Amount of Evidence: Reasonable Potential Benefits: Very High Safety: Very High
TABLE OF CONTENTS
What is nicotinamide riboside (NR)?
Nicotinamide riboside, also known as NR, is a form of vitamin B3 and one of the most exciting supplements for increasing human healthspan. While NR doesn’t share the same cholesterol-related benefits that nicotinic acid has and may be slightly less effective than nicotinic acid for increasing NAD+ levels, nicotinamide riboside appears to be much less damaging to the liver and doesn’t cause niacin flush. NR is also virtually identical to another popular form, NMN. In this article, we will look at NR’s main benefits, potential side effects, and how to use it the right way.
Potential benefits
It is important to note that all of the potential benefits mentioned below are dose-dependent. In general, the higher the dose you take, the more pronounced the effects will be. However, they do reach a plateau at a certain point. We will discuss the best dosing protocol later in this article.
Major benefits
Correcting a niacin deficiency – Severe vitamin B3 deficiency is called pellagra. The main symptoms of pellagra are “the three Ds”: dementia, diarrhea, and dermatitis (in severe cases, a fourth D can be added, death). Although it is unlikely that you will ever experience such a deficiency, an inadequate supply of dietary niacin can still lead to many health problems. The most common signs of niacin deficiency include fatigue, exercise intolerance, depression, and accelerated skin aging. People with a niacin deficiency also have a higher risk of developing esophageal cancer, skin cancer, and leukemia. The reason for this could be an impaired ability of the body to repair DNA.
Increased NAD+ levels – Because of NR’s ability to support our NAD+ levels, it appears to be one of the most effective supplements for slowing the aging process and increasing human healthspan. Increased NAD+ levels may be responsible for many of the other benefits, but the connection has not yet been proven.
Lower triglycerides – There appears to be a significant lowering of triglycerides in individuals taking high doses of niacin. While this effect has only been observed in individuals with dyslipidemia, it probably applies to people without this condition as well.
Minor benefits
Reduction in acne – This effect is most notable in people who use niacinamide topically. However, oral use of niacin is also likely to reduce the severity of acne. The same likely applies to nicotinamide riboside.
Reduced wrinkles – Both topical use of niacinamide and oral use of niacin supplements have been shown to reduce wrinkles. Oral supplements are especially helpful for wrinkles caused by long-term sun exposure. With topical niacinamide, this effect is most notable for wrinkles around the eyes.
Detoxification – Vitamin B3 appears to release toxins from fat cells. The toxins can then be flushed from the body through sweating. Therefore, taking high doses of vitamin B3 before exercising and going to the sauna after appears to be an effective way to detoxify heavy metals and other toxins.
Skin quality – Since nicotinamide riboside boosts your NAD+ levels, it is likely to slow down the aging of your skin. Topical nicotinamide makes the skin more elastic and reduces the reddening of the skin. In people with hyperpigmented spots, topical nicotinamide reduces skin pigmentation.
Decreased risk of CAD – One meta-analysis found that vitamin B3 supplements reduce the risk of CAD (coronary artery disease).
Decreased risk of CAD – One meta-analysis found that vitamin B3 supplements reduce the risk of CAD (coronary artery disease).
Lower risk of myocardial infection – While this effect may not be significant, niacin supplements appear to prevent you from myocardial infection to some extent.
Production of ketones – When taken in a fasted state, even low doses of niacin can increase the production of ketone bodies. This likely applies to NR as well.
Brain protection – In one study, nicotinamide riboside was able to prevent age-related brain damage and improve memory function in mice. This effect could apply to other forms of vitamin B3 as well since it is likely connected with increased NAD+ levels.
Reduced heart and liver fat – While vitamin B3 does not appear to reduce overall body fat, nicotinic acid has been shown to help burn fat around the liver and the heart. This may apply to nicotinamide riboside as well.
Unproven benefits
The effect of nicotinamide riboside on these parameters is either not sufficiently researched or the science shows little to no efficacy in these areas.
Increased HDL cholesterol – While niacin is undoubtedly the most effective supplement for increasing HDL cholesterol, it is important to note that this effect only applies to nicotinic acid and extended-release niacin.
Decreased LDL cholesterol – Again, this effect applies only applies to the two forms mentioned above. Nicotinamide riboside is unlikely to cause significant changes in your cholesterol levels.
Lower triglycerides – Unlike nicotinic acid, nicotinamide riboside has not been proven to lower triglycerides.
Lower risk of death from cardiovascular diseases – NR and other niacin supplements do not appear to significantly reduce mortality associated with cardiovascular diseases.
Apolipoprotein A – One study on nicotinic acid suggests an increase in ApoA, which would be cardioprotective. However, other studies show little or no effect on ApoA levels.
Apolipoprotein B – The reduction in ApoB has been noted in scientific studies but it is insignificant and has little to no impact on your health.
Blood flow – Nicotinamide riboside does not meaningfully increase blood flow.
Blood pressure – Nicotinamide riboside does not appear to affect blood pressure in healthy individuals. In hypertensives, nicotinic acid appears to be able to lower blood pressure in the short term. The same may apply to NR.
Body fat – No study has shown any benefit of nicotinamide riboside for overall fat loss. However, nicotinic acid does lead to a reduction of fat around the liver and the heart and the same might apply to niacinamide.
Reduction in CRP (C-reactive protein) – Nicotinamide riboside supplements do not appear to lower CRP in healthy individuals or in dyslipidemics.
Inflammation – Vitamin B3 has no noticeable effect on inflammation.
Prevention of muscle atrophy – Muscle NAD+ levels have been shown to protect muscle mass as we age. As of 2022, only nicotinic acid has been proven to increase muscle NAD+. Fortunately, there is a good case to be made that nicotinamide riboside should also increase muscle NAD+ but we are still waiting for a study to prove this.
Possible side effects
These side effects mostly occur when someone takes very high doses of nicotinamide riboside.
Weakness and lack of energy – This is another possible short-term effect that some people experience. Fortunately, it is not as common as niacin flushing when taking nicotinic acid. Some people actually feel energized after taking vitamin B3.
Liver damage – Very high doses of certain forms of B3 supplements may cause liver damage. In particular, slow-release niacin is the main form to be concerned about. Other forms, including NR, do not appear to damage the liver nearly as much and the side effect can be mitigated to a large extent.
Worsened allergies – Vitamin B3 can lead to the release of histamine, which can increase the intensity of allergies in the short term.
Who should avoid taking NR?
You should probably avoid nicotinamide riboside if you:
are on a budget (since NR can be very expensive and nicotinic acid is a great potential alternative)
have damaged liver
Who will benefit the most?
You should definitely consider taking NR if you:
are experiencing symptoms of vitamin B3 deficiency
suffer from a digestive disorder (such as Crohn’s and megaduodenum)
are under a lot of physical and mental stress
Other forms of vitamin B3
There are 7 main forms of vitamin B3 supplements. Each has its distinct advantages and disadvantages.
Niacinamide – Also known as nicotinamide and NAM, this is the most popular form of vitamin B3. Almost all B-complex or B3 supplements contain this form because it is the cheapest one to produce. The main problem with niacinamide is that it inhibits sirtuin activity for at least an hour after taking the supplement. Niacinamide also does not seem to affect NAD+ levels nearly as much as the other forms. For this reason, niacinamide is not as effective for increasing healthspan and lifespan as many of the other forms.
Nicotinic acid – This form, often simply called niacin, is often used in high doses to alter cholesterol levels. It is also the form that causes niacin flush because we absorb this form rapidly. The disadvantage of nicotinic acid is that it may increase your risk of diabetes. The main reason to take this form instead of the other ones is that it is more effective in most areas (particularly, increasing NAD+ and altering cholesterol levels) and significantly less expensive than NR or NMN.
Sustained-release niacin – This form was invented to avoid the flushing effect of nicotinic acid by releasing niacin over the course of 12+ hours. Unfortunately, it was soon discovered that sustained-release niacin is associated with high rates of hepatotoxicity (liver damage.)
Extended-release niacin – In this form, niacin is released for around 8 hours. Fortunately, this version does not seem to cause liver toxicity and it doesn’t cause nearly as much flushing as regular nicotinic acid. The only problem is that manufacturers sometimes mislabel their niacin products, calling them extended-release even if they are sustained-release.
Inositol hexanicotinate – This form is slowly broken down in the body and takes 6-12 hours to get absorbed. Unfortunately, it does not release enough niacin for the flushing and cholesterol-lowering effect. On top of that, this form, if taken in high doses over an extended period of time, can cause significant liver damage.
NR (nicotinamide riboside) – This relatively new form may be superior to those previously mentioned in that it has much less potential for harm. NR also does not cause flushing but does not have the same effects on cholesterol levels as nicotinic acid.
Most of the benefits described above apply to doses of 500-2000 mg.
1000 mg per day seems to be the optimal amount.
There is no reason to take more than that. Taking over 3000 mg of NR per day could lead to liver damage and a few other side effects over time.
Best time to take NR
Always take nicotinamide riboside with a meal, and divide the dose evenly across each meal.
Taking NR on an empty stomach may cause stomach upset and intensify the flushing effect.
It does not matter much whether you take nicotinamide riboside in the morning or in the evening although taking the supplement after dinner is likely the best option.
Interactions with other supplements
TMG TMG (trimethylglycine) can protect against potential liver toxicity caused by vitamin B3 supplements. If you are taking NR or NMN, combine it with half the dose of TMG for optimal effects.
CoQ10 Combining CoQ10 with any form of vitamin B3 can improve mitochondrial performance.
Glycine Glycine may have a similar effect as TMG but if you have money to afford TMG, it is more useful than glycine in this case.
Statins Taking vitamin B3 along with some statins may increase the risk of muscle damage in some people.
Alcohol Consuming alcohol and nicotinamide riboside together might lead to liver damage.
Where to buy nicotinamide riboside
Because nicotinamide riboside is so expensive to produce, it is not uncommon for supplement companies to sell low-quality NR. Therefore, you have to choose the brand you get your NR from carefully.
To find a high-quality brand to buy NR supplements from, we recommend reading through some reviews on the internet (Reddit posts, YouTube videos, unbiased articles, etc.). Beware that the conflict of interest is often high in this area.
Amazon seems to be a great option for finding a high-quality brand to buy NR supplements from. You can find many reviews for each specific product there. Also, you can choose from a wide range of brands there without having to spend time searching through other markets on the internet.
FAQ
Nicotinamide riboside can be taken daily and does not need to be cycled.
Yes. nicotinamide riboside won’t impact your sleep in any negative way. Taking it in the evening may actually be preferred.
Fortunately, NR supplements do not seem to lose potency over time. At least that is if you keep them away from heat, light, and moisture.
No, nicotinamide riboside supplements do not cause a niacin flush. Only nicotinic acid does.
The half-life of niacin is around 20-45 minutes. The same likely applies to nicotinamide riboside. Therefore, it takes about 2-6 hours to leave your system.
No, it doesn’t. The supplement does not interfere with fasting in any notable way.
References
Most of the information provided in this guide is based on scientific research that can be found and verified in the PubMed medical library. We excluded from consideration studies that are either confounded or have a high conflict of interest.
Anecdotal evidence (from reports on Reddit, YouTube, and other sources) is also taken into account unless it contradicts scientific research.
