Le riboside de nicotinamide (NR) et le mononucléotide de nicotinamide (NMN) par voie orale font une chose de façon fiable : pris par la bouche, ils élèvent le NAD+ dans le sang, de manière dose-dépendante, dans plusieurs essais randomisés. Reste à savoir si ce marqueur élevé change la façon dont une personne se sent, performe ou vieillit, et cela n'est pas tranché. Chez l'humain, les essais sur la force musculaire, le contrôle de la glycémie et les marqueurs du vieillissement reviennent le plus souvent faibles, contrastés ou nuls, même là où les mêmes composés produisent des effets frappants chez des souris âgées.
Ainsi, élever le NAD+ est établi ; que le compléter prolonge la durée de vie en bonne santé ou la longévité humaine ne l'est pas. Cette page situe chaque affirmation là où les preuves la placent, aborde le statut FDA du NMN et le bilan de sécurité à court terme, et explique en quoi une gélule quotidienne diffère d'une perfusion intraveineuse de NAD+.
Findings & Outcomes
What It Is
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme every cell uses to turn food into usable energy and to run its repair and signaling enzymes. Its level drifts down with age across many tissues, and that decline is the rationale behind the whole precursor category. NMN and NR are two precursor molecules the body converts into NAD+, sold as capsules or powder to top the pool back up. Both are relatives of vitamin B3, and NR and NMN raise NAD+ more than an ordinary diet does.
How It Works
Built from vitamin B3, NAD+ powers the enzymes of energy metabolism and feeds repair systems such as the sirtuins and the PARPs. Two of those steps are settled: NAD+ falls with age, and the precursors raise it back up.
Anatomy of the Practice
1The rationale: NAD+ falls with age
NAD+ is central to energy metabolism and cellular repair, and its levels decline with age in many tissues. That decline is why the precursor category exists: the hope is that restoring NAD+ toward a younger level restores some of what falls with it. The decline itself is well described.
2What the precursors do in the blood
Taken by mouth, NR and NMN are absorbed and converted into NAD+, and human trials consistently measure a rise in blood NAD+ and its metabolites within weeks. This is the dependable, replicated part. The marker rises, and it rises in a dose-related way, a pharmacological effect that is not in dispute.
3From a marker to an outcome
In the human trials blood NAD+ rose while strength, insulin sensitivity, and aging markers stayed where they were. A higher number on a lab report is one thing. Whether the extra NAD+ reaches the tissues that matter and does useful work there is what the functional trials must settle, and so far they mostly have not.
An intravenous NAD+ drip delivers NAD+ by a different route but runs into the same limit, and it rests on even less controlled outcome evidence than the oral capsules. For where NAD+ decline sits among the drivers of aging, see the biology of aging; for the cell structures it helps power, see the mitochondria.
What It Does
People buy a daily capsule on a simple chain: the level drops with age, precursors lift it, so lifting it should slow aging. That chain rests on animal work, and the animal work is the strong part. In aged mice, restoring NAD+ improves metabolism, muscle, and healthspan, and the field holds some of the more reproducible results in aging biology.
The human evidence sorts into tiers, strongest first. Firmest is the raised NAD+ level itself. The weak point is the payoff people pay for: added up, the precursors have not moved glucose, lipids, or muscle strength in ordinary adults over 60. Between that firm marker and those null results sit two preliminary leads in narrow groups. Above everything sits the headline claim with no completed human trial behind it, that a precursor extends healthspan or lifespan.
The weak point is the payoff people pay for: added up, the precursors have not moved glucose, lipids, or muscle strength in ordinary adults over 60.
The Research & Studies
Everything here is based on the research we have collected and checked, sorted into groups and ordered with the strongest evidence first. Click any claim to open the studies behind it.
How it works
La NR et la NMN prises par voie orale augmentent de manière fiable le NAD+ sanguin, de façon dose-dépendante (NMN testée à 300 à 900 mg par jour)
La prise orale de NR ou de NMN augmente de manière fiable le taux de NAD+ dans le sang. C'est l'unique effet pour lequel les données humaines sont solides.
Dans un essai croisé randomisé en double aveugle de 2x6 semaines (Martens et al. 2018, Nat Commun), la supplémentation chronique en NR chez des adultes en bonne santé d'âge moyen et âgés a été bien tolérée et a efficacement stimulé le métabolisme du NAD+. Une étude pharmacocinétique de première administration à l'humain (Trammell et al. 2016, Nat Commun) a montré que des doses orales uniques de NR augmentaient le métabolome du NAD+ sanguin de manière dose-dépendante. Un essai NMN à doses croissantes (Yi et al. 2023, GeroScience) a constaté une hausse significative du NAD+ sanguin à 300, 600 et 900 mg/jour par rapport au placebo et à la valeur de départ, la hausse étant la plus forte aux deux doses les plus élevées.
Who this may not transfer to:The rise in blood NAD+ is measured in both sexes across NR and NMN trials; it is a pharmacodynamic marker, so it does not by itself transfer to any clinical benefit.
The studies · 3
Martens et al. 2018, Nat Commun (NR elevates NAD+ in middle-aged and older adults) · Nat Commun
Trammell et al. 2016, Nat Commun (NR orally bioavailable in mice and humans) · Nat Commun
Yi et al. 2023, GeroScience (dose-dependent NMN trial) · GeroScience
Le NAD+ diminue avec l'âge, ce qui constitue la prémisse de la supplémentation, bien qu'il n'ait pas été démontré que le restaurer inverse le vieillissement
Le NAD+ a tendance à diminuer avec l'âge, ce qui est la raison pour laquelle certains prennent des précurseurs pour le reconstituer. Le déclin est bien décrit ; la question de savoir si l'inverser est bénéfique est une question distincte.
Les revues de la biologie du NAD+ (Lautrup et al. 2019, Cell Metab) décrivent un déclin du NAD+ lié à l'âge dans l'ensemble des tissus, avec des effets en aval sur l'activité des sirtuines et de la PARP, la réparation de l'ADN et la fonction mitochondriale. Ce déclin est la prémisse mécanistique de l'utilisation de précurseurs de NAD+ ; la revue présente la restauration comme une hypothèse à tester, non comme une intervention anti-âge établie.
Who this may not transfer to:The age-related NAD+ decline is described across tissues in both sexes; it is a biological rationale, not a population outcome.
The study · 1
Lautrup et al. 2019, Cell Metab (NAD+ in brain aging and neurodegeneration) · Cell Metab
Blood Sugar
En regroupant 8 essais chez 342 adultes, la NMN n'a modifié ni la glycémie, ni l'insuline, ni l'HbA1c, ni les lipides
En additionnant tous les essais sur la NMN, elle n'a en moyenne pas abaissé la glycémie, l'insuline ni le cholestérol. Le bénéfice métabolique général attendu ne s'est pas manifesté.
Une revue systématique et méta-analyse (Chen et al. 2024, Curr Diab Rep) a regroupé huit ECR totalisant 342 adultes d'âge moyen et avancé, 49 % de femmes et majoritairement non diabétiques, avec des doses de NMN de 250 à 2000 mg/jour pendant 14 jours à 12 semaines. Les méta-analyses à effets aléatoires n'ont trouvé aucun bénéfice significatif sur la glycémie à jeun, l'insulinémie à jeun, l'hémoglobine glyquée, l'HOMA-IR ou le profil lipidique.
Who this may not transfer to:The pooled null was in mostly non-diabetic middle-aged and older adults of both sexes, so it does not rule out an effect in metabolically impaired groups.
The study · 1
Chen et al. 2024, Curr Diab Rep (NMN on glucose and lipid metabolism meta-analysis) · Curr Diab Rep
250 mg de NMN par jour pendant 10 semaines a augmenté la sensibilité musculaire à l'insuline chez 25 femmes ménopausées prédiabétiques
Chez des femmes ménopausées prédiabétiques, dix semaines de NMN ont amélioré la réponse de leurs muscles à l'insuline. Il s'agit d'un seul petit essai dans un groupe spécifique.
Un essai randomisé en double aveugle contrôlé par placebo de 10 semaines (Yoshino et al. 2021, Science ; n=25) chez des femmes ménopausées en surpoids ou obèses présentant un prédiabète a montré que la NMN à 250 mg/jour augmentait l'élimination du glucose stimulée par l'insuline mesurée par clamp, augmentait la phosphorylation musculaire d'AKT et de mTOR, et régulait à la hausse des gènes de remodelage musculaire. Le poids corporel, les autres mesures métaboliques et les marqueurs circulants sont restés largement inchangés.
Who this may not transfer to:The trial enrolled only postmenopausal women with prediabetes; whether the muscle insulin-sensitivity effect transfers to men, to premenopausal women or to metabolically healthy people has not been tested.
The study · 1
Yoshino et al. 2021, Science (NMN increases muscle insulin sensitivity in prediabetic women) · Science
Muscle And Strength
Ni la NMN ni le NR n'ont amélioré la masse musculaire, la force de préhension ou la vitesse de marche chez les adultes de plus de 60 ans
En additionnant les essais, la NMN et le NR n'ont pas amélioré la masse musculaire, la force de préhension ni la vitesse de marche chez les personnes âgées. Les allégations sur la force et la fonction ne se sont pas confirmées.
Une revue systématique et méta-analyse (Prokopidis et al. 2025, J Cachexia Sarcopenia Muscle) d'ECR chez des adultes d'âge moyen compris entre 60.9 et 83 ans a constaté que la NMN n'avait aucun effet significatif sur l'indice musculaire squelettique, la force de préhension, la vitesse de marche ou le test de lever de chaise à cinq répétitions, et la synthèse narrative n'a montré aucun bénéfice pour la force en extension du genou, le SPPB ou la masse musculaire de la cuisse. Le NR a été associé à une distance de marche de six minutes plus longue uniquement chez les personnes atteintes d'artériopathie périphérique. Les auteurs ont conclu que les données actuelles ne soutiennent pas l'usage de la NMN ou du NR pour préserver la masse musculaire et la fonction.
Who this may not transfer to:The null applies to older adults of both sexes with mean age over 60; it does not address younger or athletic people.
The study · 1
Prokopidis et al. 2025, J Cachexia Sarcopenia Muscle (NMN and NR on muscle mass and function meta-analysis) · J Cachexia Sarcopenia Muscle
Counts once: this finding and 1 other here come from the same source, so they are one body of evidence, not separate confirmations.
Longevity And Mortality
Aucun essai humain n'a montré que les précurseurs du NAD+ prolongent la durée de vie en bonne santé ou l'espérance de vie ; les résultats frappants concernent les animaux
Les résultats frappants sur la durée de vie concernent les animaux. Chez l'humain, aucun essai n'a montré que ces précurseurs ralentissent le vieillissement ou prolongent la vie.
Une revue systématique des essais sur les précurseurs du NAD+ (Gindri et al. 2024) a recensé les résultats à travers diverses conditions cliniques et n'a identifié aucun critère lié à la durée de vie ou au vieillissement, et une méta-analyse musculaire (Prokopidis et al. 2025) n'a trouvé aucun bénéfice fonctionnel chez les adultes âgés. La littérature animale montre que la restauration du NAD+ améliore la durée de vie en bonne santé et, pour des interventions apparentées, la durée de vie, mais cela ne s'est pas traduit par un bénéfice démontré sur la durée de vie en bonne santé ou l'espérance de vie chez l'humain.
Who this may not transfer to:No human healthspan or lifespan endpoint has been measured in either sex; the extension results are in animals only.
The studies · 2
Gindri et al. 2024, Am J Physiol Endocrinol Metab (safety and effectiveness of NAD systematic review) · Am J Physiol Endocrinol Metab
Prokopidis et al. 2025, J Cachexia Sarcopenia Muscle (NMN and NR on muscle mass and function meta-analysis) · J Cachexia Sarcopenia Muscle
Counts once: this finding and 1 other here come from the same source, so they are one body of evidence, not separate confirmations.
Cardiorespiratory Fitness
600 à 1200 mg de NMN par jour ont amélioré la capacité aérobie sous-maximale chez 48 coureurs, tandis que le VO2max n'a pas changé
Chez des coureurs amateurs poursuivant leur entraînement, des doses plus élevées de NMN ont amélioré leur capacité aérobie sous-maximale, bien que leur capacité maximale n'ait pas changé.
Un essai randomisé en double aveugle à quatre bras de six semaines (Liao et al. 2021, J Int Soc Sports Nutr ; n=48, 40 hommes et 8 femmes) chez des coureurs entraînés de manière récréative a montré que les groupes NMN moyenne (600 mg) et élevée (1200 mg) amélioraient davantage la consommation d'oxygène, le pourcentage du VO2max, et la puissance aux premier et second seuils ventilatoires que le placebo. Le VO2max, le pouls d'oxygène, la VO2 relative à la charge de travail et la puissance maximale sont restés inchangés. Les auteurs ont attribué cet effet à une meilleure utilisation de l'oxygène par le muscle squelettique.
Who this may not transfer to:The trial ran in young and middle-aged recreationally trained runners, only 8 of 48 women, so transfer to untrained or older people is untested.
The study · 1
Liao et al. 2021, J Int Soc Sports Nutr (NMN and aerobic capacity in amateur runners) · J Int Soc Sports Nutr
Getting NAD+ Up, in Order
Ways to Do It
Match what you do to what you want. If the goal is the healthspan the animal work points at, the levers with human evidence are free and come first. If the goal is to raise NAD+ specifically, the precursors do that, though whether the higher level changes how you feel or age is not established. The precursors and any metabolic use are worth talking through with a clinician first.
Exercise and not eating to excess most reliably support NAD+ and mitochondrial health in people. Both carry decades of human healthspan evidence the capsules lack. If slower aging is what draws you to precursors, start here, it is the intervention most likely to actually deliver.
The body makes NAD+ from vitamin B3 in ordinary food: fish, poultry, meat, mushrooms, peanuts, and fortified grains all supply niacin and nicotinamide. Outright NAD+ shortage from diet is uncommon on a mixed diet, so for most people the base of the pool is already covered without any supplement.
Nicotinamide (niacinamide) is a cheap, long-used form of vitamin B3 that also feeds NAD+. It does not raise NAD+ as much as NR or NMN, and it is not sold as anti-aging. If the aim is simply to cover B3 at low cost, it does that, and it has the longest safety record of any form here.
NR is the precursor with the most human pharmacology behind it and a clearer regulatory footing in the United States, where it is an accepted dietary ingredient. Trial doses run around 250 to 1000 mg a day. It raises NAD+ dependably; the functional benefits beyond that are not established.
NMN raises NAD+ as well, and it carries the two most interesting human leads: better insulin sensitivity in postmenopausal prediabetic women, and improved aerobic capacity in runners. Its US regulatory status is unsettled, it sits in a gray zone though it is widely sold. Doses in trials run about 250 to 900 mg a day.
The lone clean positive result came from that same prediabetic group. For a diagnosed metabolic problem, decide it with the clinician tracking your numbers. Diet, movement, and any prescribed medication are what manage it; the pooled trials did not find an average glucose benefit from a precursor.
Go Deeper
- IV therapy and NAD+: the infusion version of the same idea, and how its outcome evidence compares with a daily oral precursor.
- The biology of aging: where NAD+ decline ranks among the drivers of aging, and how to read a marker that can move while the outcome does not.
- Rapamycin: the other longevity frontier with a strong animal record and early human aging data, and the same animal-to-human gap.
- Mitochondria: the cell's power plants that NAD+ helps run, and the reason energy is the mechanism most people have in mind here.
The Chinese Medicine View
NAD+ and its precursors are products of 20th-century biochemistry, isolated and synthesized in a laboratory, so the classical Chinese pharmacopoeia has no entry for them. No historical text assigns NMN or NR a channel, a temperature, or a flavor, and reading one back in would be invention. What the tradition offers instead is a way of thinking about aging and about building the body up.
These precursors target the reserve loss that comes with age. Chinese medicine has always reasoned about that loss, chiefly through the Kidney essence, the deep constitutional reserve it ties to growth, aging, and vitality. The tradition holds this reserve is largely fixed at birth and spent across a lifetime, conserved and supported but not simply refilled from a bottle.
Tonifying, bu, is the family of methods for building up a true deficiency, and its art is judging whether the person has one and can transform what is given. Giving more than the system can use does not build reserve; it stagnates. Yang Sheng, the cultivation of life, rests on moderation, movement, and conserving reserves. In this tradition a tonic is matched to the person, never handed to everyone alike.
Cautions For This Practice
Extra restraintEverything to be aware of is here, in one place. This practice suits most healthy people; a few situations call for real care.
Bien tolérée pendant quelques semaines à quelques mois chez 489 personnes, avec seulement des effets légers ; l'usage plus long n'a pas été étudié
Une revue systématique des essais randomisés sur le NAD+ et le NADH portant sur diverses conditions cliniques (Gindri et al. 2024, Am J Physiol Endocrinol Metab ; 10 études, 489 participants) a montré que la supplémentation était bien tolérée avec une faible incidence d'effets secondaires, les plus fréquents étant les douleurs musculaires, les maux de tête, la fatigue et les troubles du sommeil, et aucun risque grave pour la santé. Des essais dédiés au NR (Martens et al. 2018) et à la NMN (Yi et al. 2023) ont de même rapporté une bonne tolérance pendant leurs périodes d'étude.Gindri et al. 2024, Am J Physiol Endocrinol Metab (safety and effectiveness of NAD systematic review)Martens et al. 2018, Nat Commun (NR well-tolerated)
The aging payoff is an animal result, so treat anti-aging use as experimental
The lifespan and healthspan gains are a mouse result. Taking NMN or NR to live longer is a self-experiment. Do not let a capsule crowd out the exercise and eating habits with real human healthspan evidence.
Short-term safety looks good, long-term is unstudied
Across the human trials, NR and NMN were well tolerated for weeks to a few months. Effects were mostly mild (nausea, headache, fatigue) with no serious adverse events reported. No trial has run past a few months, so multi-year safety is simply unstudied. Years is the timescale anyone taking them for aging has in mind.
A theoretical concern with cancer, still unresolved
NAD+ fuels the growth and repair machinery of all cells, including cancerous ones. Some laboratory work raises the question of whether pushing NAD+ up could feed an existing tumor. It has not been shown to happen in people and stays theoretical. Still, anyone with a current or recent cancer should clear NAD+ precursors with their oncologist first.
NMN sits in a regulatory gray zone
In the United States the FDA has taken the position that NMN is excluded from the dietary-supplement definition. The reason: it was authorized for study as a drug before it was marketed as a supplement. It is nonetheless widely sold, and enforcement has been inconsistent. This does not make NMN dangerous, but the usual supplement oversight is uncertain.
Kidney or liver disease, pregnancy, and medication overlap
These precursors are processed and cleared by the body like other nutrients, and the trials showing they are tolerated were mostly in reasonably healthy adults. Supplemental doses have not been studied in kidney or liver disease, pregnancy, breastfeeding, or alongside metabolic medication. In any of those cases, clear it with your clinician first.
Buy tested, and keep the dose in the studied range
Supplements are loosely regulated. An independent testing mark such as NSF or Informed Choice is the simplest proof the label matches the contents, it matters most for NMN. Keep the dose within the range the trials used; there is no established reason to exceed it, and more is not known to be better.
Start slow, be smart, read the research, and consult a professional if you have any concerns. This is here to inform your choice, not make it for you.
Common Questions
What is the difference between NMN and NR?
For raising blood NAD+, they are broadly interchangeable, and neither has a demonstrated advantage over the other. They differ in two side matters: NR carries the longer record of human pharmacology, and NMN the more interesting narrow leads. Their US legal standing differs too. Pick on those terms; the core effect is the same either way.
Explore Related
Other pages this one connects to, by the evidence they share, the outcomes they touch, and the ground they cover.
All 12 sources on this page independently checked and cross-referenced.
Thomas Dehli, Founder & Editor, Sacred Lotus
Sacred Lotus has published Chinese medicine reference material since 2001. Integrative pages are held to the same standard as the herb and formula library: cite the source, grade the claim at its real strength, and say where the research has not looked. This page is educational and it is not medical advice. Last reviewed and updated August 9, 2026.
Evidence strength
How confidently the research supports a claim. Strength describes the evidence, not our endorsement.