Beta-Lapachone, NQO1 and NAD+: What the Research Actually Shows

Important disclaimer

This article is for educational purposes only and is not medical advice. These statements have not been evaluated by the Food and Drug Administration. Pau d'Arco is not intended to diagnose, treat, cure, or prevent any disease. We summarize published research and traditional use — this is not a recommendation to use Pau d'Arco for any specific condition. Always consult a qualified healthcare professional before starting a new supplement, especially alongside an existing medical condition or medication.

NAD+ has become one of the most talked-about molecules in wellness, and Pau d'Arco keeps coming up in that conversation because of one of its compounds, beta-lapachone. There is real research behind the connection. There is also a wide gap between that research and a cup of tea, and this article is about both.

Evidence key:Traditional UseLab / In VitroAnimal StudyHuman Trial

Why NAD+ gets so much attention

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell. It takes part in energy metabolism, and it is a required partner for several families of enzymes, including the sirtuins and PARPs, that are involved in DNA repair and other cell maintenance. Reviews describe NAD+ levels falling with age in many species, including rodents and humans, which is why researchers are interested in ways to support it.

Human Trial

This is what human evidence for a NAD+ strategy looks like. In a randomized, placebo-controlled, crossover trial in healthy middle-aged and older adults, six weeks of nicotinamide riboside, a form of vitamin B3, was well tolerated and raised NAD+ levels. It is a different compound from anything in Pau d'Arco. No comparable trial exists for Pau d'Arco, beta-lapachone or Taheebo tea.

Source: Nature Communications (2018)

Where beta-lapachone comes in

Beta-lapachone is one of the two main naphthoquinones associated with Pau d'Arco (see Lapachol and Beta-Lapachone). It was originally isolated from the heartwood of the tree, and it can also be made from lapachol. It is a substrate for an enzyme called NQO1. When NQO1 acts on it, the enzyme uses up NADH and produces NAD+, so in lab models beta-lapachone can shift the balance between the two toward NAD+.

The same chemistry is why beta-lapachone is studied in cancer research: cells with a lot of NQO1 respond to it with a burst of oxidative stress (see Pau d'Arco and Cancer). What it does depends heavily on the dose, which is the theme of the rest of this article.

What the studies found

Animal Study

The authors used beta-lapachone to stimulate NADH oxidation in rodent models of metabolic syndrome, and reported that it ameliorated obesity and related features in mice.

Source: Hwang et al., Diabetes (2009)

Animal Study

Thirteen-month-old mice were put on one of three diets for about ten months: normal chow, calorie restriction at 70% of normal, or normal chow with 0.066% beta-lapachone, which worked out to roughly 70 to 80 mg per kilogram of body weight per day. The beta-lapachone mice kept more of their motor and cognitive function, showed less disorganization of the mitochondria in their muscles, had lower glucose, cholesterol and leptin, and had a 17% longer mean survival than the controls (9.1 versus 7.8 months in that group of mice). In a separate test, an injection of beta-lapachone raised the NAD+/NADH ratio in the muscles of aged mice.

Source: Lee et al., PLoS ONE (2012)

Lab / In Vitro

In cultured mouse and human fibroblasts, beta-lapachone reduced the damage caused by the chemotherapy drug cisplatin, working through the NQO1, NAD+ and SIRT1 pathway and by maintaining mitochondrial activity. It did not reduce cisplatin's effect on the breast cancer cell lines in the same experiments. This is cell-culture work, not a clinical trial.

Source: Lin et al., Phytomedicine (2022)

Taken together, this is real, published mechanism research. It shows that purified beta-lapachone can influence NAD+ metabolism in mice and in cells. It does not show that drinking Pau d'Arco tea does the same in a person.

What these studies did not test

The dose. The mice ate purified beta-lapachone at about 70 to 80 mg per kilogram per day. We could not find any published measurement of how much beta-lapachone ends up in a cup of brewed Pau d'Arco tea. Compiled data cited in our lapachol article put lapachol at roughly 2 to 7% of high-quality bark by weight, the amounts vary with sourcing (see our sourcing guide), and solubility research indicates that beta-lapachone does not dissolve well in water. So the amount in a cup is unknown, and it may be far below what was used in the mice.
People. We found no published trials of Pau d'Arco tea, or of beta-lapachone taken by mouth, on NAD+ levels or on aging in humans.
Tea versus compound. These are studies of a purified compound. The whole bark contains many other compounds, and nobody has tested how they change the picture.

Human Trial

In a phase 1 trial of ARQ 761, a beta-lapachone analogue given by infusion to 42 people with advanced cancer, the dose-limiting toxicity was anaemia. Transient grade 3 hypoxia, possibly reflecting methemoglobinaemia, occurred in 26% of patients. This was a different form of the compound, given intravenously at cancer-treatment doses to very ill patients, so it does not describe drinking tea. It does show why more of this compound is not automatically better. A 2021 review in Phytochemistry describes low toxicity in several cell types in lab work, so the overall picture is mixed.

Source: British Journal of Cancer (2018)

What about "NAD+ boosting" recipes and tricks?

You may see recipes that blend Pau d'Arco tea with a fat such as MCT oil, on the idea that it improves absorption. The idea is not unreasonable, because solubility research indicates beta-lapachone does not dissolve well in water, and fat-soluble compounds do dissolve in fats. But no study has tested whether it works for Taheebo tea, and blending oil into tea makes an emulsion, not the liposomes that some recipes describe. We treat it as an untested idea. If you like the creamy result, enjoy it for its taste.

What this means for a cup of Taheebo tea

Beta-lapachone and NAD+ is a serious area of research. But the work so far is in mice and cell cultures using purified doses, and nobody has shown that drinking Pau d'Arco tea changes NAD+ levels in a person. Taheebo tea is a traditional drink that many people enjoy. It is not a NAD+ supplement.

If you are interested in NAD+ strategies, the human evidence is for other compounds, and it is worth talking with a healthcare provider first, especially if you are pregnant, take blood thinners or other medications, or have a medical condition. See our safety guide for who should avoid Pau d'Arco.

Where This Leaves Us

The link between Pau d'Arco and NAD+ is a real hypothesis with real animal and cell-culture research behind it, and it is worth following as more work is done. It is not yet a reason to expect any effect from the tea. For a broader look at the evidence, start with What Scientific Research Says About Pau d'Arco, and for how the tea is prepared, see How to Brew Pau d'Arco Tea Correctly. We make Taheebo Wellness Tea for people who enjoy it as a traditional daily drink.