Nicotinamide riboside (NR): what is it, benefits, and side effects

Healthcare researchers are always looking for ways to help us live longer and healthier lives. This includes improving how our bodies use their basic building blocks to reduce the signs of aging from within our bodies. 

We take in most of these essential building blocks by eating a healthy diet. However, research is starting to show that supplementing with some of them might help support healthier aging.

Nicotinamide riboside (NR) is one of these supplements. Here’s everything you need to know about NR, including what it is, its benefits, and the potential for side effects.

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Nicotinamide riboside, or niagen, is a form of Vitamin B3 (frequently called niacin). You take in most of the nicotinamide riboside you need through your diet, but there might also be some health benefits to taking an extra dietary supplement (Mehmel, 2020).

NR serves as an intermediate building block to a very important coenzyme in your body called nicotinamide adenine dinucleotide (NAD+). All of the tissues in your body produce NAD+ from either NR or another common precursor called nicotinamide (NAM) (Mehmel, 2020; Conze, 2019).

NAD+ levels decrease as you get older, particularly in the skin and brain, making it more challenging for the cells to produce enough energy to repair themselves. Taking an NR supplement can increase the NAD+ levels in your body’s tissues. Researchers think that this may help treat and prevent a wide variety of health conditions that happen with age (Dellinger, 2017; Mehmel, 2020).

NR is one of the most well-studied NAD+ precursors. It has been found to be safer, have better bioavailability, and be more effective at NAD+ synthesis than other precursors. NR may also avoid some of the common side effects of supplements that increase NAD+ (Mehmel, 2020; Conze, 2019).

There’s growing evidence that nicotinamide riboside has health benefits that can help treat a number of cardiovascular, neurodegenerative, and metabolic disorders. Since these types of disorders are on the rise in modern society, it’s more important than ever for researchers to study the potential therapeutic uses of NR (Mehmel, 2020).

Metabolism and weight

NR might help with metabolism and obesity by increasing lean muscle mass. Researchers conducted a randomized trial where 13 otherwise healthy men and women with overweight or obesity were given either nicotinamide riboside 1000 mg/day or a placebo for six weeks (Remie, 2020).

While no overall weight loss was noted, the fat-free body mass was increased in the participants taking NR, as was their sleeping metabolic rate. There was also evidence that their muscles were making more NAD+ than before, though it’s not clear what effect that had on their overall health (Remie, 2020).

The NR supplement didn’t seem to help with blood sugar levels, cholesterol, or inflammatory markers (Remie, 2020).

Cardiovascular health

Researchers aren’t completely sure why, but increasing NAD+ metabolism in the body may help reduce blood pressure and stiffness of the aorta (one sign of a person’s risk of having a heart attack or other cardiovascular event) (Martens, 2018).

Supplementing with NR tended to lower both the systolic and diastolic blood pressure. That means both the top and bottom numbers in a blood pressure measurement decreased. Lowering your top number (systolic blood pressure) by at least 10 points results in a 25% reduction in your risk of having a cardiovascular event (Martens, 2018).

Neurological disorders

You might know Alzheimer’s disease (AD) as a memory disorder that affects older adults, but AD also features a number of other changes in the brain and body. These include inflammation in the brain, plaques that affect how the brain functions, damage to the mitochondria (the powerhouse of your cells), and increased oxidative stress that causes DNA damage (Johnson, 2018). 

Researchers using mouse models have a theory that supplementing with NR may increase brain function and memory. So far, these theories only apply to mice, but in the future, they could be tested in human studies to see if they can help us avoid the problems associated with Alzheimer’s (Johnson, 2018).  

Longevity

As you age, levels of NAD+ in your body decrease, which may contribute to many age-related diseases. Studies have shown that boosting NAD+ by supplementing with nicotinamide riboside has the potential to help prevent or treat these disorders (Johnson, 2018).

NAD+ is also critical for the proper functioning of mitochondria—the powerhouses of your cells—and supplementing with it may help increase longevity. Feeding NR to aging mice protected them from damage to their muscle, brain, and skin stem cells. These are all essential for maintaining and regenerating tissues. The mice treated with NR experienced longer lifespans (Zhang, 2016).

Again, we don’t know how this would translate into humans. 

Immune system function

Clinical studies have confirmed that increasing the building blocks of NAD+ can help the body fight off a number of common viruses, bacteria, and fungi (Mehmel, 2020).

NR supplementation may help restore energy levels and improve hyper-inflammation from the immune system (Mehmel, 2020).

Nicotinamide riboside has been given “generally recognized as safe” status by the Food and Drug Administration (FDA). Substances with this status have been deemed safe by experts and can be added to food products without additional approvals (Mehmel, 2020). 

There were no reports of any serious adverse effects from NR during several research trials. Some mild side effects were occasionally reported, including (Martens, 2018; Conze, 2019):

• Nausea

• Muscle soreness or cramps

• Increased bruising

• High blood pressure

One concern with NR was the possibility that it might cause flushing. Flushing is a temporary feeling of warmth, redness, or itching on the face and chest—it’s an uncomfortable but harmless reaction that’s common with vitamin B supplements. Several studies have found minimal to no reports of flushing from participants taking NR, so you’re unlikely to experience this side effect (Martens, 2018; Conze, 2019).

No changes in cholesterol levels, heart rate, or weight were noted in participants taking NR supplements (Conze, 2019).

You can typically get all of the tryptophan and niacin that your body needs to make NAD+ from eating a healthy diet. Foods rich in these building blocks include (Mehmel, 2020):

• Meat

• Eggs

• Dairy

• Some vegetables

• Whole wheat

However, there’s growing evidence that higher rates of NAD+ production in your body can benefit your health. This can be achieved by taking an NR supplement (Mehmel, 2020).

Since NR is a supplement, there’s no official recommended dose. Studies have shown that up to one to two grams per day is safe and can increase the amount of NAD+ that your body makes. More studies are needed, though, to find an optimal dose (Mehmel, 2020; Conze, 2019)

Most niagen supplement brands recommend taking 250–300mg per day to get the benefits of NR.

As always, remember to discuss any medications or supplements, including nicotinamide riboside, with your healthcare provider.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

December 09, 2021

Written by

Ellyn Vohnoutka, BSN, RN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.