Vol. IV · No. 19
Tuesday, June 23, 2026
Issue: Spring · 2026
Established · MMXXVI
— The evidence base for longevity medicine —
Indexed by PubMed · CTG · Cochrane
Editorial team · geroevidence.com
Subscription · app.geroevidence.com
NAD+ precursor · NAD+

NMN

NAD+ precursor ·NAD+ pathway

NMN (nicotinamide mononucleotide) is a direct NAD+ precursor that replenishes intracellular nicotinamide adenine dinucleotide pools through salvage pathway kinases, restoring substrate availability for NAD+-dependent enzymes including sirtuins, PARPs, and CD38/CD157. This mechanism addresses the age-related decline in NAD+ levels, thereby modulating multiple hallmarks of aging including mitochondrial dysfunction, genomic instability, and cellular senescence through sirtuin and PARP-mediated pathways. Published evidence demonstrates improvements in metabolic parameters, exercise capacity, and muscle insulin sensitivity in human trials, while preclinical studies report extended lifespan in rodent models accompanied by enhanced mitochondrial biogenesis and improved stress resistance; however, human longevity data remain limited to surrogate biomarkers and intermediate outcomes without prospective lifespan confirmation.

Last reviewed: May 19, 2026
Evidence strength
Emerging
— for healthspan endpoints
Strong Ph. III
Moderate ≥2 RCTs
Emerging 1 RCT
Insufficient pre-clin
Single RCT or pooled small-trial signal. Promising but limited.
Key outcome
Surrogate endpoints
Yoshino 2021 · insulin sens
Evidence tier
Emerging
Updated May 19, 2026
Active trials
from ClinicalTrials.gov
Drug class
NAD+ precursor
NAD+

Recent papers — reviewed before publication

16 indexed
Review
Jun 1, 2026
An integrated anti-aging framework targeting NAD+ homeostasis, mitochondrial quality control, and redox stability: Roles of NMN/NR, PQQ, and EGT.
Sun et al. · Redox biology
Mechanism
Jun 1, 2026
Nicotinamide Mononucleotide Reduces Iron in BV-2 Cell by Up-Regulating Ferroportin 1 via Inhibiting the IL-6/STAT3/Hepcidin Pathway.
Qian et al. · Rejuvenation research
More papers available — with plain language summaries
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Active trials — from ClinicalTrials.gov

0 tracked
Full trial tracking
Active trials, phase, enrollment, primary endpoints, and completion dates — available to subscribers.
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Frequently asked

Is NMN a prescription drug or a supplement?

NMN (nicotinamide mononucleotide) is sold as a dietary supplement in the United States and is not FDA-approved as a drug for any indication, including longevity.

What human evidence exists for NMN and aging?

Available human data (e.g., Yoshino 2021) has focused on surrogate endpoints such as insulin sensitivity rather than hard outcomes like mortality. See the full profile for the current paper count and study details.

Why is NMN graded as Emerging evidence rather than higher?

Current published human evidence is limited to surrogate endpoints and small trials. No pooled mortality or major-outcome hazard ratio currently exists for NMN in longevity contexts.

Are there known safety concerns with NMN supplementation?

Published human trials to date have not identified major safety signals at studied doses, though long-term safety data and standardized dosing remain limited compared to approved pharmaceuticals.

How does NMN compare to NR as a NAD+ precursor?

Both target NAD+ repletion through different metabolic pathways. Evidence tiers are currently similar (Emerging) for both, based on surrogate-endpoint human data. See the NR profile for direct comparison.

This information is provided for educational reference only and does not constitute medical advice or a treatment recommendation.
Evidence profiles are reviewed by the Geroevidence editorial team. Key outcomes are from published meta-analyses or landmark RCTs. No clinical recommendations are made. Full evidence dossiers with paper summaries and weekly updates are available to subscribers.