Vol. I · No. 33
Thursday, August 13, 2026
Issue: Summer · 2026
Established · MMXXVI
— The evidence base for longevity medicine —
Indexed by PubMed · CTG · Cochrane
Editorial team · geroevidence.com
Subscription · app.geroevidence.com

NR (nicotinamide riboside) for longevity: the complete evidence profile in 2026

NR was the first oral NAD+ precursor to be tested in human RCTs. Here is what those trials showed, how it compares to NMN, and what remains unknown.

By Geroevidence editorial team·Published 19 July 2026·Category intervention profiles·12 min read
Emerging
Evidence tier
NAD+ precursor
Drug class
Human RCTs
Evidence base
§ Overview

NR was the first oral NAD+ precursor to be tested in human RCTs. Here is what those trials showed, how it compares to NMN, and what remains unknown.

This profile synthesizes the published human evidence. The evidence tier system — Strong, Moderate, Emerging, Insufficient — is based on published peer-reviewed data only, with hard longevity outcomes weighted more heavily than surrogate endpoints. The full profile with all indexed papers and active trial alerts is available to subscribers.

§ Key human evidence
RCT
Elhassan et al. — Cell Reports, 2019
n=12
Older adults 70–80 years. 1000mg NR daily for 21 days. Whole blood and muscle NAD+ increased significantly. Mitochondrial gene expression improved in muscle. Short duration and tiny sample size limit conclusions. Confirmed that NAD+ can be raised in aged human tissue — a key proof-of-concept.
RCT
Martens et al. — Nature Communications, 2018
n=24
Older adults 55–79 years. 500mg NR or placebo for 6 weeks with crossover. Systolic blood pressure reduced by 4–6 mmHg in the NR arm. Aortic stiffness modestly reduced. Interesting cardiovascular surrogate signal but not replicated in larger trials. N too small for conclusions.
RCT
Remie et al. — Cell Metabolism, 2020
n=13
Obese men. 1000mg NR for 6 weeks. NAD+ confirmed elevated. No significant change in liver fat content (primary endpoint), insulin sensitivity, or energy metabolism. Largely null metabolic results. Important negative: NAD+ elevation alone did not translate to metabolic benefit in this population.
§ The honest clinical position

Evidence tier: Emerging. The case for clinical consideration rests on the mechanistic coherence and the published surrogate-endpoint human trial signal. The case for caution rests on the absence of hard longevity outcome data in adequately powered trials.

A physician discussing this intervention with a patient should communicate the evidence tier honestly and distinguish between what has been shown in published trials versus what is claimed in supplement marketing. The full Geroevidence profile includes the specific papers, effect sizes, and confidence intervals that inform this assessment.

This information is provided for educational reference only and does not constitute medical advice or a treatment recommendation.

Full evidence profile
All indexed papers · active trials · daily alerts
Start free trial
14 DAYS FREE · NO CARD REQUIRED
Top interventions by evidence tier
GLP-1 agonists
Cardiovascular outcome trials
Strong
Rapamycin
mTOR inhibitor · PEARL trial
Moderate
Metformin
AMPK activator · TAME pending
Moderate
View full index →