Anyone treated any chronic diseases with fasting or NAD+ precursors?

I have a close family member who was recently diagnosed with a severe, nasty kidney disease (advanced IgAN with crescentic glomerulonephritis). The Doc wants to put him on corticosteroids and immunosuppressants, but those seem problematic for a lot of reason (awful side effects, not very good likelihood of success, etc.). There's also a little confusion about whether or not the crescentic diagnosis is correct (he has < 50% crescents in his kidneys), and his creatinine levels were much lower than would be expected for a "severe" IgAN diagnosis (only around 1.9). So we have lots of reasons to think twice before immediately jumping into extreme treatments. I know cellular senescence and NAD+ play critical roles in inflammation and promoting cellular health. Fasting (for autophagy as an antidote to cellular senescence) and NAD+ precursors are all the rage in the longevity community (a la folks like David Sinclair), and I've seen some recent studies that explicitly suggest that at least NAD+ can play an important role in improving chronic kidney disease ([https://pubmed.ncbi.nlm.nih.gov/33440677/](https://pubmed.ncbi.nlm.nih.gov/33440677/)). I'm curious if anyone has had any success experimenting with either fasting or NAD+? Via NAD+ precursor supplementation (NMN, NR, NAM, etc.) or even via lifestyle changes designed to improve circulating NAD+ levels (heat/cold shock therapy, fasting/low glucose consumption, etc.). Anyone had any luck with this? Would love anyone's thoughts if they're familiar with this stuff. Thanks so much!

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I fast 20-22hrs every day, I have ulcerative colitis and the last time I had a colonoscopy my inflammation was pretty severe. I was put on immunosuppressants long term and steroids short term. That was a few years ago, started fasting about a year ago as well as weening myself off of the immunosuppressants and had a colonoscopy last month. Almost all of the inflammation has gone! I have no symptoms anymore, no pain or discomfort and only take mild medication when I experience flare ups (which is usually triggered if I drink alcohol). My specialist was pretty skeptical about it when I informed him initially about my fasting but after my colonoscopy he was blown away. Super cool

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I’m in stage 3 chronic kidney disease and have been for 13 years. I’m only 49 years old. I’m seeing a nephrologist for the first time this coming week. Historically doctors have always told me “oh, that just must be how your body is built.” I’m finally working with a doctor who has taken it seriously enough to refer me to a specialist.

I don’t have an answer to your question, but I can tell you that 2 years ago, for reasons unrelated to my kidneys, but for severe health reasons, I abruptly did a 40-day water fast. For the first time in my life it pulled all of my blood work into the normal range. Stayed that way for 6 months. I made no attempts to follow a liver or kidney friendly diet after the fast, and my creatinine and GFR levels fell back out of the normal ranges again.

So, yes, fasting can impact your blood work in positive ways. Whether you can see those results with more subtle fasting such as intermittent fasting, or whether you have to go to extreme measures like I did, I do not know. But I would speculate that if you fast to the point of getting a positive net gain, you most certainly would have to develop a strategic game plan with your diet and fasting regimen afterwards to maintain the gains you achieve.

Edit: that’s 13 years of being pretty healthy, by the way, and within a relatively healthy weight range or slightly overweight. Nothing super unhealthy and not morbidly obese. Really unclear to me why I am in chronic kidney failure.