Evidence explainerNicotinamide riboside (NR)
Nicotinamide Riboside Benefits: Higher NAD+, One Walking Result, No Metabolic Gains
Nicotinamide riboside (NR) clearly raises NAD+ in people. Trials looking for downstream benefits found one walking improvement and mostly null metabolic and muscle results.
Key takeaways
- NR raised whole-blood NAD+ by 22%, 51% and 142% at 100, 300 and 1,000 mg/day within 2 weeks [1].
- At 2,000 mg/day for 12 weeks, NR did not improve insulin sensitivity or body composition in 40 men [2].
- In 90 people with peripheral artery disease, 6 months of NR improved six-minute walk distance versus placebo [3].
- In a 10-week pilot of 20 older adults with mild cognitive impairment, blood NAD+ rose 2.6-fold, but cognition scores did not change [4].
- No flushing was reported at 100 to 1,000 mg/day, and adverse events matched placebo [1].
The evidence, graded
Pulled from our monograph evidence tables. Grades follow our evidence-grading policy.
- Grade CImprovedBlood NAD+ levelsBlood NAD+ rose 2.6-fold with NR, with no between-group difference in adverse events. Cognition scores (MoCA) did not change.
- Grade CNo effectInsulin sensitivity and glucose metabolismNR did not improve insulin sensitivity, glucose production, glucose disposal, energy expenditure, fat oxidation or body composition. No serious adverse events were observed.
- Grade CImprovedSix-minute walking distanceNR improved six-minute walk versus placebo (+7.0 vs -10.6 meters; difference +17.6 m). Adding resveratrol did not add benefit.
- Grade DImprovedFat-free mass and sleeping metabolic rateFat-free mass was slightly higher after NR (change 1.34%) and sleeping metabolic rate rose. No effects were found on insulin sensitivity, mitochondrial function, liver fat, blood pressure or inflammation markers.
NAD+: consistent increases
In an 8-week placebo-controlled trial in overweight adults, NR raised whole-blood NAD+ dose-dependently (22%, 51% and 142% at 100, 300 and 1,000 mg/day) within 2 weeks, and the rise held through the study [1].
A 21-day crossover trial in 12 older men taking 1 g/day showed oral NR reaches muscle, raising the muscle NAD+ metabolome [5].
Metabolism and body composition: little change
In 40 sedentary men aged 40 to 70 with insulin resistance, 2,000 mg/day for 12 weeks did not improve insulin sensitivity, glucose production, energy expenditure or body composition [2].
A 6-week crossover trial in 13 overweight adults at 1,000 mg/day found a slightly higher fat-free mass (change 1.34%) and a higher sleeping metabolic rate, but no effect on insulin sensitivity, liver fat, blood pressure or inflammation markers [6]. The authors call the body-composition change minor [6].
Walking and muscle
In a 6-month trial of 90 people with peripheral artery disease, split across NR, NR plus resveratrol and placebo arms, NR improved six-minute walk distance versus placebo (+7.0 vs -10.6 m), and adding resveratrol did not add benefit [3]. The authors call for a larger trial to confirm it [3].
In older adults more generally, a 2025 meta-analysis concluded the evidence does not support NR or NMN for preserving muscle mass and function [7]. It noted lower physical-performance scores with NR in people with mild cognitive impairment [7].
Safety
In the 8-week trial there were no reports of flushing and no difference in adverse events from placebo [1]. At 2,000 mg/day for 12 weeks, no serious adverse events were seen and safety blood tests were normal [2]. Trials have not run long enough to establish long-term safety [3][2].
Comparing NR with NMN? Read NMN vs NR.
Quick answers
Does nicotinamide riboside help with weight loss?
In 40 men taking 2,000 mg/day for 12 weeks, NR did not change body composition [2]. A 6-week trial found only a minor rise in fat-free mass [6].
Does NR improve memory?
In a 10-week pilot of 20 older adults with mild cognitive impairment, cognition scores stayed stable on NR [4].
Keep reading
Full monographs
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References
- [1]Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults. Sci Rep, 2019.
- [2]A randomized placebo-controlled clinical trial of nicotinamide riboside in obese men: safety, insulin-sensitivity, and lipid-mobilizing effects. Am J Clin Nutr, 2018.
- [3]Nicotinamide riboside for peripheral artery disease: the NICE randomized clinical trial. Nat Commun, 2024.
- [4]A randomized placebo-controlled trial of nicotinamide riboside in older adults with mild cognitive impairment. Geroscience, 2024.
- [5]Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD+ Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Rep, 2019.
- [6]Nicotinamide riboside supplementation alters body composition and skeletal muscle acetylcarnitine concentrations in healthy obese humans. Am J Clin Nutr, 2020.
- [7]The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis. J Cachexia Sarcopenia Muscle, 2025.