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Nicotinamide riboside fails to slow Parkinson's progression in trial
A Phase 3 study published in JAMA found that nicotinamide riboside, intended to boost cellular energy metabolism, did not slow the progression of early-stage Parkinson's disease. The study, involving NAD augmentation, did not meet expectations for improving damaged nerve cells.
A Phase 3 study published in JAMA found that nicotinamide riboside, intended to boost cellular energy metabolism, did not slow the progression of early-stage Parkinson's disease. The study, involving NAD augmentation, did not meet expectations for improving damaged nerve cells.
The architecture take
The promise of NAD boosters for neurodegenerative conditions is still mostly aspirational science, and this is a clear reminder that preclinical excitement doesn't always translate to patient benefit. Researchers hoped nicotinamide riboside would up-regulate NAD+ pathways to improve mitochondrial function in damaged neurons, which is a solid theoretical play given Parkinson's is partly an energy crisis for brain cells. But a theory doesn't always work out in practice. This result tells me the mechanism might be too blunt, or the dose wasn't quite right, or the specific cellular problem in Parkinson's is more complex than just NAD levels. I'm watching to see if this takes the air out of the broader NAD supplement category, or if the biohacking crowd just pivots to a new molecule to push through that same cellular energy story. The nuance is always in the delivery.