Longevity/Performance/Heart

NAD+ Precursors

Compounds like NMN and NR that raise NAD+ levels, with emerging evidence for physical performance and modest cardiovascular effects in older adults.

NAD+ Precursors

Compounds like NMN and NR that raise NAD+ levels, with emerging evidence for physical performance and modest cardiovascular effects in older adults.

score

evidence

Caution

risk

Proven Benefits

01Elevates blood NAD+ levels

02Improves physical performance

03May lower blood pressure

Chemical Forms

Recommended

Nicotinamide riboside (NR)
Nicotinamide mononucleotide (NMN)

Avoid

Direct NAD+ (destroyed by stomach acid, no bioavailability)
Nicotinamide (niacinamide) — can inhibit sirtuins at high doses

Expert Note

NR and NMN are the most efficient oral precursors; they bypass the rate-limiting NAMPT enzyme. Oral NAD+ is hydrolyzed by gastric acid and does not reach circulation intact. Standard niacinamide may raise NAD+ but requires higher doses and can blunt sirtuin activity.

Protocol

Amount

250-1000 mg

Frequency

Once daily

When

Morning, with or without food — consistency matters more than timing.

Condition-Based Dosing

General wellness / anti-aging

250-500 mg daily— Start low; most human RCTs use 250-1000 mg.

Older adults targeting physical function

500-1000 mg daily— Igarashi trial used 250 mg/day; some protocols use up to 1000 mg.

Elevated blood pressure or vascular stiffness

1000-2000 mg daily— Martens trial used 1000 mg NR/day; consult clinician for higher doses.

Safety & Limits

Upper Safe Limit

2000 mg/day (highest dose studied in 12-week RCTs; no official UL established)

Cycling

Safe for continuous use

Contraindications

Active cancer or history of cancer — theoretical concern that NAD+ may fuel tumor growth

Pregnancy or breastfeeding — insufficient safety data

Chemotherapy or radiation therapy — NAD+ precursors may theoretically protect cancer cells

Synergies

Trimethylglycine (TMG)

NR/NMN metabolism consumes methyl groups; TMG or B-vitamins may help maintain healthy homocysteine levels.

Avoid Combining With

✕Alcohol (depletes NAD+ and B-vitamins, counteracting supplementation)
✕High-dose niacinamide (competes for NAD+ synthesis pathways and may inhibit sirtuins)
✕Chronic inflammation (accelerates CD38-driven NAD+ consumption)

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