Alternatives to Nicotinamide Mononucleotide (NMN) in Europe

The dietary supplement nicotinamide mononucleotide (NMN) was recently authorized as an ingredient in a new drug application by the US Food and Drug Administration. NMN may soon be limited or unavailable for sale as a dietary supplement in the US, sparking fears that the same may hold for consumers in Europe, as many had to import NMN from the US.

As the global population ages, interest in longevity has spurred the development of many dietary supplements to reverse the effects of aging. The interest in the dietary supplement NMN derives from its importance to metabolic health. The supplement is touted to offer anti-aging benefits by improving mitochondrial function. Studies in rodents found improved insulin sensitivity and several small studies in humans suggest it is safe. However, consumers in the EU report that it is difficult to find NMN for sale through European Union companies and that importing the product from the US is difficult and expensive. Alternatives to NMN include nicotinamide riboside (NR), another anti-aging supplement.

How do supplements help reverse the aging process?

To carry on biological functions, maintain cognition, and remain physically active, our internal machinery requires a great deal of energy. To create, store, and retrieve this energy, we rely on a complex metabolic pathway within each of our cells called cellular respiration. The mitochondria carry out cellular respiration by creating and breaking chemical bonds to store and release energy. Shuffling electrons around through these complex biochemical pathways is how our bodies meet the needs of our internal energy “grid.”

Two of the most important components of this electron pathway are NAD⁺ and NADH. As we age, the level of NAD⁺ declines. It is thought that by boosting the precursor molecules needed to manufacture NAD⁺ and NADH, we can reverse some natural limitations of aging. Nicotinamide mononucleotide (NMN) is one precursor to nicotinamide adenine dinucleotide (NAD⁺). Another NAD⁺ precursor is nicotinamide riboside (NR).

How much do I need to take?

To keep baseline functions, approximately 20 mg of niacin (vitamin B3) are required to synthesize NAD⁺. Supplementing the intermediate molecules can boost NAD+ rates of synthesis, which is thought to have anti-aging benefits. However, NR is also naturally available in foods such as meat, eggs, dairy, certain vegetables, and milk.

Health benefits of NR

As we age, DNA damage and oxidative stress can impair the mitochondrial functions we rely on to produce energy and repair cellular damage. A recent literature review of the potential benefits of NR supplementation includes cardiovascular health and neurodegenerative disorders. Certain health conditions and obesity can contribute to chronic, systemic inflammation. It is thought that by supplementing with NMN or NR, we can support the demands of our cellular energy grid. To put it very simply, propping up our cellular energy supply may allow us to carry out these important mitochondrial functions and repair the cellular damage associated with aging.

Is NR available in Europe?

The European Food Safety Authority (EFSA) had already approved nicotinamide riboside chloride (NR) as a way to supplement niacin (vitamin B3) in foods. In 2020, Chromadex, Inc., requested approval from EFSA to extend the approval to include selling the product in meal replacements and drink mixes, as well as for special dietary purposes or as a meal replacement for weight loss. In September 2021, the supplement was only approved as food for special medical populations (FSMP) and as a total diet replacement for weight control (TDRWC).

As such, the supplement is only available through medical suppliers. The EFSA declined to approve the supplement for meal replacement products or nutritional drink mixes. The EFSA panel concluded that nicotinamide riboside chloride, is as safe as pure nicotinamide, for use in FSMP and TDRWC. The maximum use level of 500 mg of NRC per day corresponds to a maximum intake of 210 mg nicotinamide per day.

Other secrets to anti-aging at the cellular level

Other secrets to anti-aging at the cellular level

A recent randomized controlled trial of NR vs placebo among healthy volunteers ages 70–80 found that oral supplementation did increase NAD⁺ in the muscle. These healthy volunteers provided muscle biopsies to allow researchers the opportunity to study how oral supplementation affected availability in the muscle as well as the transcription of genes related to the NAD⁺ pathway. The researchers also found a decrease in levels of circulating inflammatory cytokines, suggesting possible anti-inflammatory effects.

Calorie restriction (but not malnutrition) has also been linked to extending the lifespan, but the mechanism is not fully understood. One pathway may be via NAD⁺ and its precursors. If calorie restriction increases levels of NAD⁺, allowing for improved mitochondrial function, then downstream anti-aging benefits could be tied to our diet. While NMN and NR appear to be safe for consumption and may have beneficial anti-aging effects, the products may be expensive, difficult to source, and perhaps even unnecessary for otherwise healthy individuals.

Eating a healthy diet of whole foods and drinking milk is a good start. Milk contains complete proteins and essential amino acids as well as important metabolic pathway precursors such as NR and nicotinamide. People with dietary restrictions may benefit from considering certain nutritional supplements and multivitamins to fill in nutritional gaps. One vitamin most of us should consider is vitamin D supplementation. During the winter in most areas of the US, the angle of the sun’s rays is too shallow to allow our skin to synthesize sufficient vitamin D.

Please be aware that from the fall of 2022 NMN is under an investigation as a potential new drug by the FDA. That puts the legality of the product as a dietary supplement in question. It’s a complicated situation that’s not yet solved. However, it is important to note that since we are not a manufacturer or retailer, we do not take any responsibility for the availability of the product as a dietary supplement after having lost its dietary ingredient status.