Update 5/17/20. Nicotinamide mononucleotide is involved in the production of NAD (nicotinamide adenine dinucleotide). That's a fancy way of saying NMN helps us make energy. Some research suggests growing older may be due to declines in NAD levels in our cells. That's where NMN supplements come in. The idea is NMN supplements raise NAD levels and this will slow aging and reduce our risk of disease. So, do NMN supplements work, or are they are a scam? Does NMN have any side effects? I've read much of research and in this video review, I'll help you understand it.
What Is NMN?
Basically, it's a substance that raises NAD levels in our cells. NAD (nicotinamide adenine dinucleotide), a critical factor involved in producing energy (ATP). Research suggests declines in cellular NAD production may be associated with diseases including even the aging process. It's hoped that by boosting NAD levels, disease – 
That's were supplements like NMN, Niagen and Elysium Basis come into play. Both of these supplements contain a molecule called nicotinamide riboside. It's a substance derived from the B vitamin, niacin. All of these are touted to raise NAD levels. The makers of those other supplements feel they are better at augmenting NAD production.
They argue the NMN molecule is too big to meaningfully raise NAD levels. In the video below, I address some of that research and along the way bring up some questions I hope are addressed in future research.
NMN Video Review
In this video, I address the research on these supplements and some of its shortcomings too.
Watch on YouTube if you prefer
What's The Dosage?
Supplements may contain 100mg to 250 mg per one or two capsules. But, is that the correct dosage for humans? Given that the research involves lab animals (mostly mice and rats), I can't say for sure. Obviously, the best way to know for sure is to give different amounts to people and see what happens.
We could do the math and convert mouse dosages to human amounts but that's still going to be an estimation. Until human studies are conducted, nobody knows for sure what the right amount would be.
NMN vs. Nicotinamide Riboside
There are no direct comparisons between NMN and nicotinamide riboside supplements like Tru Niagen. There are PhDs on both sides of the fence trying to convince people that one is better than another. But none of them wants to put it to the test in a clinical study. That leaves you – the person interested in which is better -left to try each yourself to see what works best for you.
If your trying to decide, one thing to remember is nicotinamide riboside has more clinical research. That doesnt mean its better. Rather it just means researchers seem more likely to study it.
NMN Side Effects
Because NMM lacks human clinical trials, it's difficult to know what the contraindications and side effects would be. Given that the FDA has declared nicotinamide riboside as Generally Recognized As Safe (GRAS), it would be tempting to say all NAD cell activators -like NMN -would be safe too. I prefer a more cautious approach.
That said, people do tell me they feel better when they take this supplement. Some have also said it worked better for them than Niagen. Whether this is due to the placebo effect or a real biochemical change is not known.
One question nobody is talking about is can you raise NAD levels too much? It's worth noting all NMN research to date involves lab animals or isolated cells ( I call them test-tube studies). Some of the research also involves injecting NMN into lab animals.
All these leaves open the possibility humans may respond differently. Again, we can't know until human testing of supplements is performed.
Here are some general things to consider when using this supplement. This list is not complete.
- Start with less than suggested for the first week. This is to see how you respond.
- Stop taking NMN at least 2 weeks before having surgery
- Don't take if you are pregnant or breastfeeding
- Taking NMM with food may reduce GI problems if they occur
Preliminary evidence suggests NMM may reduce sperm quality, sperm motility, and increase free radical damage (oxidative stress) in testes. This is addressed in the video above also. The implications of this and whether or not it occurs in men who take NMN supplements need more study. Until more is known, men may want to consider this if he and his partner are trying to conceive.
Speak to your doctor if you have brain cancer. One study has noted people with a type of brain cancer called glioblastoma – who also had higher NAD levels – died sooner than those who had lower NAD levels.
This doesn't mean NAD booster supplements like NMN or nicotinamide riboside cause brain cancer. But it highlights how little we know about what raising NAD does, especially in those who are not healthy.
What Do I Recommend?
One supplement I take myself is Aged Garlic Extract by Kyolic. It's a supplement that boasts several human clinical trials noting it can help:
- artery function
- boost nitric oxide
- reduce blood pressure
- reduce LDL (bad cholesterol)
- reduce homocysteine levels
- reduce coronary calcium scores
Here is the supplement I take if you want to check it out.
Does NMN Work?
While I believe NMN will raise NAD levels, I think we need better studies. I want to know more about the side effects. So far, there is a lack of human evidence demonstrating that boosting NAD concentrations improves the quality of human life or reduces disease risk. Likewise is no clinical proof showing NMN supplements prolong the lifespan -or healthspan -of humans.
Here's Are The Supplements on Amazon
Any Comments or Questions?
References
- Nicotinamide mononucleotide preserves mitochondrial function and increases survival in hemorrhagic shock
- Impacts of obesity, maternal obesity and nicotinamide mononucleotide supplementation on sperm quality in mice
- NRK1 controls nicotinamide mononucleotide and nicotinamide riboside metabolism in mammalian cells
- Nicotinamide mononucleotide, a key NAD(+) intermediate, treats the pathophysiology of diet- and age-induced diabetes in mice.
- Nicotinamide Mononucleotide: Exploration of Diverse Therapeutic Applications of a Potential Molecule
- Long-Term Administration of Nicotinamide Mononucleotide Mitigates Age-Associated Physiological Decline in Mice.
- Nicotinamide mononucleotide protects against β-amyloid oligomer-induced cognitive impairment and neuronal death.
- Nicotinamide mononucleotide, a key NAD+ intermediate, treats the pathophysiology of diet- and age-induced diabetes in mice
- NAD + biosynthesis, aging, and disease
- Why NAD+ Declines during Aging: It’s Destroyed
As of Oct. 2020, I understand Dr. Sinclair takes 1 gram of NMN daily with yogurt in the morning (by capsule, not sublingually or in powder. He was very clear about that. However, I understand he did acknowledge sublingual ingestion of NMN may yield a greater amount for bioavailability. ). He takes 500 mg. of Resveratrol at the same time. He takes vitamin D3, K2 but did not give the amounts (I myself take 15,000 units D3 with the appropriate amount K2 added —the liquid–because I have MS and people with MS have low amounts D3, K2.).
Dr. Sinclair takes 500 mg. of metformin in the am as well. He avoids sugars and carbs and does intermittent fasting, as recommended in Dr. Fung’s Diabetic code book. Then in the pm he said he takes another 500 mg. resveratrol and a second 500 mg. metformin. He exercises (aerobic, and boxing) at least three times weekly. On those days, he does NOT take the metformin. He said it is not necessary to take the metformin on days when you exercise hard.
The book he wrote is extremely helpful; and he also has lots of webcasts out there. I think combining the protocol of this with Dr. Fung’s Diabetic Code would be very useful; I recommend reading both.
The intermittent fasting and the removal of sugar and carbs from the diet are essential to get results in bringing inflammation down in the body, and that is the key to anti-aging—avoiding inflammation and avoiding, at all costs, getting metabolic disease (Diabetes type 2).
It is useful for me to do a morning check on my blood sugar to be sure that after at least 12 hours of fasting, I am not above 85 on blood sugar. For people with auto-immune diseases (like MS) it is helpful to research low dose naltrexone, and implement that as part of your regime.
Elsegood’s book on Low Dose Naltrexone explains which receptor sites come into play when auto immune diseases are a problem (and certain cancers as well). You can only get the low dose Naltrexone from a compounding pharmacy, however.
The MS society, because of their funding from the large pharmaceutical companies, does not endorse in any way “repurposed drugs” such as LDN, no matter how much data the studies show on its efficacy, simply because it is not a money-maker due to it being a generic. I hope some of this information is of help, and I encourage further study.
I believe NMN shows great promise; there is new research that there is an enzyme that can be used to increase the bioavailability and Sinclair discusses that in one of the podcasts.
Anne,thanks for sharing. You’ve given me some books to add to my reading list 🙂 Ive heard some of what Dr. Sinclair says. Time will tell if he is correct. I can say Ive looked at the research and right now there seems to be more research on Nicotinamide riboside boosting NAD levels than NMN. Im still waiting to see an NMN vs. NR study. Given the resouces being poured into each of these molecules I don’t know why nobody has done that study.
While I do think both NR and NMN will boost NAD levels, Im not sure what that ultimately means. This is another piece of the puzzle that needs to be addressed. I’m a big proponent of basic human research on both of these.
I do agree with Sinclair metformin would not be needed on days when doing intense exercise as this will also reduce blood sugar levels (exercise also raises NAD levels too).
Is Metformin Anti-Aging?
I have some podcasts on this issue too
Does Tru Niagan Really Work?
can niacin raise NAD levels
What you said about low does Naltrexone is very interesting. Its a drug to treat alcohol/substance abuse. I was not aware of this.
Since you mentioned multiple sclerosis I have a couple of reviews you may find helpful
Can biotin help MS?
Can Elysium Basis help ALS?
Keep me posted on how your supplement regimen is going 🙂
If you look at the effect of sirtuin 1 in cancer you will see a slew of articles in pubmed indicating that increased SIRT1 activity promotes cancer. Too many articles to spend time on, but at a high level it looks like increased activity of SIRT1 promotes cancer cell growth which makes sense based on its function.
Taking NMN according to D. Sinclair works in part by enhancing SIRT1 expression (which in turn “erases” all the clogged up silencers DNA apparently, enhancing gene expression of those genes).
So if you are old, and likely to have some cancers somewhere in your body, NMN could speed up their growth and lethality by increasing levels of SIRT1. I only spent a few minutes on this so anyone who wants to correct me feel free.
Becky, I’ve seen that research on SIRT1 and cancer. This is one of the reasons I’m cautious about NAD boosting supplements like NMN and NR. I don’t think they have been adequately studied in humans. I’m sure they will raise NAD levels but I don’t know what that means. I don’t think anyone knows at this point.
Unfortunately, your article just asks a lot of questions with no answers. As for getting NMN from food, you would have to eat a ton of it. At least to get to the minimum dose such people as David Sinclair recommend, or rather say low doses don’t work. I,ve just started with 500 mg a day and will evaluate in 2 months.
I am old so that makes me a good candidate. I understand there is no answer whether sublingually or pill swallow is better. I wish I knew what period of time makes an adequate trial. Two months, six months? Reviews on Amazon are all over the map.
Bo, I can appreciate your frustration. Right now there are more questions than answers about NMN, nicotinamide riboside and what raising NAD levels really means. I believe Dr Sinclair is basing his NMN dosage recommendations on lab animal studies. Also, if we assume raising NAD is a good thing, given the lack of human research, how do we know Dr. Sinclairs recommendations are optimal for improving health, reducing the risk of disease or extending the human lifespan?
As for foods that raise NAD levels, given the lack of food vs NMN reserach its hard to know which would be better. I wanted to touch on foods that boost NAD levels beecuase this is something we dont hear. We only hear NMN and NR (nicotinamide riboside) supplements are the only ways to do this. I wanted you to know there were other ways. Remember exercise also raises NAD levels too.
See my nicotinamide riboside experiment for what I experienced.
Heres my review on Tru Niagen research also
I hear you about the Amazon reviews. Instad of looking at the 5 star and 1 star reviews, Ive found the 3 star reviews tend to be more relistic.
If you have any other questions or come across anything else you’d like me to look into, just let me know. Id also appreciate it if you circle back and let me know how the NMN is working for you too. I do hope it is helping you.
I was taking the glandulars because my diet isn’t the best and I have a small iron deficiency. Just thought it couldn’t hurt. Regular bloodwork doesn’t show any hypothyroidism.
Diane, I think there are better and less expensive ways to get more iron in the diet. you could always take an iron supplement or take vitamin C when you eat (vitamin C increases iron absorption). Glandulars are basically ground-up animal endocrine glands. I have not seen any good proof they do much. I’m glad to hear you do not have hypothyroidism 🙂
Agreed. No need to kill animals to get iron. Take vitamin C and iron pill on an empty stomach and your iron will be back to normal in no time. Also cook in a cast iron pan and eat spinach daily that has been lightly braised.
Dave, that is a good point also about the Iron frying pan. When I was in college, I remember hearing a teacher tell the story of a how people were getting anemia in the 1960s. It was at a time when teflon was starting to be used in cookware. When people started using using teflon cookware, they no longer were getting the little bit of iron scoffed off from the iron skilits and it was making an impact on their health.
So I have been taking Elysium for a couple of years and I have to say I haven’t noticed anything. I guess since things are supposedly happening on a “cellular” level one might not notice anything. I agree, they are expensive and I have put the supplement you are taking in my amazon list. Very glad you reviewed this supplement as the information is helpful.
Hi Diane, thanks for sharing. Yes, Elysium Basis has been out a couple of years. As you know, its a combination of nicotinamide riboside and a phytonutrient called pterostilbene. In case you missed it, I have reviews on Elysium and pterostilbene. Here they are:
Elysium Basis Review
Pterostilbene Review
I’m curious, have you had your cholesterol checked since you’ve been taking Elysium? In the pterostilbene review, I showed some research the compound may raise LDL levels. I’d like to see more evidence but just curious if you ever noticed anything.
I have my cholesterol checked every year but I am on statins ….just every third day. I did up it to every 4th day and it was over 200 + that year. It would be hard for me to know if the Elysium contributed because I have been on statins for years. The following year taking statins every third day my cholesterol total was 160+.
Diane, thanks. Yes, the statins would skew any effects. No worries. I think the evidence is preliminary right now. I’m keeping my eyes open for new research on pterostilbene and LDL. When new studies come out I will be talking about it. 🙂
Well, I stopped my subscription to Elysium & will finish what I have and then I will start taking the supplements you recommended.
Do you have a review on glandular supplements? I have started taking Heritage Glandulars. One month on two months off.
heritageglandulars.com/shop/hg-multi-glandular/?v=7516fd43adaa
Diane, Is there a reason you are taking glandulars? For energy? I looked up the product you listed. Im glad they said on the site they get their ingredients from New Zeland and Argintina because when I see glandular supplements the first question I ask myself is what country are the ingredients from. I always wonder about the quality control in countries like China. That said, Im generally not a fan of glandulars because I’m not sure if they work and I wonder about impurities.
If your taking it for energy, have you been checked for hypothyroidism?
Thanks Joe. Good to know about the possible glioblastoma connection. A friend of mine has a variant and so far she has been controlling it with diet and alternative medicine as the conventional medical prognosis has been bleak. I would personally stay away from it too. I have an acoustic neuroma that is under observation.
Thanks Judy, yeah the connection of higher NAD levels to brain cancer is interesting and at this point, I’m not sure what to make of it. Until we know more, for those with brain cancer, I think it’s probably wise to steer clear of supplements promoted to raise NAD levels. I do hope the study was a fluke. Let’s see what future studies show. Glad to hear your friend is making good progress with diet and the alternative therapies shes doing. 🙂