PRE-PRINT: Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients After COVID (Chudzik et al 2021)

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Use of 1-MNA to Improve Exercise Tolerance and Fatigue in Patients After COVID-19

View ORCID ProfileMichał Chudzik, Joanna Kapusta, Monika Burzyńska

doi: https://doi.org/10.1101/2021.07.14.21259081
This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.




Abstract
Background Coronavirus disease 2019 (COVID-19) is a serious respiratory disease that results from infection with a newly discovered coronavirus (SARS-COV-2). Unfortunately, COVID-19 is not only a short-term infection but that patients (pts) recovering from SARS-CoV2 infection complain of persisting symptoms including: fatigue, diffuse myalgia and weakness, which may lead to chronic fatigue syndrome. There is currently no evidence that nutritional supplements and/or physical exercise can assist in the recovery of pts with chronic fatigue syndrome. 1-Methylnicotinamide (1-MNA) is an endogenic substance that is produced in the liver when nicotinic acid is metabolized. 1-MNA demonstrates anti-inflammatory and anti-thrombotic properties. Therefore, we investigated whether 1-MNA supplements could improve exercise tolerance and decrease fatigue among patients recovering from SARS-CoV-2.

Methods The study population was composed of pts after COVID-19, expressing subjective feelings of limited tolerance to exercise. The selected pts were randomized into two groups: GrM0 – without supplementation; GrM1 – with 1-MNA supplementation. At the beginning of the study (Phase 0), in both groups, a 6-minute walk test (6MWT) was carried out and fatigue assessment with Fatigue Severity Scale (FSS) was performed. After 1 month (Phase 1), a follow up FSS and 6MWT once more were performed in both groups.

Results A significant improvement in the mean distance covered in the 6MWT was noted among the pts in GrM1, compared to those in GrM0. We also noted that in GrM1 the 6MWT distance was significantly higher after 1 month of supplementation with 1-MNA, compared to the beginning of the study (515.18 m in Phase 0 vs 557.8m in Phase 1; p = 0.000034). In GrM1, significantly more pts improved their distance in the 6MWT (23 out of 25 pts, equal to 92%), by a mean of 47 meters, compared to GrM0 (15 of 25 pts, equal to 60%) (p = 0.0061). After one month, significantly more patients in the group without 1-MNA had severe fatigue (FSS ≥ 4) compared to the group with supplementation (GrM1 = 5 pts (20%) vs GrM0 = 14pts (56%); p = 0.008).

Conclusions 1-MNA supplementation significantly improved physical performance in a 6-minute walk test and reduced the percentage of patients with severe fatigue after COVID-19. The comprehensive action of 1-MNA, including anti-inflammatory and anticoagulant effects, as well as activation of the SIRT1 enzyme, may be beneficial for the recovery of patients with persistent symptoms of fatigue and low tolerance to exercise after COVID-19.
 
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Is 1-MNA already available on pharma market or is it custom synthesis only? Need to get them 1-MNA supplementation.
There is no need. You could simply take nicotinic acid (Niacin). That is actually what many Covid Long-Haulers have been doing for a while, with high-dose niacin. It has not helped me, to be honest, but it is very hyped out there. Here is one of their guides:
 

Learner1

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There is no need. You could simply take nicotinic acid (Niacin). That is actually what many Covid Long-Haulers have been doing for a while, with high-dose niacin. It has not helped me, to be honest, but it is very hyped out there. Here is one of their guides:
Where does
1-Methylnicotinamide fit on this chart?
Screenshot_20210719-214418.png

I take NMN or NAD+, which are readily available. Why is 1-Methylnicotinamide better, please?
 
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Niacin has been way over hyped for long covid, in my travels. Like it’s a damn cure.
Agree with that.
I thought it was worth mentioning it since your liver already metabolizes 1-MNA from Niacin, so it might be faster and cheaper to test this theory with niacin. It's like $10 and you are good for months. You will spend much more just to bypass the liver.

But still, does anyone here know more details on the bioavailability of both 1-MNA and Niacin.

The study used 58mg/day of 1-MNA via oral route. How much of that is absorbed into the blood?
Similarly, if you take 250-500mg/day of Niacin, how much 1-MNA your liver will produce?
Then we can compare apples-to-apples.
 

Learner1

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Agree with that.
I thought it was worth mentioning it since your liver already metabolizes 1-MNA from Niacin, so it might be faster and cheaper to test this theory with niacin. It's like $10 and you are good for months. You will spend much more just to bypass the liver.

But still, does anyone here know more details on the bioavailability of both 1-MNA and Niacin.

The study used 58mg/day of 1-MNA via oral route. How much of that is absorbed into the blood?
Similarly, if you take 250-500mg/day of Niacin, how much 1-MNA your liver will produce?
Then we can compare apples-to-apples.
Why not just use NAD+ or NMN???
 
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Why not just use NAD+ or NMN???
Not sure what you mean. The paper on this thread is on a study specific to 1-MNA.
And it mentions that niacin (nicotinic acid) is a precursor to this compound. Does our liver do the same with NMN or NAD+? I don't know, maybe someone more versed in biochemistry could help out.
 
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Not sure what you mean. The paper on this thread is on a study specific to 1-MNA.
And it mentions that niacin (nicotinic acid) is a precursor to this compound. Does our liver do the same with NMN or NAD+? I don't know, maybe someone more versed in biochemistry could help out.
what would also be my question is that the product of that metabolic cycle is the coenzyme NAD+ which you can already buy and why one should buy Niacin which has to be converted before.
69BDD344-0B70-489D-9600-45047CB36594.gif
 
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Learner1

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Exactly!
Not sure what you mean. The paper on this thread is on a study specific to 1-MNA.
And it mentions that niacin (nicotinic acid) is a precursor to this compound. Does our liver do the same with NMN or NAD+? I don't know, maybe someone more versed in biochemistry could help out.
NAD+ is what actually gets used to make energy, So it should be the most effective. NMN is one step away from that, so almost as good. I'm not sure where 1-MNA comes in at all. Niacin and niacinamide have to go through several conversions to get to NAD+, so not as direct and some people have unpleasant side effects from the niacin.