NMN vs NAD+: Which Raises NAD Levels?

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Short answer: The NMN vs NAD+ difference is that NMN (nicotinamide mononucleotide) is a building block the body uses to make the coenzyme NAD+. In the trials cited here, 250 mg a day of oral NMN raised NAD+ in blood cells or whole blood (Yoshino 2021; Igarashi 2022), but one of those trials found no change in muscle NAD+. None of these trials compared NMN head to head with NAD+ itself, so the published evidence cannot say which one raises NAD+ levels more.

Below is what each study measured, in which tissue, at what dose and for how long, followed by how NMN and prescription NAD+ differ. PrescribedRX does not sell NMN or NR.

What is the difference between NMN and NAD+?

NAD+ (nicotinamide adenine dinucleotide, listed in PubChem as nadide) is a coenzyme found in cells (PubChem). NMN is a precursor: the Yoshino trial authors describe NMN availability as “a rate-limiting factor in mammalian NAD+ biosynthesis” (Yoshino et al., 2021). NR (nicotinamide riboside) is another precursor that has been tested in trials (Martens et al., 2018).

In plain terms, NMN and NR are raw materials, and NAD+ is the finished molecule. Our explainer on whether NAD+ is a peptide covers the chemistry in more detail.

Which raises NAD levels: NMN, NR or NAD+?

Each study below measured NAD+ in a different place, at a different dose, in a different group of people. That makes direct comparison between rows unreliable.

Study	What was given	Who and how long	Where NAD+ was measured	What was reported
Yoshino 2021	Oral NMN 250 mg/day vs placebo	25 postmenopausal women with prediabetes and overweight or obesity (13 NMN, 12 placebo), 10 weeks	Blood cells (PBMCs) and thigh muscle	PBMC NAD+ increased with NMN; muscle NAD+ did not change
Igarashi 2022	Oral NMN 250 mg/day vs placebo	Healthy older men, 6 or 12 weeks	Whole blood	NAD+ and NAD+ metabolites increased significantly
Martens 2018	Oral NR 500 mg twice daily vs placebo (crossover)	30 healthy middle-aged and older adults, two 6-week periods	Blood cells (PBMCs)	NAD+ about 60% higher than placebo
Grant 2019	IV NAD+, 3 μmol/min for 6 hours	Small pilot (author affiliations include NAD+ Research Inc.)	Plasma and urine	No change in plasma NAD+ until after 2 hours

Yoshino 2021: NMN in women with prediabetes

This 10-week randomized, placebo-controlled, double-blind trial gave 250 mg of NMN a day. The authors reported that basal NAD+ in blood cells (PBMCs) increased after NMN but not placebo. In muscle, “NAD+ and nicotinamide content did not change” in either group, while some NAD+ breakdown products rose, which the authors read as a sign of higher NAD+ turnover. They also reported increased muscle insulin sensitivity and insulin signaling in this group, and no adverse events (Yoshino et al., Science 2021). The paper’s competing-interests statement lists a patent application related to NMN for one author and patent-licensing fees for another.

Igarashi 2022: NMN in older men

This placebo-controlled, randomized, double-blind trial gave 250 mg of NMN a day to older men for 6 or 12 weeks. Whole-blood analysis showed NMN “significantly increased the NAD+ and NAD+ metabolite concentrations.” The authors reported nominally significant changes in gait speed and left grip strength “which should be validated in larger studies,” and no significant effect on body composition. Three authors were employees of Mitsubishi Corporation Life Sciences (Igarashi et al., npj Aging 2022).

Martens 2018: NR in middle-aged and older adults

In this 2 x 6-week randomized, double-blind, placebo-controlled crossover trial, 30 participants took 500 mg of NR twice a day. The authors reported that NR raised NAD+ in blood cells (PBMCs) by about 60% compared with placebo. Seven of the 30 participants reported 14 adverse events in total: 9 during the placebo phase and 5 during the NR phase (nausea, skin rash, flushing, leg cramps and increased bruising). Blood pressure changes were described as exploratory, for future trials to test (Martens et al., Nature Communications 2018).

Grant 2019: NAD+ given by IV

For NAD+ itself, the human study cited here used an infusion. In that 2019 pilot, a 6-hour IV infusion at 3 μmol per minute produced no change in plasma NAD+ or its metabolites until after 2 hours, and the authors wrote that NAD+ was “rapidly and completely removed from the plasma for at least the first 2 h” (Grant et al., 2019). This study did not test NMN or oral NAD+.

Does raising NAD+ levels change health outcomes?

A 2026 systematic review of 33 human intervention studies found that oral NR and NMN “consistently demonstrated biochemical target engagement” (raised NAD+-related markers in blood or cells), but that effects on functional, metabolic, vascular and other outcomes were “heterogeneous and often null or endpoint-specific.” It concluded that clinical effectiveness for anti-aging or wellness outcomes “remains inconclusive” (Gallagher and Emmanuel, 2026).

A 2025 meta-analysis of randomized trials in adults with a mean age over 60 reported that NMN had no significant effect on skeletal muscle index, grip strength, gait speed or chair-stand time. Its authors concluded that “current evidence does not support NMN and NR supplementation for preserving muscle mass and function” in that age group (Prokopidis et al., 2025).

Taken together, these two reviews report that higher NAD+ readings in blood have not been shown to produce the anti-aging, wellness or muscle outcomes they studied.

NR vs NMN: how do they compare?

The trials on this page tested NR and NMN separately, in different people, at different doses, with NAD+ measured in different places (see the table above). None of them compared NR with NMN directly. The 2026 review grouped them together, reporting raised NAD+ markers for both and mixed outcome results for both (Gallagher and Emmanuel, 2026).

Is NMN a supplement or a drug?

The NMN and NR trials on this page gave them by mouth, as supplements (Igarashi et al., 2022; Martens et al., 2018). NAD+ offered as an injection or nasal spray is different: it is a compounded prescription product, and a licensed provider decides whether it is appropriate for you.

How is NAD+ offered through PrescribedRX?

PrescribedRX offers NAD+ as a compounded injection and a compounded nasal spray. Compounded medications are prepared by licensed pharmacies and are not FDA-approved. The oral NMN and NR trials above did not test these products, so their results do not apply to them. For what has been published on these routes, see the research on NAD+ injections and our IV vs injection vs nasal spray comparison.

Prices as displayed on the product pages on October 16, 2026:

Plan	3-month price as displayed	Monthly price as displayed
NAD+ Injection 200mg/mL 6ml (compounded)	3 month plan $412 · $137/mo · Billed every 3 months. Cancel anytime.	Monthly plan $169 a month
NAD+ Nasal Spray 200mg/mL 6ml (compounded)	3 month plan $412 · $137/mo · Billed every 3 months. Cancel anytime.	Monthly plan $169 a month

A prescription is issued only if a licensed provider determines treatment is appropriate, and your provider sets the dose. All plans are on the pricing page.

When should you talk to a doctor?

Talk to a licensed provider before starting NMN, NR or NAD+ in any form, especially if you have a health condition or take other medicines. In the Martens trial, events reported during the NR phase included nausea, skin rash, flushing, leg cramps and increased bruising, although more events were reported during the placebo phase (Martens et al., 2018). For prescription NAD+, our page on NAD+ side effects summarizes what has been reported. In an emergency, call 911.

See whether NAD+ is available to you

If you want a provider to review whether NAD+ injection or nasal spray is appropriate for you, start with the eligibility check. Both are compounded, and the price is shown before you pay. Browse all longevity treatments.

Related reading: NAD IV therapy cost · liposomal NAD+: what the evidence shows · NAD+ supplements vs injections · Do NAD+ Patches Work? What the Evidence Shows · Does NAD+ Help With Weight Loss? What Studies Report

Sources

1. Yoshino M, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021;372:1224-1229. PubMed. Accessed Oct 2026.
2. Igarashi M, et al. Chronic nicotinamide mononucleotide supplementation elevates blood nicotinamide adenine dinucleotide levels and alters muscle function in healthy older men. NPJ Aging. 2022;8:5. PubMed. Accessed Oct 2026.
3. Martens CR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9:1286. PubMed. Accessed Oct 2026.
4. Grant R, et al. A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD. Front Aging Neurosci. 2019;11:257. PubMed. Accessed Oct 2026.
5. Gallagher C, Emmanuel OO. NAD+ supplementation for anti-aging and wellness: a PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Res Rev. 2026;116:103057. PubMed. Accessed Oct 2026.
6. Prokopidis K, et al. The effect of nicotinamide mononucleotide and riboside on skeletal muscle mass and function: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2025;16(3):e13799. PubMed. Accessed Oct 2026.
7. PubChem, National Library of Medicine. Nadide (NAD+), CID 5892. pubchem.ncbi.nlm.nih.gov. Accessed Oct 2026.

This article is for general information. It is not medical advice and it is not a recommendation for any particular treatment. Whether a treatment is appropriate for you is a decision for a licensed clinician who has reviewed your health history and current medications.