A landmark clinical trial from Japan found that nicotinamide riboside, a derivative of vitamin B3 (also called nicotinic acid or niacin), may have anti-aging effects.

Researchers tested a nicotinamide riboside supplement on people with Werner Syndrome, a rare genetic condition that accelerates aging, thus causing skin ulcers, arterial stiffness, and kidney disease. When the participants took it, several aspects of the disease improved—all without serious side effects. The results indicated that nicotinamide riboside supplements may be a valuable treatment for Werner Syndrome, and the authors wondered whether it has broader anti-aging implications.

A New Outlook for Premature Aging Disorders

Werner Syndrome is an incurable disease causing premature signs of aging, such as gray hair. Those with the disease also exhibit age-related conditions—including cataracts and Type 2 diabetes—while still in their 20s. Other concerns include severe skin ulcers that frequently necessitate limb amputations and early death from cancer or heart disease. The average age of death for Werner Syndrome patients is 59.

Earlier research has shown that people with Werner Syndrome have lower levels of nicotinamide adenine dinucleotide (NAD), a body molecule vital for DNA repair, cellular energy production, and several metabolic processes. This finding suggests that depletion of NAD may contribute to the physiological effects of the disease. While it isn’t possible to supplement NAD directly, it is possible to supplement it indirectly with nicotinamide riboside, a precursor.

To determine whether nicotinamide riboside supplements can be of value for treating Werner Syndrome, researchers undertook a placebo-controlled clinical trial. The participants self-administered a daily dose of either nicotinamide riboside or a placebo for 26 weeks and then changed to the opposite treatment for 26 weeks.

The results showed that the nicotinamide riboside supplement significantly increased NAD blood levels compared with the placebo. Additionally, nicotinamide riboside slowed the progression of kidney disease, reduced skin ulcers, and improved arterial stiffness, an indicator of heart disease.

“We hope our work will accelerate studies on not only [Werner Syndrome] but also other premature aging disorders and common age-related diseases—ultimately helping to extend health span and improve quality of life in both patients and the broader population,” Masaya Koshizaka, an associate professor from the Center for Preventive Medical Sciences, Chiba University, Department of Diabetes, Metabolism and Endocrinology, said in a statement.

Magic Bullet for Aging?

“NAD levels are known to decline with age in several tissues—such as muscle, brain, liver, and immune cells—across multiple species, including humans,” Koshizaka told The Epoch Times in an email.

According to Koshizaka, other aging mechanisms include:

• Telomere Attrition: Telomeres are stretches of chemical DNA code that protect chromosomes from damage, and attrition refers to the gradual shortening that happens in aging


• Genomic Instability: Denotes a high frequency of DNA changes


• Epigenetic Alterations: Changes that occur when the environment and behavior alter the way genes work


• Cellular Senescence: A state in which the normal cell division process no longer occurs, but cells still survive

To date, there is no definitive evidence that NAD decline alone is a central driver of aging, Koshizaka said.

“Though the study involved a rare genetic aging disease, the mechanisms we observed—mitochondrial dysfunction, NAD depletion, and inflammation—are also common in normal aging,” said coauthor Dr. Vilhelm Bohr, affiliate professor in genome instability and neurodegeneration at the University of Copenhagen. Mitochondrial dysfunction means the cellular structures that produce energy, mitochondria, don’t work as well as they should.

These three effects seen in normal aging make the findings relevant beyond the Werner disease population, Bohr told The Epoch Times in an email.

In general, Bohr recommends nicotinamide riboside as a safe and well-tolerated supplement for older adults—particularly those interested in improving energy metabolism, muscle maintenance, or inflammatory balance. However, he said, researchers still need to identify who can benefit the most.

Although nicotinamide riboside is found in trace amounts in some foods such as milk, the quantities are far lower than those in supplements, he said.

Other Anti-Aging Benefits

Nicotinamide riboside supplements may be beneficial for other age-related health conditions:

Heart Disease. A clinical trial found that taking 2 grams per day of nicotinamide riboside over 12 weeks can increase NAD in people with heart failure. Increased NAD production led to reduced inflammation and increased energy production in cells.

Neurodegenerative Disease. Nicotinamide riboside can potentially prevent cognitive decline in aging-associated diseases. In a study, it reduced neuroinflammation in mouse models involving dementia and improved memory and learning in mouse models involving Alzheimer’s disease. Additionally, a clinical trial found that taking 500 mg of nicotinamide riboside twice per day for six weeks can reduce biomarkers that indicate the presence of neurodegenerative diseases, including insulin resistance and brain inflammation.

Neuromuscular Disorders. Animal studies indicate that nicotinamide riboside can help protect the muscles and bones from age-related dysfunction. Additionally, a clinical trial involving 12 older men who took 1 gram of nicotinamide riboside daily for 21 days found that it stimulated NAD skeletal muscle metabolism and reduced inflammatory substances.