Should I take NR (nicotinamide riboside)? — Whalespan
Should I take NR (nicotinamide riboside)?
⚠ High risk
Our read is that taking NR (nicotinamide riboside) is well supported for certain applications, though its broad longevity benefits remain debated.
✓WELLSUPPORTED
⚠
High-risk intervention — consult a physician before acting.Drug-drug interactions, dose-dependence, and screening contraindications apply.
Consensus
87%
broad agreement
Evidence quality
10/100
speculative
Risk
High
specialist only
Cost / month
$
estimated
Effort
Low
time & habit
Abstract
Oral supplementation with nicotinamide riboside (NR) is considered relatively safe at certain doses, with some experts noting its potential for exercise recovery, increased energy, and positive effects in specific conditions like peripheral artery disease and LongCo.
However, there is significant expert skepticism regarding its efficacy for general human longevity and a lack of demonstrated phenotypic benefits in healthy individuals, with concerns about potential side effects and the depletion of methyl donors.
Method
Oral supplementation with 250mg each of NR and NMN (total 0.5g) is considered relatively safe if homocysteine levels are monitored. NR and NMN supplements should be kept cold and purchased from manufacturers who ensure they have not been stored in hot conditions.
Evidence detail
01Oral supplementation with 250mg each of NR and NMN (total 0.5g) is relatively safe if homocysteine levels are monitored (Peter Attia, Paul Saladino).
02Nicotinamide riboside (NR) may aid in exercise recovery (Rhonda Patrick).
03The speaker takes NR and NMN for increased energy levels throughout the day (Andrew Huberman).
04In a clinical trial for peripheral artery disease (PAD), NR improved the six-minute walk test, while resveratrol blocked some of NR's benefits (Rhonda Patrick).
05Niogen (nicotinamide riboside) has demonstrated anti-inflammatory benefits in eight randomized clinical trials and positive effects in peripheral artery disease and LongCo (Rhonda Patrick).
Conflict Watch
Every Sunday: the week’s new conflicts and verdict changes — and nothing else.
06Oral nicotinamide riboside (NR) is available to cardiac tissue, skeletal muscle, and peripheral nerves (Peter Attia, Rhonda Patrick, David Sinclair).
07NAD+ boosters (NR and NMN) at high doses have improved aging in multiple tissues in animal studies (Peter Attia, Andrew Huberman, Rhonda Patrick, David Sinclair).
08NR-supplemented mothers in mice produced more milk, leading to better weight management and potentially higher levels of bioactives in their offspring (Rhonda Patrick).
09Nicotinamide riboside (NR) has shown positive effects on the brain in animals, including increased neurogenesis (Rhonda Patrick).
10Bryan Johnson found both NR (Tru Niagen) and NMN (Jinfiniti) effective in raising intracellular NAD+ levels to an equivalent of age 16 after 90 days of each (Peter Attia, Bryan Johnson, David Sinclair).
11NAD+ precursors like NR can boost mitochondrial activity in mice with mitochondrial disease (Peter Attia).
12NAD+ can be synthesized from precursors NR or NMN, or via the de novo pathway from tryptophan (Peter Attia).
13Supplementing with nicotinamide riboside (NR) increases NAD+ in muscle, derived from liver-produced nicotinamide (Peter Attia, Rhonda Patrick).
14Oral nicotinamide riboside (NR) can raise NAD+ levels in whole blood and white blood cells (Rhonda Patrick, David Sinclair).
15Nicotinamide riboside (NR) can enter cells and be converted into its final nucleotide form, whereas NMN cannot directly enter cells due to its phosphate group (Rhonda Patrick).
16There is evidence supporting nicotinamide riboside (NR) transporter involvement in cellular uptake (Peter Attia, Rhonda Patrick).
17The only human study showing a significant benefit of nicotinamide riboside (NR) was in ALS patients, where it delayed the need for ventilation (Peter Attia, Rhonda Patrick).
Caveats
Our experts express significant reservations about the broad applicability of NR for human longevity. Peter Attia is unconvinced that oral supplementation of NR or NMN benefits human health, and he, along with Andrew Huberman, suggests the evidence for NAD precursors being geroprotective in healthy individuals has a low probability of being true. Paul Saladino believes he can regenerate NAD from food and a ketogenic diet without NR or NMN, and that optimal NAD+ levels are best achieved through metabolic health. Concerns include that supplementing with NR and NMN may accelerate NAD+ 'leak' and exacerbate the problem (Peter Attia), and that excess nicotinamide (NAM) from supplementation can deplete methyl donors like SAMe, potentially causing issues with methylation (Paul Saladino). High doses of NR (1000mg) have led to significant dropout rates due to side effects like rashes and flushing (Rhonda Patrick). NR did not extend lifespan in rigorous animal models (Peter Attia) and did not improve grip strength in older men in a placebo-controlled crossover trial (Rhonda Patrick). Peter Attia suggests oral supplementation with NR or NMN is unlikely to benefit longevity and may primarily enrich supplement companies. Andrew Huberman notes that NR is made from vitamin B3, found in milk, and is less effective than NMN for increasing NAD levels. Many brands of NR/NMN on Amazon contain less active ingredient than stated (Rhonda Patrick). There is no meaningful logical connection between caloric restriction, NR, and lifespan extension (Andrew Huberman). Peter Attia also notes that NR may increase tumor growth in triple-negative breast cancer, and human trials of oral NR (500-1000mg daily) have not shown benefits on glucose or lipid metabolism. Increased NAD+ levels in the blood from NAD+ precursor supplementation do not necessarily indicate increased NAD+ levels in the brain or muscle (Rhonda Patrick). Oral doses of NR or NMN in commercial supplements may not significantly increase intracellular NAD levels in a physiologically meaningful way (Peter Attia).
What would change this verdict
The verdict would change if robust human clinical trials in healthy individuals consistently demonstrated significant phenotypic benefits for longevity, beyond pathological states, with clear mechanisms and minimal side effects. Further research clarifying the long-term impact on methylation, potential acceleration of NAD+ 'leak', and the efficacy of commercial supplements would also be crucial.