Key Takeaways

NAD+ is the essential coenzyme your cells need. By age 50, levels drop by roughly 50%.
NMN (nicotinamide mononucleotide) and NR (nicotinamide riboside) are precursors your body converts into NAD+.
NMN is closer to NAD+ in the biosynthesis pathway (one step away); NR requires two conversion steps.
The Sinclair camp favours NMN; the Brenner camp champions NR. Both raise NAD+ levels in humans.
In Malaysia, NMN costs RM 150–500/month; NR (as Tru Niagen) runs RM 200–350/month. IV NAD+ drips cost RM 1,500–3,000/session.

Disclaimer: This article is educational. NAD+ boosting supplements are not approved to treat any disease. Consult your doctor before starting supplementation.

Why NAD+ Matters for Aging

Nicotinamide adenine dinucleotide (NAD+) is arguably the most important molecule in your body that you've never heard of. It's a coenzyme present in every living cell, essential for:

Energy metabolism — converting food into ATP (cellular energy)
DNA repair — fuelling PARP enzymes that fix DNA damage
Sirtuin activation — powering the "longevity genes" (SIRT1–7) that regulate aging
Circadian rhythm — maintaining your body clock
Immune function — CD38 enzyme activity

The problem: NAD+ levels decline dramatically with age. Research from Shin-ichiro Imai's lab at Washington University shows roughly a 50% decline by middle age. This decline is implicated in virtually every hallmark of aging — mitochondrial dysfunction, DNA damage accumulation, inflammation, and metabolic decline.

The longevity strategy is simple: boost NAD+ back to youthful levels. The question is how.

The Three Options: NAD+ vs NMN vs NR

Direct NAD+ Supplementation

Why not just take NAD+ directly? It's a large molecule (663 Da) that doesn't cross cell membranes easily when taken orally. Most oral NAD+ is broken down in the gut before reaching your cells.

Routes that work:

IV NAD+ drips — bypasses the gut entirely, delivers NAD+ directly to the bloodstream. Highly effective but expensive and time-consuming (2–4 hour infusion).
Sublingual NAD+ — absorbed through mucous membranes under the tongue. Some evidence of modest absorption.
Oral NAD+ — largely ineffective at reaching cells intact. Some newer liposomal formulations claim better absorption, but data is limited.

NMN (Nicotinamide Mononucleotide)

NMN is the direct precursor to NAD+. It requires just one enzymatic step (via NMNAT enzymes) to become NAD+. This is the supplement championed by David Sinclair of Harvard Medical School, who takes 1g daily himself and has published extensively on NMN's effects.

Key NMN research:

Improved insulin sensitivity in prediabetic women (Yoshino et al., 2021, Science)
Enhanced aerobic capacity in recreational runners (Liao et al., 2021)
Improved muscle insulin signalling and remodelling
Multiple ongoing clinical trials for cognitive function, cardiovascular health, and metabolic syndrome

The Slc12a8 transporter: In 2019, Imai's lab discovered a dedicated NMN transporter in the gut (Slc12a8), suggesting NMN can be absorbed intact — not requiring conversion to NR first. This was a major point in NMN's favour.

NR (Nicotinamide Riboside)

NR is two steps away from NAD+ in the biosynthesis pathway. It must first be converted to NMN (by NR kinases), then NMN to NAD+. NR's leading champion is Charles Brenner of City of Hope, who discovered the NR kinase pathway and co-founded ChromaDex (maker of Tru Niagen).

Key NR research:

Raised blood NAD+ levels by 60% in healthy middle-aged adults (Martens et al., 2018, Nature Communications)
Improved mitochondrial function and reduced inflammation markers
NASA studied NR for protecting astronauts from cosmic radiation damage
More published human clinical trials than NMN (as of 2025, NR had 20+ human trials vs NMN's 10+)

Head-to-Head Comparison

Factor	NAD+ (IV)	NMN (Oral)	NR (Oral)
Steps to NAD+	0 (direct)	1	2
Bioavailability	100% (IV)	Good (Slc12a8 transporter)	Good (NR kinase pathway)
Human trials	Limited	10+	20+
Typical dose	250–750mg IV	250–1000mg oral	300–600mg oral
Cost (Malaysia)	RM 1,500–3,000/session	RM 150–500/month	RM 200–350/month
Convenience	Low (clinic visit)	High (capsule/powder)	High (capsule)
Key advocate	Various clinics	David Sinclair (Harvard)	Charles Brenner (City of Hope)
Stomach stability	N/A	Stable	Stable (patented as Niagen®)

The Sinclair vs Brenner Debate

This is one of the most entertaining rivalries in longevity science.

Team Sinclair (NMN)

NMN is one step closer to NAD+ — more efficient conversion
The Slc12a8 transporter allows direct NMN absorption in the gut
Sinclair takes 1g NMN daily and credits it (alongside resveratrol and metformin) for his biological age improvements
NMN showed impressive results in animal models for reversing vascular aging, improving cognition, and restoring fertility

Team Brenner (NR)

NR has more human clinical trial data
The Slc12a8 transporter study has been questioned — some researchers argue NMN is largely converted to NR in the gut before absorption anyway
NR (as Tru Niagen) has GRAS status and is sold through regulated supplement channels
Brenner argues NMN supplements have quality control issues — some products tested contained little actual NMN

The Reality

Both raise NAD+ levels in humans. Both have shown health benefits. The difference may be marginal for practical purposes. The bigger factors for most people will be cost, availability, and product quality.

Dosing Protocols

NMN Dosing

Starting dose: 250mg/day
Standard dose: 500mg/day (most human trials use this)
High dose: 1000mg/day (Sinclair's personal protocol)
Timing: Morning, preferably on an empty stomach or with a light meal
Form: Powder (sublingual) may have better absorption than capsules. Some prefer sublingual administration — hold under tongue for 30–60 seconds before swallowing.

NR Dosing

Standard dose: 300mg/day (one Tru Niagen capsule)
Higher dose: 600mg/day (two capsules)
Research doses: Up to 1000mg/day in clinical trials
Timing: Morning, with or without food

IV NAD+ Dosing

Standard: 250mg per session
Loading protocol: 250–500mg, 2–3x per week for 2 weeks, then monthly maintenance
High dose: 500–750mg per session (used in addiction recovery protocols)
Duration: 2–4 hours per infusion (too fast causes nausea, chest tightness)

Buying NMN and NR in Malaysia

NMN — Where to Buy

Shopee & Lazada Malaysia:

ProHealth Longevity NMN Pro 500 — RM 350–450 for 60 capsules (500mg). Third-party tested. One of the more reputable brands.
Alive By Science (sublingual NMN) — RM 250–400 for 30g powder. Popular sublingual option.
Double Wood NMN — RM 180–250 for 60 capsules (250mg). Budget option.
Generic/China brands — RM 80–150. Significantly cheaper but quality control is a concern. Look for third-party CoA (Certificate of Analysis).

iHerb (ships to Malaysia):

Wider selection, often cheaper than Shopee for premium brands
Shipping: RM 20–40, free over RM 160
Import duties may apply on orders over RM 500

NR — Where to Buy

Tru Niagen (ChromaDex): The gold standard NR product.

Available on Shopee, Lazada, and direct from ChromaDex (ships internationally)
Price: RM 200–350 for 30 capsules (300mg) — one month supply at standard dose
Patented Niagen® form — guaranteed potency and purity

Life Extension NAD+ Cell Regenerator: Contains NR (Niagen®) plus other NAD+ supportive compounds.

RM 250–400 for 30 capsules
Available on iHerb and some Shopee sellers

IV NAD+ — Clinics in Malaysia

For those who want the most direct route to boosting NAD+ levels, IV drip therapy is available at several clinics in KL:

Pricing ranges from RM 1,500–3,000 per session depending on dose and clinic
Sessions typically take 2–4 hours
Some clinics offer NAD+ combined with other nutrients (glutathione, vitamin C)

For a full guide on NAD+ therapy in Malaysia, see our dedicated article.

Cost Comparison (Monthly, RM)

Option	Dose	Monthly Cost (RM)	Notes
NMN (budget)	500mg/day	150–200	Generic brands, verify CoA
NMN (premium)	500mg/day	350–500	ProHealth, Alive By Science
NR (Tru Niagen)	300mg/day	200–350	Patented, quality guaranteed
NR (600mg)	600mg/day	400–700	Two capsules daily
IV NAD+ (monthly)	250mg session	1,500–3,000	One session per month
IV NAD+ (loading)	250mg × 4	6,000–12,000	First month loading phase

Quality Control: A Serious Concern

The NMN supplement market has a quality problem. Independent testing by various labs has found that some NMN products contain significantly less NMN than labelled — and some contain none at all.

How to Verify Quality

Third-party Certificate of Analysis (CoA): Reputable brands publish these on their websites. Look for HPLC testing showing NMN purity >98%.
Uthever® NMN: A patented, pharmaceutical-grade NMN ingredient used by several brands. If the label says Uthever®, you know the NMN itself is legitimate.
Niagen® NR: ChromaDex's patented NR. Tru Niagen is the primary consumer product.
Avoid: Products with no CoA, suspiciously low prices (under RM 100 for "500mg × 60 capsules"), or sellers with no verifiable brand information.

Sublingual vs Oral vs IV: Delivery Methods Compared

Oral Capsules/Powder

Most convenient. NMN and NR are both stomach-stable. Absorption through the gut is the primary route. Effectiveness: good for most people.

Sublingual

NMN powder held under the tongue for 30–60 seconds before swallowing. Absorbed through the sublingual mucosa, partially bypassing first-pass liver metabolism. Some users report more noticeable effects. No rigorous comparative human data vs oral.

IV Infusion

100% bioavailability. Most expensive and least convenient but provides the largest acute boost. Best for: initial loading, people with gut absorption issues, or those who want measurable results quickly (can test blood NAD+ levels before and after).

Nasal Spray

Emerging delivery method. Some NMN products are available as nasal sprays. Theoretically good absorption through nasal mucosa, but limited data. Available on some specialty supplement sites.

So Which Should You Take?

Best Value: NMN (Budget Brands With CoA)

At RM 150–200/month for 500mg/day, budget NMN with verified third-party testing offers the best cost-per-benefit. Just verify the CoA.

Best Quality Guarantee: NR (Tru Niagen)

If you want zero quality concerns and are willing to pay a premium, Tru Niagen at RM 200–350/month is the safest bet. Patented ingredient, extensive human trial data, regulatory compliance.

Best for Quick Results: IV NAD+

If budget isn't a constraint and you want measurable, rapid NAD+ restoration, start with a loading course of IV NAD+ (4 sessions over 2 weeks), then maintain with oral NMN or NR. This combination approach is what many longevity clinics recommend.

The Peak Protocol Recommendation

For most Malaysian readers optimizing for longevity on a reasonable budget:

Start with NMN 500mg/day (sublingual powder for best absorption, reputable brand with CoA)
Combine with a broader longevity protocol (the supplement alone isn't magic)
Test your baseline — get longevity blood work before starting and at 3 months
Consider IV NAD+ for an initial boost if budget allows, then switch to oral maintenance

This article is for informational purposes only and does not constitute medical advice. Consult a healthcare professional before beginning any supplementation regimen.

NAD+ vs NMN vs NR: Which Supplement Should You Take?