Subscribe to Dr. Meschino’s Free Newsletter

Subscribe Now

NMU 278 – Nicotinamide Ribose (vitamin B3 derivative) Reduces Biomarkers for Alzheimer’s disease in Older Adults

Nutrition/Natural Medicine Update No 278 (March 8, 2023)

with Dr. James Meschino

Topic: Nicotinamide Ribose (vitamin B3 derivative) Reduces Biomarkers for Alzheimer’s disease in Older Adults

Source: Journal Aging Cell (December 14, 2022)


An important study was published in December 2022 in the journal, Aging Cell, showing that oral supplementation with Nicotinamide Ribose (NR) crosses the blood-brain-barrier and exerts important effects on processes involved in preventing the development of Alzheimer’s disease. NR is typically synthesized in the body from the ingestion of vitamin B3 (niacin). The body converts a great deal of niacin (B3) we ingest into NAD+ (Nicotinamide Adenine Dinucleotide), which it requires for energy production in most body cells, including the brain.  But NAD+ is also required to “turn on” the activity of longevity genes, known as Sirtuin Genes, and to activate PARP enzymes (Poly-ADP Ribose Polymerase), which repair DNA damage in most body cells, including brain cells. The problem is that as we age our brain levels of NAD+ decline quite substantially. So, not only can’t the brain generate optimal amounts of energy, but the function of Sirtuin Genes and PARP enzymes also begins to faulter. One of the ways to raise brain levels of NAD+ appears to be by taking an NR supplement daily, according to the December 2022 study.

How is a decline in NAD+ linked to Alzheimer’ disease? Well, Sirtuin enzymes act like epigenetic switches that modulate other genes in brain cells, helping to reduce brain inflammation and to prevent the synthesis of beta-amyloid plaque and the coalescing of tau protein into neurofibrillary tangles. Three hallmark features of Alzheimer’s disease include brain inflammation, the synthesis of amyloid plaque and the breakdown (acetylation) and coalescing of tau protein into neurofibrillary tangles. There is no question that higher brain levels of NAD+ can help the brain maintain more optimal energy production and evidence strongly suggests that higher NAD+ brain levels help prevent or slow these Alzheimer’s-related processes. So, the question has been, can we increase brain NAD+ later in life and will that help to prevent the development of amyloid plaque, neurofibrillary tangles, and brain inflammation. Well, the 2022 study in Aging Cell, has given us some encouraging results. These researchers showed that providing 22 healthy older adults with 500 mg of Nicotinamide Ribose Supplementation, twice daily, for six weeks resulted in lower biomarkers of inflammation, amyloid plaque, and tau protein breakdown in the plasma levels of these subjects.

More specifically, the researchers measured these effects in what are called extracellular vesicles for neuronal origin (NEVs). So, NEVs are particles found in the blood that originate in the brain that provide an indirect measurement of brain inflammation, amyloid plaque development and tau protein breakdown. After six weeks of NR supplementation these 22 older subjects showed significant declines in all three of these blood markers (NEV’s) for Alzheimer’s disease. This is very encouraging indeed, and the next step is to provide patients with existing cognitive impairment with NR supplementation to see if it can reverse early-stage memory loss, which is often the prelude into Alzheimer’s disease. These studies are being conducted by the Delaware Center for Cognitive Aging and Research. As an aside, it may be possible to raise brain levels of NAD+ by supplementing with nicotinamide (a form of vitamin B3) or Nicotinamide Mononucleotide (NMN). All three of these supplements (NR, Nicotinamide and NMN) show promise in raising NAD+ levels in the body. But the 2022 study in the journal Aging Cell, has confirmed that NR crosses the blood-brain-barrier and appears to inhibit key processes linked to Alzheimer’s disease development.  I’ll just add that simply taking a B-50 complex during all of adult life, containing 50 mg of niacin (vitamin B3), has also shown promise in preventing Alzheimer’s disease later life in life (Chicago Rush Institute Study).

I personally take a high potency multiple vitamin and mineral each day that is antioxidant enriched and contains a B-50 complex (including 50 mg of niacin). I’m not sure that healthy adults need to take 500 mg of NR, twice per day to prevent Alzheimer’s disease. This is a very high daily dosage. I’m quite sure future research will show that preventive effects can be accomplished with lower doses of Niacin, NR and/or NMN. In fact, sublingual supplements of these niacin products will likely prove to be a great deliver system for these particular nutrients. Sublingual administration enables you to take a much lower dose because the active ingredients are absorbed right into the bloodstream, without being degraded by stomach acids, intestinal enzymes, or liver detoxification enzymes. I’ll explain more about sublingual nutrient deliver in a future episode. For today, I want you to appreciate that niacin supplementation (B3) and some of its downstream metabolites like NR and NMN are showing great promise in helping to prevent Alzheimer’s disease.

I have included the reference for nicotinamide ribose in the journal Aging Cell in the text below.



Vreones M et al. Oral nicotinamide ribose raises NAD+ and lowers biomarkers of neurodegenerative pathology in plasma extracellular vesicles enriched for neuronal origin. Aging Cell. December 14, 2022.

Nicotinamide Ribose supplement linked to reduced biomarkers for Alzheimer’s disease. February 23, 2023.


Eat Smart, Live Well, Look Great,
Dr. Meschino

Facebook Comments