If you’re interested in aging and longevity innovations, you may have heard of NMN, which stands for nicotinamide mononucleotide.

It’s a molecule your body makes naturally, but some people also take it as a supplement. Researchers are currently investigating its promising potential benefits for many different areas of health, including longevity, heart health, and exercise training.

Research on the effects of NMN supplements is still emerging, and more investigation is needed. Learn what we know so far about its potential benefits, optimal dosage, side effects, and safety.

What is nicotinamide mononucleotide (NMN)?

Put simply, NMN is a naturally occurring molecule that helps power your body.

NMN is a type of molecule called a nucleotide. Nucleotides play many roles in your body, including as the building blocks of DNA.

Within your cells, NMN is converted into another molecule known as nicotinamide adenine dinucleotide (NAD). Your body needs NAD for a variety of functions involved in metabolism and energy production.

You might think of NMN as raw material and NAD as the refined version that your body can actually use.

The amount of NAD your body can make depends on the amount of NMN available in your body.

What does NMN do in the body?

All the cells in your body use NAD and therefore require NMN, its precursor, to function properly. NAD helps cells regulate a number of essential functions that help keep your cells running smoothly, including:

• energy metabolism
• DNA repair
• gene expression
• cellular stress responses

It’s essential that your cells have plenty of NMN to produce enough NAD to support these functions.

Your NMN levels naturally decline over time, and, as a result, your levels of NAD decline, too. This may contribute to some of the health effects you might experience during aging.

For example, research has shown that people with different age-related conditions, including diabetes and liver diseases, may have lower levels of NMN and NAD.

Potential benefits of NAD

Since taking NMN may help your body produce more NAD, it’s also important to consider the research behind the benefits of NAD. Studies investigating NAD shed light on its potential benefits:

• It may increase longevity. In your cells, NAD activates a group of proteins called sirtuins, which help repair your DNA. The activity of sirtuins is linked to longevity. On the flip side, low-NAD levels are associated with age-related diseases.
• It may have protective effects on the brain. NAD is thought to regulate the production of a protein that helps guard cells against oxidative stress. These cellular stressors are related to some neurological diseases, including Alzheimer’s disease.
• It may protect against cancer. Elevated NAD levels may help protect cells against oxidative stress and DNA damage, which are associated with cancer development.
• It may help with jet lag. Research suggests NAD may help adjust your internal clock, potentially helping ease jet lag or other circadian rhythm disorders.

It’s important to note that these benefits were found for NAD, not for NMN specifically. More research on the benefits of NMN and NAD is needed.

Recent research has found that taking NAD as a supplement doesn’t lead to the same potential benefits — but taking NMN can.

“The real breakthrough that occurred recently is our understanding of how to get NAD levels closer to those of our youth,” says Professor Andrew Salzman, MD, a Harvard Medical School alumni and a prominent drug inventor who’s leading NAD and NMN research at Wonderfeel.

“We now know that it can’t be done by delivering NAD either orally or by IV — because NAD has no mechanism for entering the cell.

“However, it can be done by providing the starting material for NAD, which is NMN. Cells have evolved a receptor for NMN — it’s a special protein on the surface of the cell which attaches to NMN and shuttles it into the cell. Once inside, NMN is converted by cellular enzymes to create NAD.”

What are the benefits of taking an NMN supplement?

Given the benefits of NMN on human health, some experts believe that taking an NMN supplement can help reverse the effects of aging. Some even claim that NMN is a proverbial “fountain of youth,” at least as shown in animal models.

Here we take a closer look at the human research on NMN supplementation, including potential benefits, safety risks, and available data on the most effective dosage.

Does NMN supplementation work?

Studies in animal models, especially mice, suggest that NMN supplements can provide various benefits, including reversing aging and improving cognitive health.

But does NMN supplementation actually work in humans?

That’s a hard question to answer at this point. Research on the effects of NMN supplementation in people is relatively new, and very few clinical trials (the gold standard for demonstrating a clinical benefit) have been published.

One study looked at the effects of taking 250 milligrams (mg) of NMN per day for 10 weeks in postmenopausal people with prediabetes and overweight or obesity. Those who took NMN had increased insulin sensitivity and signaling.

Note that two of the authors involved in this study are listed as inventors on patents involving the use of NMN.

Another recent study examined the effects of NMN on sleep quality in Japanese adults 65 years old or older. Participants received either 250 mg of NMN or a placebo control for 12 weeks.

Although taking NMN supplements did not appear to improve sleep quality, the researchers did see improvements in overall drowsiness and muscle responsiveness in the people who received NMN in the afternoon compared with the placebo group or those who took it in the morning.

Can it help with aging?

NMN and NAD levels naturally decline with age, so many researchers have suggested that taking NMN supplements may help with age-related health concerns.

A study in 10 Japanese men found that taking NMN (100, 250, or 500 mg) increased levels of NMN byproducts in the blood, including NAD.

Insulin resistance can develop with age and is one of the reasons diabetes is more common in older adults. Although studies haven’t specifically looked at the effects of taking NMN supplements, the research available suggests that it may help you maintain or regain insulin sensitivity with age.

More studies on these effects in humans are needed to investigate this potential benefit.

How can I increase my NMN naturally?

NMN is found naturally in a variety of foods, but. Some NMN-rich dietary sources include:

• avocados — 0.36 to 1.60 mg per 100 grams
• broccoli — 0.25 to 1.12 mg per 100 grams
• cabbage — up to 0.9 mg per 100 grams
• tomatoes — 0.26 to 0.30 mg per 100 grams
• raw beef — 0.06 to 0.42 mg per 100 grams

Small amounts of NMN are also found in cow’s milk, cucumbers, and edamame.

Is NMN safe, and does it have side effects?

NMN is an ideal supplement to increase cellular levels of NAD because it’s well-tolerated, and both human and animal studies have observed it had minimal side effects.

Research in humans has shown that doses of up to 1,200 mg daily are safe to consume.

Before adding any supplements to your diet, it’s important to talk with a healthcare professional about your unique situation and the potential risks and benefits you should consider.

What dosage of NMN should I take?

Given the limited data available on taking NMN supplements, it’s difficult to determine the ideal dose. Studies have found health benefits with doses as low as 250 mg of NMN per day, up to a maximum of 900 mg daily.

Only three studies, including those described above, have looked at the effects of taking NMN supplements over multiple doses. Importantly, safety does not appear to differ across different doses of NMN used.

In a study involving amateur runners, the aerobic benefits of NMN supplementation were greater with higher doses of NMN (1,200 mg) compared with lower doses (300 mg). But there was no difference observed in the benefits observed at a high dose compared with a medium dose (600 mg).

Takeaway

Many people, including experts, suggest that taking NMN supplements may provide a variety of health benefits. While animal studies have found the supplement reversed many age-related health effects, the evidence in humans is still limited.

Early studies suggest taking NMN supplements at doses of up to 1,200 mg per day may provide health benefits related to insulin sensitivity, aerobic function, and fatigue, with minimal risk of undesirable side effects.

Before adding any supplements to your diet, it’s important to talk with a healthcare professional about your unique situation and the potential risks and benefits you should consider.

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If you don’t make an effort to prevent it, odds are that you’ll catch the flu this season.

For most of us it means a couple of weeks out of work or school, then life goes back to normal. But the flu can be serious, even deadly, if you have a health condition like asthma, heart disease, diabetes, or a weakened immune system.

The trick is not to get sick in the first place. Here are proven ways to avoid the flu.

Get Vaccinated

Experts say the single best way to avoid the flu is to get the flu shot as soon as you can. The ideal time is early fall. But any time during the winter is fine if you haven’t already done it.

The vaccine is designed to protect against the flu strains health experts believe will be most widespread each season — for example, the H1N1 “swine flu.” Some vaccines work against three flu strains — you might hear them called trivalent. Others guard against four strains — doctors will call them quadrivalent.

Know the Vaccine Types

The flu “shot” contains a dead virus. One kind that’s approved for people 6 months and older goes straight into the muscle. Another uses a smaller needle that only goes into the top layer of your skin. It’s available for people ages 18 to 64.

The nasal spray, FluMist, contains a live but weakened form of the virus. It’s approved for those between ages 2 and 49 who are healthy, not allergic to the flu vaccine, and not pregnant. 

Egg-free vaccines are for people between ages 18 and 49 who have severe egg allergies. If your allergy is severe, you should get the flu shot from a doctor who can treat a severe allergic reaction — either at your doctor’s office, a hospital, a clinic, or a health department. Many children with egg allergies are at risk for complications from the flu, so it’s important for them to get the flu shot.

Fluzone is a high-dose version for those ages 65 and older. It’s better at protecting an older person’s immune system.

There is a “needle-less” option for people ages 18 to 64:  the jet injector vaccine with Afluria, which uses a tool and high pressure to deliver the vaccine.

Don’t make excuses for skipping your flu shot. Your arm might be a little sore the next day. And you may feel a little achy or run a low fever afterward. But you can’t catch the flu from the vaccine. It contains a weakened or killed form of the virus.

Build a Germ Barrier

It’s easy to catch the flu. When a nearby sick person sneezes or coughs, they send out a spray of virus-laden droplets straight to your open mouth or nose.

You can also pick it up from touching a surface — like the restaurant table where a sick person dined before you. Flu germs can linger on places like tables, counters, desks, doorknobs, and faucets for up to 8 hours.

When you touch a germy surface and put your hands on your eyes, nose, or mouth, your fingers bring the virus right into your body.

You can try to avoid sick people, but that’s not always easy to do, especially when you’re in close quarters like movie theaters and malls. If you can’t steer clear of the virus, at least use good hygiene to create a barrier against flu germs.

• Wash your hands with warm water and soap every time you shake hands or touch a surface that might be germ-covered.
• Carry an alcohol-based hand sanitizer with you for times when you can’t get to a sink.
• Bring along disinfectant wipes to clean any surfaces you’re about to touch.
• Take extra care to not touch your mouth, eyes, or nose without washing your hands first.

Sharing is wonderful, but not during flu season. Be stingy with your utensils, plates, glasses, and anything else you touch with your mouth. Wash used dishes and utensils in the dishwasher or in the sink with hot water and soap.

Take Care of Yourself

If you want your immune system to be in good enough shape to fight off the flu and other germs, you need to stay healthy.

• Eat a balanced diet.
• Exercise at least 4 days a week.
• Get 7 to 9 hours of sleep a night.

All these will give your body the strength it needs to fend off an influenza attack.

Quit Smoking

In addition to everything else smoking does to your body — from boosting your cancer risk to giving you premature wrinkles — it could make you more likely to get the flu.

There’s evidence that smokers get the flu more often than people who don’t light up. And when they do get sick, smokers tend to have a more severe infection and a higher risk of dying from the flu.

Holding off this nasty illness is just one more reason to talk to your doctor about ways to quit smoking.

Take Your Medicine

All these steps should keep you pretty well armed against the flu. Still, even the best defense isn’t perfect.

In case you do get sick, ask your doctor about antiviral flu drugs like oseltamivir (Tamiflu), peramivir (Rapivab), zanamivir (Relenza) or baloxavir (Xofluza). They can help you get better faster. But you need to take them within the first 2 days of getting sick.

If you do come down with the flu this season, look out for others. You can spread it for up to a week after you get sick. Don’t share germs with your friends, family, and co-workers.

• Stay home until you feel better and your fever has been gone (without the help of medicine) for at least 24 hours.
• Sneeze into your elbow, not your hand. That way you can’t pass it around.
• Toss used tissues after you blow your nose. Don’t leave them lying around for someone else to find.

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The pressure on our sprawling healthcare system in the U.S. has never been greater. There’s an urgent need to expand testing and treatment for COVID-19 to all residents who need it, regardless of health insurance status. Massive federal cash influxes have sought to shore up hospitals sagging under the weight of the coronavirus burden and the related cessation of elective surgery and regular medical care.

Long before this crisis, the U.S. led other industrialized nations in high spending on healthcare and getting a low bang for the buck in terms of health outcomes and the percentage of the population served. Life expectancy in the U.S., for example, is 78.8 years, while it ranges from 80.7 to 83.9 in 10 other high-income countries, according to an influential study in the Journal of the American Medical Association (JAMA). And only 90% of the population in the U.S. has health insurance, compared to 99% to 100% of the population in the other industrialized countries examined.

Costly Healthcare Hurts Everyone

The high cost of healthcare affects everyone, sick or well. It has depressed individual spending power for the past few decades. Salaries for American workers have risen, but net pay has stayed the same because of increasing charges for health insurance. Today, tightening up on overspending is urgent to help stretch medical and hospital resources to control COVID-19.

Here are six underlying reasons for the high cost of healthcare in the U.S.

1. Multiple Systems Create Waste

“Administrative” costs are frequently cited as a cause for excess medical spending. The U.S. spends about 8% of its healthcare dollar on administrative costs, compared to 1% to 3% in the 10 other countries the JAMA study looked at.

The U.S. healthcare system is extremely complex, with separate rules, funding, enrollment dates, and out-of-pocket costs for employer-based insurance, private insurance from healthcare.gov, Medicaid, and Medicare, in all its many pieces. In each of these sectors consumers must choose among several tiers of coverage, high deductible plans, managed care plans (HMOs and PPOs) and fee-for-service systems. These plans may or may not include pharmaceutical drug insurance which has its own tiers of coverage, deductibles, and copays or coinsurance.

For providers, this means dealing with myriad regulations about usage, coding, and billing. And, in fact, these activities make up the largest share of administrative costs.

2. Drug Costs Are Rising

On average, Americans shell out almost four times as much for pharmaceutical drugs as citizens of other industrialized countries pay. High drug prices are the single biggest area of overspending in the U.S. compared to Europe, where drug prices are government regulated, often based on the clinical benefit of the medication.

With little regulation of drug prices, the U.S. spends an average of $1,443 per person, compared to $749, on average, spent by the other prosperous countries studied. In the U.S. private insurers can negotiate drug prices with manufacturers, often through the services of pharmacy benefit managers. However, Medicare, which pays for a hefty percentage of the national drug costs, is not permitted to negotiate prices with manufacturers.

3. Doctors and Nurses Are Paid More

The average U.S. family doctor earns $218,173 a year, and specialists make $316,000—way above the the average in other industrialized countries. American nurses make considerably more than elsewhere, too. The average salary for a U.S. nurse is about $74,250, compared to $58,041 in Switzerland and $60,253 in the Netherlands.

U.S. managed care plans (HMOs and PPOs) may succeed in lowering healthcare costs by requiring prior authorization for seeing a high-priced specialist. Use of a nurse practitioner instead of a family doctor can also save money.

4. Hospitals Are Profit Centers

Hospital care accounts for 33% of the nation’s healthcare costs. Between 2007 and 2014, prices for inpatient and outpatient hospital care rose much faster than physician prices, according to a 2019 study in Health Affairs. U.S. prices for surgical procedures in hospitals greatly exceed those of other countries. A typical angioplasty to open a blocked blood vessel, for example, costs $6,390 in the Netherlands, $7,370 in Switzerland, and $32,230 in the United States. Similarly, a heart bypass operation in the U.S. costs $78,100 compared to $32,010 in Switzerland.

Today, many hospitals are on the brink financially. What’s more, the cessation of elective surgery and severely declining provider visits because of the coronavirus lockdown account for a big part of the decline in the overall economy.

5. U.S. Healthcare Practices Defensive Medicine

Both physicians and hospitals have an interest in preventing lawsuits, so “just in case” tests and scans may be ordered. And these tests can be costly! While a CT scan costs just $97 in Canada and $500 in Australia, the average cost is $896 in the U.S. A typical MRI scan costs $1,420 in the United States, but around $450 in Britain. Researchers have concluded that it’s not the sheer number of tests and procedures but their high price that explains why it’s so expensive to be sick in the U.S.

6. U.S. Prices Vary Wildly

Because of the complexity of the system and the lack of any set prices for medical services, providers are free to charge what the market will bear. The amount paid for the same healthcare service can vary significantly depending on the payer (i.e. private insurance or government programs, such as Medicare or Medicaid) and geographical area. For COVID-19, for example, the cost of an urgent care visit and lab tests averages $1,696, but can range from a low of $241 to a high of $4,510 depending on the provider.

The Bottom Line

Most other developed countries control costs, in part, by having the government play a stronger role in negotiating prices for healthcare. Their healthcare systems don’t require the high administrative costs that drive up pricing in the U.S. As the global overseers of their country’s systems, these governments have the ability to negotiate lower drug, medical equipment, and hospital costs. They can influence the treatments used and patients’ ability to go to specialists or seek more expensive treatments. Consumers may have fewer choices, but costs are controlled.

In the U.S., a lack of political support has prevented the government from taking a larger role in controlling healthcare costs. The Affordable Care Act focused on ensuring access to healthcare but maintained the status quo to encourage competition among insurers and healthcare providers.

Now that the costs related to COVID-19 threaten to swamp both the healthcare system and government budgets, the time for change may be at hand.

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