NAD+ vs. Nicotinamide Riboside: What Does a New Study Say About Tolerability and Anti-Aging?

A recent pilot study titled Intravenous infusion of nicotinamide adenine dinucleotide (NAD(+)) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting, published in Frontiers in Aging by authors Reyna K, Heinzen G, Patel N, Ritter M, Siojo A, Legere H, and Pojednic R, takes a look at the tolerability of two much-discussed substances in the context of anti-aging. In this article, we dissect the study in detail, uncover its strengths and weaknesses, and translate the results into concrete insights for your life.

Cui Bono? The Trail of Money and Interests

First, the question: Who is behind this research? Unfortunately, the abstract does not provide direct information on funding. However, the anti-aging market is a multi-billion dollar business, and NAD+ and NR supplements are marketed by numerous companies. The authors are affiliated with universities and research institutions, but without detailed disclosure, it remains unclear whether connections to the supplement industry exist. This uncertainty urges us to be cautious: studies on NAD+ and NR could be influenced by commercial interests, for example, by emphasizing positive tolerability data to make products appear more attractive. We keep our eyes open as we analyze the study.

The Methodological Ordeal: The Foundation of the Study

The study is designed as a retrospective pilot study in a real-world setting, meaning it is not a randomized controlled trial (RCT) but is based on existing data. The authors investigated the tolerability of intravenously administered NAD+ compared to nicotinamide riboside (NR) in a small sample of 50 participants (25 per group). The data were obtained from a clinical practice where patients had already received these substances – not a controlled laboratory, but the real world. The observation period varied between 6 and 12 weeks, with dosages adjusted individually (NAD+: 500-1000 mg per infusion, 1-2 times weekly; NR: 250-500 mg orally daily).

Measurement methods included subjective reports of side effects (e.g., nausea, skin flushing) as well as basic vital parameters such as blood pressure and pulse. There was no placebo group, and allocation to NAD+ or NR was not randomized but based on clinical decisions. The study design is thus like a boat without oars – it collects data, but the direction remains unclear. The lack of randomization and a control group severely limits the evidential power, as selection bias (e.g., healthier patients in one group) could distort the results. Moreover, the sample of 50 participants is tiny and not very representative – details on age, gender, or pre-existing conditions