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Nicotinamide mononucleotide (NMN) sparked quite the controversy with U.S. federal regulators in recent years. According to the Food and Drug Administration (FDA), NMN cannot lawfully be marketed as a dietary supplement in the U.S.; however, plenty of manufacturers sell it, boasting its purported anti-aging properties.
Meanwhile, clinical studies on NMN in humans are limited, as most existing research relies on animal studies, so its efficacy has yet to be confirmed. Read on to learn about NMN, including its potential benefits, side effects and what experts know about proper dosing.
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NMN is a naturally-occurring molecule that, chemically speaking, classifies as a bioactive nucleotide. It’s a precursor of nicotinamide adenine dinucleotide (NAD+) and a driving force in the body’s production of NAD+, which is an essential coenzyme involved in multiple biological processes including aging and gene expression. “NAD+ is involved in turning the food we eat into energy for our cells,” explains Kathryn Piper, a registered and licensed dietitian nutritionist in the states of Missouri and Illinois. “It also helps enzymes that repair DNA and prevent damage to our cells.”
Nicotinamide converts to NMN, which then converts to NAD+ once it enters the body. An NAD+ deficiency can lead to potential health issues, including age-related metabolic disorders, mental disorders and neurodegenerative diseases. “Obesity, type 2 diabetes, depression, anxiety, Alzheimer’s disease and Parkinson’s disease are examples of age-related diseases that may be related to NAD+ deficiency,” says Piper.
NMN appears in small amounts in various animal and plant food sources, including broccoli, avocados and cucumbers. “The body gets NMN from certain foods containing niacin, a B vitamin,” says Piper. “An enzyme called nicotinamide phosphoribosyltransferase (NAMPT) converts niacin into NMN.” Additional supplementation may be necessary if food alone can’t ultimately provide a person with sufficient amounts of NMN.
Aging can lead to declining NAD+ levels in various tissues throughout the body, including skeletal muscle. “This decline is believed to contribute to age-related cellular dysfunction and impairments in tissue function… and affect tissues by disrupting the balance between energy production and energy consumption,” says Mary Sabat, a registered dietitian based in Georgia.
A 2022 study on skeletal muscle biopsies from younger and older adults found NAD+ levels to be lower in older adults than younger adults[1]Janssens GE, Houtkooper RH, Hoeks J. NAD+ to assess health in aging humans. Aging (Albany NY). 2022;14(15):5962-5963. .
For older adults, physical activity is one potential way to increase NAD+ levels naturally. “Exercise [can] stimulate the production of NAMPT, which is involved in the synthesis of NAD+,” explains Sabat. “By increasing NAMPT activity, physical activity can lead to elevated NAD+ levels, potentially helping counteract some age-related decline.”
A 2019 study in Physiological Reports revealed positive effects on older adults’ NAD+ levels after 12 weeks of aerobic and resistance exercise[2]de Guia RM, Agerholm M, Nielsen TS, et al. Aerobic and resistance exercise training reverses age-dependent decline in NAD+ salvage capacity in human skeletal muscle. Physiological Reports. 2019;7(12):e14139. .
“Preliminary research suggests NMN may support healthy aging,” says Piper. However, she also shares that most studies on NMN are in vitro or animal studies.
There is minimal clinical evidence on the potential benefits of NMN for humans. Thus, more human clinical trials are needed to confirm its benefits as a dietary supplement.
Meanwhile, researchers do know that as one of the primary precursors of NAD+ and intermediaries in NAD+ biosynthesis, NMN is as essential as NAD+ in the body’s proper functioning of cells.
NAD+ plays an important role in the following cellular functions (according to existing research):
Many commercial products containing NMN typically offer between 50 milligrams and 150 milligrams per capsule. There are also anti-aging and longevity supplements with higher NMN dosages, reaching up to 500 milligrams per dose.
“NMN is generally considered safe, and no major side effects have been reported in humans,” says Sabat. “[However], since NMN is a relatively new supplement, long-term safety data is limited, and it’s always advisable to consult with a health care professional before starting any new supplement.”
One small 2021 study in Frontiers in Nutrition observed 30 participants taking either 250 milligrams of NMN or a placebo daily for 12 weeks and concluded that NMN users may experience mild side effects including abdominal pain, diarrhea, gas and upper respiratory health issues[3]Okabe K, Yaku K, Uchida Y, et al. Oral Administration of Nicotinamide Mononucleotide Is Safe and Efficiently Increases Blood Nicotinamide Adenine Dinucleotide Levels in Healthy Subjects. Front Nutr. 2022;9:868640. .
In 2022 the FDA ruled that NMN must be excluded from the dietary supplement category in the U.S. This decision was announced months after Inner Mongolia Kingdomway Pharmaceutical Limited (“Kingdom”) filed a new dietary ingredient (NDI) notification to the FDA for NMN, a motion that’s necessary when brands want to market dietary supplements with a “new dietary ingredient” never marketed in the U.S. prior to Oct. 15, 1994.
The FDA’s response reiterated that products classified as dietary supplements exclude ingredients “authorized for investigation as a new drug” or those in which “substantial clinical investigations have been instituted” and “made public.” Since NMN’s authorized investigation as a new drug happened before it was lawfully marketed as a dietary supplement, the FDA concluded that it should be excluded from the dietary supplement category until further notice.
Therefore, manufacturers marketing NMN products as supplements in the U.S. are doing so unlawfully, according to FDA regulations.
“While some studies show promising results in animal models and limited human trials, more research is needed to establish conclusively the effectiveness of NMN supplements in humans,” says Sabat. Considering the limited research on NMN, it’s too soon to verify whether the supplement alone is effective in increasing NAD+ levels. Pending human trials should help provide clarity on how well they work and in what capacity.
A 2023 study revealed that oral dosing of 900 milligrams of NMN daily is generally safe for and well-tolerated in adults[4]Yi L, Maier AB, Tao R, et al. The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial. Geroscience. 2023;45(1):29-43. . With that said, Sabat notes it’s crucial to consult with a health care provider to determine an appropriate dose based on individual factors, such as body weight, dietary intolerances, preexisting health conditions and any potential interactions with existing medications.
Consuming foods containing NMN could provide some benefits in increasing a person’s NAD+ levels. Such foods include edamame, cucumbers, broccoli and avocados. “However, the levels of NMN obtained through diet alone may not be sufficient [to create] significant effects,” says Sabat. Generally, “healthy lifestyle practices, such as regular exercise and a balanced diet, can help support NAD+ production in the body,” she adds.
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Johnaé De Felicis is a health writer and passionate wellpreneur. Her mission in life is to inspire others to lead happy, healthy and wholesome lives, and she covers a variety of topics that are centered around this goal. Johnaé's work also appears in Healthline, Well+Good and Blue Zones.
Sodium Ascorbyl Phosphate Distributors Keri Gans is a registered dietitian nutritionist, certified yoga teacher, spokesperson, speaker, writer and author of The Small Change Diet. The Keri Report, her own bi-monthly podcast and newsletter, helps to convey her no-nonsense and fun approach to living a healthy lifestyle. Gans is a sought-after nutrition expert and has conducted thousands of interviews worldwide. Her expertise has been featured in popular media outlets such as, Forbes, Shape, Prevention, Women’s Health, The Dr. Oz Show, Good Morning America and FOX Business. She lives in New York City with her husband Bart and four-legged son Cooper, is a huge animal lover, Netflix aficionado and martini enthusiast.