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#172 - NMN or NR or NAD+

#172 - NMN or NR or NAD+

Your evidence‐first playbook—dosing, labs, and the cheapest way to boost NAD+

October 02, 2025

October 2nd, 2025 | Issue #172

NMN or NR or NAD+ What A Freakin Mess!You’ve asked many time times: NMN or NR? Pills, powders, or IV? This week we cut through the noise—what actually raises NAD⁺ in humans, how to run a clean n=1, which options won’t torch your budget, and how to test if anything is working.

TWO BIG THINGS THIS WEEK

🧪 FDA says NMN is lawful as a dietary supplement (again) → shelves are coming backWhy it matters: After nearly three years of limbo, the FDA responded to industry petitions and recognized β‑NMN as lawful in dietary supplements—expect re-listings and more stable pricing. Also, this is why I’m writing about NMN this week. I was confused, and frankly, still am a little - Natural Products Association

💊 First once‑daily oral for acromegaly gets FDA green light (Crinetics’ paltusotine)Why it matters: Injection‑heavy endocrine care just tilted oral. Palsonify™ (paltusotine) won FDA approval on Sep 25, 2025, with launch targeted for early October. Oral options can improve adherence—and longevity‑adjacent hormone control. Reuters

Go Ahead, Light Your Money On Fire! Let’s GO!

TL;DR: If you want to move NAD⁺ without lighting money on fire: start with NR (300–600 mg/day) or NMN (250–500 mg/day) for 8–12 weeks, measure something objective (sleep/HRV, energy, optional labs), and only then decide whether to keep going. IV NAD⁺ is the only route I’ve personally “felt,” but it’s expensive and evidence‑light for longevity outcomes.

What Problem Are We Even Solving Here?

NAD⁺ supports energy metabolism, repair, and cell stress responses—and appears to decline with age. Precursors like NR, NMN, and nicotinamide (niacinamide) can raise NAD metabolites in humans, but clinical endpoints have been modest or population‑specific so far. Cell

What does human evidence actually show?

NR: Multiple human studies show increases in blood and skeletal‑muscle NAD metabolites after oral dosing; downstream outcomes are small/mixed. Start here if you want the strongest human PK/PD track record. Cell
NMN: In a 10‑week RCT (postmenopausal women with prediabetes), 250 mg/day improved muscle insulin sensitivity. Newer 12‑week trials in older adults show blood NAD⁺ increases and sleep/walking signals. Science+2Springer
Niacinamide (nicotinamide): Cheapest precursor and, at 500 mg twice daily, reduced non‑melanoma skin cancer recurrence risk in high‑risk adults (not a general anti‑aging claim). Topically, it helps barrier/pigment—a point Andrew Huberman has highlighted in public discussions—supported by clinical/derm literature. New England Journal of Medicine

What’s the most economical vs. “most evidence‑based” way to try?

Niacinamide (oral): pennies/day; use derm‑guided dosing if your goal is skin‑cancer prevention (not longevity per se). New England Journal of Medicine
NR: common retail ~$50 for 30×300 mg (≈$1.67/day). GNC
NMN: now lawful again; typical consumer range ~$30–$100+ / month depending on dose/form. Longevity Technology
IV/IM NAD⁺: most “felt” in my n=1, but $250–$1,500+ per session and not FDA‑approved for longevity; evidence for sustained NAD⁺ level changes or outcomes is limited. Verywell Health

How do you know if anything’s working?

Direct(ish) labs: Whole‑blood/RBC NAD⁺ via mass‑spec/enzymatic methods; dried blood spot approaches are emerging—treat results as directional, and retest with the same method/lab. SpringerLink
Proxies: HRV (weekly average), morning energy, sleep staging, RHR; plus homocysteine if stacking with high‑dose precursors (methylation demand).
Stacking: Pairing NR/NMN with TMG is common (theory: offset methylation sinks), but we lack RCTs showing outcome benefits. Keep optional unless homocysteine runs high. Cell

And, not that it matters, and I am not advising this for ANYONE (I’m NOT a doctor, consult with yours before doing ANYTHING you read here), and what I do is Niacinamide 2x daily at 500mg before noon. Upon waking, I take about 800-1000 mg of the oil into my mouth, with a squirt of MCT oil (as fat helps absorption rates), and I swish it around for a few minutes while I prepare my other vitamins and green drink for the day.

MARKET INTEL (past 60 days)

Neurodegeneration | Access: FDA-approved Leqembi IQLIK—a weekly, at‑home auto injector for maintenance dosing after 18 months IV (Aug 29). So what: movement of complex biologics into the home is a massive access shift. Reuters
Regulatory | Obesity orals: FDA “priority voucher” pilot could shorten review of Lilly’s orforglipron to 1–2 months if used; Lilly says details are still unclear. So what: pills could ease supply/price pressure vs injectables. Reuters
Aesthetics of evidence: Celebrity‑driven NAD⁺ IV buzz persists, but mainstream medical reporting still calls the human data limited, with $200–$1,500 per infusion norms. So what: buyer beware; start with orals and metrics. Verywell Health
Endocrine | Public markets: Crinetics read‑through: oral somatostatin mimetics validated; watch payer coverage and IGF‑1 targets into launch month. So what: adherence > injections is the story. Reuters

CITY GUIDE SPOTLIGHT

Boston Longevity Doctors & Clinics — from metabolic medicine to sleep labs to dermatology, Boston’s bench‑to‑bedside ecosystem is hard to beat.Plan your consults → Read the guide →

Have a great evening (or morning, depending on when you’re reading this)

See you at the Healthspan Summit in LA this weekend. If you spot someone in bright yellow Nike trail runners, say hi—it’s me. Event info → Healthspan Summit 2025

Brent

Check our latest Podcast Episode!

I dig into wealth × longevity—what “longevity risk” means for real people and how to plan for a longer life financially.Listen to it here > YouTube, Apple Podcasts, and Spotify.

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Do You Want To Start YOUR Longevity Journey?Talk To A Provider Here for FREE!

YOUR LONGEVITY PLAN — 3 Steps

✅ Step 1: Measurable (this week): Pick one: NR 300–600 mg/day or NMN 250–500 mg/day for 8–12 weeks. Track sleep (REM/efficiency), morning HRV, RHR, energy (1–10). Baseline today → checkpoints at week 4 and week 8.

✅ Step 2: Accessible: If you have high NMSC risk, discuss niacinamide 500 mg BID with your derm (evidence‑based for recurrence prevention). If not, niacinamide is still the cheapest precursor to try—with sane dosing and liver awareness at high grams. New England Journal of Medicine

✅ Step 3: Forward‑looking: If you want numbers, consider a whole‑blood/RBC NAD⁺ assay (mass‑spec/enzymatic; some dried blood spot options). Use the same lab/method pre/post; treat as directional, not diagnostic. SpringerLink

Sources for this newsletter this week: Research compiled from 30+ longevity publications, biotech funding reports, clinical trial databases, and Google News.Medical disclaimer: Content is for educational purposes only and is not medical advice. Always consult a qualified healthcare professional before making changes to your health regimen.Affiliate disclosure (email footer): Spannr may receive compensation when you click partner links and make a purchase. As an Amazon Associate, we earn from qualifying purchases. Some products may be provided at no cost for evaluation; opinions are our own.HIPAA/PHI notice: Do not send personal medical information to this inbox. Spannr does not collect or store PHI via email.

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