Dr. Craig Koniver: NAD & CoQ10 Benefits for Energy & Health

Feb 01, 2025

How CoQ10 Supports Energy Production in Mitochondria

The intricate process of cellular energy production relies heavily on a fascinating molecule called Coenzyme Q10 (CoQ10). While many people take supplements indiscriminately, CoQ10 stands out as a particularly valuable addition to one’s daily regimen, especially when taken at 200 milligrams in the morning.

To understand CoQ10’s importance, we must first grasp how our cells generate energy. The process occurs in three main stages within the mitochondria, our cellular powerhouses. It begins with glycolysis, where glucose molecules are split to form pyruvate. This pyruvate then converts to acetyl CoA, entering the Krebs cycle to produce NADH and other intermediate products.

The most critical phase occurs at the mitochondrial membrane, where five distinct cytochrome hubs facilitate the exchange of electrons for protons—a sophisticated electrical process that ultimately powers our cells. Each hub requires specific nutrients:

• Cytochrome 1: NAD
• Cytochrome 2: Riboflavin (B2) and succinic acid
• Cytochrome 3: CoQ10 and vitamin K2
• Cytochrome 4: Methylene blue
• Cytochrome 5: Magnesium, vitamin A, and copper

Koniver explains that energy production often faces “traffic jams” at these cytochrome hubs, particularly at Cytochrome 1. While many people benefit from NAD supplementation to clear this congestion, others may experience bottlenecks at different points, including Cytochrome 3, where CoQ10 plays its crucial role.

Research has demonstrated CoQ10’s remarkable safety profile, with studies showing no harmful effects at doses up to 2,400 milligrams daily. Beyond its role in energy production, Koniver reports dramatic personal benefits, including the complete elimination of migraine headaches through CoQ10 supplementation.

To optimize mitochondrial function and cellular energy production, incorporating nutrients that support all five cytochrome hubs is ideal. However, CoQ10’s specific action at Cytochrome 3 makes it a particularly valuable supplement for those seeking to enhance their cellular energy production and overall health.

Methylated B Vitamins and Health Benefits

The role of methylated B vitamins in health optimization has gained significant attention in recent years, particularly regarding their impact on cardiovascular health and energy metabolism. At the core of this discussion is the MTHFR gene and its variants, which affect how efficiently our bodies process certain B vitamins.

MTHFR (methylenetetrahydrofolate reductase) variations can exist as either heterozygous (one copy from one parent) or homozygous (copies from both parents) forms. While these genetic variations have garnered much attention, Koniver suggests their impact may be less dramatic than often portrayed in health circles.

One key marker for assessing cardiovascular risk is homocysteine levels. Elevated homocysteine (typically above 7-9, depending on the lab) indicates increased risk for cardiovascular events such as heart attacks or strokes. The most effective way to address elevated homocysteine is through methylated B vitamins.

Methylated B vitamins include:
– Methyl B12
– Methylfolate
– Methylated B6
– Trimethylglycine (TMG)
– Methionine (a methyl-donating amino acid)

These methylated forms add a methyl group to the vitamin structure, enhancing their bioavailability and supporting crucial metabolic and detoxification pathways in the liver. This methylation process helps lower homocysteine levels more effectively than standard B vitamins.

Timing of supplementation can impact effectiveness. Morning supplementation is generally recommended, though some may benefit from an afternoon dose. Koniver suggests that instead of reaching for caffeine or sugar during the afternoon energy dip, experimenting with methylated B vitamins might provide a more sustainable energy boost.

While Huberman notes that some people may feel relieved to hear they don’t need numerous supplements, methylated B vitamins represent one category that offers tangible benefits for many individuals, particularly those concerned with cardiovascular health and energy metabolism.

The key takeaway is that if you’re going to supplement with B vitamins, opt for methylated forms. They provide superior bioavailability and can help overcome potential genetic variations in the methylation pathway, regardless of whether you’ve been tested for MTHFR mutations.

NAD Treatment Effects on COVID and Viral Infections

NAD therapy has emerged as a fascinating intervention for viral infections, with both clinical observations and personal experiences suggesting remarkable effects. The treatment appears to work through mechanisms that extend beyond our current understanding of NAD’s role in cellular function.

Huberman’s experience with NAD infusion during a COVID-19 infection presents a compelling case study. After receiving a 750mg NAD infusion, he observed a dramatic improvement in symptoms within 24 hours, moving from a 6/10 to a 2/10 on the severity scale. More notably, his positive COVID test shifted from a strong positive band to negative the following day.

While correlation doesn’t equal causation, Koniver’s clinical experience supports these observations. Having pioneered NAD infusion protocols and treated thousands of patients, he has consistently witnessed rapid transformational effects, particularly in cases of viral infections. One striking example involves a patient with chronic Epstein-Barr virus who, after receiving a loading dose of five NAD treatments over ten days, experienced a complete turnaround from being bedroom-bound to fully functional.

The biochemistry behind these effects remains somewhat unclear. While we understand that NAD influences mitochondrial function and cellular energy production, the dramatic improvements suggest additional mechanisms may be at play. Different NAD precursors, such as NR and NMN, show varying degrees of effectiveness, with IV NAD consistently producing the most dramatic results in clinical settings.

Current research indicates that NR (nicotinamide riboside) may reduce inflammation, though human studies on NMN (nicotinamide mononucleotide) are still limited. The cost difference between these supplements has led some, like Huberman, to opt for sublingual NMN, which he reports increases hair and nail growth significantly.

The standard protocol of 750mg NAD infusions, developed through extensive clinical experience, appears to be particularly effective. This dosage has become widely adopted due to its consistent results in treating various conditions, from acute viral infections to chronic fatigue syndromes.

These observations suggest that NAD therapy might be working through multiple pathways beyond just cellular energy production. The rapid and transformative effects seen in viral infections point to potential systemic anti-inflammatory properties or other yet-to-be-understood mechanisms that could revolutionize our approach to treating viral infections.

NAD Effects Benefits and Treatment Options

NAD therapy has emerged as a powerful tool in modern medicine, despite our incomplete understanding of its mechanisms. The treatment, which gained prominence in the 1990s for substance abuse treatment in Mexico, has evolved significantly in both application and delivery methods.

Through extensive clinical observation, we’ve learned that 750mg delivered intravenously represents an optimal dosage for most patients. This is a significant reduction from the original 3,000mg protocols that required 6-10 hours per infusion. The current approach typically involves five treatments over ten days as a loading dose, followed by monthly maintenance sessions.

The effects are remarkably consistent across patients. Approximately 95% report enhanced cognitive function, increased creativity, elevated mood, improved sleep efficiency, and heightened sensory perception. These benefits appear to manifest first in the nervous system, likely due to the high concentration of mitochondria in neurons, with physical performance improvements following later.

For those unable to access or afford IV treatments, subcutaneous injection presents an alternative. A protocol of 100mg injected subcutaneously for five consecutive days, followed by two days off, has shown promising results. While this method may cause mild stomach discomfort, it remains effective.

The hierarchy of NAD delivery methods, from most to least effective (and expensive), is:
1. Intravenous infusion (500-1000mg)
2. Subcutaneous injection (100mg)
3. NMN supplementation
4. Sublingual NR

While topical applications exist, they often present practical challenges, such as adhesive irritation with transdermal patches.

The transformative effects of NAD therapy align with emerging research showing how nutritional deficiencies can impact various conditions, including mental health. Just as certain B vitamin deficiencies have been linked to depression in some patients, NAD appears to address fundamental cellular needs that can have far-reaching effects throughout the body.

Based on extensive clinical experience across hundreds of practices globally, NAD therapy stands out as perhaps the single most impactful intervention available. While peptides and other treatments certainly have their place, NAD’s broad-spectrum benefits make it a cornerstone of advanced preventative medicine and optimization.

Read Andrew Huberman

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