Supplement of the Year (2019): Q&A on NAD+, NR, and NMN
Plus a buying guide for identifying safety & quality in supplements
This year, nothing has been more talked about on podcasts than the science of aging. From David Sinclair to Peter Attia, Rhonda Patrick to Tim Ferriss, and Ben Greenfield to Joe Rogan—everyone wants to stem the effects of aging.
We recently put together a summary of the five pillars to optimize: Sleep, Diet, Exercise, Emotional Health, and Exogenous Molecules & Supplements. But, when it comes to supplements, the science remains confusing, the claims are hard to verify, and if you don’t know what you’re buying (or the quality), it can be downright dangerous.
Below you’ll find a Q&A on the most talked-about set of exogenous molecules & supplements: NAD+ and its precursors, most notably NR and NMN. We also included an important guide for buying supplements which will help you vet them their quality and safety. CLICK HERE TO JUMP TO THE SUPPLEMENT BUYING GUIDE.
Before we get to it our recommendation (based on everything you’ll read below): We’ve partnered with Elysium Health’s Basis, the only brand in the NAD+ category we’ve taken and trust. Their research, safety, and quality protocols set them apart in the supplement space. And, we got you a discount. You can buy their NR supplement using this link for $45 off a semi/annual subscription.
LET THE Q&A BEGIN
Question: Who is talking about the science of aging?
Everyone and their brother. If you’re like us and love to geek out on this stuff, make yourself a mushroom (or bulletproof) coffee, and give the following Podcast Notes a read (take a look at those names!):
Don’t worry; the abbreviations are much more common.
Question: What is NAD+?
If you want the technical definition: NAD+ is a coenzyme (a helper molecule) that assists enzymes in chemical reactions.
Question: What does NAD+ do?
NAD+ is most critical for energy creation: It has to be present for the body to turn nutrients into energy. If you didn’t have NAD+ in your body, you’d be dead in about 30 seconds. Nothing can live without NAD+, and adverse health consequences often accompany low levels.
NAD+ is also responsible for the regulation of our circadian rhythm. Not only does the circadian system dictate our sleep/wake cycle, but it also plays a vital role in our energy levels, hormone fluctuations, body temperature, and metabolism.
If you needed one more reason why NAD+ is important: Sirtuins, a class of genes that regulate cellular health, need NAD+ to function. We’ll dig into sirtuins later.
Question: What happens to NAD+ as you age?
NAD+ declines with age, no matter how much you exercise and how well you eat. By the time you’re 50, your NAD+ levels are about half what they were when you were 20.
NAD+ has two general sets of reactions in the human body: helping turn nutrients into energy as a key player in metabolism and working as a helper molecule for proteins that regulate other biological activity. These processes are incredibly important because they are responsible for regulating oxidative stress and circadian rhythms while maintaining the health of DNA. But, NAD+ levels decline as we age, which is something that has been shown in both human and animal studies
Question: What is NR?
NR is a precursor to NAD+; it provides the raw material from which your body makes NAD+. That’s where Elysium Basis comes in. Basis is a proprietary formulation of crystalline NR and pterostilbene (a polyphenol which has been shown to activate sirtuins, more on this below) that supports cellular health by increasing and sustaining NAD+ levels. If you want to increase your energy levels, replenish your NAD+ levels in the most efficient way possible with Elysium Basis ($45 off).
Question: What is a polyphenol?
A polyphenol is just a fancy word for the type of micronutrients in foods such as blueberries and chocolate. They are thought to have a variety of health benefits.
Question: Does NR really raise NAD+ levels?
Elysium Health’s double-blind, randomized, placebo-controlled clinical trial showed that Basis can increase NAD+ levels an average of 40%. The here evidence was published in Nature Partner Journals, which is at the highest tier of peer-reviewed journals. NRPT stands for nicotinamide riboside and pterostilbene. NRPT 1x indicates a single, recommended dose, while NRPT 2x indicates a double dose.
Question: What is pterostilbene, and
why does Elysium Basis pair it with NR?
Pterostilbene (PT) is a molecule found in
blueberries that aids in the specific activation of sirtuin 1 (SIR1).
SIR1 plays a critical role in maintaining healthy DNA. Here’s the analogy: NR is the gas for the car, and pterostilbene
is the nitrous to make it go fast.
Question: What are sirtuins, and what
do they do?
Sirtuins are a class of seven proteins that play a role in aging and keep your cells healthy. Think of them as the “guardians of the genome.” Sirtuins (and all the body’s cells) need the coenzyme NAD+ to function properly.
Question: What is NMN?
NMN, like NR, is simply another precursor to NAD+.
Question: What should you supplement
with, NR or NMN?
NMN is larger than NR. So large, in fact, that it needs to be broken down to enter the body’s cells. NR, on the other hand, can enter a cell as is and follows the most efficient path of conversion to NAD+.
One way for NMN to enter a cell is to first
chemically transform into NR. Once it crosses the cell membrane, it converts back to NMN and then
ultimately becomes NAD+. Long story
short, you might
as well supplement with NR, which can enter the cell as is.
Question: What happens to NAD+ when you
exercise (or fast)?
During exercise or fasting, when cellular energy levels are low, cellular NAD+ levels are increased. This response serves as a sensor for the body to activate sirtuin proteins. 
Question: How does your body make NAD+?
Your cells take raw materials—NAD+ precursors—which go through a series of chemical transformations that turn them into NAD+ the body can put to work. Every NAD+ precursor follows a unique pathway to convert into NAD+. Some paths are more efficient than others (thus producing more NAD+).
We’ve already covered the NAD+ precursors NR and NMN. Nicotinic acid (NA), also called niacin, and nicotinamide (Nam), are two additional examples of common NAD+ precursors utilized by the body. Both are forms of vitamin B3. Tryptophan, an amino acid you’ll probably be consuming a decent amount of come Thanksgiving, is another NAD+ precursor, but by far the least efficient.
Question: Can’t I eat more foods with B3, exercise, & fast rather than take a supplement?
You can and should do all of those things, but the boost in NAD+ may not be enough to outpace the losses due to aging. Taking the right supplement can definitely help you raise your NAD+ levels more efficiently.
Of NA, NMN, and NR, which produces the most NAD+?
We’ll leave NMN out here, as we already know that NR is superior in terms of the conversion to NAD+. While NA, Nam, and NR each provide their own benefits and all eventually get made into NAD+, one stands above the rest as the most efficient: NR.
Take a look at this 2016 study, which tested all three precursors in mice, concluding that supplemental NR resulted in the highest levels of circulating NAD+. That said, additional research is needed to confirm a similar effect in humans.
Why can’t you supplement with NAD+?
NAD+ isn’t bioavailable, meaning it can’t be taken orally and survive the digestion process. On the other hand, NAD+ precursors, like NR, found in Elysium Basis, do survive the digestion process and convert into NAD+ via their respective pathways.
Q&A on Identifying Quality and Safety in Supplements
Question: Why do I need to worry about quality and safety? There are standards, right?
Nutritional supplements are not regulated the same way that pharmaceuticals are. Pre-approval from the FDA is not needed before they go on the market—as with pharmaceutical medicines. Most of the time, when you buy supplements at health stores or from online e-retailers, you don’t know what you’re getting, whether it works, or if it’s safe. There could be unknown substances in the supplement that cause you physical harm, to fail a sports drug test, or worse.
Question: What is ICH and USP?
Generally, for Prescription Medicines, although often used by the supplement industry, these guidelines (U.S. and International versions) are designed to set an extremely high regulatory standard for quality. For example, there are set standards for the levels of Heavy Metals, Residual Solvents, Yeast, Mold, and other “objectionable organisms.” Basically, exactly what you had no idea could be in your supplement. This level of testing is rare and incredibly valuable in an industry ripe with abuse and scandalously low standards.
Question: What is NSF International Certified?
This is used to certify a supplement is safe for professional athletes and won’t lead them to fail performance-enhancing drug tests. In particular, there are 270+ substances banned by major athletic organizations, including the NFL, MLB, NHL, and PGA. Consequently, this is one of the most meaningful tests done to ensure nothing unexpected is in your supplement.
Question: What is a randomized, placebo
controlled clinical trial and why does that matter?
This is the GOLD Standard for testing the effect of any drug/supplement. Generally, these are only done by drug manufacturers who can afford expensive trials and have high confidence that their medicine will have an effect and prove safe. This is incredibly rare for supplements given their cost and the lack of tangible short-term benefits. Including a placebo control is there to establish that effects are not simply the result of luck or due to a “placebo effect.” The larger the sample and longer the trial, the more meaningful the trial.
Question: Why can’t you trust health foods stores or the local pharmacy?
As the continuous streams of exposes have shown, their quality control is not nearly what I/you might think it is (here, here, etc.). They aren’t vetting their sources or what is coming in every bottle. Buyer beware.
Question: Why can’t you trust everything you buy on Amazon?
Amazon doesn’t verify the products they are selling. In fact, Amazon views itself only as the technology connecting buyers & sellers—they don’t purport to stand behind any of the products they sell. Increasingly, Amazon products are being knocked off with counterfeits and potentially dangerous Chinese versions. Even if you know and trust a supplement brand, you can’t be sure you’re actually getting the real deal from Amazon. Go directly to the brand’s websites and order there; it’s worth the extra minute of signups/payments.
[The above applies for baby formula, cosmetics, or anything else you don’t want to take chances on.]
Question: What NAD / NMN / NR
Supplements meet the quality standards?
From what we could find, only Elysium’s Basis meets all of the various standards above (ICH/USP, NSF) and they do so transparently on their site. You can even see the results of every lot they manufacture – here. They also control their own supply chain entirely and only sell direct, not on Amazon.
We recommend Elysium’s Basis based on science & safety. And we believe it’s worth paying a premium for what you can trust.
The only NR brand who invests in gold standard research
Scientific proof that NR is the most efficient NAD+ precursor
Safe & wholly controlled supply chain means you aren’t getting snake oil or worse.
NSF, ICH, USP Certified means nothing hidden is in your supplement
You can buy their Elysium Basis using this link for $45 off a semi/annual subscription.