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Understanding Nicotinamide Riboside

10/10/2024 | by

Several NAD+ precursors have been studied as an alternative method to boost NAD+ levels, including a form of vitamin B3 known as nicotinamide riboside (NR). NR IV infusions are a new potential avenue for those looking to boost NAD+ levels to support their health and wellness.

What is Nicotinamide Riboside?

Nicotinamide riboside (NR) is an alternative form of vitamin B3. NR has only recently started to be studied, but may have exciting and widespread benefits for human health.

The majority of the potential benefits of nicotinamide riboside are based on its role as a building block for the coenzyme (or “helper molecule”) NAD+.

NAD+ is required for numerous processes and functions within the body, but our levels of this coenzyme decrease as we age.1 NR may help to support healthy aging from within by boosting levels of NAD+.

Nicotinamide riboside

NR supplementation may help to reduce the risk of chronic illnesses, including Alzheimer’s disease, diabetes, and heart disease. It may also have a role to play in protecting brain cells, supporting healthy metabolic function, and improving high blood pressure.

Read on to learn more about what the current body of research says about the benefits of NR, the differences between nicotinamide riboside and the other members of the B3 family (including niacin), the connection between NR and anti-aging, possible side effects, and whether supplementation may be right for you.2

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The Connection Between NR and NAD

Nicotinamide riboside offers a wide range of potential benefits primarily because it acts as a precursor to the molecule NAD+. In other words, when you take a nicotinamide riboside supplement, your body then converts it to NAD+. So, when we talk about the benefits of NR, we’re in many ways talking about the benefits of NAD+.

NAD+ is a coenzyme (a type of molecule that helps enzymes perform their tasks) naturally found in all of our cells and required for numerous biological functions.3

NAD+ helps to initiate several important processes, including: 

  • Repairing DNA
  • Strengthening cellular defense systems
  • Converting food into energy
  • Regulating circadian rhythm (your body’s internal clock)
  • Synthesizing fatty acids

Our levels of NAD+ decrease as we get older, and these lower levels may be responsible for some of the negative health effects we associate with aging.4

By increasing our levels of NAD+ with nicotinamide riboside supplementation, we may be able to reduce some of the unwanted effects of aging.5

Low levels of NAD+ have also been associated with an increased risk of numerous chronic illnesses, including heart disease, Alzheimer’s disease, and diabetes. Again, boosting NAD+ levels with a nicotinamide riboside supplement might help to reduce these risks.

Research interest in NAD+ itself has grown substantially in recent years, as we continue to learn more about the numerous biological processes it contributes to and the strength of its role in age-associated health changes. Numerous studies have now confirmed the benefits of boosting NAD+ levels – but the question of how to best do this has remained.

Direct NAD+ supplementation is not thought to be effective, as oral NAD+ is poorly absorbed and not taken up properly by our cells. Some health centers offer IV NAD+; however, this approach is costly and inaccessible for many.

This has led to the emphasis on studying precursors to NAD+. There are other identified precursors to NAD+, including the better known form of vitamin B3, niacin, as well as tryptophan, nicotinamide (NAM), nicotinic acid (NA), and nicotinamide mononucleotide (NMN).

However, each of these other precursors comes with limitations, such as risk of side effects (as in the case of niacin, which may cause flushing in the face or chest, or digestive symptoms), or challenges related to efficiency or absorption.

In contrast, NR seems to be quite effective and efficient at increasing NAD+ levels, with a very low risk of side effects.6 For these reasons, it’s quickly becoming one of the most studied and exciting precursors to NAD+.

What Causes Low NAD+ Levels?

Beyond age itself, certain disease states can cause us to use up more NAD+ than usual. Oxidative stress, inflammation, and DNA damage are among the possible factors. Infections, including COVID-19, have also been shown to deplete levels of NAD+.

Low NAD+, in turn, may exacerbate the disease states that have brought it on, including inflammation and oxidative stress. When it comes to COVID specifically, some have theorized that low NAD+ may play a role in the increased likelihood of death among those with certain pre-existing medical conditions. This connection is currently being studied.

How NR Works to Boost Low NAD+ Levels

Nicotinamide riboside works by helping to increase levels of NAD+ within your cells. NAD+ then works to initiate numerous different biological processes.

Here are a few key ways in which NR, once converted to NAD+, may function:

  • Activating enzymes involved in healthy aging, DNA repair, stress response, and more. NAD+ activates a number of important enzymes that affect our health. Key examples include sirtuins, which may play a role in improving lifespan, enhancing stress resistance, and reducing inflammation, as well as Poly (ADP-Ribose) polymerases (PARPs), which help to repair damaged DNA.(7, 8, 9, 10, 11)
  • Protecting brain cells. NAD+ has been shown to help protect brain cells against damage and deterioration, including from oxidative stress and mitochondrial dysfunction. Both oxidative stress and mitochondrial dysfunction are thought to be involved in neurodegenerative disorders including Alzheimer’s and Parkinson’s.(12, 13)
  • Reducing inflammation. Nicotinamide riboside has been shown to reduce levels of inflammatory markers in blood and immune cells.14 As inflammation plays a central role in innumerable chronic illnesses, there are many possible implications of this beneficial effect.

Potential Uses and Benefits of NR

Based on the widespread beneficial actions of NAD+, there are numerous possible uses and benefits of its newest star precursor, nicotinamide riboside.

Research has consistently shown that NR does increase levels of NAD+ in the blood. More research is still needed in order to elucidate exactly which conditions NR supplementation may benefit via this pathway (and to what degree). However, studies to date have been promising.

It’s worth noting that nicotinamide riboside as a form of vitamin B3 was only recently discovered. When a new potential supplement or drug ingredient emerges, clinical trials on humans can’t start right away. Researchers have to first prove their concepts and begin to assess safety and efficacy through cell and/or animal studies. Early human trials are then often small and focused largely on safety.

Given these necessary limitations, it’s encouraging that, both in animal and cell trials, and since the first human trials began in 2016, a number of benefits have been found, with research still very much ongoing. In the future, we may see more evidence of the benefits of NR for a variety of metabolic, cardiovascular, and neurodegenerative disorders.

Possible uses and benefits of nicotinamide riboside include

Preventing and treating age-related brain disorders

NAD+ plays an important role in supporting mitochondrial function and reducing oxidative stress, which may help to prevent and/or slow the progression of neurodegenerative disorders.

  • A study on mice with Alzheimer’s disease found that NR increased levels of NAD+ and significantly improved memory.15
  • In a test tube study, NR was shown to improve NAD+ levels and mitochondrial function in the cells of an individual with Parkinson’s disease. 
  • A 2024 clinical trial found that NR supplementation significantly increased NAD+ levels among older adults with mild cognitive impairment (MCI).16 However, no significant changes were seen in cognitive function. Further research is needed to see what cognitive benefits NR may have for those with MCI.

Reducing the risk and severity of heart disease

As we age, our risk of heart disease increases for a number of reasons, including the thickening and stiffening of the aorta and other blood vessels. This can increase blood pressure and cause excess strain on the heart. NR may help to prevent or even reverse this damage, thus lowering the risk of cardiovascular disease.

  • Research on adults at risk for high blood pressure has shown that NR can boost NAD+ levels, reduce aortic stiffness, and reduce blood pressure.
  • A randomized controlled trial on 90 participants with peripheral artery disease (PAD) found reduced oxidative stress, improved mitochondrial activity, and better walking performance among those who took NR supplements (compared with those who took a placebo).

Improving weight loss and metabolism

Nicotinamide riboside may help to speed up metabolism, which can aid healthy weight loss.17

  • In trials on animals with diabetes, NR has been shown to improve glucose tolerance and insulin sensitivity, help slow or decrease weight gain, and help to protect against diabetic neuropathy.18 It’s not yet clear whether these effects will translate for humans.19

Reducing cancer risk

NAD+ helps to protect against many of the risk factors and concerns linked to cancer, including oxidative stress, mitochondrial dysfunction, and DNA damage.(20, 21)

  • NR supplementation reduced the risk of developing skin cancer by 23% in one study involving participants who had previously overcome this type of cancer.22
  • A 2023 animal trial found that NR supplementation with the purposes of boosting NAD+ levels was able to slow the progression of liver cancer and repair certain kinds of damage brought on by the disease.23
  • Nicotinamide riboside may help to prevent or reduce the harmful loss of muscle and fat associated with certain kinds of cancer.

Protecting against damage from COVID-19 and other infections

NR may help to reduce the risk of infection with SARS-CoV-2 (responsible for COVID-19) and other pathogens. For those who do contract COVID or other infections, NR supplementation may help to reduce the risk of serious side effects. Numerous ongoing studies are looking into these effects, but here are a few of the insights we have so far:

  • Supplementation with NR has been shown to reduce levels of inflammatory cytokines.24 Elevated levels of inflammatory cytokines are associated with more severe COVID and other infections.
  • A mixture of NAD+ precursors (including nicotinamide riboside) and the antioxidant glutathione was found to speed up recovery, reduce symptoms, and decrease inflammation among those with COVID.25
  • NAD+ has been shown to improve fatigue that persists following a COVID-19 infection.

Other potential uses and benefits may include: 

  • Resetting circadian rhythm (your body’s internal clock) and reducing jet lag26
  • Reducing hearing loss
  • Improving muscle strength and endurance27
  • Assisting in exercise recovery
  • Reducing the risk of vision loss

Possible Side Effects of NR

Nicotinamide riboside is thought to be safe for most people, with a low risk of side effects.28

Because research on NR is still in its early stages, most studies have been relatively small and have only looked at short term use of the supplement. However, to date it seems that side effects are uncommon and generally mild.29

Possible side effects may include: 

  • Nausea
  • Diarrhea
  • Bloating
  • Upset stomach or indigestion
  • Fatigue
  • Itchiness
  • Increased sweating

Unlike other forms of vitamin B3 (specifically niacin), NR has not been shown to cause facial flushing.30

NR may also be safe for those who are pregnant or breastfeeding, but it’s always best to speak with your practitioner before introducing a new supplement.

If you are taking medication for high blood pressure (antihypertensive drugs), speak with your doctor before introducing NR. NR may also lower blood pressure, so combined with medication for the same purpose, blood pressure may become too low.

NR Infusion Treatment: How Does it Work?

One option that has recently become available is NR infusion treatments (intravenous NR). In general, vitamin and nutrient IVs can offer superior potency compared to oral supplementation (though they are also likely to be more costly and less convenient).

IV infusions of NAD+ itself are currently offered at some medical wellness centers and clinics. However, given nicotinamide riboside’s positive safety profile and efficiency within the body, some have wondered if using NR infusions to boost NAD+ may be a more effective option. IV NR is now available from certain in-home medical services, which can bring NR infusions directly to patients.

In June 2024, the first human clinical trial evaluating IV infusions of NR was published. In this small study, which has not yet been peer reviewed, intravenous NR infusions were compared to intravenous NAD+ infusions.

The researchers found that, compared to direct administration of NAD+, nicotinamide riboside worked faster and was tolerated better with fewer adverse effects. Three hours after treatment, blood levels of NAD+ were significantly higher in the group who received NR infusions compared to those who received NAD+ directly. This promising finding will likely lead to more research on intravenous NR.

FDA Approval Status

The US Food and Drug Administration (FDA) doesn’t evaluate and approve supplements the way they do with drugs. However, they have given a trademarked form of nicotinamide riboside, Niagen®, Generally Regarded as Safe (GRAS) status, which means just what it sounds like: the ingredient is thought to be safe for use in dietary supplements and/or food products.

Recommended NR Dosage

Dosage of nicotinamide riboside usually starts at 300 mg daily, which is usually contained within one or two capsules or tablets, or a serving of powder. There are supplements available in higher concentrations, up to 1000 mg per dose.

Studies have found that up to 2000 mg per day is likely safe; however, there is likely no need to start on the higher end.31 As always, it’s best to speak with your practitioner to determine the best dosage for you.

Research has found that up to 230 mg per day is likely safe for those who are pregnant or breastfeeding.32

Cost of NR

Based on the NR supplements currently on the market, the cost per dose ranges from roughly $0.75 – $1.85. As with most supplements, they’re usually sold in quantities that will last one or two months if taking the recommended dose.

The number of companies currently making NR supplements is relatively low. If interest in nicotinamide riboside continues to grow, we may start to see increased availability and competition among supplement companies, which might in theory drive the average cost down.

New methods of production are also being researched in the hopes of reducing the cost of making NR supplements. This may also help to facilitate more affordable options for consumers.

Last Words

If you’re interested in exploring nicotinamide riboside supplements for anti-aging, disease prevention, or other purposes, the best first step is to speak with a healthcare provider about whether supplementation is right for you.

If you decide to move forward, you can purchase NR supplements at certain health food stores or online. Be sure to follow the instructions on the package to ensure safe use and maximum effectiveness.

NR IV infusions are the fastest and most effective way to boost NAD+ levels so you can enjoy the benefits of this essential coenzyme. You can now get a Niagen NR IV infusion administered by a licensed medical professional in the comfort of your home with Drip Hydration.

Get Niagen NR IV therapy

Turn back the clock with our Niagen NR IV therapy. Schedule your appointment and feel youthful and revitalized!

NAD - Frequently Asked Questions

What is NAD?

NAD is a coenzyme that is naturally produced by the body and is essential for various physiological processes, including energy production and DNA repair. It is found in all living cells and plays a critical role in many of the body's metabolic processes. NAD is a dinucleotide, which means that it consists of two nucleotides joined together. It is made up of two molecules: nicotinamide and adenine, which are joined together by a phosphate group.

NAD is involved in a wide range of biological processes, including the metabolism of carbohydrates, proteins, and fats, and is essential for the proper functioning of the body's cells and tissues.

What can I expect during a NAD IV treatment?

Our nurse will arrive at your location of choice with all the equipment necessary for the appointment. They will then administer the IV into your arm and stay with you to monitor the treatment and answer any questions you may have.

Our NAD IV treatments generally last couple of hours per session. You can sit back, watch a movie or a favorite show, browse social media, or even work while the treatment is in progress.

What sets Drip Hydration apart from other NAD IV treatment providers?

Drip Hydration brings appointments directly to you whether you are at home, at a hotel, or at the office. We make getting at home NAD IV treatments easy and convenient, saving you the time and hassle of sitting in traffic or waiting in a clinic.

Is NAD right for me?

You don’t have to wait until you are experiencing a medical condition to enjoy the benefits of NAD IV therapy. NAD plays a role in hundreds of chemical functions throughout your body. This versatile treatment helps promote whole-body wellness and can help your body maintain optimal performance over time.

Is IV therapy FDA approved?

IV therapy in general is FDA approved. Our nurses are overseen by our Medical Director, Abe Malkin, and every nurse is registered and certified per state standards.

Is NAD safe?

NAD is considered a dietary supplement, not a drug. The FDA does not currently evaluate dietary supplements in their current regulations. However, NAD is well-tolerated, meaning that there are rarely side effects.

How long do IV treatments take?

Our IV NAD treatments take couple of hours to administer per session. The number of sessions vary by individual and will be determined during your initial consultation.

Does NAD help battle aging?

Some studies have suggested that NAD may have anti-aging effects by helping to support the production of enzymes that are involved in DNA repair and maintenance, which are essential for maintaining healthy cells and tissues. Additionally, NAD may support the production of enzymes that are involved in the body's natural detoxification processes, which can help to reduce the effects of oxidative stress and support healthy aging. 

Does NAD Improve metabolic function?

Some studies have suggested that NAD may support healthy metabolism by helping to regulate the body's energy production and utilization, and may also support the production of enzymes that are involved in various metabolic processes. Additionally, NAD may support the body's natural detoxification processes, which are important for maintaining overall health and wellness.

How often can I get an NAD treatment?

NAD IV treatments are most effective when used over time. You can get treatments several times per month unless you are otherwise advised during your initial consultation.

What can I expect to feel after a NAD IV drip?

Following a NAD IV drip, most patients feel more energetic, clearer-headed, and focused. Regular treatments may improve these effects over time.

Is there any downtime or recovery after a NAD drip?

Not at all! You can resume your normal activities immediately after your appointment. Where do you deliver NAD IV treatments? Drip Hydration delivers NAD IV treatments anywhere within our service areas, which you can find on our service area pages. That said, we recommend choosing a comfortable place for NAD treatments since this type of IV couple of hours per appointment.

How is IV NAD better than an oral NAD supplement?

IV NAD is delivered directly into your bloodstream, where it becomes available to your cells for immediate use. Because NAD bypasses the digestive and metabolic systems, you can expect a 100% absorption rate for maximum effect and minimal waste. Oral NAD supplements, on the other hand, must pass through your digestive system, where they are partly metabolized before your body has access to orally given NAD.

What is the difference between a NAD IV and a vitamin drip?

There are two main differences between a NAD IV and a Vitamin Drip: duration and ingredients. NAD IVs generally take couple of hours to administer per session while vitamin drips take 30 - 45 minutes. Our vitamin drips are specially blended to improve a variety of symptoms and ailments. Our NAD+ Boost treatments contains vitamins that can help make this IV more effective with longer-lasting effects.

Do I need any special supplies for my NAD IV appointment?

No, you do not need any special supplies. Our nurse will bring everything needed for the appointment.

Does NAD improve brain health and function?

NAD is believed to have potential benefits for brain health and function, although more research is needed to fully understand its effects. Some studies have suggested that NAD may have neuroprotective effects, meaning that it may help to protect the brain from damage and support healthy brain function. Additionally, NAD may support the production of neurotransmitters, which are chemicals that help to transmit signals between the brain's cells, and may help to improve cognitive function and memory.

NAD Injection Therapy

What are the benefits of NAD Injection Therapy?

NAD injection therapy is believed to have several potential benefits, including improving energy levels, supporting cognitive function, reducing inflammation, and supporting the body's natural detoxification processes. Additionally, NAD injection therapy is often used in combination with other treatments, such as IV vitamin therapy, to support the body's natural recovery processes and improve overall health and wellness.

What is the difference between NAD injection vs NAD IV therapy?

The main difference between NAD injection and NAD IV therapy is the method of delivery. NAD injection involves injecting NAD directly into the bloodstream using a syringe, while NAD IV therapy involves infusing NAD into the bloodstream through a small tube that is inserted into a vein.

What is the difference between NAD injections and NAD supplements?

The main difference between NAD injections and NAD supplements is the method of delivery. NAD injections involve injecting NAD directly into the bloodstream using a syringe, while NAD supplements are taken orally in the form of pills or capsules.

How to best self-administer a NAD injection?

When administering the injection, it is important to use a clean, sterile needle and syringe, and to inject the NAD into a vein using a slow, steady motion. It is also important to properly dispose of the used needles and syringes to avoid the risk of injury or infection. It is also important to carefully follow the instructions provided by the healthcare professional and the manufacturer of the NAD injection, including proper storage and handling of the injection and any necessary preparation steps.

NAD+ Nasal Spray

What are the benefits of NAD+ nasal spray?

NAD+ nasal spray is believed to have several potential benefits, including improving energy levels, supporting cognitive function, reducing inflammation, and supporting the body's natural detoxification processes.

What is the difference between NAD injection and NAD+ nasal spray?

The main difference between NAD injection and NAD+ nasal spray is the method of delivery. NAD injection involves injecting NAD directly into the bloodstream using a syringe, while NAD+ nasal spray involves delivering NAD directly into the bloodstream through the nose.

What is the difference between NAD+ nasal spray and NAD supplements?

The primary distinction between NAD+ nasal spray and NAD supplements is the route of administration. NAD+ nasal spray delivers NAD directly into the bloodstream via the nose, whereas NAD supplements are taken orally as tablets or capsules.

How often can I use the NAD+ nasal spray?

The frequency of NAD+ nasal spray use will depend on the specific product and the individual's needs and preferences. It is important to consult with a healthcare professional to determine the appropriate frequency of NAD+ nasal spray use, as well as any potential risks or side effects. In general, NAD+ nasal spray can be used daily or as needed, depending on the individual's goals and needs. It is also important to carefully follow the instructions provided by the healthcare professional and the manufacturer of the NAD+ nasal spray, including any recommended dosing guidelines and precautions.

What can I expect to feel after using the NAD+ nasal spray?

The effects of NAD+ nasal spray may vary depending on the individual and their unique physiology and health needs. In general, people may experience improved energy levels, cognitive function, and overall health and wellness after using NAD+ nasal spray. Additionally, NAD+ nasal spray may help to support the body's natural recovery processes and reduce the symptoms of conditions such as chronic fatigue syndrome, fibromyalgia, and addiction.


Related:

References

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