NAD Booster Supplements Review (NAD+/NADH, Nicotinamide Riboside, and NMN)

How Important Is Boosting NAD+ Levels? Find Out and Learn How Booster Supplements Compare.

Medically reviewed and edited by Tod Cooperman, M.D.

Last Updated : 12/10/2021 | Initially Posted: 11/02/2021Latest Update: 64% of NMN Supplements Fail Tests

NAD Boosters (NAD+/NADH, Nicotinamide Ribose, and NMN)

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Table of Contents

Summary

What Are NAD Boosters and Do They Help? Most cells in your body use NAD as a coenzyme in the production of energy from glucose. The thinking behind supplements that boost NAD levels is that they can, therefore, boost energy and have other positive effects in the body. Conditions for which they have been tried in small studies include chronic fatigue syndrome (CFS), improving cognitive function, dementia, Parkinson's disease, depression, cholesterol-lowering, and blood sugar control. However, there is no good clinical evidence (based on the studies reviewed in this report) to support these uses despite some interesting laboratory findings. It is not even clear that taking these supplements will increase NAD in cells in organs such as the brain, even though they raise NAD levels in the blood and blood cells. Furthermore, if you have adequate intake of vitamin B3 (as niacin, niacinamide, or nicotinamide), you are already getting the basic building block for NAD, which is nicotinamide. (See What It Is)

· What Did ConsumerLab's Tests Show? We purchased and tested the quality of several types of NAD boosting supplements: NAD, NADH, nicotinamide riboside, and NMN (nicotinamide mononucleotide) supplements. While we found each to provide its listed amount of key ingredient, and none was contaminated with lead, arsenic, or cadmium, we found many of these products to be relatively expensive, although you can save a lot (as much as 67%) by carefully comparing products to choose the right brand. (See What CL Found)

In addition, it's important to know that the amount of nicotinamide riboside in a supplement is typically not shown on the label and includes the weight of the attached salt (which is needed to stabilize the compound). This is a significant amount and differs depending on the salt, e.g., chloride or hydrogen malate). In this report, we've made it easy to compare actual amounts of nicotinamide riboside.

· Which NAD Boosters Are CL's Top Pick? In each category of NAD booster, NAD/ NADH, nicotinamide riboside, and NMN, we chose a Top Pick, based on high quality and low cost.

· Concerns with NAD Boosters? In addition to the strong possibility that these supplements will not provide a benefit and tend to be expensive, be aware that some provide amounts of vitamin B-3 above the established daily upper tolerable intake level. There is also a theoretical safety concern that compounds that raise NAD+ levels like, nicotinamide riboside, as well as NAD, NADH, and possibly NMN, may promote the growth of existing cancers. (See Concerns and Cautions).

What It Is:

"NAD Boosters"
Nicotinamide adenine dinucleotide (NAD), is a substance needed as a coenzyme in the production of energy in the mitochondria of cells throughout the body. It exists as either NAD+ or NADH , depending on whether it is in its oxidized state (which has a positive charge) or reduced state (in which a hydrogen atom is attached, making it neutral).

Your cells convert niacin (vitamin B-3) and its derivatives, including nicotinamide and nicotinamide riboside, into NAD, which is why vitamin B-3 is essential. Some NAD is stored in red blood cells, increasing levels in the blood. Excess amounts of NAD are broken down in the liver and excreted in urine.

In addition to vitamin B-3, NAD, and NADH, other nicotinamide compounds may act as "NAD boosters" such as nicotinamide riboside and nicotinamide mononucleotide (NMN). Due to the focus on raising NAD levels, products that contain these ingredients often have the name "NAD" in their names.

If you already get adequate amounts of vitamin B-3 (14 to 16 mg daily for adults) from your diet (which is not hard to do as B-3 is in many foods) and/or supplements, it is unclear if any of the NAD Boosters in this review are important to take.

NAD and NADH:
These supplements contain NAD or, if in the reduced form, NADH. The name of the ingredient may read, in its longest form, "beta-nicotinamide adenine dinucleotide-coenzyme vitamin B-3." If it is in the NADH form, it may say "reduced" before the name.

Nicotinamide riboside (NR): This is sold in various forms, including:

· Nicotinamide riboside chloride (branded as Niagen, as found the product Tru Niagen)

· Nicotinamide riboside hydrogen malate

· Crystalline nicotinamide riboside (as found in the product Basis)

Nicotinamide mononucleotide (NMN):
This is typically marketed as NMN or beta-NMN, which are the same.

What It Does:

Interest in NAD-boosting compounds was sparked by preliminary laboratory research suggesting that NAD+ declines with age (Massudi, PLoS One 2012; Gomes, Cell 2013), raising the hope that increasing NAD+ levels could provide an anti-aging effect. However, a subsequent study in people found no significant difference in NAD+ levels between older people compared to younger people (Elhassan, bioRxiv 2019 — preprint), making it less likely that taking nicotinamide riboside (or NMN) to raise NAD+ levels would provide an anti-aging effect.

NAD+/NADH:
NADH, but not NAD+, has been evaluated in several clinical studies, although both forms are sold. As discussed below, limited evidence suggests that supplementing with NADH may improve some symptoms of chronic fatigue syndrome. Taking NADH along with CoQ10 may also help, although results are mixed. NADH has also been evaluated for Parkinson's disease, Alzheimer's disease, and depression, but results are even more limited and some are inconsistent. In all cases, any benefits appear to be small. Daily dosage used in studies has ranged from 5 mg to 20 mg of NADH (the "reduced" form of NAD. NADH is 99.85% NAD).

Chronic fatigue syndrome (CFS) has been associated with increased activity of certain enzymes that deplete ATP, the main compound in cells that stores and transfers energy. Since NADH is involved in ATP generation, there has been interest in using it to help increase energy and reduce fatigue in people with CFS.

A crossover study among 26 people with CFS who were given 10 mg of stabilized NADH (ENADA) or placebo daily for 4 weeks showed that 31% of those given NADH experienced a clinically meaningful improvement in symptoms (defined as an improvement of at least 10%) compared to only 8% of those given placebo. No between-group comparison was made to determine if the between-group difference was statistically significant. One person in the study reported feeling overly stimulated while receiving NADH (Forsyth, Ann Allergy Asthma Immunol 1999).

Another small study among 20 people with CFS — 12 of whom received 5 mg of NADH daily (increased to 10 mg daily if symptoms did not improve) and eight of whom received nutritional supplements and psychological therapy for up to 24 months — showed that symptoms improved for both groups during the first 3 months of the study compared to baseline, but there was no significant between-group difference and neither group showed improvement in symptoms in subsequent months (Santaella, P R Health Sci 2004).

Taking NADH in combination with coenzyme Q10 (CoQ10) has shown mixed results in people with CFS. One study among 73 people with CFS showed that taking 20 mg of NADH along with 200 mg of CoQ10 daily for 8 weeks modestly improved overall Fatigue Impact Scale (FIS-40) scores by about 7.5 points (out of 160) compared to baseline, and this improvement was significant compared to placebo (Castro-Marrero, Antioxid Redox Signal 2015). However, another slightly larger study among 144 people with CFS showed the same combination of NADH and CoQ10 taken daily for 8 weeks did not improve physical functioning, psychosocial symptoms, overall Fatigue Impact Scale (FIS-40) scores, or sleep quality, compared to placebo. Although the NADH/CoQ10 group showed modest improvement in perception of cognitive fatigue (improvement of about 1.1 points out of 40) compared to baseline, the improvement was not significant compared to the placebo group (Castro-Marrero, Nutrients 2021).

Based on the limited available evidence, the European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE) has stated that NADH may be tried by people with CFS to relieve fatigue or cognitive dysfunction (Nacul, Medicina (Kaunas) 2021).

One small, uncontrolled study among 19 people with mild to moderate dementia (Alzheimer's, vascular, and fronto-temporal types) found that taking 10 mg of NADH (ENADA) daily for 3 months did not improve measures of cognition compared to baseline (Rainer, J Neural Transm (Vienna) 2000). Although a subsequent study among 24 people with probable Alzheimer's disease showed that those who took the same dose (10 mg) of the same NADH product (ENADA) daily for 6 months experienced no cognitive decline and had higher scores on the Mattis Dementia Rating Scale compared to the placebo group, there was no between-group difference in measures of attention or memory, nor was there between-group difference in clinician rating of dementia severity (Demarin, Drugs Exp Clin Res 2004).

NADH is a coenzyme involved in the synthesis of L-DOPA, a precursor of dopamine — a chemical in the brain that is deficient in people with Parkinson's disease. While two open-label studies (i.e., no placebo control) suggested modest benefit with NADH in Parkinson's patients, a placebo-controlled clinical trial found no benefit. These studies are discussed below.

An open-label study among 885 people with Parkinson's disease already being treated with conventional medication found that taking 5 mg of enteric-coated NADH by mouth or receiving 12.5 mg of NADH by 30-minute infusions every other day for 2 weeks improved disability score based on the Birkmayer-Neumayr disability scale by similar amounts (19.8% vs. 20.6%, respectively) (Birkmayer, Acta Neurol Scand Suppl 1993). Another open-label study showed that receiving 10 mg of NADH by 30-minute infusion for a period of 7 days along with 100 mg of levodopa improved scoring on the Unified Parkinson's Disease Rating Scale (UPDRS) by 9.3 points (out of 199) and slightly increased blood levels of levodopa compared to baseline (Kuhn, J Neural Transmission 1996). However, a placebo-controlled clinical study showed that infusions of 25 mg of NADH for 4 days, then intramuscular injections of 25 mg of NADH on days 20 and 35 did not improve UPDRS score compared to placebo, although both groups showed improvement compared to baseline (7.6 and 5.3 point improvement, respectively) (Dizdar, Acta Neurol Scand 1994).

Preliminary evidence suggests that L-DOPA medication may improve depression symptoms and, as previously noted, NADH plays a role in the production of L-DOPA. One open-label study among 188 people with depression found that taking 5 mg of NADH by mouth or receiving injections providing 12.5 mg of NADH daily for up to about 10 months improved symptoms in 93% of participants, with 32% of people showing marked improvement (defined as improvement of disability greater than half the original value) (Birkmayer, New Trends Clin Neuropharmacol 1991). However, no conclusions can be made based on these results due to the lack of control group.

Nicotinamide riboside:
Many studies that have shown that nicotinamide riboside can raise NAD+ levels in the blood. However, in terms of providing a therapeutic benefit, evidence is largely limited to laboratory studies. There is no good clinical evidence that nicotinamide riboside provides a therapeutic benefit. Daily dosage used in studies has ranged from 100 mg to 2,000 mg. This is often divided over two doses.

Among the studies showing that nicotinamide riboside can raise NAD+ levels are the following:

· A study by ChromaDex, the maker of Niagen, among 11 healthy men and women showed that a one-time dose of Niagen of 100 mg, 300 mg or 1,000 mg increased NAD+ levels without any serious adverse events, although two people reported flushing at the 300 mg dose and two others reported "feeling hot" at the 1,000 mg dose (Trammell, Nat Commun 2016).

· A study in which these same doses were given daily for 8 weeks to overweight, but otherwise healthy men and women, showed that whole blood NAD+ levels increased by 22%, 51% and 142%, respectively, within two weeks, and these increases were maintained throughout the remainder of the study. There were no reports of flushing and no significant differences in adverse events between the Niagen and placebo-treated groups, and no elevation of low-density lipoprotein cholesterol ("bad cholesterol") which, as noted further below, has been reported with a combination of nicotinamide riboside and pterostilbene (Conze, Sci Rep, 2019).

· A study among 24 healthy older men and women (ages 55 to 79) found that 500 mg of Niagen taken twice daily for six weeks significantly increased average blood levels of NAD+ by 60% compared to placebo; flushing was reported in one participant when taking Niagen, and in two participants while taking placebo. Nausea, leg cramps and increased bruising were each reported in one participant while taking Niagen (Martens, Nat Commun 2018). (Supplements typically provide about 250 mg nicotinamide riboside per daily dose.)

· A study of the effects of a combination of nicotinamide riboside and pterostilbene (Basis, Elysium Health) among 120 older people found that those who took one capsule (providing 250 mg of nicotinamide riboside and 50 mg of pterostilbene — the recommended amount on the product label) or two capsules daily with breakfast for two months had average increases in blood levels of NAD+ of 40% and 55%, respectively. There was a slight but significant increase in LDL ("bad") cholesterol with two capsules and among overweight people taking one capsule. There were no significant changes in total cholesterol, triglyceride levels, or blood pressure -- except for a slight but significant decrease in diastolic blood pressure among those who took 2 capsules per day (Dellinger, NPJ Aging Mech Dis 2017). Six of the 80 people taking Basis reported experiencing nausea, mild fatigue, or moderate abdominal discomfort. [Note: The maker of Niagen claims that the nicotinamide riboside in Basis is not the same as in Niagen, which has been generally recognized as safe].

Due to the role of NAD in energy production in cells, it had been hoped that supplementing with nicotinamide riboside would, therefore, improve one's energy levels. However, this has not been proven in clinical studies: Clinical studies evaluating nicotinamide riboside for physical performance in older people have been small and short-term, and results have been mixed (Cusodero, Exp Gerontol 2020). In fact, the maker of Niagen, ChromaDex, had claimed that Niagen increased energy, but removed that claim in 2021 following a challenge by a division of the Better Business Bureau (BBB) National Programs. The energy boosting claim was apparently based only on laboratory research showing that it may increase cellular energy but not necessarily at a functional level.

Studies in mice have shown nicotinamide riboside to reduce a main component of amyloid plaque associated with Alzheimer's disease and improve cognitive function (Gong, Neurobiol Aging 2013) and to improve stem cell function (Zhang, Science 2016).

Nicotinamide riboside has been promoted for lowering cholesterol levels in the liver, although this has only been shown in laboratory and animal studies (Lee, J Med Food 2015) and not in clinical studies.

Although animal and laboratory studies have suggested nicotinamide riboside may help to improve blood sugar control (Lee, J Med Food 2015), a study in Denmark among 40 overweight men with insulin resistance (HOMA-IR ≥ 2.5) found that 1,000 mg of nicotinamide riboside (Niagen) taken twice daily for three months did not decrease fasting blood sugar levels or HbA1c (a measure of blood sugar levels over several months), or improve insulin sensitivity compared to placebo. There were no improvements in body composition (body fat, lean mass or total body mass) compared to placebo. Side effects were generally mild but included itching, excessive sweating, bloating and changes in stool (Dollerup, Am J Clin Nutr 2018).

Be aware that the FDA sent a warning letter to ChromaDex, the manufacturer of Niagen, in November 2020 that it cannot be promoted as preventing or treating COVID-19. According to the FDA, ChromaDex made claims that having low NAD+ levels can worsen COVID-19 and promoted Niagen products with statements such as "early preclinical data suggests that increasing cytoplasmic NAD levels through a NAD precursor, such as NR, may support innate immunity to coronaviruses and other viruses…"

Nicotinamide mononucleotide (NMN)
Like nicotinamide riboside, NMN is a precursor to NAD and may boost levels of NAD+ in the body (Shade, Integr Med (Encinitas) 2020). A few studies have assessed the clinical effects of NMN in humans, but results from these studies are limited. Overall, there is no good evidence that NMN has any significant clinical benefits in humans. Daily dosage used in studies has ranged from 250 mg to 1,200 mg. The larger dosage is typically divided over two doses.

A study among overweight or obese postmenopausal women with prediabetes found that taking 250 mg of NMN daily for 10 weeks increased NAD+ content in peripheral blood mononuclear cells (immune cells in the blood) by about 43% compared to placebo. Skeletal muscle content of NAD+ was not increased (Yoshino, Science 2021).

One study in China among 48 recreational runners (average age 36) showed that taking 300 mg or 600 mg of NMN twice daily for 6 weeks while participating in 40- to 60-minute training sessions five to six times weekly increased the time until breathing begins to increase during exercise (VT₁) and improved power at the time point during exercise at which the person becomes out of breath (VT²) compared to placebo, with the effects being dose-dependent. However, neither dose increased maximum oxygen consumption, nor did it improve the ratio of oxygen consumption to heart rate. Based on these results, the researchers speculated that NMN may improve the use of oxygen by skeletal muscles, but NMN does not appear to have a cardiac benefit (Note: NMN is frequently touted as have cardiovascular benefits). A lower daily dose of NMN (150 mg twice daily) did not improve any outcome measures. No adverse effects were reported for the NMN groups (Liao, J Int Soc Sports Nutr 2021).

A study among overweight or obese postmenopausal women with prediabetes found that taking 250 mg of NMN daily for 10 weeks increased muscle insulin sensitivity by 25% compared to baseline. There was no improvement in muscle insulin sensitivity in the placebo group, and neither group showed improvement in liver insulin sensitivity (Yoshino, Science 2021). While these results suggest that NMN may have some benefit for improving insulin sensitivity in people with prediabetes, this study has been criticized by another researcher (the Chief Scientific Advisor for ChromaDex) because, at the start of the study, the placebo group had 2.35 times the level of liver fat as those in the treatment group, and other research has shown that liver fat reduces muscle insulin sensitivity. Consequently, it is unclear if the difference between the treatment and placebo group was due to NMN supplementation or differences in liver fat content (Brenner, Science 2021).

Quality Concerns and Tests Performed:

No U.S. government agency is responsible for routinely testing dietary supplements, such as NAD+, NADH, nicotinamide riboside, or nicotinamide mononucleotide for their contents or quality. In this review, ConsumerLab.com selected, purchased and tested such products to determine whether they contained the amounts of key ingredients stated on their labels. In addition, all were tested for potential contamination with lead, cadmium and arsenic. All regular tablets were also tested to determine if they would properly disintegrate. (See How Products Were Evaluated for information on testing methods and passing score.)

UPDATE: (12/9/2021): Twenty-two brands of NMN with the highest market share on Amazon were recently tested by ChromaDex, which sells the nicotinamide riboside ingredient Niagen and the product Tru Niagen and is an indirect competitor of these brands. Single samples were tested using HPLC, similar to what ConsumerLab applied in this review. ChromaDex found that only three products contained their claimed amounts of NMN or slightly higher amounts: Infinite Age NMN, ProHealth Longevity NMN Pro 300, and maac10 NMN 250M (which also passed ConsumerLab testing), and another five contained 88-99% of claimed amounts (ForestLeaf NMN, GeneX Formulations NMN, Jarrow Formulas NMN, Toniq NMN, and Double Wood NMN (which also passed ConsumerLab testing).

Fourteen products tested by ChromaDex contained less than 1% of their claimed NMN. These were Komprocha NMN & Resveratrol, monoHerb NMN, Paragon Health NMN 500, VIVALIFER NMN, and the following ten products all from the same distributor (SerumLab S&C International LLC, Oregon) and having similar labeling: ChriBubble NNM, EliteHealth NMN, Energecko NMN Longevity, LIVEMAX NNM, NMN MAX 500 mg, NMN PLUS 500 mg, NMN Star 500 mg, Starhonor NMN, VitaBlossom NMN Refresh, and Vitamin Shower NMN 500 mg.

Interestingly, many of the products found to contain virtually no NMN have hundreds or thousands of positive reviews on Amazon and some display images of certificates of analysis indicating that they provide their claimed amounts of NMN.

What CL Found:

All eight of the supplements that ConsumerLab.com selected, purchased and tested for this review were found to contain their listed amounts of nicotinamide compounds, and none was found to be contaminated with lead, arsenic, or cadmium.

What was most striking in our review was the wide range in dosage among NAD+ and NADH products, the difficulty a consumer could have in comparing amounts of nicotinamide riboside from different chemical forms, and the range in cost among products in each category, most of which are relatively expensive, as discussed below.

Amounts of Ingredient
As shown in the graph below, among NAD/NADH products there was a 10-fold difference in dosage, with PipingRock.com True N.A.D providing 200 mg of NAD per 2-capsule serving, while each of the NADH lozenges provided one-tenth that amount — about 20 mg. However, published clinical studies have tended to use the lower amount, in the NADH form.

The differences in dose per serving were less than two-fold for the other two categories, although, for nicotinamide riboside products, consumers should be aware that the chloride form (in Tru Niagen) is 87.5% nicotinamide riboside while it is only 65.7% in the hydrogen malate form (in Thorne NiaCel). To make it easy to compare, we've done the calculations to show the amounts of just nicotinamide riboside in the products in the graph below.

Among NMN products, Double Wood and MAAC10 provide the same amount (125 mg) per capsule, although Double Wood lists a serving as two capsules while MAAC10 lists one.

Amounts of NAD, Nicotinamide Riboside, and NMN in Supplements* (Per Serving)

Cost
In all three supplement categories shown below, there was a large difference in the cost to get an equivalent amount of active compound.

This was most striking with NAD and NADH products, with the cost for 20 mg of NAD ranging from about 14 cents to $2.47, and between two lozenges there was a three-fold difference in cost: $2.47 from two Source Naturals lozenges versus 76 cents from one Swanson lozenge.

The cost to get 300 mg of nicotinamide riboside was nearly double with Tru Niagen ($1.80) versus Thorne NiaCel (95 cents).

The cost to get NMN was similar from the two products sold as capsules (Double Wood and MMAC10), while the powder (Alive By Science) was much less expensive.

Cost Per 20 mg of NAD, 300 mg Nicotinamide Riboside, or 125 mg NMN In Supplements

Top Picks:

NAD/NADH:
Although Piping Rock True N.A.D. provides much more NAD (260 mg per 2-capsule serving) than the 10 mg and 20 mg lozenges from, respectively, Source Naturals and Swanson, and at a lower cost for NAD, the dose in Piping Rock is much higher than has been used in clinical trials, which have used just 5 to 20 mg of NAD (as NADH) daily. It would seem more prudent to use the lower amounts in the lozenges despite the fact they are more expensive sources of NAD, as discussed above.

Each Source Naturals NADH lozenge provides 10 mg of NADH (9.9 mg of NAD) -- a dose more commonly used in clinical trials than the 20 mg in Swanson. On the other hand, Swanson's 20 mg lozenge costs much less (76 cents) than Source Naturals 10 mg lozenge ($1.23) — making Source Naturals more than 3 times as expensive as a source of NADH than Swanson. Since these lozenges can be easily broken in half, it would be more economical to purchase the Swanson lozenges and break them as needed to get the dose you want. For this reason, our Top Pick for NAD/NADH is Swanson Maximum Strength NADH.

Of course, if you don't want to break lozenges and are okay with paying a much higher price, Source Naturals NADH is a fine alternative — in fact, some of the clinical trials with NADH have been conducted with the ENADA brand of NADH listed in Source Naturals but not in Swanson.

Nicotinamide Riboside:
Both nicotinamide riboside supplements that we tested met our quality standards. If you are looking to purchase one, you need to consider the fact that there is a large amount of clinical information around the chloride form (branded as Niagen) in Tru Niagen and little information about the hydrogen malate form in Thorne Niacel 200, although it is half the cost to get nicotinamide riboside.

While it is possible that any effects would be the same with an equal dose of nicotinamide riboside from either product, Tru Niagen is our Top Pick for nicotinamide riboside because it is better studied and the FDA did not object in 2016 to a filing by Niagen's maker, ChromaDex, that Niagen should be "generally recognized as safe" (GRAS) for use in foods, while there does not appear to be a public record of any filing with the FDA for the hydrogen malate form of nicotinamide riboside in Niacel. The FDA also did not object to ChromaDex's New Dietary Notification in 2018 on Niagen at 300 mg per day.

It should be noted that nicotinamide riboside is a source of vitamin B-3, and both Tru Niagen and Niacel exceed the U.S. tolerable upper intake level for B-3 of 35 mg. European limits are higher — 500 mg to 900 mg (see Concerns and Cautions), but the European Food Safety Authority has also raised concern with high doses of nicotinamide riboside and other nicotinamide compounds, writing that "Experimental data indicate several pathways by which intakes of nicotinamide that are substantially higher than the physiological requirement, or its precursors, might cause adverse effects." (EFSA 2021).

Another supplement containing nicotinamide riboside, in crystalline form, is Elysium Basis, which was tested by ConsumerLab.com in 2019 as part of its B Vitamin Supplements Review. It passed testing, providing its claimed 250 mg of nicotinamide riboside per 2-capsule serving (costing $2.00), making it a more expensive source of nicotinamide riboside than Tru Niagen and NiaCel.

NMN:
Alive by Science NMN SL, a powder, provides 160 mg of NMN at about 1/3 the cost (28 cents) of the other two Approved products (Double Wood and MAAC10) which each provide less NMN (125 mg per capsule) at higher cost (respectively, 82 and 77 cents). Due to this large savings, Alive by Science is our Top Pick for NMN. However, if you don't care for the overly sweet and sour taste of the powder (which, the label suggests, be placed under the tongue, perhaps to stimulate salivation to dissolve the powder) and you don't mind paying more, you next best choice would be MAAC10 capsules, as they cost a little less than capsules from Double Wood.

Be aware that the Alive by Science company was previously named Alive by Nature. The change in name took place after it received a Warning Letter from the FDA on May 5, 2020, indicating that its NAD+ and NMN sublingual gel products were being sold as unapproved and misbranded drugs based on primarily claims made by the company suggesting that these products could treat COVID-19. The FDA cited statements on the company's website such as "NMN shows great promise in case studies of humans with COVID-19... The NMN mixture lead [sic] to a surprisingly rapid and thorough reversal of COVID-19."

Test Results by Product:

Listed below are the test results for eight products alphabetically within their respective category. ConsumerLab.com selected all of these products. Shown for each product are the labeled amounts of the various forms of nicotinamide per listed serving. Products that exceed the tolerable upper intake level for vitamin B-3 are indicated with a with a ">UL" symbol. Prices paid for each product and the costs per daily serving are shown in the fourth to last column. Listed in the second to last column are other notable ingredients and features, and the last column shows a full listing of labeled ingredients.

Results of ConsumerLab.com Testing of NAD Boosters Supplements

(NAD+/NADH, Nicotinamide Ribose, and NMN)

(Click arrows or swipe left or right to see all columns)

Approval Statusⓘ

Product Name

Claimed Amount of Nicotinamide Ingredientⓘ

Heavy Metals

Pill Sizeⓘ

Suggested Serving on Label

Cost for Suggested Serving

Price

Notable Features

Full List of Ingredients Per Serving

NAD/NADH (Nicotinamide Adenine Dinucleotide/Reduced Nicotinamide Adenine Dinucleotide):

APPROVED

PipingRock.com® True N.A.D. 260 mg

Mfd. by Piping Rock Health Products

2 capsules

200 mg NAD

NAD: 200 mg ✔

Metals: Pass

Medium/large capsule

For adults, take two (2) quick release capsules daily, preferably with a meal.

$1.43/2 capsules

[$0.14 per 20 mg NAD]

$42.99/60 capsules

No Gluten, Wheat, Milk, Lactose, Soy, Artificial Color, Artificial Flavor, Artificial Sweetener, Preservatives.

2 capsules
Nicotinamide Rejuvenator™ NAD (Nicotinamide Adenine Dinucleotide) 260 mg.

Other Ingredients: Cellulose (Plant Origin), Gelatin Capsule, Vegetable Magnesium Stearate, Silica.

APPROVED

Source Naturals® NADH

Dist. by Source Naturals, Inc.

2 lozenges

20 mg NADH

NADⓘ: 19.9 mg ✔

Metals: Pass

Medium circular lozenge

1 to 2 lozenges daily.

Taste: Mild peppermint-flavored lozenge tablet.

$2.47/2 lozenges

[$2.47 per 20 mg NAD]

$36.99/30 lozenges

Sodium 10 mg per 2 lozenges

Contains no yeast, dairy, egg, gluten, soy or wheat. Contains no sugar, preservatives, or artificial color, flavor or fragrance.

2 lozenges
Sodium 10 mg, ENADA® NADH (Reduced β-Nicotinamide Adenine Dinucleotide-Coenzyme Vitamin B-3) 20 mg.

Other Ingredients: D-Mannitol, sodium bicarbonate, microcrystalline cellulose, crospovidone, natural peppermint flavor, and magnesium stearate.

APPROVED

Top Pick

for NAD/NADH

Swanson® Maximum Strength NADH

Dist. by Swanson Health Products

1 lozenge

20 mg NADH

NADⓘ: 19.9 mg ✔

Metals: Pass

Medium circular lozenge

Place one lozenge under the tongue and allow to dissolve.

Taste: Mild peppermint-flavored lozenge tablet.

$0.76/lozenges

[$0.76 per 20 mg NAD]

$22.88/30 lozenges

Dairy Free. Soy Free. Vegetarian. Nut Free.

1 lozenge
NADH (reduced β-nicotinamide adenine dinucleotide) 20 mg.

Other Ingredients: Xylitol, hydroxypropyl cellulose, crospovidone, rice extract, natural peppermint flavor, sodium copper chlorophyllin.

Nicotinamide Ribosides:

APPROVED

Thorne® NiaCel 200®

Mfd. by Thorne Research

$ Price Check

1 capsule

207.5 mg nicotinamide riboside hydrogen malate

nicotinamide riboside expectedⓘ: 136.4 mg^>UL ✔
(Found: 145 mg nicotinamide riboside, calculated as 221 mg nicotinamide riboside hydrogen malate)

Metals: Pass

Large capsule

Take 1 capsule one to two times daily or as recommended by your health-care practitioner.

$0.43/capsule

[$0.95 per 300 mg nicotinamide riboside]

$26.00/60 capsules

Betaine anhydrous 42.5 mg per capsule

Gluten Free.

1 capsule
Nicotinamide Riboside Hydrogen Malate 207.5 mg, Betaine Anhydrous (Trimethylglycine) 42.5 mg.

Other Ingredients: Hypromellose (derived from cellulose) capsule, Microcrystalline Cellulose, Calcium Laurate, Silicon Dioxide.

APPROVED

Top Pick

for nicotinamide riboside

Tru Niagen® 300 mg

Dist. by ChromaDex, Inc.

1 vegetarian capsule

300 mg nicotinamide riboside chloride

nicotinamide riboside expectedⓘ: 263.4 mg^>UL ✔
(Found: 303 mg nicotinamide riboside, calculated as 345 mg nicotinamide riboside chloride)

Metals: Pass

Large vegetarian capsule

Adults, take one capsule daily or as recommended by your healthcare professional.

$1.58/vegetarian capsule

[$1.80 per 300 mg nicotinamide riboside]

$47.30/30 vegetarian capsule

NSF Certified Sport seal. Halal. Kosher.

1 vegetarian capsule
NIAGEN® (nicotinamide riboside chloride) 300 mg.

Other Ingredients: Microcrystalline Cellulose, Hypromellose (vegetarian Capsule), Vegetable Magnesium Stearate.

NMN (Nicotinamide Mononucleotide):

APPROVED

Top Pick

for NMN

Alive By Science NMN SL

Dist. by Alive By Science, LLC

1 scoop [250 mg]

160 mg NMN
✔

Metals: Pass

Take one (1) level scoop, 2 times per day under the tongue and allow to completely dissolve.

Taste: Extremely sweet, citrus-flavored powder with strong sugar alcohol aftertaste from mannitol. Elicits saliva, which dilutes the powder in the mouth.

$0.36/scoop

[$0.28 per 125 mg NMN]

$31.95/22 g (approx. 88 servings)

Betaine anhydrous 30 mg per scoop

No artificial colors, preservatives or additives. Gluten-free. Non-GMO. Suitable for vegans.

1 scoop
β-Nicotinamide Mononucleotide 160 mg, Betaine Anhydrous (TMG) 30 mg.

Other Ingredients: Mannitol, Monk Fruit, Citrus Burst™.

APPROVED

Double Wood® NMN 250 mg

Dist. by Double Wood LLC

2 capsules

250 mg NMN
✔

Metals: Pass

Medium/large capsule

Take 2 capsules per day.

$1.63/2 capsules

[$0.82 per 125 mg NMN]

$48.95/60 capsules

Non-GMO. Gluten Free.

2 capsules
Nicotinamide Mononucleotide 250 mg.

Other Ingredients: Gelatin (capsule), organic rice flour.

APPROVED

MAAC10® Nicotinamide Mononucleotide

Dist. by MAAC10, LLC

1 capsule

125 mg NMN
✔

Metals: Pass

Medium/large capsule

Take 1-4 capsules per day or as directed by your healthcare professional.

$0.77/capsule

[$0.77 per 125 mg NMN]

$22.99/30 capsules

Does Not Contain: Milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soy, GMO, or preservatives.

1 capsule
NMN (beta-nicotinamide mononucleotide) 125 mg.

Other Ingredients: Cellulose (capsule), rice fiber, and rice hulls.

Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested.

The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information.

Concerns and Cautions:

All of the NAD boosters in this review are sources of vitamin B-3 which has an established upper tolerable intake level of 35 mg per day for adults in the U.S. Nearly all of the products exceed this limit. However, it should be noted that this limit based on causing flushing of the skin, which is not thought to be a side effect of the nicotinamide form of vitamin B-3. Nevertheless, more serious toxicities can occur with much higher intakes nicotinamide (also known as niacinamide), which has prompted government agencies in Europe to set tolerable upper intake levels of 500 mg in the UK and 900 mg in the European Union for adults. Toxicities at high levels include liver injury, damage to the macula (part of the retina of the eye), gout, declines in platelet counts. High doses may also impair glucose control and increase blood levels of anticonvulsant drugs (See "Upper Limit" for vitamin B-3 in the B Vitamins Review.)

There is a theoretical concern that compounds like nicotinamide riboside, as well as NADH and possibly NMN, that raise NAD+ levels may promote the growth of existing cancers (Poljsak, J Clin Exp Oncol 2016). In fact, one group of researchers suggested that reducing NAD+ levels (rather than raising them) may be a promising approach to a cancer treatment (Gujar, PNAS 2016; Wash U Sch Med news 2016). Furthermore, one CL member reported (6/17/2019) that "After one year taking Elysium Basis [which provides nicotinamide riboside] supplements, I experienced a sharp rise in PSA levels from 1.8 to 4.9. After stopping these supplements for one month my PSA returned to 1.9." [Increases in PSA may indicate prostate cancer.] He told us he contacted Elysium Health, but was told they have no data "that point to a correlation or interaction between Basis and PSA levels" although they did acknowledge that "a handful of people" have "reached out to us about positive changes to their PSA levels." While there is no current evidence of nicotinamide riboside causing or fostering cancer, it would seem prudent to avoid this form of niacin if you have been diagnosed with cancer. [ConsumerLab tested Basis in its B Vitamin Supplements Review in 2019, in which it passed tests and was Approved for quality.]

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease. Consumers should inform their healthcare providers of the dietary supplements they take.

Latest Clinical Research Updates for NAD Boosters (NAD+/NADH, Nicotinamide Riboside, and NMN)

64% of NMN Supplements Fail Tests

12/10/2021

Fourteen of the 22 most popular NMN supplements (which can boost NAD+ levels) on Amazon were recently discovered to contain no detectable NMN. See the results in the Update to our NAD Boosters Review, which includes CL's tests of additional NMN, NADH, and nicotinamide riboside supplements, as well as our Top Picks.