Compare
Side by side.
| NAD+ / NMN | Metformin | |
|---|---|---|
| Evidence | GRADE C | GRADE B |
| Category | NAD+/mitochondrial | metabolic |
| Status | Supplement | Rx |
| Typical cost | $40–$150 / mo | $5–$20 / mo |
| Mechanism | Supplying precursors aims to restore NAD+ levels, supporting mitochondrial function and sirtuin enzymes involved in DNA repair. | Lowers glucose production by the liver and improves insulin sensitivity. It mildly affects mitochondrial energy signaling (AMPK), which may mimic some effects of caloric restriction. |
| Human evidence | Human trials confirm NAD+ levels rise. Effects on muscle, insulin sensitivity and physical performance have been small or inconsistent. US regulatory status of NMN as a supplement has been contested. | Observational data suggest diabetics on metformin may have outcomes comparable to non-diabetics. The TAME trial is designed to test aging outcomes but has not reported. Some data suggest it can blunt exercise adaptations in older adults. |
| Side effects | Generally well tolerated · Flushing (with niacin forms) · IV NAD+: chest tightness, nausea during infusion | GI upset, diarrhea · Vitamin B12 deficiency with long use · Rare lactic acidosis (kidney impairment) |
Not medical advice — talk to a licensed clinician. Content is educational, reflects published literature, and is not a recommendation to start, stop or change any treatment.