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04. NAD+, NMN and NR — What Is the Difference and What Does Longevity Research Show?
NAD+, NMN and NR: what is the difference and what does longevity research show?
NAD+ is a substance our cells need to obtain energy from nutrients and for the activity of certain enzymes involved in DNA repair. NMN and NR are its precursors — substances the body can use to make NAD+. Researchers are therefore studying their role in metabolic health, muscle function and healthy ageing. They examine outcomes such as muscle sensitivity to insulin, cellular metabolism and walking ability in people with artery disease. This article explains the differences between NAD+, NMN and NR and looks at findings from clinical studies.
Sources for the introduction: [1] [2] [3] [4]
NAD+, NMN and NR are not the same
NAD+ stands for nicotinamide adenine dinucleotide. It is a coenzyme — a helper molecule that enzymes use in chemical reactions inside cells. It helps transfer electrons when nutrients are processed. Certain enzymes also consume it in regulating cellular processes and repairing DNA. NMN and NR are precursors — substances the body can use to make NAD+. [1] [4]
| Abbreviation | Name | Meaning |
|---|---|---|
| NAD+ | Nicotinamide adenine dinucleotide | A helper molecule used in obtaining energy from nutrients and in other cellular processes. |
| NMN | Nicotinamide mononucleotide | A substance the body can use to make NAD+. |
| NR | Nicotinamide riboside | Another substance used to make NAD+; it is not identical to NMN. |
Research findings for one substance cannot automatically be attributed to another substance or a different route of administration.
Why is NAD+ discussed in relation to longevity?
In research on cells and animals, changes in NAD+ metabolism are associated with ageing and metabolic disorders. This provides a reason for clinical testing. However, a finding in a cell or a rodent does not establish an effect in humans.
A 2025 review in Nature Metabolism points out that evidence of an age-related decline in NAD+ in humans is limited and also depends on the tissue studied. Human studies so far show limited benefits; the effect also depends on the outcome measured and the group studied. [1]
Three examples of human research
NMN: a metabolic finding in a narrowly defined group
A randomised, double-blind study from 2021 was completed by 25 postmenopausal women with prediabetes and overweight or obesity. Researchers compared NMN with placebo over 10 weeks. Muscle sensitivity to insulin improved — the muscles responded better to the signal that helps them take up glucose from the blood. There was no change in body composition or improvement in the measured ability of muscle mitochondria to use oxygen. [2]
This is an interesting metabolic finding in a specific population. The study did not demonstrate rejuvenation of the body or an extension of lifespan, and it does not provide the same answer for healthy young people.
NR: changes in substances in muscle without improved energy production
In a 2019 study, 12 older men received both NR and placebo during different study periods. This design allows results to be compared within the same people. After three weeks, NR changed some substances related to NAD+ metabolism in muscle but did not improve the measured energy-related function of muscle mitochondria. [3]
This example shows why we need to distinguish between a substance affecting a metabolic pathway and improving tissue function. The small number of participants and short duration also limit the conclusions.
NR: walking in people with peripheral artery disease
The 2024 NICE trial enrolled 90 people with peripheral artery disease. After six months, the difference between NR and placebo in the change in six-minute walking distance was 17.6 metres in favour of NR. [4]
The result met this study’s prespecified statistical rule: one-sided p < 0.10, with a reported p-value of 0.08. This threshold was less strict than the commonly used threshold of 0.05. The finding is therefore best viewed as a promising reason for a larger confirmatory study, which the authors also call for. Adding resveratrol provided no demonstrated additional benefit. This is not evidence of a longer life in healthy people.
How to read claims about “cellular rejuvenation”
| What research measures | What it does not yet establish |
|---|---|
| A change in the amount of a substance produced during metabolism in blood or muscle | That all organs have changed in the same way. |
| An improvement in a specific functional test | That all ageing processes have slowed down. |
| An effect in one group of patients | That the effect will be the same in a healthy person. |
| A result after weeks or months | That the effect and safety will persist for years. |
Questions to ask before accepting a major promise
- Did the research involve people, animals or only cells?
- How many participants were included, and what was the result compared with?
- Was this the study’s primary objective or an additional analysis?
- Did it measure a health benefit or only a laboratory marker?
- Was the finding confirmed by another independent study?
These questions help us assess the evidence without dismissing a promising finding or attributing more to it than it actually shows.
Frequently asked questions
Is NMN the same as NAD+?
No. NMN is a precursor, whereas NAD+ is a coenzyme with its own roles in cells. These names are not interchangeable.
Is NR better than NMN?
The studies described do not support that conclusion. They examined different groups of people and different outcomes; they are not a direct comparison of the two substances.
Have these studies demonstrated an extension of human lifespan?
No. These clinical studies assessed metabolic or functional markers, not a demonstrated extension of lifespan.
Does research on capsules also apply to NAD+ infusions?
Not automatically. A different substance and a different route of administration require their own clinical data. This article does not evaluate the effectiveness of infusions.
Is this a recommendation to take these substances?
No. This article explains the research and does not specify a dose or determine whether use is appropriate for any individual. If you have a health condition or are receiving treatment, decisions should be discussed with a doctor.
Sources and further reading · 4 sources
- Vinten K. T. et al. (2025): NAD+ precursor supplementation in human ageing: clinical evidence and challenges. Nature Metabolism. Review article, not a new clinical study. DOI: 10.1038/s42255-025-01387-7.
- Yoshino M. et al. (2021): Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. Randomised clinical trial. DOI: 10.1126/science.abe9985.
- Elhassan Y. S. et al. (2019): Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD+ Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Reports. Randomised crossover study. DOI: 10.1016/j.celrep.2019.07.043.
- McDermott M. M. et al. (2024): Nicotinamide riboside for peripheral artery disease: the NICE randomized clinical trial. Nature Communications. Randomised clinical trial. DOI: 10.1038/s41467-024-49092-5.
Sources selected by the author, not a systematic review of all publications. This text is educational and does not replace diagnosis or individual medical advice.
