Nicotinamide Riboside (NR)

Nicotinamide Riboside (NR) is a dietary supplement available in the US from ChromaDex (NASDAQ: CDXC), competitor Elysium and others. The legal battle between ChromaDex and Elysium is covered here with more of the history behind the dispute here.

Purpose?

• NIAGEN®, also known as nicotinamide riboside (NR), is a very unique member of the vitamin B3 family. The body converts NR into Nicotinamide Adenine Dinucleotide (NAD+) which is an essential molecule found in every living cell. It is necessary for optimal cell health.
• NAD+ is a coenzyme which enables cells to convert glucose into cellular energy. NAD+ is also the communication molecule between the cell nucleus and the mitochondria which are the energy producing factories in the cell. If NAD+ levels are low, then communication may be impaired and mitochondria dysfunction may result. When this occurs, everything begins to breakdown.
• Emerging biosimilar supplements such as Nicotinamide Mononucleotide (NMN) have not proven effective.

Why Supplement? … and Why Not.

• Several published animal studies provide evidence that NR is a powerful geroprotector—an anti-aging compound that helps organisms maintain a state of health and avoid disease. In trials, older animals have been returned to a 15-20% more youthful state and outlived their placebo cohorts.
• NAD+ levels are highest at birth and decrease dramatically with age. Also, certain lifestyle choices such as over-eating or a sedentary routine deplete NAD+ levels.
• NAD⁺ depletion leads to degenerative diseases, including aging as well as inflammatory alterations, infections, cardiovascular diseases, and cancer.
• Boosting NAD+ levels promotes cellular metabolism, mitochondrial function, and energy production.
• NR increases NAD+ levels in cells and tissues and supports healthy skin.
• Promotes mitochondrial function which is an important component of aging. Without sufficient NAD, mitochondria can’t make the ATP energy our cells need. Nor can they communicate properly.
• Prevents memory loss.
• 6 Nobel Prize winning bio-scientists take it.

With all of that said, according to Consumer Labs, there is a strong possibility that boosting NAD levels does not provide significant benefit to most humans. See the Clinical Trials section below.

Dosage?

• The dose in the Nature Communications study and most other clinical trials was 1000mg daily (two 500mg doses).
• ChromaDex recently changed their recommendation to 1000mg daily, yet still only sell pills in 300mg sizes. They are the most expensive NR provider at about $1.5 per pill.
• Elysium Health’s NAD supplement called Basis is sold as 2 capsules providing a 250mg daily dose for $40/month. Elysium’s supplement also includes 50mg of Pterostilbene. Trial results showed a slight, but significant increase in LDL cholesterol.

Clinical Trials

• 60 Clinical Trials
  • Successfully boosted NAD levels by 33% with 2 gram dose (1 gram, twice daily)
  • 4 studies corroborate findings that NR effectively raises levels of nicotinamide adenine dinucleotide (NAD) in humans without adverse effects. See Safety affirmed for NR.
  • Study results have not yet proven statistically significant health benefits in humans from NR.
    • Boosting NAD+ levels in 19 study participants reduced high blood pressure in four of them. However, this is too small of a trial to be statistically significant.
    • In a 12 week study of 40 sedentary, obese, insulin-resistant men, nicotinamide riboside did not improve insulin sensitivity, glucose metabolism, blood lipid levels, or body composition compared to placebo. It also did not improve total or LDL cholesterol compared to placebo.
    • Small studies did not conclusively prove improvement in chronic fatigue syndrome, dementia, depression, Parkinson’s symptoms, functional energy levels, cholesterol levels and blood sugar control. For Parkinson’s, longer studies are needed.
    • See additional trial results at Self-Hacked.

Adverse Interactions?

• In 2016 the FDA granted generally recognized as safe (GRAS) status for NR as a food ingredient in enhanced water products, protein shakes, nutrition bars, gum and chews at no more than 0.027% of NR by weight.
• NR is a natural product, a little-noticed vitamin found in cow’s milk.
• From this January, 2021  Nature study, an excessive increase in NR can contribute to cancer progression.

Data Sources

• ChromaDex — Chromadex is partnered with top education institutions and companies in the US.
• Consumer Lab
• Elysium Health
• SelfHacked
• Wikipedia
• Medical News Today: “This supplement may promote healthy arterial aging,” by Catharine Paddock PhD
• Sci-News: “Nicotinamide Riboside Improves Blood Pressure and Arterial Health, Mimics Caloric Restriction: Study”
• Science Daily: “Dietary supplement shows promise for reversing cardiovascular aging”
• Genetic Engineering & Biotechnology News: “Vitamin Precursor Could Help Reverse Cardiovascular Aging Effects”
• Nature Communications, “Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults.”
• Elysium vs Chromadex in Neo.Life