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NR5.5

Nicotinamide Riboside Research

Mostly mechanism / observational

50 peer-reviewed studies

What the evidence says

Mostly mechanism / observational

Most Nicotinamide Riboside studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.

Most evidence is from high-quality meta-analyses and randomised trials published 2017–2026 with a typical study size of 30 participants.

Based on 50 studies · 2 meta-analyses · 36 RCTs · 499 total participants

Confidence

High confidence

By outcome

Longevity & agingIncreased NAD+ levels supporting cellular repair, sirtuin activity, and mitochondrial function associated with healthy aging · 2–4 weeks
Mostly mechanism / observational46 studies
Therapeutic & clinical
Mostly mechanism / observational15 studies
Lean body mass & muscle growth
Mostly mechanism / observational6 studies
Cognitive functionMemory metrics stayed stable with no significant improvement vs placebo in an MCI pilot trial · 10–16 weeks
Mostly mechanism / observational5 studies
Heart & blood pressureA hypertension pilot missed its primary BP endpoint; modest walk-distance gain seen in peripheral artery disease · 6–12 weeks
Mostly mechanism / observational5 studies
InflammationReduction in circulating inflammatory cytokines and systemic inflammation markers · 4–8 weeks
Mostly mechanism / observational4 studies
Safety profile
Mostly mechanism / observational4 studies
Neuroprotection & brain agingSupports neuronal NAD+ and mitochondrial function · 8-12 weeks
Mostly mechanism / observational3 studies
Glucose & metabolicBoosts NAD+ for mitochondrial efficiency and metabolic flexibility · 8-12 weeks
Mostly mechanism / observational3 studies
RecoveryRaises muscle NAD+ metabolome but did not improve recovery from experimental muscle injury · 4–8 weeks
Too few graded studies2 studies
Energy & fatigueRaises NAD+ but controlled trials have not shown reduced fatigue or improved energy · 4–8 weeks
Too few graded studies2 studies
Weight management
Too few graded studies2 studies
Endurance & exercise performance
Too few graded studies1 study
Liver health
Too few graded studies1 study

By the numbers

Pulled from 9 studies with measurable effects

People studied

499

typical study: 30 people

Strongest designs

2 pooled, 36 randomised

How long studies ran

1–3 months

3+ months

Populations Studied

Healthy middle-aged and older adults1

Patients with Friedreich's ataxia1

Aging populations1

Healthy older adults1

Active research area

35 studies in the last 5 years · Latest meta-analysis: 2025

20172026

1Meta-Analysis2022

Fels JA, Casalena G, Konrad C, Holmes HE, Dellinger RW, Manfredi G · Hum Mol Genet (2022)

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2Systematic Review2024

Alghamdi M, Braidy N · J Alzheimers Dis (2024)

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3Systematic Review2022

Lippi L, Uberti F, Folli A, Turco A, Curci C, d'Abrosca F · Aging Clin Exp Res (2022)

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4Systematic Review2020

Braidy N, Liu Y · Exp Gerontol (2020)

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5NAD+ metabolism and tolerabilityCrossoverCited 451×n=24 · very small study2018

Chronic supplementation with the NAD+ precursor vitamin, nicotinamide riboside (NR), is well tolerated and effectively stimulates NAD+ metabolism in healthy middle-aged and older adults.

Martens CR et al. · Nature communications (2018)

Randomized, double-blind, placebo-controlled crossover trial (2×6 weeks) in healthy adults aged 55–79
NR 500 mg twice daily was well-tolerated with no significant adverse events vs. placebo
NR significantly elevated blood NAD+ and its metabolites compared to placebo

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6RCT2025

Shoji M, Kato H, Koshizaka M, Kaneko H, Baba Y, Ishikawa T · Aging Cell (2025)

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7RCT2025

Lin Y, Zeidan RS, Lapierre-Nguyen S, Costello HM, Anton SD, Buford TW · Geroscience (2025)

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8ataxia rating scales improvementRCTn=60 · small study2024

This RCT provides important evidence for NR supplementation in a rare neurological disease population, demonstrating both NAD+ elevation and potential functional neurological benefit.

Nachbauer W et al. · The Lancet Neurology (2024)

NR supplementation significantly elevated blood NAD+ levels throughout the 12-month trial
The combination of NR plus individualized exercise produced the greatest improvements in ataxia rating scales
NR was well tolerated with no serious adverse events attributed to supplementation

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9RCT2024

Orr ME, Kotkowski E, Ramirez P, Bair-Kelps D, Liu Q, Brenner C · Geroscience (2024)

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10RCT2024

Norheim KL, Ben Ezra M, Heckenbach I, Andreasson LM, Eriksen LL, Dyhre-Petersen N · Nat Aging (2024)

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11RCT2023

Berven H, Kverneng S, Sheard E, Søgnen M, Af Geijerstam SA, Haugarvoll K · Nat Commun (2023)

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12RCT2023

Ahmadi A, Begue G, Valencia AP, Norman JE, Lidgard B, Bennett BJ · JCI Insight (2023)

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13RCT2023

Vreones M, Mustapic M, Moaddel R, Pucha KA, Lovett J, Seals DR · Aging Cell (2023)

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14RCT2023

Dellinger RW, Holmes HE, Hu-Seliger T, Butt RW, Harrison SA, Mozaffarian D · Hepatology (2023)

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15RCT2023

Yulug B, Altay O, Li X, Hanoglu L, Cankaya S, Lam S · Transl Neurodegener (2023)

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16RCT2023

Pencina KM, Lavu S, Dos Santos M, Beleva YM, Cheng M, Livingston D · J Gerontol A Biol Sci Med Sci (2023)

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17RCT2022

Brakedal B, Dölle C, Riemer F, Ma Y, Nido GS, Skeie GO · Cell Metab (2022)

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18RCT2022

Jensen JB, Dollerup OL, Møller AB, Billeskov TB, Dalbram E, Chubanava S · JCI Insight (2022)

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19RCT2022

Song M, Armenian SH, Bhandari R, Lee K, Ness K, Putt M · BMC Cancer (2022)

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20RCT2021

Altay O, Arif M, Li X, Yang H, Aydın M, Alkurt G · Adv Sci (Weinh) (2021)

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View in Research Library

Nicotinamide Riboside Research

Mostly mechanism / observational

By the numbers

Gene expression profiles in sporadic ALS fibroblasts define disease subtypes and the metabolic effects of the investigational drug EH301.

Supplementation with NAD+ Precursors for Treating Alzheimer's Disease: A Metabolic Approach.

Impact of nutraceuticals and dietary supplements on mitochondria modifications in healthy aging: a systematic review of randomized controlled trials.

NAD+ therapy in age-related degenerative disorders: A benefit/risk analysis.

Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD(+) in healthy middle-aged and older adults.

Nicotinamide Riboside Supplementation Benefits in Patients With Werner Syndrome: A Double-Blind Randomized Crossover Placebo-Controlled Trial.

Nicotinamide riboside combined with exercise to treat hypertension in middle-aged and older adults: a pilot randomized clinical trial.

Safety and efficacy of individualised exercise and NAD+ precursor supplementation in patients with Friedreich's ataxia in the USA: a single-centre, 2 × 2 factorial, randomised controlled trial

A randomized placebo-controlled trial of nicotinamide riboside in older adults with mild cognitive impairment.

Effect of nicotinamide riboside on airway inflammation in COPD: a randomized, placebo-controlled trial.

NR-SAFE: a randomized, double-blind safety trial of high dose nicotinamide riboside in Parkinson's disease.

Randomized crossover clinical trial of coenzyme Q10 and nicotinamide riboside in chronic kidney disease.

Oral nicotinamide riboside raises NAD+ and lowers biomarkers of neurodegenerative pathology in plasma extracellular vesicles enriched for neuronal origin.

Nicotinamide riboside and pterostilbene reduces markers of hepatic inflammation in NAFLD: A double-blind, placebo-controlled clinical trial.

Combined metabolic activators improve cognitive functions in Alzheimer's disease patients: a randomised, double-blinded, placebo-controlled phase-II trial.

MIB-626, an Oral Formulation of a Microcrystalline Unique Polymorph of β-Nicotinamide Mononucleotide, Increases Circulating Nicotinamide Adenine Dinucleotide and its Metabolome in Middle-Aged and Older Adults.

The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease.

A randomized placebo-controlled trial of nicotinamide riboside and pterostilbene supplementation in experimental muscle injury in elderly individuals.

Exercise training and NR supplementation to improve muscle mass and fitness in adolescent and young adult hematopoietic cell transplant survivors: a randomized controlled trial {1}.

Combined Metabolic Activators Accelerates Recovery in Mild-to-Moderate COVID-19.