NAD+, NMN and NR: what the studies really show

NAD+ (nicotinamide adenine dinucleotide) is found in every cell. It helps generate energy in the mitochondria and is needed by enzymes involved in repairing DNA and regulating cells. As we age, NAD+ levels in the cells decline. This observation, together with animal studies, gave rise to the idea that ageing could be slowed by topping up NAD+.

The body makes NAD+ itself from precursors. The most important of these is niacin (vitamin B3), which people in Germany get in sufficient amounts from a normal diet. The AOK magazine (a German health insurer) also points this out.

• NR (nicotinamide riboside): a precursor of NAD+. As nicotinamide riboside chloride, it has been authorised in the EU for some years as a novel food for use in food supplements for adults, not for pregnant or breastfeeding women
• NMN (nicotinamide mononucleotide): a precursor that sits directly before NAD+ in metabolism. In the EU a “novel food” that requires authorisation (see below)
• NAD+/NADH directly: available as capsules or powder. It is questionable how much of it reaches the cells unchanged

The enthusiasm is based mainly on animal studies. In humans, the picture is more sobering:

The pattern: the precursors measurably raise NAD levels in the blood. Whether that leads to a noticeable benefit for health, performance or lifespan is an open question. The studies are small and short, partly contradictory, and long-term data are missing. The AOK magazine also concludes that there is no evidence of a long-term positive effect on ageing. The German consumer advice centre (Verbraucherzentrale) speaks of “indications” of individual effects for NMN, not of proof.

Besides capsules, NAD+ infusions and injections are offered, often as self-pay services in practices or longevity clinics. For anti-ageing, more energy or better performance, there is no approved medicine in Germany and no solid evidence of efficacy. Online, NAD+ and NMN are also sold as “research substances” for injection. Nobody checks their content, purity or sterility (see quality and certificates of analysis).

In the studies, NR was well tolerated over a few weeks. Mild complaints such as nausea, flushing or leg cramps were reported. There are no data on safety over years. NR and NMN are not intended for pregnant or breastfeeding women.

NMN in the EU: NMN counts as a novel food and so far could not be sold in food supplements or other foods, as the Würzburg Administrative Court confirmed in 2021. In May 2026 EFSA published a positive safety opinion for one specific NMN product: it considers it safe for adults up to a set daily amount, excluding pregnant and breastfeeding women. EFSA explicitly did not assess efficacy. An opinion is not yet an authorisation – that has to be granted by the European Commission, and it then applies only to the product concerned. As of September 2026 the situation can change quickly, so check the current status if needed.

If you take medication, for example a weight-loss injection, blood pressure medication or diabetes medication, talk to your doctor or pharmacy before taking it. This is general information and not legal or medical advice.

Products with NMN or NR are an ongoing cost that no health insurance covers (in Germany). Infusions are private services and considerably more expensive than capsules. If you want to put money into biohacking, sleep, strength training, enough protein and good monitoring deliver more, based on current knowledge (see sleep and HRV tracking and biohacking overview).

If you still want to try it:

• Only choose products that may legally be sold as food supplements in the EU, and do not exceed the manufacturer’s stated amount
• Tell your doctor what you take – especially if you are on medication
• Decide beforehand how you want to measure a benefit, for example sleep, HRV or training performance, and take an honest look after a few weeks
• Bear in mind that a perceived effect can also be placebo – that is why placebo-controlled studies matter so much

• Don’t believe miracle promises – “rejuvenation” has not been shown in humans
• Don’t inject research products
• No NMN from unclear sources while its legal status is open