lindsey (43:12.827)
Exactly. So is right now nadmed only available for b2b or researchers or is there a consumer version of this?

Jari Narhi (43:23.666)
And there is no consumer version at the moment. Of course, the consumer version then is a laboratory that provides a test to a clinic that then provides the test to the consumer. But we don’t directly. We have no home test kit.

Leigh Ann Lindsey (43:44.623)
Yes, yep.

Jari Narhi (43:47.46)
I don’t think we’ll see anything like that in the very near future because the reason it’s been difficult to measure and is the reason is that it is difficult. then making a home test out of it, now we have a very well working laboratory test but it requires the lab environment.

Leigh Ann Lindsey (44:02.779)
You

Leigh Ann Lindsey (44:11.891)
Mm-hmm.

Jari Narhi (44:12.768)
not research lab anymore. Now it can be any clinical laboratory that, you know, there are thousands of them all over. Yeah.

Leigh Ann Lindsey (44:20.081)
Yeah. So to that end, are you, are you also trying to work with clinicians and doctors and have your test available to them? Or are you still just strictly working with the labs? Cause where my mind goes is for the audience who’s listening to this and they’re going, Whoa, okay. I’m sold. I really want to understand my NAD. And I don’t want to just have the NAD plus that we’re talking about here. I want to understand the broader.

Jari Narhi (44:35.247)
Jari Narhi (44:43.018)
Mm-hmm.

Leigh Ann Lindsey (44:50.432)
landscape of what’s going on with my N and D in all these four ways. How can I get the NAD Med test? Can I ask my doctor for that specific test?

Jari Narhi (44:59.116)
Depending on where you are, it is not widely available in the US yet, but there will be by mid this year, there will be a couple of laboratories that are offering nationwide.

Leigh Ann Lindsey (45:14.023)
Okay.

Jari Narhi (45:17.532)
still the gap to be closed, that the knowledge that it is available and where it’s available then you know that it’ll take some time before you know all the clinicians know that that is possible but we’re headed that way.

Leigh Ann Lindsey (45:25.342)
Exactly.

Leigh Ann Lindsey (45:31.495)
Yeah, and I’m just, this is a side of it I don’t understand. So you guys work with the labs. So let’s just say there’s, I’m making a random number up, five labs in the US that use the NADMED form of NAD testing. It’s up to the doctor to be able to know, this lab does that form of testing. So I’m gonna use that lab for my patients, send their blood over there so that we can use that test. Okay.

Jari Narhi (45:45.065)
Mm-hmm. Yep.

Jari Narhi (45:58.674)
Exactly, yes. And of course it is also up to the lab to make sure that the doctors know that this is available. So there’s, mean, typical lengthy supply chain, if you will, know, olfactory to the patient.

Leigh Ann Lindsey (46:07.878)
Okay.

Leigh Ann Lindsey (46:12.693)
Yeah.

Leigh Ann Lindsey (46:18.431)
Well, right, and are you guys, I think this is just an interesting marketing question, are you guys focused on we mainly just promote and work with labs, then it’s the lab’s job to get it out to practitioners or are you also trying to go direct to practitioners and doctors and clinicians to let them know, hey, we’re over here in this lab now?

Jari Narhi (46:37.676)
to some degree, but our resources are quite limited. So we’re not going to run Super Bowl ads anytime soon because we’re too small for that. But that of course would be very nice, but we can do that. So we will rely on the laboratories to reach the tens of thousands of clinicians who will need that. So that is the pathway marketing wise for us.

Leigh Ann Lindsey (46:42.41)
Yeah.

Leigh Ann Lindsey (46:45.673)
No.

Leigh Ann Lindsey (46:58.577)
Yeah. Yeah.

Leigh Ann Lindsey (47:03.657)
Well, and you’re doing some consumer marketing here today because all of us are the audience. to have thousands of people come to their doctor and say, hey, I heard about this test. I really want it. That then gets doctors going, what is this test? Let me look it up. are there any labs in the US that do this? So it can work in reverse as well. So it’s interesting. That’s a whole.

Jari Narhi (47:07.692)
Oops.

Jari Narhi (47:29.578)
Yeah, there you go. mean, that is part of what we do, but for a small team, there’s only so much we can do. So we’re really, for the scaling of it, we rely on our customers and partners for most part.

Leigh Ann Lindsey (47:36.613)
Totally.

Leigh Ann Lindsey (47:43.669)
100%. Yeah. Well, Yari, thank you so much. Was there anything we didn’t cover that you feel is really, really important for us to touch on?

Jari Narhi (47:52.594)
I think we covered quite a bit and I can’t think of anything that would be sorely missing. think there’s a plate for a mouthful for anyone already. So I think we did.

Leigh Ann Lindsey (48:06.687)
Good.

I’m glad. I’m glad. Well, and we’ll make sure your guys’s website is linked in the show notes. So like I said, our audience can go look it up and introduce their doctors to it and generate that kind of conversation from the consumer end as well. But thank you so much. I think this was a really, really fun, fascinating conversation. And I was so appreciative that I know you guys are on the testing side, but it was so great to have you indulge us with just NAD general talk and what is it and how do we support it? I think that was the helpful founding.

we needed to get into that.

Jari Narhi (48:40.854)
Well, thank you. I really enjoyed it.