Rankings / Longevity — Supplements

NAD+ / NMN / NR

Longevity · NAD+ precursor

Also known as: Nicotinamide mononucleotide ·Nicotinamide riboside ·Niagen

Tier B+

Reviewed by Read Off Label · Last reviewed · How we grade

nad+otc
7.1 / 10
Tier B+
Ev 6 Bn 5 Sf 9

Bottom line

Read Off Label grades NAD+ / NMN / NR as B+ (7.1/10) based on moderate evidence, variable benefit magnitude, and a low-risk safety profile.

Yoshino 2021: NMN 250 mg/day improved muscle insulin sensitivity 25% in prediabetic women.

Studied, labeled, or reported-use context: 250-1000 mg/day NMN or NR (sublingual or oral); IV NAD+ infusions also used — OTC; not individualized guidance.

If you were testing this on yourself

Two properties decide whether an n-of-1 experiment is readable and recoverable. These describe the experiment — they are not a judgment about whether to run it, and nothing here is a recommendation.

Can you undo it?

Reverses on stopping

Reversible; blood NAD returns to baseline after stopping.

Can you tell if it worked?

Readable — Weeks for NAD levels

Blood NAD can be measured by some consumer labs — but a Phase II trial confirmed that doubling it produced no change in cognition, cerebral blood flow, or blood pressure. Measuring the biomarker tells you the supplement is absorbed and nothing about whether it did anything for you.

What would fool you This is the sharpest example of a measurable proxy that does not track the outcome anyone wants. A rising NAD level feels like evidence and is not.

What the evidence says

Yoshino 2021: NMN 250 mg/day improved muscle insulin sensitivity 25% in prediabetic women. Multiple RCTs show elevated NAD+ but inconsistent functional outcomes (strength, cognition, CV markers). Boosting NAD+ is easy; demonstrating clinical benefit is not. Phase II randomised placebo-controlled pilot in amnestic mild cognitive impairment (Alzheimer's & Dementia, Jul 2026; n=42 completers, 12 weeks): nicotinamide riboside doubled blood NAD with no serious adverse effects, but produced no improvement in cognitive function (primary outcome), total cerebral blood flow, or blood pressure. Exploratory analysis suggested possible regional cerebral-blood-flow increases in the hippocampus. A direct illustration of the row's existing split: raising NAD+ is reliable, translating that into a functional outcome is not.

Mechanism

Precursors to NAD+ — essential cofactor for sirtuins (SIRT1-7), PARPs, CD38; ETC; cellular NAD+ declines with age

Studied, labeled, or reported dose & route

250-1000 mg/day NMN or NR (sublingual or oral); IV NAD+ infusions also used

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about NAD+ / NMN / NR's effects?
Read Off Label rates the evidence for NAD+ / NMN / NR as Moderate and the benefit magnitude as variable, producing an overall grade of B+ (7.1/10). Yoshino 2021: NMN 250 mg/day improved muscle insulin sensitivity 25% in prediabetic women.
What safety findings are reported for NAD+ / NMN / NR?
NAD+ / NMN / NR has a low risk profile in the database. Low Legal status: OTC.
What doses or routes are reported for NAD+ / NMN / NR?
250-1000 mg/day NMN or NR (sublingual or oral); IV NAD+ infusions also used This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does NAD+ / NMN / NR work?
Precursors to NAD+ — essential cofactor for sirtuins (SIRT1-7), PARPs, CD38; ETC; cellular NAD+ declines with age

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.