"Fountain of Youth" Benefits of Nicotinamide Riboside - a New Form of Vitamin B3

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NAD benefitsHow "the central regulator of metabolism" works brilliantly as the latest anti-aging trick.

A new form of niacin (vitamin B3) known as Nicotinamide riboside (NR) has exciting “fountain of youth” properties for healthy DNA & cellular aging.

There are two other forms of niacin that are normally available in supplements. These forms of Vitamin B3 are nicotinic acid & a delayed release form known as niacinamide.

I'm aware that "Fountain of youth"-potential is a bold claim - but the research on the new form of niacin known as nicotinamide riboside is quite interesting.

I’ll briefly cover nicotinic acid & niacinamide & then demonstrate what makes nicotinamide riboside (commercially available as TruNiagen and TruNiagenPRO) so unique & groundbreaking for cellular health & anti-aging to propose such a claim.

Nicotinic Acid -  Traditional Flushing form of Vitamin B3:

Niacin (known as vitamin B3), is normally thought of for helping to reduce high lipids (1) . Nicotinic acid is the fast absorbing and flush-causing form of Niacin.

I use nicotinic acid regularly to help dilate my blood vessels to optimize waste & nutrient exchange in my brain and body. It has been essential in my recovery from mercury and mold toxicity & a history of burnout.

Some also use niacin in the nicotinic acid form to help create a better “muscle pump” while lifting - & you’ll see nicotinic acid in some pre-workout supplements.

Niacin flushing, while uncomfortable to most, is something I willingly invite.

I still prefer nicotinic acid as my source of niacin & warn others to start low (25-50mg Niacin) & work up until you know what a normal flush feels like before using 250-500mg versions of nicotinic acid.

I generally keep my higher dose at 500mg, so you might be anywhere between 25mg & 500mg to trigger a flush. Better to trigger a flush at 50-100mg than at 500mg the first time! You’ll thank me.

Don’t overdo Niacin above 500mg for any period of time as it will put unnecessary strain on your liver as you deal with toxin release, lipid metabolism & more. 

There are times during a niacin flush when your heart will feel like it’s beating hard & your skin might feel sunburnt - it’s normal, temporary, & ultimately healthy response - but it’s not for everyone.

If this happens, take a cool shower, strip your clothes to reduce itching & trust that it will pass in 10-30 minutes.

The flushing effects are from the dilation of tiny blood vessels known as capillaries.

Normally, capillaries are so small that just 1-2 microscopic molecules can pass through at a time.

During a flush, the capillary dilation allows double or triple the nutrients in & double to triple the wastes out. This is where the "niacin flush" offers unique benefits versus other forms of niacin. 

The boost in microcirculation is also the same reason many spend thousands on Bemer mats & similar microcirculation boosters.

In the process of flushing, you feel very warm & your skin turns red or blotchy. You may experience itching, welting, or sunburnt feeling on your skin. This is all a result of that capillary dilation & boost in microcirculation.

You will not get the nutrient/waste exchange benefit of capillary dilation unless you flush.

The itching that may occur during or after a flush comes from a histamine release that can leave your skin welty & itchy. This is also healthy as it dumps that excess histamine.

The more I need to detox, the itchier & more welt-like I’ll be during a flush. The more easily or robust your flush is….the more you needed it! 

If you have been drinking or have been otherwise unhealthy - take half or less of your usual dose to prevent excess discomfort.

For cardiovascular, lipid-lowering, & fat-burning benefits, the slow-release niacinamide version discussed below will offer benefit for those areas - without the uncomfortable flushing effect.

A niacin flush (using nicotinic acid form of B3) offers a nice “reset” to my system after a stressful day.

The brain is very rich in capillaries & subject to many benefits from a microcirculation boost. For instance, flushing helps the brain get rid of adrenochrome which is a metabolite of adrenaline that can build-up in the brain after a period of stress. Niacin therapy was part of early therapies for Schizophrenia in the 1950's & 1960's taking advantage of this mechanism.

You also release toxins that are normally sheltered away from the body in the form of fat storage. You get a rebound fat-burning effect following a flush which may also motivate you to deal with the short-term discomfort.

You’ll also help flush heavy metals, pesticides & other agents from stores in the body where they can be filtered by the liver & kidneys or released via sweat.

Nicotinic acid and niacinamide benefts are not too shabby at a cost of $8-15 depending on the dose & bottle size.


I had a history of panic disorders & anxiety in the past. I found niacin flushes to be a soothing experience to me. Whenever I felt a little anxious, I would take some Niacin & enjoy a flush 30 minutes to 2 hours later.

Flushing helped me understand what was going on with my body. I felt so great after flushing - which led to me investigating "Why?".

After the flush, I would get a calm over my body & I'd go back to something I was working on or fall asleep more soundly. It's also how I fell in love with sauna therapy.

niacin and saunaNiacin Flushes and Saunas

I now use niacin as an adjunct to a hot sauna session - where I optimize the sweating out of toxins at the same time that they’re being released during the flush.

I will take some
liposomal glutathione, an electrolyte drink & other liver support during this process. I also use it after any alcohol use or high coffee intake.

If I'm at a conference in a new city breathing in toxins from car exhaust, flame retardants, or I am sleeping in a in mold-prone hotel rooms, I use niacin & sauna therapy to help my body free itself from & sweat out those toxins.

Scared of flushing?  

That’s okay, skip the flush & find another way to sweat!

Sauna therapy itself will help dilate blood vessels & release toxins on its own. Saunas lead to increase expression of stress-resilient heat shock proteins (zinc carnosine helps heat shock proteins too).

Plus, you can supplement with the new form of niacin known as nicotinamide riboside & enjoy vast cellular & anti-aging benefits instead - without the flushing.

Niacinamide:

Niacinamide provides some of the lipid-reducing, cardiovascular-protective properties of niacin, without the flushing effect of the rapidly absorbed nicotinic acid.

The non-flushing nature makes niacinamide the staple form of niacin found in the supplement aisle. It is a delayed-release form of niacin that does not allow the flush to happen & is easier on the liver too.


It turns out that retail stores do not want beet-red, itchy & flushing patients demanding refunds or worse, going to the emergency room thinking they’re having an allergic reaction when they’re just experiencing a normal niacin flush.

Stores tend to carry the delayed-release, niacinamide form of niacin on their shelves - & make sure the nicotinic acid-containing forms are clearly labeled as capable of triggering a “flush”.

Nicotinamide Riboside (NR) Benefits for Total Cellular Health

A new, patented form of niacin is known as nicotinamide riboside (nicotinamide riboside chloride) was recently discovered.

The nicotinamide riboside form is non-flushing & has been discovered to aid directly in a number of anti-aging mechanisms in the body that you do not see with the other forms of niacin.

On a basic level NR helps to turn the nutrients you eat into energy more efficiently - but the implications of that are profound for aging.

I refer to it as NR for ease of reading.

NR leads to the direct creation of NAD+ (nicotinamide adenine dinucleotide) in the body with no adverse effects (2; 3; 4).

Not many substances are capable of increasing NAD+. NR is what you take orally, NAD+ is what your body makes after consuming it.

NAD+ is a coenzyme that greases the function of enzymes & genes in the body. When depleted, your cellular machinery can “rust” or bind up without the cellular greasing of NAD+.

The boosting of NAD+ is why researchers are so excited about NR being the latest anti-aging tool. The founder Dr. Charles Brenner refers to NAD+ as "the central regulator of metabolism".

While all three forms of niacin will lead to some NAD+ creation in the body, NR leads to the most production of NAD+ - without the flushing effect.

I take NR every day at least once, sometimes twice if I have a harder workout or had some alcohol or a dessert that might put extra strain on my mitochondria.

In general, stress, inflammation, overeating & excessive alcohol will strain your body's ability to keep up with NAD+ demand.

NAD+ helps deal with the day-to-day demands you put on your body & will aid your circadian rhythms. It will also help your body respond to any skin damage from the sun that may help reduce wrinkles as you age (5).

I’ll do NR in the morning & nicotinic acid at night prior to sitting in the sauna. I’ll also take a second NR capsule at night if I’ve had alcohol, felt I overate,or had a hard workout.

It’s hard to say one is better than the other - which is why I take advantage of both strategies. When it comes to NAD+, NR is the better strategy.

NR is new, sexy and is known for a more direct anti-aging benefit with the production of NAD+.

The crux of the benefits is a boost in mitochondrial health and efficiency. Mitochondrial health is behind most mechanisms of early aging. If you want to age gracefully - protect your mitochondria! 

More research is underway that will expand our understanding of its benefits even more.

Nicotinamide Riboside Benefits: NAD+ and Anti-Aging

nicotinamide riboside benefitsNAD+ is found in all living cells & helps your body sense stress on the cellular level.

NAD production naturally declines as we age - and as such it makes the function of mitochondria & ATP (energy) creation less efficient.

NAD+ has a demonstrated ability to reverse this process & restore energy production back to youthful levels.

NAD+ helps turn on longevity genes. It also helps repair damaged DNA (6). Higher levels help your mitochondria burn fuel efficiently, & may help with Alzheimer’s, weight management, macular degeneration & promote healthy cell development (generally thought to lessen risk of cancer development).

NAD+ directly activates sirtuins (7). Sirtuins are a group of longevity genes that work to decrease age-promoting genes. Sirtuin activation promotes blood sugar regulation & reduces inflammation & fat storage.

FAD+ is similar in nature to NAD+ in that it acts as a coenzyme & “wheel grease” for your cellular engines. You promote FAD+ by consuming high intake of vitamin B2, known as riboflavin (along with ample supply of magnesium & zinc).

I also supplement with riboflavin to get the benefits of FAD+. Your pee will be highlighter yellow when taking Riboflavin. It's normal! The “Flavin” root refers to the yellow color. And FAD+ is “Flavin adenine nucleotide” and is made readily from riboflavin.


Like NAD+ from B3 supplementation, the benefits of FAD+ from vitamin B2 supplements also come back to mitochondrial health - which is rich in brain & muscle tissue.

My wife suffered from chronic migraines and we put her on a combination of coenzyme Q10 (ubiquinol) and vitamin B2 and she hasn’t had a migraine since. She is also now taking nicotinamide riboside too.


Both NAD+ & FAD+ will help you metabolize sugar and fat. It will help you breakdown and metabolize histamine too. 

These unique enzymes alone & together also help spur the recycling of homocysteine, neurotransmitter metabolism & the creation of reduced glutathione. FAD+ will also help those with MTHFR gene snps arguably more so than taking methylated folate!

NR & Vitamin B2 (riboflavin) are perfect support aids for those who have partial slowing of these pathways based on their unique genetics.

Low NAD+ (and Low activity of sirtuins):

NAD+ is rate-limiting for proper activation of sirtuin enzymes. Sirtuins are a major group of anti-aging enzymes in the body.

“Rate-limiting” means that the more NAD+ available, the more you will activate sirtuins & the less NAD+ you have, the less your body will be able to activate sirtuins.

When the body does not have enough NAD+, it promotes:

-Higher risk of neurodegeneration (8)

-Increased fat accumulation in the body including fatty liver & belly fat (9). NAD+ may help you move the needle on your weight management goals.

-Higher incidence of insulin resistance (10; 11; 12)

-Mitochondrial aging (less ability to produce energy as we age)

-Loss of muscle (known as "sarcopenia" in older adults)

The first signs of deficiency might be difficulty concentrating, or neurotransmitter imbalances that lead to anxiety, depression, sleep disorders or general mood changes.

Currently, leading scientists are looking at a role of NR (and subsequent NAD+ production) in protecting cellular health in those with type 2 diabetes or undergoing chemotherapy.

As a B vitamin derivative, it is safe & any excess would just be peed out in the urine.

Natural Ways to Boost NAD+

increase NADNatural diet sources:

Natural sources of NAD+ include cow's milk & beer - things generally warned against by nutrition experts. These sources are associated with their own issues of allergy, insulin resistance & inflammation.

The following lifestyle & supplementation strategies are the next best sources.

Caloric restriction:

Intermittent fasting or “time-restricted feeding” is the calorie restriction strategy I’m most fond of as it is easiest to comply with long-term & is associated with most of the benefits you’ll get from more aggressive fasting strategies.

It is also associated with maintenance of NAD+ levels in the body as it reduces metabolic strain on the body (13; 14).

Reducing sugar availability:

I refer to this strategy as "reducing glycemic variability". Glycemic variability is how stable you keep your blood sugar throughout a normal day.

While your body may be able to handle spikes of glucose without gaining weight - it doesn’t mean you are exempt from the metabolic stress your body undergoes to keep your system in balance.

This metabolic stress at the cellular level is a trigger of aging, oxidative stress & inflammation. I personally undergo a couple of strategies to reduce my glycemic variability (and boost NAD+ as a secondary benefit) including...

  1.  Performing 30 seconds of squats, push-ups or burpees directly before eating.

    This technique boosts sugar utilization right after eating - buffering some of the stress from my cells. It exhausts your muscle stores of sugar & sensitizes your body's insulin receptors so the body uses the first bit of sugar you eat to resupply this muscle supply.

    Yes, I’m the weirdo who will go to a restaurant bathroom & do 30 seconds of body squats in the bathroom stall. I’ll take a few seconds of social awkwardness for better health if it means reducing my glycemic variability.

  2. Taking 500mg Berberine prior to eating. Berberine has an insulin-sensitizing effect which means it will not drive you into hypoglycemia but will only help if there’s excess sugar to be managed. It also may have prebiotic benefits in the gut - promoting beneficial bacteria & clearing out the bad guys.

    Some use bitter melon, but it’s difficult to find in a supplement by itself - it’s usually in blood sugar reducing formulations that may contain more support than you need.

    Cinnamon & 
    Gymnema sylvestre may also be a suitable supplement too. I personally like Gymnema for reducing cravings between meals & have had very consistent feedback from clients confirming the craving reduction.

  3. Taking digestive bitters to boost my digestive efficiency prior to eating. I use the line of “Better Bittersby Herb Farm. You can also use these in alcohol-containing drinks to increase your glucose utilization & ease the metabolic stress on your body

  4. Engage in a light 15-20 minute walk after eating. This also forces your body to utilize some of the sugar you just consumed - so that your body does not have to process it or deal with the oxidative stress that results. This is a great time to chat with your significant other, walk the dogs & get outside before getting back to work or parking in front of the television. 

    Walking is also free - an added bonus when you invest in a number of supplements like me. Generally wait 2-3 hours after eating for more intense exercise.

Some medical professionals are recommending Metformin for an anti-aging effect even in the absence of diabetes or blood sugar issues - I generally do not like that strategy because metformin may decrease key B-vitamins despite it’s insulin-lowering effects (15).

I can get the same effects using strategies like those above without medication-induced nutrient deficiencies. If you use this strategy, take a good B-complex or work with a CNS/CCN professional who is trained in medication-induced nutrient deficiencies.

Routine Exercise

Exercise, especially interval training (16), will also boost Sirtuin activity as it introduces some cellular stress & triggers protective mechanisms of the body (17).

Overexercise & overtraining do the opposite (18)

This is partly why you do not see body-builders, marathoners & ultramarathoners living to be 100 years old. Strength for bulk, or fitness for the sake of fitness and not health - while they can lead to high levels of performance in a specific sport or event, they are inordinate stresses on the body & can put extra strain on metabolic and heart health.

You want lean, efficient, fast, strong, buoyant & mitochondria-rich muscles, not bulky, metabolic-demanding, & inefficient muscles. Overtraining for strength or endurance will invite these age-promoting changes. 

"Overexercise" is loosely defined as vigorous activity that extends over 120 minutes at at time (19), seen with runners, marathoners, triathletes, body-builders & some Crossfit athletes

I stick to "minimum effective dose" exercise like Body by Science (book resource)-style slow rep weight lifting. I will mix short, (4-16 minute very high intensity "Tabata" style workouts), sprinkled in with mobility, yoga & sauna sessions. I treat myself to monthly massage, myofascial release & Chiropractic adjustments to decrease soreness & maintain healthy biomechanics.

About 2x/month, I'll engage in a low-intensity 1.5 hours hike that provides the aerobic, cardiovascular fitness we're familiar with that offers some unique benefits than the minimum effective dose lifting & shorter, more intense workouts.

Taking nicotinamide riboside will also help with muscular strength & may boost strength & performance gains when engaging in these workouts!

Key Research Findings of Nicotinamide Riboside:

  • Low NAD+ associated with key mechanisms of aging - particularly in the mitochondria, the energy powerhouses of every cell - especially rich in nerve & muscle (including cardiac muscle) tissue.
  • Studies published in the highly prestigious journals Cell & Science demonstrated a reversal of age-related muscle loss, mitochondrial damage, inflammation & diabetes in mice after just a week of supplementation.
  • Over a 6 week period, age-related changes in muscle growth, stem cells  DNA damage were reversed & mitochondrial function was improved. (20; 21).
  • May help reduce blood pressure and arterial stiffness (22). I'm a fan of Vitamin K2 to promote vessel health & metabolism too. If your blood is prone to being sticky, check out Nattokinase too.
It is for these reasons (and those discussed above!) that despite the absence of human clinical trials, I have included NR in my long-term daily supplement regimen (1-2x per day) & have started recommending it regularly to my one-on-one clients.

How to Supplement with Nicotinamide Riboside

NAD supplementI take TruNiagen, which is available in a more affordable, regular dose & a professional dose via TruNiagenPRO.

Take once a day in the morning. Take it a second time after intense exercise, drinking alcohol, or other event or activity that is associated with inflammation.

Taking NR twice a day is optimum as the peak level is 8 hours after dose, but you maintain those optimal levels by taking it twice a day (12 hours between doses).

So as the initial dose levels are falling, the 2nd dose levels are rising & maintained as you sleep!

I opt for the PRO version for best dosage and affordability, but either form will be a fantastic addition to the support of cellular health.

Any support is better than no support when it comes to NAD+ availability in the body.

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Dr Alex Rinehart

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