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NR (nicotinamide riboside)

NAD+ precursor with multiple RCTs confirming raised whole-blood NAD+, clinical outcome trials emerging but preliminary.

Why

Nicotinamide riboside (NR) is a vitamin B3 precursor that raises whole-blood and tissue NAD+ levels in humans more efficiently than nicotinic acid or nicotinamide at equimolar doses. Multiple RCTs (Trammell, Martens, Conze, Dollerup) confirm sustained NAD+ elevation at 300–1,000 mg/day. Clinical outcome trials are emerging, small RCTs report modest blood-pressure reduction in elevated-BP adults, lower aortic stiffness, and improved metabolic markers, but disease-endpoint outcome trials are not yet available.

How it works

Converted via the salvage pathway (NRK1/NRK2 kinases) to nicotinamide mononucleotide and then to NAD+. NAD+ is the central cofactor for sirtuins, PARPs, and mitochondrial electron transport. Bypasses the rate-limiting NAMPT step that constrains nicotinamide-to-NAD+ conversion.

Expected onset · NAD+ elevation within days; clinical endpoints assessed over months

How to take

Dosage

100–500 mg/day single dose. Some trials use up to 1,000 mg/day without obvious added benefit beyond plasma NAD+ saturation.

Timing

Once daily, with or without food

On the label

Niagen (ChromaDex) is the trademarked NR ingredient used in the published trials. Stated mg per serving.

Ideal for

Adults exploring NAD+ supplementation as a longevity-focused intervention; older adults with measured NAD+ decline; people with high metabolic demand.

Safety

Generally very well tolerated at trial doses. Mild GI upset, headache, occasional skin flushing (less than nicotinic acid). Long-term safety beyond 6–12 months is not yet established. Theoretical interaction with chemotherapy (NAD+ modulation in cancer cells). Coordinate with oncology if relevant. Pregnancy and breastfeeding: data not yet available; avoid.

Evidence

At a glance

Martens 2018 Nat Commun RCT (n=24 older adults): NR 1,000 mg/day for 6 weeks raised whole-blood NAD+ by ~60% and lowered systolic BP by ~10 mmHg in elevated-BP subgroup. Trammell 2016 confirmed oral bioavailability in humans. Clinical outcome trials remain small; long-term outcome evidence is the gap. NAD+ raising is established; clinical translation is provisional.

Where to get it

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