Can NMN Supplements Cause Cancer?

Several studies examined the possible link between the popular anti-aging supplements component beta-nicotinamide mononucleotide (β-NMN), also known as NMN, and increased cancer risk. Healthnews asked two experts to interpret the research.

NMN, a component of dietary supplements, is thought to raise levels of nicotinamide adenine dinucleotide (NAD+), a compound that repairs and protects DNA and mitochondria in the body.

As we age, NAD levels steadily decline, leaving us with less energy, inflammation, and cognitive impairments.

Until recently, NMN had been accepted as a New Dietary Ingredient (NDI) in the US, meaning it could be marketed as a dietary supplement component. However, on October 11, 2022, the US Food and Drug Administration (FDA) revoked the NDI.

Can supplements cause cancer?

Jan Vincent Beltran, a PhD candidate in Molecular Medicine at the Institute of Biomedical Science, says that, in general, cancer is very heterogeneous.

"Cancer in any patient is actually not really exactly the same, so scientists can only target the dominant pathways or mechanisms that they discovered. In this line, depending on the molecular context, like what major pathway or mechanism is activated or deactivated, any molecule may be pro-tumor or anti-tumor," he told Healthnews.

Beltran says that the same is true for our immune cells, which are not always protective.

"When certain pathways and mechanisms become abnormal, or during cancer, immune cells can also help tumor growth or activity," he added.

Research on NMN and cancer

In the 2021 study, mice were injected with lung cancer cells to develop tumors and received NMN injections daily for two weeks. Researchers then measured the tumor incidence, size, volume, and cancer markers.

Vaidas Dirsė, PhD, a medical biologist at Santariškių Klinikos, says that in the study, NMN did not affect the tumor size — it did not increase the growth or reduce it.

"The tumor markers also did not change. So it shows again that NMN did not have any effect. However, biochemical inflammatory markers decreased in mice, which is good for general health. Mice weight also decreased," he told Healthnews.

In the 2016 study, researchers from the Washington University School of Medicine in St. Louis examined the benefits of NMN in mice. They also monitored the animals for an increased risk of developing cancer due to NMN administration.

"Some tumor cells are known to have a higher capability to synthesize NAD, so we were concerned that giving NMN might increase cancer incidence," said Shin-ichiro Imai, MD, PhD, a study author. "But we have not seen any differences in cancer rates between the groups."

NMN may work in two ways

When it comes to NMN, this molecule may promote or inhibit cancer growth depending on the pathways activated or deactivated in cancer cells, Beltran explains. Therefore, the most effective solution in deciding therapies and treatment should be the stratification of patients according to the active mechanisms.

"For example, 100 cancer patients are most definitely heterogeneous. Hence, maybe 50% of them have the pathway activated that allows cancer cells to monopolize the NMN absorption as if they overexpress the receptors and metabolic mechanisms for NMN utilization much more aggressively than normal cells.

Or suppose the cancer cells don't really activate that increased ability to absorb NMN, such that instead of it, NMN goes to immune cells to supercharge them against their fight tumor cells. In that case, that's the beneficial scenario," Beltran said.

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