Nicotinamide Riboside (NR): Why It's in Your HOP Box
Restoring the Fuel Your Cells Need
NAD+ (nicotinamide adenine dinucleotide) is a molecule found in every cell of your body. It is essential for energy production, DNA repair, and the activity of sirtuins, a family of proteins that regulate aging and longevity.
The problem: NAD+ levels decline by roughly 50% between ages 40 and 60. This decline is linked to fatigue, metabolic slowdown, cognitive fog, and accelerated aging at the cellular level.
Nicotinamide riboside (NR) is a form of vitamin B3 that your body efficiently converts into NAD+. It is one of the most clinically studied NAD+ precursors, with multiple human trials confirming that oral NR supplementation safely and significantly raises NAD+ levels in the blood.
HOP Box includes NR as part of the Hourglass Tipper blend, alongside spermidine and CaAKG, to restore cellular energy and support longevity pathways.
What the Research Shows
NAD+ elevation in humans
The foundational question was simple: does taking NR actually raise NAD+ levels in people? Multiple trials have answered with a definitive yes.
Key study: A randomized, double-blind, placebo-controlled trial in 60 healthy middle-aged and older adults found that NR supplementation (500 mg twice daily for 6 weeks) increased NAD+ levels in blood by approximately 60%, with good tolerability and no serious adverse effects.
Martens CR, Denman BA, Mazzo MR, et al. "Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults." Nature Communications. 2018;9:1286.
Cardiovascular health
Arterial stiffness is a major predictor of cardiovascular events and increases with age. NR has shown promise for vascular health.
Key study: The same crossover trial by Martens et al. found that NR supplementation tended to reduce systolic blood pressure and aortic stiffness in participants with elevated baseline blood pressure, suggesting cardiovascular benefits from NAD+ restoration.
Martens CR, Denman BA, Mazzo MR, et al. "Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults." Nature Communications. 2018;9:1286.
Safety and tolerability
Long-term safety is critical for any daily supplement. NR has an excellent safety profile in human trials.
Key study: The first clinical pharmacokinetics study of NR in humans showed dose-dependent increases in NAD+ with single doses from 100 to 1000 mg, with no adverse effects reported at any dose level.
Trammell SAJ, Schmidt MS, Weidemann BJ, et al. "Nicotinamide riboside is uniquely and orally bioavailable in mice and humans." Nature Communications. 2016;7:12948.
Physical function improvement
Beyond markers, NR has been shown to improve real-world physical performance in aging populations.
Key study: The NICE randomized clinical trial found that NR supplementation for 6 months significantly improved 6-minute walk distance in people with peripheral artery disease (+7.0 vs. -10.6 meters in placebo, a between-group difference of +17.6 meters), demonstrating meaningful improvement in physical function.
McDermott MM, Martens CR, Domanchuk KJ, et al. "Nicotinamide riboside for peripheral artery disease: the NICE randomized clinical trial." Nature Communications. 2024;15:5099.
Epigenetic age reduction
Perhaps most exciting for longevity: NR may actually turn back the biological clock.
Key study: A randomized placebo-controlled trial in older adults with mild cognitive impairment found that NR supplementation significantly increased blood NAD+ and showed a reduction in epigenetic age as measured by PhenoAge and GrimAge DNA methylation clocks, suggesting a biological age reversal effect.
Orr ME, Kotkowski E, Bair-Kelps D, et al. "A randomized placebo-controlled trial of nicotinamide riboside in older adults with mild cognitive impairment." GeroScience. 2024;46:665-682.
Why It's in HOP Box
Dr. Amy Killen included NR in HOP Box because NAD+ decline is one of the most fundamental and measurable changes that occurs with aging. Restoring NAD+ levels supports mitochondrial function (your cells' powerhouses), activates sirtuin longevity pathways, and enables efficient DNA repair.
In the Hourglass Tipper blend, NR works alongside spermidine (which boosts autophagy) and CaAKG (which has been shown to reduce biological age), creating a multi-pathway approach to slowing cellular aging.
The HOP Box Difference
- Clinically validated NAD+ precursor with multiple human safety trials
- Combined with spermidine and CaAKG in the Hourglass Tipper blend
- Doctor-formulated by Amy Killen, MD, a longevity medicine specialist
- Convenient daily packs for consistent NAD+ support
Ready to restore your cellular energy and support healthy aging?
This page is for educational purposes only and is not medical advice. Always consult your healthcare provider before starting any supplement regimen.
Sources cited are peer-reviewed human clinical studies. HOP Box is formulated by Amy Killen, MD.
