NAD+ precursors
NMN / NR · Longevity supplement
What it is
Nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR) — precursors that raise cellular NAD+, a coenzyme that declines with age. Heavily marketed off the back of Sinclair-lab mouse work; NR is sold as a supplement, NMN's US status has been contested since the FDA moved to classify it as a drug candidate.
What human evidence shows
They do raise blood NAD+ — that part is proven. What that DOES for a human is the unanswered part: trials show scattered small wins (some insulin sensitivity in specific groups, some vascular markers) and plenty of nulls. Nothing approaching the mouse rejuvenation story has appeared in people. Ten years of trials have not produced one endpoint worth the price of the powder.
Risks
Flushing (NR less than niacin), mild GI effects — genuinely low risk. The real costs are money and the one theoretical flag: NAD+ metabolism feeds cancer cells too, so "more is better" is not a settled assumption. Product quality varies wildly; NMN sold after the FDA notice is a regulatory grey zone.
Legal status
US: NR is a lawful dietary ingredient; NMN's supplement status is contested (FDA drug-preclusion notice). Both freely sold in practice.
Evidence base
established literature
Strong human evidence: either a phase 3 or 4 trial report alongside review-level evidence, or ten or more randomised controlled trial reports.
- phase 3/4
- 1
- randomised
- 45
- reviews
- 14
- human trials
- 59
Counts are of published papers, not distinct trials, and measure how much research exists — not whether this works or is safe for you.
Research (12)
- The Safety and Antiaging Effects of Nicotinamide Mononucleotide in Human Clinical Trials: an UpdateAdv Nutr · 2023
- Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic womenScience · 2021
- NAD+ Precursors Nicotinamide Mononucleotide (NMN) and Nicotinamide Riboside (NR): Potential Dietary Contribution to HealthCurr Nutr Rep · 2023
- Nicotinamide mononucleotide (NMN) as an anti-aging health product - Promises and safety concernsJ Adv Res · 2022
- Long-Term Administration of Nicotinamide Mononucleotide Mitigates Age-Associated Physiological Decline in MiceCell Metab · 2016
- Nicotinamide riboside and nicotinamide mononucleotide facilitate NAD(+) synthesis via enterohepatic circulationSci Adv · 2025
- NAD+ and sirtuins in aging and diseaseTrends Cell Biol · 2014
- Dietary Supplementation With NAD+-Boosting Compounds in Humans: Current Knowledge and Future DirectionsJ Gerontol A Biol Sci Med Sci · 2023
- Regulation of and challenges in targeting NAD(+) metabolismNat Rev Mol Cell Biol · 2024
- NAD(+) Intermediates: The Biology and Therapeutic Potential of NMN and NRCell Metab · 2018
- β-Nicotinamide mononucleotide activates NAD+/SIRT1 pathway and attenuates inflammatory and oxidative responses in the hippocampus regions of septic miceRedox Biol · 2023
- Therapeutic Potential of NAD-Boosting Molecules: The In Vivo EvidenceCell Metab · 2018
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