WEIGHT LOSS NAD+
WEIGHT LOSS

NAD+

1000MG

Studied for aging and longevity, cellular energy and mitochondrial function, DNA repair, nerve and brain, blood sugar and metabolic health, and inflammation. Every paper behind those is linked below, positive and negative.

Market price $115.00

$89.00

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Pack tier: NAD+ (KAIRO-NAD-PLUS-1000MG) 1 - 2 $89.00
Pack of 3+: 10% off 3 - 4 $80.10
Pack of 5+: 15% off 5 - 9 $75.65
Pack of 10+: 20% off 10 + $71.20

For laboratory research use only. Not for human or veterinary use, not for diagnostic or therapeutic use, and not for food or drug manufacture. No preparation or usage guidance is provided anywhere on this page.

Getting in is the hard part.

Almost everything known about raising NAD+ in people comes from studies of the building blocks that make it, because NAD+ itself is taken apart at the cell surface before it can get in.

  1. Cellular energy and mitochondrial function

    Preclinical strong Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown.

    NAD+ is described in a 2021 review of the field as the coenzyme that carries electrons through the reactions cells use to make energy. In a 12-week human trial with muscle biopsies, an oral building block changed nothing about muscle mitochondria in 40 men.

  2. Aging and longevity

    Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    NAD+ is reported to fall in aging tissue, partly because enzymes like CD38 destroy it faster as animals get older. In mice, a building block given for 12 months kept the animals leaner and more active, and a different building block extended lifespan in aged mice. Both are mouse results, not human ones.

  3. DNA repair

    Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    NAD+ is described in the same review as an essential cofactor for the PARP enzymes, which spend it as they repair DNA. In worms and mice carrying an inherited DNA-repair defect, replenishing NAD+ inside cells reduced the neurological damage and extended their lifespan.

  4. Nerve and brain

    Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    NAD+ was measured rising inside the living human brain in a 30-day phase I trial of an oral building block. That is the brain being reached, not anything being improved. In a stressed nerve fiber, NAD+ is reported to be destroyed by a protein called SARM1, and all of that work is preclinical.

  5. Blood sugar and metabolic health

    Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    In a 10-week randomized trial, an oral building block raised insulin-stimulated glucose disposal in postmenopausal women whose blood sugar handling was already impaired. That trial drew a published Comment disputing how to read it, so it stays contested rather than settled. In mice, the same building block restored glucose tolerance.

  6. Inflammation

    Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    NAD+ is reported to drain out of tissue where inflammation is active. In mice, inflammatory cells carrying CD38 gather in belly fat and liver with age and consume it. In 12 aged men, a building block taken for 21 days was followed by a fall in circulating inflammatory markers. That is a blood measurement, not a clinical result.

Every line above describes what was measured in a laboratory. None of it establishes what the compound would do in a person.

Frequently paired with

What shoppers usually add alongside this one

What the research says about pairing these

5-amino-1MQ (an NNMT inhibitor)

Co-marketed Not co-studied

5-amino-1MQ is routinely sold and discussed alongside NAD+ in longevity and metabolic research contexts. The rationale offered in that discourse is that blocking NNMT, the enzyme that methylates nicotinamide on its way to being excreted, should leave more nicotinamide available for NAD+ synthesis. That is a claim assembled by stitching 2 separate literatures together, not a finding about the pair.

No published study gives 5-amino-1MQ together with NAD+, in any model. The verification pass behind this page located the primary 5-amino-1MQ pharmacology paper, re-resolved it cleanly, and then removed it from this page precisely because it supports nothing about the combination. The pairing is co-marketed, not jointly validated.

MOTS-c (a mitochondrial-derived peptide)

Co-marketed Not co-studied

MOTS-c is sold and discussed alongside NAD+ on the strength of a shared mitochondrial and metabolic framing. That framing is drawn from 2 separate bodies of work, one about each compound.

No study gives MOTS-c and NAD+ together, and none located shows MOTS-c raising NAD+. As with the row above, the primary MOTS-c citation re-resolved cleanly and was still removed, because a sound paper about one compound is not evidence about a pair.

27 areas of published research
30 peer-reviewed papers, every one linked
The research
  1. Studied for

    NAD+ decline with age, and what the field agrees on

    A wide-ranging review of the field describes NAD+ as a coenzyme for redox reactions and an essential cofactor for the sirtuin, CD38 and PARP enzyme families, and reports that tissue and cellular NAD+ levels decline gradually with age in multiple model organisms, including rodents and humans. The same review states plainly that much remains to be learned about how NAD+ influences human health and aging, including whether restoring it is safe and whether restoring it would have beneficial effects in aging people. It is a survey of other people's work, not an experiment. a review article covering laboratory, animal and some human data; not itself a study Preclinical strong Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown. Open for the full finding and the paper it came from.
    In the literature

    NAD+ decline with age, and what the field agrees on

    A wide-ranging review of the field describes NAD+ as a coenzyme for redox reactions and an essential cofactor for the sirtuin, CD38 and PARP enzyme families, and reports that tissue and cellular NAD+ levels decline gradually with age in multiple model organisms, including rodents and humans. The same review states plainly that much remains to be learned about how NAD+ influences human health and aging, including whether restoring it is safe and whether restoring it would have beneficial effects in aging people. It is a survey of other people's work, not an experiment.References 1

    Modela review article covering laboratory, animal and some human data; not itself a study

    Confidence: strong

    Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown.

    Source

    Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22(2):119-141. DOI: 10.1038/s41580-020-00313-x (PMID: 33353981)

    How this citation was checked

    Crossref on the DOI returned the exact title, the 4 authors in the written order Covarrubias Anthony J., Perrone Rosalba, Grozio Alessia, Verdin Eric, Nature Reviews Molecular Cell Biology, volume 22, issue 2, pages 119-141, issued online 2020-12-22 for a February 2021 print issue, which is why 2021 is used. PubMed esearch by DOI returned PMID 33353981 and efetch returned the same title, authors, journal, volume, issue and pages. The abstract was read in full and contains verbatim the redox-coenzyme and cofactor roles, the sirtuins/CD38/PARP list, the 'gradual decline in tissue and cellular NAD+ levels in multiple model organisms, including rodents and humans', and the closing caveats about what is still unknown in humans.

  2. Studied for

    Raising whole-blood NAD+ in humans

    In 140 healthy but overweight adults aged 40 to 60, 8 weeks of oral nicotinamide riboside raised whole-blood NAD+ in proportion to how much was taken. At 2 weeks the 3 ascending arms were up 22 plus or minus 9 percent, 51 plus or minus 7 percent and 142 plus or minus 14 percent against their own baselines. At 8 weeks the 2 higher arms held at about 48 and 139 percent, while the lowest arm had slipped back to about 10 percent and was similar to placebo. There were no reports of flushing and no significant difference in adverse events between the precursor and placebo groups or between arms. This is the study that establishes the blood biomarker genuinely moves in people by the precursor route, and it says nothing about what that movement does. Disclosure: the trial was funded by the company that makes the branded ingredient tested; 2 authors are its employees and a third is the inventor of intellectual property licensed to it and serves as its chief scientific adviser. human randomized, double-blind, placebo-controlled parallel trial; precursor route, not NAD+ itself Preclinical strong Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown. Open for the full finding and the paper it came from.
    In the literature

    Raising whole-blood NAD+ in humans

    In 140 healthy but overweight adults aged 40 to 60, 8 weeks of oral nicotinamide riboside raised whole-blood NAD+ in proportion to how much was taken. At 2 weeks the 3 ascending arms were up 22 plus or minus 9 percent, 51 plus or minus 7 percent and 142 plus or minus 14 percent against their own baselines. At 8 weeks the 2 higher arms held at about 48 and 139 percent, while the lowest arm had slipped back to about 10 percent and was similar to placebo. There were no reports of flushing and no significant difference in adverse events between the precursor and placebo groups or between arms. This is the study that establishes the blood biomarker genuinely moves in people by the precursor route, and it says nothing about what that movement does. Disclosure: the trial was funded by the company that makes the branded ingredient tested; 2 authors are its employees and a third is the inventor of intellectual property licensed to it and serves as its chief scientific adviser.References 2

    Modelhuman randomized, double-blind, placebo-controlled parallel trial; precursor route, not NAD+ itself

    Confidence: strong

    Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown.

    Source

    Conze D, Brenner C, Kruger CL. Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults. Sci Rep. 2019;9(1):9772. DOI: 10.1038/s41598-019-46120-z (PMCID: PMC6611812)

    How this citation was checked

    Crossref on the DOI returned the exact title and the complete 3-author list Conze Dietrich, Brenner Charles, Kruger Claire L. exactly as written, Scientific Reports, volume 9, issue 1, article 9772, 2019. The PMC6611812 full text was fetched separately and supplies verbatim the enrollment of 140 subjects with an age range of 40-60 years, the day-14 values 'increased by 22 +/- 9%, 51 +/- 7% and 142 +/- 14%', the day-56 values 'sustained at increases of 10% +/- 4%, 48 +/- 8% and 139 +/- 19%', the statement that blood NAD+ in the lowest arm was 'similar to the placebo group at all time points', the flushing and adverse-event sentence, and the competing-interests statement naming ChromaDex as employer, licensee and funder.

  3. Studied for

    Skeletal muscle mass and function in older adults (negative result)

    Researchers gathered 10 randomized controlled trials in adults whose mean ages ranged from 60.9 to 83 years, 6 testing NMN and 4 testing nicotinamide riboside. The statistical pooling was performed for the NMN trials against placebo only, and it found no significant effect on skeletal muscle index, grip strength, gait speed, or the 5-time chair-stand test. Those null results held in sensitivity analyses that excluded trials at high risk of bias and trials in people whose blood sugar handling was already impaired. The 4 nicotinamide riboside trials were not pooled for any outcome and were described narratively instead: 1 signal was positive, a longer 6-minute walking distance in a trial run in adults with impaired blood flow to the legs, while in a trial run in adults with early cognitive impairment the placebo group did better on the short physical performance battery and the chair-stand test. The authors' overall conclusion is that current evidence does not support either compound for preserving muscle mass and function in adults with a mean age over 60. It is on this page deliberately, as the counterweight to the rodent muscle literature below. systematic review and meta-analysis of human randomized controlled trials; precursor route Preclinical strong Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown. Open for the full finding and the paper it came from.
    In the literature

    Skeletal muscle mass and function in older adults (negative result)

    Researchers gathered 10 randomized controlled trials in adults whose mean ages ranged from 60.9 to 83 years, 6 testing NMN and 4 testing nicotinamide riboside. The statistical pooling was performed for the NMN trials against placebo only, and it found no significant effect on skeletal muscle index, grip strength, gait speed, or the 5-time chair-stand test. Those null results held in sensitivity analyses that excluded trials at high risk of bias and trials in people whose blood sugar handling was already impaired. The 4 nicotinamide riboside trials were not pooled for any outcome and were described narratively instead: 1 signal was positive, a longer 6-minute walking distance in a trial run in adults with impaired blood flow to the legs, while in a trial run in adults with early cognitive impairment the placebo group did better on the short physical performance battery and the chair-stand test. The authors' overall conclusion is that current evidence does not support either compound for preserving muscle mass and function in adults with a mean age over 60. It is on this page deliberately, as the counterweight to the rodent muscle literature below.References 3

    Modelsystematic review and meta-analysis of human randomized controlled trials; precursor route

    Confidence: strong

    Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown.

    Source

    Prokopidis K, Moriarty F, Bahat G, McLean J, Church DD, Patel HP. The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis. J Cachexia Sarcopenia Muscle. 2025;16(3):e13799. DOI: 10.1002/jcsm.13799 (PMCID: PMC12022230)

    How this citation was checked

    Crossref on the DOI returned the exact title and the complete 6-author list Prokopidis Konstantinos, Moriarty Frank, Bahat Gulistan, McLean Joseph, Church David D., Patel Harnish P. exactly as written, Journal of Cachexia, Sarcopenia and Muscle, volume 16, issue 3, article e13799, 2025. The PMC12022230 full text was fetched and the results section read, because a bibliographic-only check would not have supported the content claims here. It states verbatim 'In total, 10 studies were included in the systematic review and meta-analysis, from which, six used nicotinamide mononucleotide and four used nicotinamide riboside' and 'The mean age range of the included participants was 60.9-83 years'. The pooled analyses are NMN versus placebo only, k = 3 for skeletal muscle index, k = 5 for handgrip strength, k = 4 for gait speed and k = 2 for the 5-time chair stand test, none significant; nicotinamide riboside appears only in narrative synthesis. The discussion states the nulls held in sensitivity analyses excluding high-risk-of-bias studies and studies in adults with impaired blood sugar handling. Both directions of the narrative synthesis are reported above.

  4. Studied for

    Skeletal muscle mitochondria in humans (negative result)

    40 middle-aged, obese, insulin-resistant men took nicotinamide riboside or placebo for 12 weeks, with muscle biopsies before and after. NAD+ levels in muscle did not change. Neither did the mitochondria's respiratory capacity, their abundance, or their shape and network structure. One protein of the NAD+ manufacturing pathway, NAMPT, actually fell by about 14 percent. The authors state that their data do not support the hypothesis carried over from rodent work. human randomized, placebo-controlled trial with muscle biopsies; precursor route Preclinical strong Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown. Open for the full finding and the paper it came from.
    In the literature

    Skeletal muscle mitochondria in humans (negative result)

    40 middle-aged, obese, insulin-resistant men took nicotinamide riboside or placebo for 12 weeks, with muscle biopsies before and after. NAD+ levels in muscle did not change. Neither did the mitochondria's respiratory capacity, their abundance, or their shape and network structure. One protein of the NAD+ manufacturing pathway, NAMPT, actually fell by about 14 percent. The authors state that their data do not support the hypothesis carried over from rodent work.References 4

    Modelhuman randomized, placebo-controlled trial with muscle biopsies; precursor route

    Confidence: strong

    Convergent results from more than one independent laboratory across more than one experimental system. On this page the strong rows include human randomized trials, and 2 of the 4 report a null result: 'strong' describes how consistent the evidence is, never how good the news is, and never that a benefit in a person has been shown.

    Source

    Dollerup OL, Chubanava S, Agerholm M, et al. Nicotinamide riboside does not alter mitochondrial respiration, content or morphology in skeletal muscle from obese and insulin-resistant men. J Physiol. 2020;598(4):731-754. DOI: 10.1113/JP278752 (PMID: 31710095)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Dollerup Ole L., Chubanava Sabina, Agerholm Marianne in the written order, The Journal of Physiology, volume 598, issue 4, pages 731-754, print February 2020. PubMed efetch on PMID 31710095 returned the same title, journal, volume, issue and pages, and its abstract supports each clause: 40 participants, 12 weeks, muscle biopsies before and after, NAMPT protein decreased by 14 percent, steady-state NAD+ levels unchanged, respiratory capacity and mitochondrial protein abundance unaffected, no changes in mitochondrial fractional area or network morphology, and the authors' closing statement that their data do not support the hypothesis. An earlier draft attached PMID 32463114 to this citation; that identifier returns a different paper entirely, a 2-page commentary by Moore MP in J Physiol 2020;598(16):3327-3328, and it is not used here.

  5. Studied for

    What consumes NAD+ with age: CD38

    In mice, an enzyme called CD38 that breaks NAD+ apart becomes more abundant and more active as the animals age. Removing CD38 prevented the age-related fall in NAD+ and the mitochondrial dysfunction that came with it, through a route involving the protein SIRT3. The same enzyme turned out to be the main one destroying the NAD+ building block NMN inside a living animal. In plain terms, part of the age-related loss looks like faster destruction rather than only slower manufacture. mouse studies, including enzyme activity measured in living animals Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    What consumes NAD+ with age: CD38

    In mice, an enzyme called CD38 that breaks NAD+ apart becomes more abundant and more active as the animals age. Removing CD38 prevented the age-related fall in NAD+ and the mitochondrial dysfunction that came with it, through a route involving the protein SIRT3. The same enzyme turned out to be the main one destroying the NAD+ building block NMN inside a living animal. In plain terms, part of the age-related loss looks like faster destruction rather than only slower manufacture.References 5

    Modelmouse studies, including enzyme activity measured in living animals

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Camacho-Pereira J, Tarrago MG, Chini CCS, et al. CD38 Dictates Age-Related NAD Decline and Mitochondrial Dysfunction through an SIRT3-Dependent Mechanism. Cell Metab. 2016;23(6):1127-1139. DOI: 10.1016/j.cmet.2016.05.006 (PMID: 27304511)

    How this citation was checked

    Crossref on the DOI returned the exact title with first authors Camacho-Pereira Juliana, Tarrago Mariana G., Chini Claudia C.S. in the written order, Cell Metabolism, volume 23, issue 6, pages 1127-1139, 2016. PubMed efetch on PMID 27304511 returned the identical title, journal, year, volume, issue and pages. The abstract was read in full and supports every clause verbatim, including that CD38 expression and activity increase with aging, that CD38 is required for the age-related NAD decline and mitochondrial dysfunction via a pathway mediated at least in part by regulation of SIRT3 activity, and that CD38 is the main enzyme degrading NMN in vivo.

  6. Studied for

    Senescent cells and CD38-positive macrophages

    In mice, inflammatory macrophages carrying high levels of CD38 accumulate in visceral belly fat and liver during aging and during acute inflammation, and their CD38-driven enzyme activity lowers NAD+ in the surrounding tissue. Senescent cells, meaning old cells that stop dividing but keep signaling, build up in the same tissues, and the inflammatory signals they secrete drive macrophages to multiply and switch CD38 on. This is a second and independent line of work arriving at the same enzyme. mouse studies plus work on isolated macrophages Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Senescent cells and CD38-positive macrophages

    In mice, inflammatory macrophages carrying high levels of CD38 accumulate in visceral belly fat and liver during aging and during acute inflammation, and their CD38-driven enzyme activity lowers NAD+ in the surrounding tissue. Senescent cells, meaning old cells that stop dividing but keep signaling, build up in the same tissues, and the inflammatory signals they secrete drive macrophages to multiply and switch CD38 on. This is a second and independent line of work arriving at the same enzyme.References 6

    Modelmouse studies plus work on isolated macrophages

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Covarrubias AJ, Kale A, Perrone R, et al. Senescent cells promote tissue NAD+ decline during ageing via the activation of CD38+ macrophages. Nat Metab. 2020;2(11):1265-1283. DOI: 10.1038/s42255-020-00305-3 (PMID: 33199924)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Covarrubias Anthony J., Kale Abhijit, Perrone Rosalba in the written order, Nature Metabolism, volume 2, issue 11, pages 1265-1283, 2020. PubMed efetch on PMID 33199924 returned the same title, journal, volume, issue and pages. The abstract was read in full and supports each clause, including the M1-like macrophage accumulation in visceral white adipose tissue and liver, their high CD38 expression and enhanced CD38-dependent NADase activity reducing tissue NAD, and the senescence-associated secretory phenotype inducing macrophages to proliferate and express CD38.

  7. Studied for

    Blocking the NAD+-consuming enzyme (CD38 inhibitor)

    A purpose-built laboratory molecule called 78c that blocks CD38 specifically was given to mice. The authors reported that it reversed the age-related fall in tissue NAD+ and improved glucose tolerance, muscle function, exercise capacity and heart function in models of both normal and accelerated aging. Those effects depended on tissue NAD+ levels and were reversed when NAD+ synthesis was blocked, which ties the result back to NAD+ itself. 78c is a research compound, not a consumer ingredient, and none of this was tested in people. mouse studies (natural and accelerated aging models) Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Blocking the NAD+-consuming enzyme (CD38 inhibitor)

    A purpose-built laboratory molecule called 78c that blocks CD38 specifically was given to mice. The authors reported that it reversed the age-related fall in tissue NAD+ and improved glucose tolerance, muscle function, exercise capacity and heart function in models of both normal and accelerated aging. Those effects depended on tissue NAD+ levels and were reversed when NAD+ synthesis was blocked, which ties the result back to NAD+ itself. 78c is a research compound, not a consumer ingredient, and none of this was tested in people.References 7

    Modelmouse studies (natural and accelerated aging models)

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Tarrago MG, Chini CCS, Kanamori KS, et al. A Potent and Specific CD38 Inhibitor Ameliorates Age-Related Metabolic Dysfunction by Reversing Tissue NAD+ Decline. Cell Metab. 2018;27(5):1081-1095.e10. DOI: 10.1016/j.cmet.2018.03.016 (PMID: 29719225)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Tarrago Mariana G., Chini Claudia C.S., Kanamori Karina S. in the written order, Cell Metabolism, volume 27, issue 5, pages 1081-1095.e10, 2018. PubMed efetch on PMID 29719225 returned the same title, journal, volume, issue and pages. The abstract was read in full and supports the finding verbatim, including the identification of 78c as a highly potent and specific CD38 inhibitor, the reversal of age-related NAD+ decline, the named physiological improvements, and the statement that the physiological effects depend on tissue NAD+ levels and were reversed by inhibition of NAD+ synthesis.

  8. Studied for

    Extracellular NAD+ handling (why route matters)

    Human aortic valve and vessel tissue was studied outside the body. NAD+ placed outside cells was broken down right at the cell surface by enzymes including CD73 and NAD+-glycohydrolase CD38, with alkaline phosphatase and eNPP1 also contributing. In calcified valve tissue, CD73 activity had fallen and CD38 became the dominant breakdown route, and tissue from those donors broke NAD+ down significantly faster than control tissue. Work using specific inhibitors and CD73-knockout mice confirmed that CD38 makes a significant contribution. This is the practical reason the distinction between NAD+ itself and its building blocks matters when reading everything else on this page: of the 12 human trials cited here in which people received something, only 2 gave NAD+ itself, and every other one used a precursor. human aortic valve and vessel tissue studied outside the body, plus knockout mice Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Extracellular NAD+ handling (why route matters)

    Human aortic valve and vessel tissue was studied outside the body. NAD+ placed outside cells was broken down right at the cell surface by enzymes including CD73 and NAD+-glycohydrolase CD38, with alkaline phosphatase and eNPP1 also contributing. In calcified valve tissue, CD73 activity had fallen and CD38 became the dominant breakdown route, and tissue from those donors broke NAD+ down significantly faster than control tissue. Work using specific inhibitors and CD73-knockout mice confirmed that CD38 makes a significant contribution. This is the practical reason the distinction between NAD+ itself and its building blocks matters when reading everything else on this page: of the 12 human trials cited here in which people received something, only 2 gave NAD+ itself, and every other one used a precursor.References 8

    Modelhuman aortic valve and vessel tissue studied outside the body, plus knockout mice

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Jablonska P, Kutryb-Zajac B, Mierzejewska P, et al. The new insight into extracellular NAD+ degradation - the contribution of CD38 and CD73 in calcific aortic valve disease. J Cell Mol Med. 2021;25(13):5884-5898. DOI: 10.1111/jcmm.15912 (PMID: 34142751, PMCID: PMC8256368)

    How this citation was checked

    Crossref on the DOI returned the exact title and the author order Jablonska Patrycja, Kutryb-Zajac Barbara, Mierzejewska Paulina, Journal of Cellular and Molecular Medicine, volume 25, issue 13, pages 5884-5898, 2021. PubMed esearch by DOI returned PMID 34142751 and efetch returned the same title, author order, journal, volume, issue and pages, confirming that an earlier draft's citation of 25(12):5723-5733 with the order Jablonska/Mierzejewska/Kutryb-Zajac was wrong on both counts. The abstract was read in full and supports each clause, including human non-stenotic valves converting NAD+ via both CD73 and CD38, stenotic valves degrading NAD+ predominantly by CD38 with alkaline phosphatase and eNPP1 additionally, the significantly higher hydrolytic rates in the affected donors than in controls, and the inhibitor and CD73-knockout mouse work confirming CD38's contribution. An earlier draft's clause that cells take up the breakdown products rather than intact NAD+ is not stated in this source and was deleted. The closing sentence of the finding is an arithmetic observation about this page's own citation list, not a claim attributed to the paper.

  9. Studied for

    NAD+ metabolome and inflammatory markers in aged human muscle

    12 aged men took oral nicotinamide riboside for 21 days in a placebo-controlled, randomized, double-blind crossover trial. Careful measurement showed the precursor did reach muscle and raised the muscle NAD+ metabolome, visible as increased nicotinic acid adenine dinucleotide and nicotinamide clearance products. Gene-expression analysis of the muscle showed energy-metabolism and mitochondria pathways turned down, with no change in how the mitochondria actually performed, and levels of circulating inflammatory signaling molecules fell. The authors' own conclusion is about availability to aged muscle and a signature in those circulating markers, which is a biomarker and not a clinical result. This is not a performance result. Disclosure: one author is the inventor of patents licensed by the ingredient company, owns stock in it, and serves as an adviser to it. human randomized, double-blind, placebo-controlled crossover trial, 12 aged men; precursor route Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    NAD+ metabolome and inflammatory markers in aged human muscle

    12 aged men took oral nicotinamide riboside for 21 days in a placebo-controlled, randomized, double-blind crossover trial. Careful measurement showed the precursor did reach muscle and raised the muscle NAD+ metabolome, visible as increased nicotinic acid adenine dinucleotide and nicotinamide clearance products. Gene-expression analysis of the muscle showed energy-metabolism and mitochondria pathways turned down, with no change in how the mitochondria actually performed, and levels of circulating inflammatory signaling molecules fell. The authors' own conclusion is about availability to aged muscle and a signature in those circulating markers, which is a biomarker and not a clinical result. This is not a performance result. Disclosure: one author is the inventor of patents licensed by the ingredient company, owns stock in it, and serves as an adviser to it.References 9

    Modelhuman randomized, double-blind, placebo-controlled crossover trial, 12 aged men; precursor route

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Elhassan YS, Kluckova K, Fletcher RS, et al. Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD+ Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Rep. 2019;28(7):1717-1728.e6. DOI: 10.1016/j.celrep.2019.07.043 (PMID: 31412242, PMCID: PMC6702140)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Elhassan Yasir S., Kluckova Katarina, Fletcher Rachel S. in the written order, Cell Reports, volume 28, issue 7, pages 1717-1728.e6, 2019. PubMed efetch on PMID 31412242 returned the same record and its abstract supplies verbatim the 12 aged men, the 21 days, the placebo-controlled randomized double-blind crossover design, the elevated muscle NAD+ metabolome evident by increased nicotinic acid adenine dinucleotide and nicotinamide clearance products, the downregulation of energy metabolism and mitochondria pathways without altering mitochondrial bioenergetics, and the depressed circulating inflammatory cytokines. The PMC6702140 full text was fetched separately for the conflict statement, which names ChromaDex as licensee, the author as a stockholder, and the advisory role.

  10. Studied for

    Cardiovascular measures in humans

    30 healthy adults aged 55 to 79 were randomized into a 6-week crossover trial of nicotinamide riboside against placebo, and 24 completed it. The precursor was well tolerated, with no serious adverse events; the reported side effects were mild and occurred in both the precursor and the placebo phases. It raised NAD+ in circulating immune cells by roughly 60 percent compared with placebo. Signals on systolic blood pressure and aortic stiffness were exploratory only, and the authors themselves presented them as the most promising hypotheses for future larger trials rather than as results. The tolerability and the NAD+ rise are what this trial actually establishes. The authors declared no competing interests. human randomized, double-blind, placebo-controlled crossover trial; precursor route Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Cardiovascular measures in humans

    30 healthy adults aged 55 to 79 were randomized into a 6-week crossover trial of nicotinamide riboside against placebo, and 24 completed it. The precursor was well tolerated, with no serious adverse events; the reported side effects were mild and occurred in both the precursor and the placebo phases. It raised NAD+ in circulating immune cells by roughly 60 percent compared with placebo. Signals on systolic blood pressure and aortic stiffness were exploratory only, and the authors themselves presented them as the most promising hypotheses for future larger trials rather than as results. The tolerability and the NAD+ rise are what this trial actually establishes. The authors declared no competing interests.References 10

    Modelhuman randomized, double-blind, placebo-controlled crossover trial; precursor route

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9(1):1286. DOI: 10.1038/s41467-018-03421-7 (PMID: 29599478, PMCID: PMC5876407)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Martens Christopher R., Denman Blair A., Mazzo Melissa R. in the written order, Nature Communications, volume 9, issue 1, article 1286, 2018. PubMed esearch by DOI returned PMID 29599478 with the same record. The PMC5876407 full text was fetched separately and supplies verbatim 'a total of 30 subjects remaining for randomization', 'a total of 24 subjects who completed the trial', the age range 55 to 79 years, 'Oral NR supplementation effectively elevated levels of NAD+ in PBMCs by ~60% compared with placebo', 'no serious adverse events occurred' with all self-reported adverse events mild and occurring in both conditions, the authors' own framing of blood pressure and arterial stiffness as hypotheses for future larger-scale trials, and 'Competing interests: The authors declare no competing interests.' The 60 percent figure is specifically in peripheral blood mononuclear cells and is stated that way here rather than as a whole-body figure.

  11. Studied for

    Insulin sensitivity and metabolic research in humans (contested)

    In a 10-week randomized, placebo-controlled, double-blind trial, postmenopausal women who were overweight or obese and whose blood sugar handling was already impaired took the building block NMN. Insulin-stimulated glucose disposal, measured with the clamp technique that is the reference standard for this question, increased, as did insulin signaling in muscle, while nothing changed on placebo. The result drew a published Comment in the same journal disputing the interpretation, and the authors replied, so it belongs on any honest page as contested rather than settled. human randomized, double-blind, placebo-controlled trial; precursor route Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Insulin sensitivity and metabolic research in humans (contested)

    In a 10-week randomized, placebo-controlled, double-blind trial, postmenopausal women who were overweight or obese and whose blood sugar handling was already impaired took the building block NMN. Insulin-stimulated glucose disposal, measured with the clamp technique that is the reference standard for this question, increased, as did insulin signaling in muscle, while nothing changed on placebo. The result drew a published Comment in the same journal disputing the interpretation, and the authors replied, so it belongs on any honest page as contested rather than settled.References 11, 12

    Modelhuman randomized, double-blind, placebo-controlled trial; precursor route

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021;372(6547):1224-1229. DOI: 10.1126/science.abe9985 (PMID: 33888596). Contested by: Brenner C. Comment on 'Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women'. Science. 2021;373(6554):eabj1696. DOI: 10.1126/science.abj1696

    How this citation was checked

    Crossref on 10.1126/science.abe9985 returned the exact title, first 3 authors Yoshino Mihoko, Yoshino Jun, Kayser Brandon D. in the written order, Science, volume 372, issue 6547, pages 1224-1229, 2021; PubMed esearch by DOI returned PMID 33888596 and the abstract was read in full, confirming the 10-week randomized placebo-controlled double-blind design in the described population and the increase in insulin-stimulated glucose disposal assessed by hyperinsulinemic-euglycemic clamp along with muscle insulin signaling. Crossref on 10.1126/science.abj1696 separately returned the Comment with the exact title, sole author Brenner Charles, Science, volume 373, issue 6554, article eabj1696, 2021, confirming the dispute exists as described. Two claims carried by an earlier draft, that muscle NAD+ content did not detectably change and that the trial reported no weight loss, could not be verified and were deleted rather than carried forward.

  12. Studied for

    Neurological research (a phase I brain trial)

    30 adults with a newly diagnosed neurological condition, none of them yet on medication for it, received nicotinamide riboside or placebo for 30 days in a double-blinded phase I trial. It was well tolerated and raised NAD+ in the brain, measured non-invasively by phosphorus magnetic resonance spectroscopy, though the size of the increase varied considerably between individuals. The people whose brain NAD+ rose showed altered brain metabolism on PET scanning, and that was associated with mild clinical improvement. A phase I trial is designed to test safety and whether a compound reaches its target, not whether it works, and the authors call for larger trials. What this row establishes is that a precursor can raise NAD+ inside a living human brain. human phase I randomized double-blinded trial; precursor route Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Neurological research (a phase I brain trial)

    30 adults with a newly diagnosed neurological condition, none of them yet on medication for it, received nicotinamide riboside or placebo for 30 days in a double-blinded phase I trial. It was well tolerated and raised NAD+ in the brain, measured non-invasively by phosphorus magnetic resonance spectroscopy, though the size of the increase varied considerably between individuals. The people whose brain NAD+ rose showed altered brain metabolism on PET scanning, and that was associated with mild clinical improvement. A phase I trial is designed to test safety and whether a compound reaches its target, not whether it works, and the authors call for larger trials. What this row establishes is that a precursor can raise NAD+ inside a living human brain.References 13

    Modelhuman phase I randomized double-blinded trial; precursor route

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Brakedal B, Dolle C, Riemer F, et al. The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease. Cell Metab. 2022;34(3):396-407.e6. DOI: 10.1016/j.cmet.2022.02.001 (PMID: 35235774)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Brakedal Brage, Dolle Christian, Riemer Frank in the written order, Cell Metabolism, volume 34, issue 3, pages 396-407.e6, 2022. PubMed efetch on PMID 35235774 returned the same title, journal, volume, issue and pages, and its abstract supports each clause: 30 newly diagnosed participants not yet on medication, 30 days, well tolerated, a significant but variable increase in cerebral NAD levels measured by 31-phosphorus magnetic resonance spectroscopy, altered cerebral metabolism on 18-fluoro-deoxyglucose PET in recipients showing increased brain NAD, and the association with mild clinical improvement. The page range is given as 396-407.e6 to match both sources. The condition studied is named in the citation and is deliberately not named in the finding.

  13. Studied for

    A precursor plus pterostilbene: the blood biomarker

    A branded combination of nicotinamide riboside and pterostilbene was tested against placebo in 120 healthy adults aged 60 to 80 for 8 weeks, in 3 arms: placebo, a lower amount and double that amount. Whole-blood NAD+ rose in proportion to the amount taken, by approximately 40 percent in the lower-amount arm and approximately 90 percent in the higher-amount arm at 4 weeks compared with both placebo and baseline, and the rise held across the full 8 weeks. NAD+ did not rise in the placebo group. No serious adverse events were reported. Disclosure: the product is sold by the company that funded the trial, and 6 of the 7 authors are its employees who all own shares in it, although the trial data were collected independently by a contract research organization. human randomized, double-blind, placebo-controlled trial; precursor combination, not NAD+ itself Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    A precursor plus pterostilbene: the blood biomarker

    A branded combination of nicotinamide riboside and pterostilbene was tested against placebo in 120 healthy adults aged 60 to 80 for 8 weeks, in 3 arms: placebo, a lower amount and double that amount. Whole-blood NAD+ rose in proportion to the amount taken, by approximately 40 percent in the lower-amount arm and approximately 90 percent in the higher-amount arm at 4 weeks compared with both placebo and baseline, and the rise held across the full 8 weeks. NAD+ did not rise in the placebo group. No serious adverse events were reported. Disclosure: the product is sold by the company that funded the trial, and 6 of the 7 authors are its employees who all own shares in it, although the trial data were collected independently by a contract research organization.References 14

    Modelhuman randomized, double-blind, placebo-controlled trial; precursor combination, not NAD+ itself

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Dellinger RW, Santos SR, Morris M, Evans M, Alminana D, Guarente L, Marcotulli E. Repeat dose NRPT (nicotinamide riboside and pterostilbene) increases NAD+ levels in humans safely and sustainably: a randomized, double-blind, placebo-controlled study. npj Aging Mech Dis. 2017;3:17. DOI: 10.1038/s41514-017-0016-9 (PMID: 29184669, PMCID: PMC5701244)

    How this citation was checked

    Crossref on the DOI returned the exact title and the complete 7-author list Dellinger Ryan W., Santos Santiago Roel, Morris Mark, Evans Mal, Alminana Dan, Guarente Leonard, Marcotulli Eric exactly as written, npj Aging and Mechanisms of Disease, volume 3, article 17, 2017. PubMed efetch on PMID 29184669 returned the same record and its abstract supplies verbatim the 120 healthy adults aged 60 to 80, the 3 arms, the approximately 40 percent and approximately 90 percent increases at 4 weeks compared to placebo and baseline, the sustainment throughout the 8-week trial, the absence of any increase in the placebo group, and the absence of serious adverse events. The PMC5701244 full text was fetched separately for the competing-interests statement, which records Elysium Health as the marketer and funder, KGK Synergize as the independent contract research organization that ran the trial, and 6 named authors as employees and shareholders.

  14. Studied for

    The same combination measured against a clinical endpoint (liver fat)

    The same nicotinamide riboside and pterostilbene combination was given for 6 months to 111 adults whose livers carried excess fat, again in 3 arms. It missed its primary endpoint: the paper reports that 'no significant change was seen in the primary endpoint of hepatic fat fraction with respect to placebo'. Among prespecified secondary measures, the liver enzymes ALT and GGT and the toxic lipid ceramide 14:0 fell against placebo in the lower-amount arm, and that effect did not scale with the higher amount. The combination appeared safe and well tolerated. The honest reading is a missed primary endpoint with secondary signals, and it is reported that way here. human randomized, double-blind, placebo-controlled trial; precursor combination Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    The same combination measured against a clinical endpoint (liver fat)

    The same nicotinamide riboside and pterostilbene combination was given for 6 months to 111 adults whose livers carried excess fat, again in 3 arms. It missed its primary endpoint: the paper reports that 'no significant change was seen in the primary endpoint of hepatic fat fraction with respect to placebo'. Among prespecified secondary measures, the liver enzymes ALT and GGT and the toxic lipid ceramide 14:0 fell against placebo in the lower-amount arm, and that effect did not scale with the higher amount. The combination appeared safe and well tolerated. The honest reading is a missed primary endpoint with secondary signals, and it is reported that way here.References 15

    Modelhuman randomized, double-blind, placebo-controlled trial; precursor combination

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Dellinger RW, Holmes HE, Hu-Seliger T, et al. Nicotinamide riboside and pterostilbene reduces markers of hepatic inflammation in NAFLD: A double-blind, placebo-controlled clinical trial. Hepatology. 2023;78(3):863-877. DOI: 10.1002/hep.32778 (PMID: 36082508)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Dellinger Ryan W., Holmes Holly E., Hu-Seliger Tina in the written order, Hepatology, volume 78, issue 3, pages 863-877, print September 2023. PubMed efetch on PMID 36082508 returned the same title, journal, volume, issue and pages, and its abstract supplies verbatim the 6-month randomized double-blind placebo-controlled design in 111 adults, the 3 arms, the quoted primary-endpoint sentence reproduced above, the prespecified secondary decreases in ALT, GGT and ceramide 14:0 in the lower-amount group, and the absence of a scaling effect in the higher-amount group.

  15. Studied for

    The same combination measured against muscle recovery

    32 elderly people took the same nicotinamide riboside and pterostilbene combination or a matched placebo, and 2 weeks later had muscle injury induced experimentally, with muscle biopsies taken before, 2 hours after, and 2, 8 and 30 days after the injury. The injury was substantial and clearly called muscle stem cells into action, but the supplement did not improve stem cell recruitment or any other measure of muscle recovery or subsequent regeneration. The authors describe the supplement as safe but ineffective for this purpose. This trial was funded by a public research foundation rather than by the product's maker. human randomized, placebo-controlled trial with repeated muscle biopsies; precursor combination Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    The same combination measured against muscle recovery

    32 elderly people took the same nicotinamide riboside and pterostilbene combination or a matched placebo, and 2 weeks later had muscle injury induced experimentally, with muscle biopsies taken before, 2 hours after, and 2, 8 and 30 days after the injury. The injury was substantial and clearly called muscle stem cells into action, but the supplement did not improve stem cell recruitment or any other measure of muscle recovery or subsequent regeneration. The authors describe the supplement as safe but ineffective for this purpose. This trial was funded by a public research foundation rather than by the product's maker.References 16

    Modelhuman randomized, placebo-controlled trial with repeated muscle biopsies; precursor combination

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Jensen JB, Dollerup OL, Moller AB, et al. A randomized placebo-controlled trial of nicotinamide riboside and pterostilbene supplementation in experimental muscle injury in elderly individuals. JCI Insight. 2022;7(19):e158314. DOI: 10.1172/jci.insight.158314 (PMID: 35998039)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Jensen Jonas Brorson, Dollerup Ole L., Moller Andreas B. in the written order, JCI Insight, volume 7, issue 19, article e158314, 2022. PubMed efetch on PMID 35998039 returned the same title, journal, volume, issue and article number, and its structured abstract supplies verbatim the 32 elderly individuals aged 55 to 80, the randomization to the combination or matched placebo, the 2-week lead-in before electrically induced eccentric muscle injury, the biopsy schedule, the finding that muscle stem cell content, proliferation and cell size showed a large demand for recruitment after injury 'but this was not affected by NRPT', the absence of any histological supplementation effect, the conclusion that supplementation 'is safe but does not improve recruitment of the MuSC pool or other measures of muscle recovery', and the Novo Nordisk Foundation funding.

  16. Studied for

    Mitochondrial and stem cell function, and lifespan, in mice

    Aged mice were given the NAD+ precursor nicotinamide riboside. The authors reported that muscle stem cells were rejuvenated, that senescence of neural and pigment-producing stem cells was delayed, and that the mice given it lived longer. Lifespan extension here is a mouse result and does not transfer to any statement about people. aged mice, plus a genetic mouse model of muscle degeneration; the precursor was used, not NAD+ itself Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Mitochondrial and stem cell function, and lifespan, in mice

    Aged mice were given the NAD+ precursor nicotinamide riboside. The authors reported that muscle stem cells were rejuvenated, that senescence of neural and pigment-producing stem cells was delayed, and that the mice given it lived longer. Lifespan extension here is a mouse result and does not transfer to any statement about people.References 17

    Modelaged mice, plus a genetic mouse model of muscle degeneration; the precursor was used, not NAD+ itself

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Zhang H, Ryu D, Wu Y, et al. NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science. 2016;352(6292):1436-1443. DOI: 10.1126/science.aaf2693 (PMID: 27127236)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Zhang Hongbo, Ryu Dongryeol, Wu Yibo in the written order, Science, volume 352, issue 6292, pages 1436-1443, 2016. PubMed efetch on PMID 27127236 returned the same title, journal, volume, issue and pages. The abstract was read in full and supports each clause, including nicotinamide riboside rejuvenating muscle stem cells in aged mice, preventing their senescence in the mdx model, delaying senescence of neural and melanocyte stem cells, and increasing mouse life span.

  17. Studied for

    A full year of a precursor in normally aging mice

    Ordinary wild-type mice were given the NAD+ building block NMN for 12 months during normal aging. The authors reported that it was quickly converted into NAD+ in tissues, and that the animals given it gained less weight with age, were more physically active, handled insulin and blood fats better, and had better eye function, without obvious toxicity at the amounts tested. This is a long, well-designed mouse study, and it is still a mouse study. 12-month mouse study in wild-type C57BL/6N animals; precursor route Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    A full year of a precursor in normally aging mice

    Ordinary wild-type mice were given the NAD+ building block NMN for 12 months during normal aging. The authors reported that it was quickly converted into NAD+ in tissues, and that the animals given it gained less weight with age, were more physically active, handled insulin and blood fats better, and had better eye function, without obvious toxicity at the amounts tested. This is a long, well-designed mouse study, and it is still a mouse study.References 18

    Model12-month mouse study in wild-type C57BL/6N animals; precursor route

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Mills KF, Yoshida S, Stein LR, et al. Long-Term Administration of Nicotinamide Mononucleotide Mitigates Age-Associated Physiological Decline in Mice. Cell Metab. 2016;24(6):795-806. DOI: 10.1016/j.cmet.2016.09.013 (PMID: 28068222)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Mills Kathryn F., Yoshida Shohei, Stein Liana R. in the written order, Cell Metabolism, volume 24, issue 6, pages 795-806, 2016. PubMed esearch by DOI returned PMID 28068222 and efetch returned the same title, journal, volume, issue and pages. The abstract was read in full and supports each clause verbatim, including the 12 months of regular chow-fed wild-type C57BL/6N mice during normal aging, rapid tissue conversion to NAD+, suppression of age-associated body weight gain, enhanced energy metabolism and physical activity, improved insulin sensitivity and plasma lipid profile, improved eye function, and the absence of obvious toxicity.

  18. Studied for

    A precursor in mouse models of impaired blood sugar handling

    In mice whose blood sugar handling was impaired either by a high-fat diet or by age, the cellular machinery for making NAD+ was itself impaired in metabolic organs. Giving the building block NMN restored NAD+ levels and improved glucose tolerance, liver insulin sensitivity, and blood fat profiles, partly through the protein SIRT1. This mouse work is the groundwork on which the later human NMN trial was built. diet-induced and age-induced mouse models of impaired blood sugar handling; precursor route Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    A precursor in mouse models of impaired blood sugar handling

    In mice whose blood sugar handling was impaired either by a high-fat diet or by age, the cellular machinery for making NAD+ was itself impaired in metabolic organs. Giving the building block NMN restored NAD+ levels and improved glucose tolerance, liver insulin sensitivity, and blood fat profiles, partly through the protein SIRT1. This mouse work is the groundwork on which the later human NMN trial was built.References 19

    Modeldiet-induced and age-induced mouse models of impaired blood sugar handling; precursor route

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Yoshino J, Mills KF, Yoon MJ, Imai S. Nicotinamide mononucleotide, a key NAD(+) intermediate, treats the pathophysiology of diet- and age-induced diabetes in mice. Cell Metab. 2011;14(4):528-536. DOI: 10.1016/j.cmet.2011.08.014 (PMID: 21982712)

    How this citation was checked

    Crossref on the DOI returned the exact title and the complete 4-author list Yoshino Jun, Mills Kathryn F., Yoon Myeong Jin, Imai Shin-ichiro exactly as written, Cell Metabolism, volume 14, issue 4, pages 528-536, 2011. PubMed efetch on PMID 21982712 returned the same title, authors, journal, volume, issue and pages. The abstract was read in full; the compromise of NAMPT-mediated NAD+ biosynthesis in metabolic organs on a high-fat diet, the amelioration of glucose intolerance by restoring NAD+, the enhanced hepatic insulin sensitivity, the age-induced arm, and the SIRT1 involvement all appear in it.

  19. Studied for

    DNA repair and mitophagy in a genetic-defect model

    In worms and mice carrying an inherited DNA-repair defect, cells showed low NAD+ and mitochondrial dysfunction. Replenishing NAD+ inside those cells reduced the severity of the neurological damage, normalized neuromuscular function, delayed memory loss and extended lifespan in both animal models, with the effect traced to better DNA repair and to mitophagy, the process by which a cell clears out damaged mitochondria. This is a model of a rare inherited defect, named in the citation below, and not healthy animals. C. elegans worms and mice carrying a specific genetic defect Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    DNA repair and mitophagy in a genetic-defect model

    In worms and mice carrying an inherited DNA-repair defect, cells showed low NAD+ and mitochondrial dysfunction. Replenishing NAD+ inside those cells reduced the severity of the neurological damage, normalized neuromuscular function, delayed memory loss and extended lifespan in both animal models, with the effect traced to better DNA repair and to mitophagy, the process by which a cell clears out damaged mitochondria. This is a model of a rare inherited defect, named in the citation below, and not healthy animals.References 20

    ModelC. elegans worms and mice carrying a specific genetic defect

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Fang EF, Kassahun H, Croteau DL, et al. NAD+ Replenishment Improves Lifespan and Healthspan in Ataxia Telangiectasia Models via Mitophagy and DNA Repair. Cell Metab. 2016;24(4):566-581. DOI: 10.1016/j.cmet.2016.09.004 (PMID: 27732836)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Fang Evandro Fei, Kassahun Henok, Croteau Deborah L. in the written order, Cell Metabolism, volume 24, issue 4, pages 566-581, 2016. PubMed efetch on PMID 27732836 returned the same title, journal, volume, issue and pages. The abstract was read in full and supports each clause, including increased PARylation, low NAD+ and mitochondrial dysfunction in ATM-deficient neurons, mice and worms, and replenishment of intracellular NAD+ reducing neuropathology, normalizing neuromuscular function, delaying memory loss and extending lifespan in both animal models via DNA repair and mitophagy.

  20. Studied for

    De novo NAD+ synthesis as a separate lever (ACMSD)

    Cells can also build NAD+ from scratch, and an enzyme called ACMSD limits how much of it they make. Blocking ACMSD, either genetically or with purpose-built compounds, raised from-scratch NAD+ production and sirtuin 1 activity and improved mitochondrial function, through a mechanism that held in both worms and mice. Because ACMSD is present mostly in kidney and liver, the authors framed this as a tissue-targeted approach. Disclosure: the paper's own competing-interests statement records that authors are inventors on ACMSD-inhibitor patents and that several are employed by the company that developed the compounds. C. elegans worms and mice Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    De novo NAD+ synthesis as a separate lever (ACMSD)

    Cells can also build NAD+ from scratch, and an enzyme called ACMSD limits how much of it they make. Blocking ACMSD, either genetically or with purpose-built compounds, raised from-scratch NAD+ production and sirtuin 1 activity and improved mitochondrial function, through a mechanism that held in both worms and mice. Because ACMSD is present mostly in kidney and liver, the authors framed this as a tissue-targeted approach. Disclosure: the paper's own competing-interests statement records that authors are inventors on ACMSD-inhibitor patents and that several are employed by the company that developed the compounds.References 21

    ModelC. elegans worms and mice

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Katsyuba E, Mottis A, Zietak M, et al. De novo NAD+ synthesis enhances mitochondrial function and improves health. Nature. 2018;563(7731):354-359. DOI: 10.1038/s41586-018-0645-6 (PMID: 30356218)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Katsyuba Elena, Mottis Adrienne, Zietak Marika in the written order, Nature, volume 563, issue 7731, pages 354-359, print November 2018. PubMed efetch on PMID 30356218 returned the same title, journal, volume, issue and pages. The abstract was read in full and supports each clause, including ACMSD limiting spontaneous cyclization in the de novo pathway and controlling cellular NAD+ levels through a mechanism conserved between C. elegans and mouse, genetic and pharmacological inhibition boosting de novo synthesis and sirtuin 1 activity and enhancing mitochondrial function, and ACMSD expression being largely restricted to kidney and liver.

  21. Studied for

    Cardiac research

    Failing hearts showed a characteristic shift in the enzymes that build NAD+, and the same shift appeared in biopsy tissue from human failing hearts as well as in the mouse models. NAD+ fell by about 30 percent in the failing mouse heart. Adding the precursor nicotinamide riboside to the food of those mice stabilized heart NAD+ levels and slowed the loss of heart function, most clearly in one of the 2 mouse models tested, which the citation below names. The human part of this study is tissue analysis only; no person received anything. 2 mouse models of failing heart function, plus analysis of human failing-heart biopsy tissue; only the mice received anything Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Cardiac research

    Failing hearts showed a characteristic shift in the enzymes that build NAD+, and the same shift appeared in biopsy tissue from human failing hearts as well as in the mouse models. NAD+ fell by about 30 percent in the failing mouse heart. Adding the precursor nicotinamide riboside to the food of those mice stabilized heart NAD+ levels and slowed the loss of heart function, most clearly in one of the 2 mouse models tested, which the citation below names. The human part of this study is tissue analysis only; no person received anything.References 22

    Model2 mouse models of failing heart function, plus analysis of human failing-heart biopsy tissue; only the mice received anything

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Diguet N, Trammell SAJ, Tannous C, et al. Nicotinamide Riboside Preserves Cardiac Function in a Mouse Model of Dilated Cardiomyopathy. Circulation. 2018;137(21):2256-2273. DOI: 10.1161/CIRCULATIONAHA.116.026099 (PMID: 29217642)

    How this citation was checked

    Crossref on the DOI returned the exact title, first 3 authors Diguet Nicolas, Trammell Samuel A.J., Tannous Cynthia in the written order, Circulation, volume 137, issue 21, pages 2256-2273, 2018. PubMed esearch by DOI returned PMID 29217642 and efetch returned the same title, journal, volume, issue and pages. The abstract was read in full and supports each clause, including the 30 percent loss of NAD+ in the failing murine heart, the same enzyme-expression shift observed in human failing heart biopsies compared with non-failing controls, and nicotinamide riboside supplementation in food attenuating the loss of function in mice, more robustly in one of the 2 models.

  22. Studied for

    A plant flavonoid as a CD38 inhibitor

    Working first in cultured cells and then in obese mice, researchers characterized 2 plant flavonoids, quercetin and apigenin, as inhibitors of CD38. Blocking CD38 pharmacologically raised NAD+ inside cells and reduced overall protein acetylation. Giving apigenin to obese mice raised NAD+, decreased protein acetylation, and improved several aspects of glucose and fat handling. This is cell and mouse work; nothing here was tested in people, and apigenin is not NAD+. cultured cells and obese mice Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    A plant flavonoid as a CD38 inhibitor

    Working first in cultured cells and then in obese mice, researchers characterized 2 plant flavonoids, quercetin and apigenin, as inhibitors of CD38. Blocking CD38 pharmacologically raised NAD+ inside cells and reduced overall protein acetylation. Giving apigenin to obese mice raised NAD+, decreased protein acetylation, and improved several aspects of glucose and fat handling. This is cell and mouse work; nothing here was tested in people, and apigenin is not NAD+.References 23

    Modelcultured cells and obese mice

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Escande C, Nin V, Price NL, et al. Flavonoid apigenin is an inhibitor of the NAD+ase CD38: implications for cellular NAD+ metabolism, protein acetylation, and treatment of metabolic syndrome. Diabetes. 2013;62(4):1084-1093. DOI: 10.2337/db12-1139 (PMID: 23172919)

    How this citation was checked

    Crossref on the DOI returned the title 'Flavonoid Apigenin Is an Inhibitor of the NAD+ase CD38' with first 3 authors Escande Carlos, Nin Veronica, Price Nathan L. in the written order, Diabetes, volume 62, issue 4, pages 1084-1093, 2013. PubMed efetch on PMID 23172919 returned the full title including the subtitle used in the citation, the same journal, volume, issue and pages. The abstract was read in full and supports each clause, including the characterization of quercetin and apigenin as CD38 inhibitors, higher intracellular NAD+ with pharmacological inhibition, decreased global acetylation in cell cultures given apigenin, and improved glucose and lipid homeostasis in obese mice given apigenin.

  23. Studied for

    Axon degeneration and the SARM1 pathway

    A review describes SARM1, a protein whose TIR domain splits NAD+ apart and which switches on in response to injury or stress to a nerve fiber. That NAD+ destruction is what drives the fiber to degenerate, and SARM1 sitting on the outer mitochondrial membrane links it to mitochondrial dysfunction as well. The review surveys genetic and drug studies implicating SARM1 across peripheral and central nervous system disorders and the small molecules being developed against it. Everything described is preclinical. review of laboratory and animal studies Preclinical moderate A well-described result with several independent outcome measures, but from a single laboratory or a single study design. Open for the full finding and the paper it came from.
    In the literature

    Axon degeneration and the SARM1 pathway

    A review describes SARM1, a protein whose TIR domain splits NAD+ apart and which switches on in response to injury or stress to a nerve fiber. That NAD+ destruction is what drives the fiber to degenerate, and SARM1 sitting on the outer mitochondrial membrane links it to mitochondrial dysfunction as well. The review surveys genetic and drug studies implicating SARM1 across peripheral and central nervous system disorders and the small molecules being developed against it. Everything described is preclinical.References 24

    Modelreview of laboratory and animal studies

    Confidence: moderate

    A well-described result with several independent outcome measures, but from a single laboratory or a single study design.

    Source

    Karnik A, Joshi A. SARM1: The Checkpoint of Axonal Degeneration in the Nervous System Disorders. Mol Neurobiol. 2025;62(7):9240-9257. DOI: 10.1007/s12035-025-04835-3 (PMID: 40097763)

    How this citation was checked

    Crossref on the DOI returned the exact title and both authors as Karnik Aaditi and Joshi Abhijeet, Molecular Neurobiology, volume 62, issue 7, pages 9240-9257, print July 2025. PubMed efetch on PMID 40097763 returned the same title, authors, journal, volume, issue and pages. The abstract was read in full and supports each clause, including the TIR domain governing NAD+ hydrolysis leading to axonal deficits, SARM1 localization in the outer mitochondrial membrane and its association with mitochondrial dynamics, the genetic and pharmacological studies implicating SARM1 in peripheral and central nervous system disorders, and the small-molecule scaffolds tested against it. An earlier draft named specific injury models that the abstract does not itemize; those specifics were removed rather than carried forward.

  24. Studied for

    Human pharmacokinetics of intravenous NAD+ (the compound itself, not a precursor)

    11 healthy men took part in a small pilot study: 8 received NAD+ intravenously over 6 hours and 3 received saline, with blood and urine sampled throughout. Nothing moved in the blood for the first 2 hours. The authors concluded that at that infusion rate NAD+ was being cleared from the bloodstream as fast as it arrived. By the 6-hour end of the infusion, plasma NAD+ had risen sharply, about 398 percent above baseline, and NAD+ and methylnicotinamide, though not nicotinamide, were being excreted in urine. The pattern of breakdown products matched the action of NAD+-splitting enzymes. No adverse events were observed during the infusion in either group. Disclosure: 2 of the 7 authors are commercially tied to intravenous NAD+ as a paid service. The paper's conflict statement records that one is a director of NAD+ Research Inc. and medical director of the wellness center that offers intravenous NAD+ clinically and where these infusions were given, and that another received consulting fees from that company, which co-funded the study. Both the early clearance result and the later plasma rise are reported here so that neither endpoint is cherry-picked. human pilot study, 11 healthy men aged 30 to 55, randomized to NAD+ infusion (8) or saline (3) Preclinical preliminary A single study, an early mechanistic observation, or a result whose interpretation is the authors' own inference. Open for the full finding and the paper it came from.
    In the literature

    Human pharmacokinetics of intravenous NAD+ (the compound itself, not a precursor)

    11 healthy men took part in a small pilot study: 8 received NAD+ intravenously over 6 hours and 3 received saline, with blood and urine sampled throughout. Nothing moved in the blood for the first 2 hours. The authors concluded that at that infusion rate NAD+ was being cleared from the bloodstream as fast as it arrived. By the 6-hour end of the infusion, plasma NAD+ had risen sharply, about 398 percent above baseline, and NAD+ and methylnicotinamide, though not nicotinamide, were being excreted in urine. The pattern of breakdown products matched the action of NAD+-splitting enzymes. No adverse events were observed during the infusion in either group. Disclosure: 2 of the 7 authors are commercially tied to intravenous NAD+ as a paid service. The paper's conflict statement records that one is a director of NAD+ Research Inc. and medical director of the wellness center that offers intravenous NAD+ clinically and where these infusions were given, and that another received consulting fees from that company, which co-funded the study. Both the early clearance result and the later plasma rise are reported here so that neither endpoint is cherry-picked.References 25

    Modelhuman pilot study, 11 healthy men aged 30 to 55, randomized to NAD+ infusion (8) or saline (3)

    Confidence: preliminary

    A single study, an early mechanistic observation, or a result whose interpretation is the authors' own inference.

    Source

    Grant R, Berg J, Mestayer R, Braidy N, Bennett J, Broom S, Watson J. A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+. Front Aging Neurosci. 2019;11:257. DOI: 10.3389/fnagi.2019.00257 (PMID: 31572171, PMCID: PMC6751327)

    How this citation was checked

    Crossref on the DOI returned the exact title and the complete 7-author list Grant Ross, Berg Jade, Mestayer Richard, Braidy Nady, Bennett James, Broom Susan, Watson James exactly as written, Frontiers in Aging Neuroscience, volume 11, article 257, 2019. PubMed efetch on PMID 31572171 returned the same title, journal, volume and article number, and its abstract supplies the 2-hour no-change result, the rapid and complete plasma removal conclusion, the glycohydrolase and pyrophosphatase interpretation, and the urinary NAD+ and methylnicotinamide but not nicotinamide result. The PMC6751327 full text was fetched separately and supplies verbatim 'Eleven (Test n = 8, Control n = 3) male participants aged 30-55 years', 'No adverse events were observed during the 6 h infusion with either placebo (saline) or test (NAD+) cohorts', the significant 398 percent increase in plasma NAD+ at the 6 h time point relative to baseline, and the conflict-of-interest statement summarized in the finding.

  25. Studied for

    Tolerability of intravenous NAD+ versus a precursor in humans

    A commercial clinic reviewed the medical records of 14 clients who each had 4 consecutive days of intravenous infusions: 6 received NAD+ and 8 received the precursor nicotinamide riboside. The paper's own words: 'All clients (n = 6) in the NAD+ group reported moderate to severe abdominal cramping, diarrhea, nausea, vomiting, increased heart rates, pain in throat, congestion, and chest pressure during infusion'. 5 of the 8 precursor recipients had minor tongue, jaw and arm tingling and minor cramping. Every symptom stopped when the infusion ended, but the discomfort meant NAD+ infusions had to run far more slowly, averaging about 97 minutes against about 37. Over 30 days there was no significant change in ALT, AST, hsCRP, BUN/creatinine or TSH in either group. Alkaline phosphatase fell significantly in the NAD+ group only, with values staying inside normal reference ranges, and exploratory metabolic markers moved inconsistently between the groups. This is a small, unblinded, uncontrolled record review with no placebo arm, and all 7 authors were employed by the commercial wellness company that gave the infusions. human retrospective chart review, 14 clients (6 NAD+, 8 precursor) Preclinical preliminary A single study, an early mechanistic observation, or a result whose interpretation is the authors' own inference. Open for the full finding and the paper it came from.
    In the literature

    Tolerability of intravenous NAD+ versus a precursor in humans

    A commercial clinic reviewed the medical records of 14 clients who each had 4 consecutive days of intravenous infusions: 6 received NAD+ and 8 received the precursor nicotinamide riboside. The paper's own words: 'All clients (n = 6) in the NAD+ group reported moderate to severe abdominal cramping, diarrhea, nausea, vomiting, increased heart rates, pain in throat, congestion, and chest pressure during infusion'. 5 of the 8 precursor recipients had minor tongue, jaw and arm tingling and minor cramping. Every symptom stopped when the infusion ended, but the discomfort meant NAD+ infusions had to run far more slowly, averaging about 97 minutes against about 37. Over 30 days there was no significant change in ALT, AST, hsCRP, BUN/creatinine or TSH in either group. Alkaline phosphatase fell significantly in the NAD+ group only, with values staying inside normal reference ranges, and exploratory metabolic markers moved inconsistently between the groups. This is a small, unblinded, uncontrolled record review with no placebo arm, and all 7 authors were employed by the commercial wellness company that gave the infusions.References 26

    Modelhuman retrospective chart review, 14 clients (6 NAD+, 8 precursor)

    Confidence: preliminary

    A single study, an early mechanistic observation, or a result whose interpretation is the authors' own inference.

    Source

    Reyna K, Heinzen G, Patel N, Ritter M, Siojo A, Legere H, Pojednic R. Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. Front Aging. 2026;7:1652582. DOI: 10.3389/fragi.2026.1652582 (PMID: 41704678, PMCID: PMC12907335)

    How this citation was checked

    Crossref on the DOI returned the exact title and the complete 7-author list Reyna Kirsten, Heinzen Greer, Patel Nikita, Ritter Marie, Siojo Alexandra, Legere Henry, Pojednic Rachele exactly as written, Frontiers in Aging, volume 7, article 1652582, published 2026-02-02. PubMed efetch on PMID 41704678 returned the same record and its structured abstract supplies the tolerability contrast, the 97 versus 37 minute infusion times, the ALT/AST/hsCRP/BUN-creatinine/TSH null, the alkaline phosphatase decrease within normal ranges, and the exploratory metabolic results. The PMC12907335 full text was fetched separately and supplies the quoted sentence reproduced above verbatim, 'Some, but not all, clients (n = 5) in the NR group experienced minor tongue, jaw and arm tingling and minor cramping during infusion', and the employment statement naming Restore Hyperwellness. The prevalence wording '5 of the 8' and the fuller NAD+ symptom list including throat pain and congestion come from that full text rather than from the abstract, which compresses both.

  26. Studied for

    A precursor combined with endurance exercise

    8 healthy young men took nicotinamide riboside or a cellulose placebo for 1 week, then completed an hour of cycling, with muscle biopsies before supplementation and before, immediately after and 3 hours after the exercise. Fuel use at rest and during exercise did not change, muscle mitochondrial respiration did not change, and the NAD+-sensitive signaling pathways that respond in rodents did not move. Muscle NAD+ concentration itself did not increase, though deaminated precursors and methylated breakdown products did rise, showing that the compound was reaching muscle. A commentary in the same journal framed this as a direct rodent-versus-human divergence. HUMAN human trial in 8 healthy young men; precursor route Preclinical preliminary A single study, an early mechanistic observation, or a result whose interpretation is the authors' own inference. Open for the full finding and the paper it came from.
    In the literature

    A precursor combined with endurance exercise

    8 healthy young men took nicotinamide riboside or a cellulose placebo for 1 week, then completed an hour of cycling, with muscle biopsies before supplementation and before, immediately after and 3 hours after the exercise. Fuel use at rest and during exercise did not change, muscle mitochondrial respiration did not change, and the NAD+-sensitive signaling pathways that respond in rodents did not move. Muscle NAD+ concentration itself did not increase, though deaminated precursors and methylated breakdown products did rise, showing that the compound was reaching muscle. A commentary in the same journal framed this as a direct rodent-versus-human divergence.References 27, 28

    Modelhuman trial in 8 healthy young men; precursor route

    Confidence: preliminary

    A single study, an early mechanistic observation, or a result whose interpretation is the authors' own inference.

    Source

    Stocks B, Ashcroft SP, Joanisse S, et al. Nicotinamide riboside supplementation does not alter whole-body or skeletal muscle metabolic responses to a single bout of endurance exercise. J Physiol. 2021;599(5):1513-1531. DOI: 10.1113/JP280825 (PMID: 33492681). Commentary: Ferreira LSS, De-Souza EA. Of mice and men: opposing effects of nicotinamide riboside on skeletal muscle physiology at rest and during exercise. J Physiol. 2021;599(10):2525-2526. DOI: 10.1113/JP281428

    How this citation was checked

    Crossref on 10.1113/JP280825 returned the exact title, first 3 authors Stocks Ben, Ashcroft Stephen P., Joanisse Sophie in the written order, The Journal of Physiology, volume 599, issue 5, pages 1513-1531, print March 2021; PubMed efetch on PMID 33492681 returned the same title, journal, volume, issue and pages, and its abstract supplies the 8 male participants, the 1 week of supplementation, the hour of cycling at 60 percent of maximum power, the biopsy schedule, the absence of any effect on substrate utilisation at rest or during exercise and on skeletal muscle mitochondrial respiration, the unchanged NAD+-sensitive signaling readouts, and the statement that NAD+ concentration in muscle did not increase while deaminated precursors and methylated breakdown products did, demonstrating bioavailability. Crossref on 10.1113/JP281428 separately returned the commentary's exact title with authors Ferreira Lais S. S. and De-Souza Evandro A., The Journal of Physiology, volume 599, issue 10, pages 2525-2526, 2021. The trial is described as placebo-controlled rather than randomized or crossover, because neither term is asserted in the record verified.

  27. Studied for

    Supplying a building block while blocking the consuming enzyme

    One team combined the NAD+ building block NMN with apigenin, which blocks the NAD+-consuming enzyme, and gave the pair by mouth to aged mice. They reported that the combination reduced cellular senescence, promoted skeletal precursor cells to become cartilage, bone and muscle cells, and reduced cartilage degeneration, bone loss and muscle wasting while improving exercise capacity, with mitochondrial SIRT3 proposed as the mechanism. This is a single study in aged mice and cultured cells, and it is the only study located that gives the two together. Neither of the 2 compounds given is NAD+ itself. aged mice and cultured cells Preclinical preliminary A single study, an early mechanistic observation, or a result whose interpretation is the authors' own inference. Open for the full finding and the paper it came from.
    In the literature

    Supplying a building block while blocking the consuming enzyme

    One team combined the NAD+ building block NMN with apigenin, which blocks the NAD+-consuming enzyme, and gave the pair by mouth to aged mice. They reported that the combination reduced cellular senescence, promoted skeletal precursor cells to become cartilage, bone and muscle cells, and reduced cartilage degeneration, bone loss and muscle wasting while improving exercise capacity, with mitochondrial SIRT3 proposed as the mechanism. This is a single study in aged mice and cultured cells, and it is the only study located that gives the two together. Neither of the 2 compounds given is NAD+ itself.References 29

    Modelaged mice and cultured cells

    Confidence: preliminary

    A single study, an early mechanistic observation, or a result whose interpretation is the authors' own inference.

    Source

    Yu J, Hou M, Deng Y, et al. Double-Pronged NAD Preservation: Delaying Cellular Senescence and Initiating Musculoskeletal Regeneration. Aging Cell. 2026;25(4):e70468. DOI: 10.1111/acel.70468 (PMID: 41944220)

    How this citation was checked

    Checked with extra care because a recent primary paper carrying a combination claim is a high-risk item. Crossref on the DOI returned the exact title, first 3 authors Yu Jianfeng, Hou Mingzhuang, Deng Yaoge in the written order, Aging Cell, volume 25, issue 4, article e70468, 2026. PubMed esearch by DOI returned PMID 41944220 and efetch returned the same title, journal, volume, issue and article number. The abstract was read in full and states the NMN-plus-apigenin 'N + A' regimen, oral use in aged mice, the senescence and skeletal-precursor-differentiation results, the cartilage, bone, muscle and exercise-capacity outcomes, and the mitochondrial SIRT3 deacetylation mechanism verbatim.

4 strong / 19 moderate / 4 preliminaryRated by how many independent labs and how many kinds of experiment found the same thing.

The material

What is in the vial.

Specification
CompoundNAD+
Dosage formLyophilized powder
PurityPURITY EXCEEDS 99%
StorageSTORE LYOPHILIZED. KEEP COLD AND OUT OF LIGHT.
Lot formatLOT + EXP printed per vial
DistributionDISTRIBUTED BY KAIRO, KAIROPEPTIDES.COM
Research context

A coenzyme, not a peptide.

The full technical write-up 3 paragraphs, plus the fact row

NAD+ is not a peptide. It is a coenzyme: a small helper molecule that enzymes require in order to work, built from 2 nucleotides joined tail to tail through a pair of phosphate groups, and made in the body from vitamin B3 family building blocks. Its technical name is beta-nicotinamide adenine dinucleotide, oxidized form; the reduced partner form is NADH, and the pair shuttles electrons through hundreds of metabolic reactions. What makes it unusual is that it is also consumed as a substrate rather than simply recycled, by 3 enzyme families researchers study closely: sirtuins, PARPs and CD38. A fourth NAD+-splitting enzyme, SARM1, runs the nerve-injury literature. That is why so much of the work below is about the enzymes that destroy NAD+ rather than the ones that build it.

Almost everything known about NAD+ in people is actually known about its building blocks. Of the 12 human trials cited on this page in which participants received something, only 2 gave NAD+ itself, and both are small: an 11-person pilot and a 14-record review from a commercial clinic. Every other trial used nicotinamide riboside or NMN, because NAD+ sitting outside a cell is taken apart at the cell surface before it can get in, which is a measured property of human tissue rather than an assumption. Where the precursor trials measured the number in blood, it moved reliably and in proportion to how much was taken. Where they measured function instead, the results have been mixed and frequently negative, and those negatives are on this page in full.

Several of the positive human trials here were funded by the company selling the ingredient tested, and both studies of NAD+ itself come from commercial clinics that sell the infusion; each of those disclosures is printed inside the finding it belongs to rather than in a footnote. No regulatory status for this compound was checked in this verification pass, so none is asserted anywhere on this page: that is an absence of evidence, not evidence of absence. Everything described below is what researchers measured in laboratory systems, in animals, and in the human trials named. Where a trial is described, what it measured and what it failed to measure are both stated, and no amount, concentration or preparation figure appears anywhere on this page.References 1, 8, 24

Also known as
Nadide, beta-NAD, NAD+, beta-nicotinamide adenine dinucleotide (oxidized form). The reduced partner form is NADH.
Status
Not an approved drug in the United States or anywhere else

Sold as a laboratory research material.

Molecular identity

Sequence, formula and registry numbers
Formula
Free acid C21H27N7O14P2
Molar mass
Free acid 663.4 g/mol
CAS
Free acid 53-84-9
PubChem CID
Free acid 5892

No molar mass, CAS number or purity figure here is inferred or calculated. Purity is not a property of the compound: the only purity figure that should ever be stated is the one printed on the certificate of analysis for the actual lot in hand, and catalog grades are not used. Which salt form and which physical form a given lot is supplied as are supplier-specific facts and are not asserted here.References 30, 31

Storage

Once it is mixed, it goes in the fridge.

Water is what ages a peptide, so the rules change the moment you add it.

The longer version 3 rows
Before you mix it
Supplied as a lyophilized (freeze-dried) powder. The physical form of research-grade material varies between preparations and is a property of a given lot's own documentation rather than of the compound. Standard laboratory practice for lyophilized and crystalline reagents of this class is freezer storage, commonly around -4 F (-20 C), sealed, kept dry and protected from light and moisture, with the vial allowed to reach room temperature before it is opened so that condensation does not pull water into the solid. That is general reagent practice, stated generically; it is not a finding from a stability study on this compound and it is not attributed to any supplier or brand.
Once it is mixed
No in-use window is given here, and that is a deliberate decision rather than an omission. NAD+ is genuinely unstable in water, and that is the single most important handling fact about it. The one peer-reviewed stability study located compared sodium phosphate, HEPES and Tris buffers at pH 8.5 at 66 F (19 C) and 77 F (25 C) for up to 43 days. For the oxidized form it reports that buffer identity matters enormously: a 2 mM solution in HEPES degraded nearly entirely over 43 days, while in Tris the 260 nm peak decreased only slightly, by about 4 percent, over the same window, and in sodium phosphate it degraded at a rate similar to NADH. Tris was the most stable of the 3 and HEPES the worst, which is the reverse of HEPES's middle ranking for the reduced form, and the oxidized form degrades by base catalysis at high pH while the reduced form degrades by acid catalysis at low pH, so the 2 forms are destabilized by opposite conditions. Two precision limits on that paper, both of which cut against overreading it: its quantitative degradation rates and its temperature comparison are reported for NADH rather than for NAD+, because NADH breakdown products also absorb at 260 nm and complicate measuring NAD+ directly, and its own ideal-conditions conclusion is written about NADH. For NAD+ it supports the qualitative ranking above and nothing more. Those are cell-free biocatalysis buffer conditions studied over 43 days, not vial-storage recommendations, so carrying them across to any mixed preparation is an extrapolation and is flagged as one here. Windows of 7 to 28 days are quoted for this compound in the market; no published stability data was located behind any of them, and the published chemistry argues against taking them at face value. Reconstitution volumes, concentrations, routes, schedules and every other preparation-for-use step are withheld, as they are everywhere on this store.
In the literature
Two compound-specific properties are documented rather than inferred. First, the oxidized form absorbs at 260 nm and, unlike NADH, does not absorb at 340 nm, which means degradation of a solution is trackable by UV-visible spectroscopy and the potency of an aged solution can be confirmed analytically rather than assumed. Second, the buffer and pH dependence described above is specific to this molecule and runs opposite to that of its own reduced partner form (Wolfe KD, et al. Molecules. 2024;29(22):5453). Standard practice for reagents of this class otherwise applies, stated generically: handle solutions gently rather than vortexing, keep them cold and protected from light, avoid repeated freeze-thaw cycles, and regard any aqueous solution as actively degrading from the moment it is made. Solubility figures, preservatives and diluents are deliberately absent: the only numbers available for those are supplier catalog figures, and no supplier or brand catalog is a source anywhere in this file. References 30
References

Every paper this page is built on.

Click any journal to open the paper.

The full list 31 references, each linked
  1. 1

    Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22(2):119-141.

  2. 2

    Conze D, Brenner C, Kruger CL. Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults. Sci Rep. 2019;9(1):9772.

  3. 3

    Prokopidis K, Moriarty F, Bahat G, McLean J, Church DD, Patel HP. The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis. J Cachexia Sarcopenia Muscle. 2025;16(3):e13799.

  4. 4

    Dollerup OL, Chubanava S, Agerholm M, et al. Nicotinamide riboside does not alter mitochondrial respiration, content or morphology in skeletal muscle from obese and insulin-resistant men. J Physiol. 2020;598(4):731-754.

  5. 5

    Camacho-Pereira J, Tarrago MG, Chini CCS, et al. CD38 Dictates Age-Related NAD Decline and Mitochondrial Dysfunction through an SIRT3-Dependent Mechanism. Cell Metab. 2016;23(6):1127-1139.

  6. 6

    Covarrubias AJ, Kale A, Perrone R, et al. Senescent cells promote tissue NAD+ decline during ageing via the activation of CD38+ macrophages. Nat Metab. 2020;2(11):1265-1283.

  7. 7

    Tarrago MG, Chini CCS, Kanamori KS, et al. A Potent and Specific CD38 Inhibitor Ameliorates Age-Related Metabolic Dysfunction by Reversing Tissue NAD+ Decline. Cell Metab. 2018;27(5):1081-1095.e10.

  8. 8

    Jablonska P, Kutryb-Zajac B, Mierzejewska P, et al. The new insight into extracellular NAD+ degradation - the contribution of CD38 and CD73 in calcific aortic valve disease. J Cell Mol Med. 2021;25(13):5884-5898.

  9. 9

    Elhassan YS, Kluckova K, Fletcher RS, et al. Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD+ Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Rep. 2019;28(7):1717-1728.e6.

  10. 10

    Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9(1):1286.

  11. 11

    Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021;372(6547):1224-1229.

  12. 12

    Brenner C. Comment on 'Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women'. Science. 2021;373(6554):eabj1696.

  13. 13

    Brakedal B, Dolle C, Riemer F, et al. The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease. Cell Metab. 2022;34(3):396-407.e6.

  14. 14

    Dellinger RW, Santos SR, Morris M, Evans M, Alminana D, Guarente L, Marcotulli E. Repeat dose NRPT (nicotinamide riboside and pterostilbene) increases NAD+ levels in humans safely and sustainably: a randomized, double-blind, placebo-controlled study. npj Aging Mech Dis. 2017;3:17.

  15. 15

    Dellinger RW, Holmes HE, Hu-Seliger T, et al. Nicotinamide riboside and pterostilbene reduces markers of hepatic inflammation in NAFLD: A double-blind, placebo-controlled clinical trial. Hepatology. 2023;78(3):863-877.

  16. 16

    Jensen JB, Dollerup OL, Moller AB, et al. A randomized placebo-controlled trial of nicotinamide riboside and pterostilbene supplementation in experimental muscle injury in elderly individuals. JCI Insight. 2022;7(19):e158314.

  17. 17

    Zhang H, Ryu D, Wu Y, et al. NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science. 2016;352(6292):1436-1443.

  18. 18

    Mills KF, Yoshida S, Stein LR, et al. Long-Term Administration of Nicotinamide Mononucleotide Mitigates Age-Associated Physiological Decline in Mice. Cell Metab. 2016;24(6):795-806.

  19. 19

    Yoshino J, Mills KF, Yoon MJ, Imai S. Nicotinamide mononucleotide, a key NAD(+) intermediate, treats the pathophysiology of diet- and age-induced diabetes in mice. Cell Metab. 2011;14(4):528-536.

  20. 20

    Fang EF, Kassahun H, Croteau DL, et al. NAD+ Replenishment Improves Lifespan and Healthspan in Ataxia Telangiectasia Models via Mitophagy and DNA Repair. Cell Metab. 2016;24(4):566-581.

  21. 21

    Katsyuba E, Mottis A, Zietak M, et al. De novo NAD+ synthesis enhances mitochondrial function and improves health. Nature. 2018;563(7731):354-359.

  22. 22

    Diguet N, Trammell SAJ, Tannous C, et al. Nicotinamide Riboside Preserves Cardiac Function in a Mouse Model of Dilated Cardiomyopathy. Circulation. 2018;137(21):2256-2273.

  23. 23

    Escande C, Nin V, Price NL, et al. Flavonoid apigenin is an inhibitor of the NAD+ase CD38: implications for cellular NAD+ metabolism, protein acetylation, and treatment of metabolic syndrome. Diabetes. 2013;62(4):1084-1093.

  24. 24

    Karnik A, Joshi A. SARM1: The Checkpoint of Axonal Degeneration in the Nervous System Disorders. Mol Neurobiol. 2025;62(7):9240-9257.

  25. 25

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31 sources: 30 peer-reviewed papers and 1 primary documents.

Sources re-verified July 28, 2026

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