NAD+ precursor: human trials, bioavailability and translational evidence

Nicotinamide Riboside (NR) Research Data Center

Explore 98 publications on nicotinamide riboside (NR), spanning human trials, pharmacokinetics, evidence reviews, rare-disease reports, foundational biology and nonclinical safety. The library includes recent studies of Parkinson’s disease, cognition, peripheral artery disease, kidney disease, exercise and NAD+ biomarker interpretation. NR reliably changes several NAD-related biomarkers in human studies, while clinical outcomes vary by population, preparation and endpoint. Each research record distinguishes the tested intervention and model, summarizes findings and limitations, and links to the original publication.

Evidence at a glance

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Tier 1
45
Tier 2
19
Tier 3
30
Tier 4

Aging and stem cells: preclinical models

Bioavailability

Tier 2

The differential impact of three different NAD+ boosters on circulatory NAD and microbial metabolism in humans

Stefan Christen et al. · Nature Metabolism · 2026 · Volume 8, issue 1, pages 62–73

Randomized, open-label, placebo-controlled human trial with a pre-registered primary endpoint (NCT05517122): 67 participants were randomized and 65 were included in the modified intention-to-treat analysis. Validated metabolomics plus complementary ex vivo microbiome and whole-blood experiments strengthen mechanistic interpretation, but the open-label design, healthy population and indirect nature of the proposed gut mechanism limit inference.

Sourcedoi:10.1038/s42255-025-01421-8PMID 41540253PMC12855009

Cancer biology: preclinical evidence

Chronic kidney disease

Tier 2

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

Armin Ahmadi et al. · JCI Insight · 2023 · 8(11):e167274

Randomized, double-blind, placebo-controlled three-period crossover trial with objective ergometry outcomes and extensive metabolomics/lipidomics. Internal validity is strong for the tested short-term physiology endpoints, but only 25 participants with CKD were studied and treatment lasted six weeks per period.

Sourcedoi:10.1172/jci.insight.167274PMID 37159264PMC10393227

Cognition and neurological biomarkers

Combination treatments: NR plus pterostilbene

Corrections and source integrity

Evidence reviews and clinical translation

Foundational NAD+ and NR biology

Gut microbiome and NAD+ metabolism

Heart failure and cellular inflammation

Heart failure: preclinical models

Intravenous NR: route-specific evidence

Kidney disease: clinical evidence

Metabolic health and glucose regulation

Metabolic health: preclinical models

Multi-ingredient metabolic activators

Muscle & Physical Function

Tier 1

The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis

Konstantinos Prokopidis et al. · Journal of Cachexia, Sarcopenia and Muscle · 2025 · 16(3):e13799

Peer-reviewed systematic review and meta-analysis of randomized placebo-controlled nicotinamide-precursor trials in adults with mean ages above 60 years, with NMN-specific pooled analyses for key sarcopenia outcomes.

Sourcedoi:10.1002/jcsm.13799PMID 40275690PMC12022230

NAD biology / neuroinflammation

NAD precursors and methyl-donor context

Tier 2

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

Haakon Berven et al. · Nature communications · 2023 · 14(1):7793

Randomized phase I RCT. High-dose NR increased NAD-related metabolites and was tolerated in this short study. An initial homocysteine rise occurred without evidence of depletion of the measured methyl-donor pool. Direct human intervention or pharmacokinetic evidence. This is an individual study, not replicated highest-tier clinical proof; sample size, controls and the measured endpoint limit its interpretation.

Sourcedoi:10.1038/s41467-023-43514-6PMID 38016950PMC10684646

NAD+ Augmentation — Systematic Evidence Synthesis

Tier 1

NAD+ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence

Cory Gallagher et al. · Ageing Research Reviews · 2026 · 116:103057

PRISMA-guided systematic review of 113 eligible intervention studies, including 33 human studies (28 randomized) and 80 rodent studies. Broad synthesis of NAD-related interventions; strong for evidence mapping, though it is primarily narrative rather than a pooled NMN-only meta-analysis.

Sourcedoi:10.1016/j.arr.2026.103057PMID 41655607

NAD+ Biology — Aging Biomarkers

Tier 1

Human whole-blood NAD+ levels do not vary with age or lifestyle interventions

Maria M Tretowicz et al. · Nature Metabolism · 2026 · 8(6):1282–1290

Large multi-cohort human observational/metabolomics analysis using a rigorously validated whole-blood NAD+ assay across seven independent cohorts. High-quality evidence for the specific question of whole-blood NAD+ and aging, but it does not establish that NAD+ is age-stable in every tissue.

Sourcedoi:10.1038/s42255-026-01537-5PMID 42135539

NAD+ Pharmacokinetics — Direct NMN vs NR Comparison

Tier 2

The NAD-brain pharmacokinetic study of NAD augmentation in blood and brain using oral precursor supplementation

Haakon Berven et al. · iScience · 2026 · 29(3):114764

Phase I, open-label pharmacokinetic study with a randomized crossover stage directly comparing NR and NMN in six healthy adults, followed by longer NR exposure in healthy adults and people with Parkinson’s disease. Valuable direct comparative human PK evidence, but extremely small and not an efficacy trial.

Sourcedoi:10.1016/j.isci.2026.114764PMID 41858901PMC12996706

NAD+ bioavailability and pharmacokinetics

NRH: distinct precursor chemistry

Neurodegeneration: preclinical models

Parkinson’s disease: clinical evidence

Peripheral nerves and sensory function

Rare disorders: human clinical reports

Rare disorders: preclinical models

Respiratory and immune function

Safety and formulation: nonclinical evidence

Safety and methylation

Safety and tolerability

Skeletal muscle, exercise and epigenetics

Skeletal muscle: preclinical models

Skin Biology — Keratinocyte Inflammation

Vascular function and blood pressure