Nicotinamide riboside resveratrol benefits have attracted considerable interest in nutritional science, with both compounds studied for their potential roles in cellular health and metabolism. Nicotinamide riboside (NR), a form of vitamin B3, serves as a precursor to NAD+, a coenzyme essential for energy production and DNA repair. Resveratrol, a polyphenolic compound found in red grapes and berries, has been investigated for its antioxidant properties. Whilst laboratory research suggests these substances may influence cellular pathways, human evidence remains limited and inconsistent. In the UK, both are authorised novel foods with specific conditions of use. This article examines the current evidence, potential benefits, safety considerations, and practical guidance for those considering these supplements.

What Are Nicotinamide Riboside and Resveratrol?

Nicotinamide riboside (NR) is a form of vitamin B3 that serves as a precursor to nicotinamide adenine dinucleotide (NAD+), a crucial coenzyme involved in cellular energy metabolism and DNA repair. NAD+ levels naturally decline with age, and this reduction has been associated with various age-related physiological changes. NR supplementation aims to boost NAD+ levels, potentially supporting cellular function and metabolic health. Unlike niacin (another form of vitamin B3), nicotinamide riboside does not typically cause the uncomfortable flushing reaction that some individuals experience.

Resveratrol is a naturally occurring polyphenolic compound found predominantly in red grape skins, berries, and certain nuts. It belongs to a class of compounds called stilbenes and has been studied for its potential antioxidant and anti-inflammatory properties. Resveratrol gained attention following observations of the 'French paradox'—the relatively low incidence of cardiovascular disease in populations consuming moderate amounts of red wine despite diets high in saturated fats, though this association is observational and not proof of causation.

Both substances have attracted significant interest in nutritional science and gerontology research. They are often marketed together as complementary supplements. In the UK, nicotinamide riboside chloride and trans-resveratrol are authorised novel foods with specific conditions of use, including maximum daily intake levels. These products are generally regulated as food supplements under food law, not as medicines, unless medicinal claims are made. This means they have not undergone the same rigorous testing for efficacy as pharmaceutical products, though they must comply with food safety regulations.

While laboratory studies suggest these compounds may influence cellular pathways potentially associated with ageing processes, it's important to note that many of these mechanisms remain hypothetical in humans, with limited clinical confirmation of their relevance to health outcomes.

Potential Health Benefits of Nicotinamide Riboside and Resveratrol

Research into nicotinamide riboside has focused primarily on its role in cellular energy metabolism and mitochondrial function. By increasing NAD+ levels, NR may support the activity of sirtuins—a family of proteins involved in cellular repair, inflammation regulation, and metabolic control. Some clinical studies have suggested potential cardiovascular benefits, including modest improvements in blood pressure and arterial stiffness in specific populations. For example, a 2018 study published in Nature Communications showed small reductions in systolic blood pressure in some participants. Additionally, animal research has indicated possible neuroprotective effects, though human evidence remains limited and requires further investigation.

Resveratrol has been studied for its antioxidant and anti-inflammatory properties. Laboratory research suggests it may help protect cells from oxidative stress—a process implicated in ageing and various chronic diseases. Some studies have explored resveratrol's potential cardiovascular benefits, including effects on endothelial function (the health of blood vessel linings), lipid profiles, and platelet aggregation. There is also emerging interest in its possible role in glucose metabolism and insulin sensitivity, though findings have been inconsistent across different study populations, with many trials showing no clinically meaningful effects.

When considering these potential benefits, it is crucial to maintain realistic expectations. Much of the existing evidence comes from cell culture and animal studies, which do not always translate directly to human physiology. Human clinical trials have produced mixed results, with some showing modest benefits and others finding no significant effects. The doses used in research often exceed those typically consumed through diet or standard supplementation, and may exceed UK-authorised maximum daily intakes for these novel foods. Furthermore, individual responses may vary considerably based on factors such as age, baseline health status, genetic variations, and lifestyle factors.

Currently, neither NICE nor the NHS provides specific guidance recommending these supplements for disease prevention or treatment. Individuals interested in these compounds should focus on evidence-based lifestyle interventions—including a balanced diet rich in fruits and vegetables, regular physical activity, and maintenance of a healthy body weight—as the foundation of health promotion.

Evidence for Combined Use: What Research Shows

The rationale for combining nicotinamide riboside and resveratrol stems from their proposed complementary mechanisms of action. In laboratory studies, resveratrol has been hypothesised to activate sirtuins, whilst NR increases NAD+ availability—a necessary cofactor for sirtuin function. Theoretically, this combination might produce synergistic effects, enhancing cellular energy metabolism and stress resistance more effectively than either compound alone. However, it's important to note that the human relevance of these mechanisms remains uncertain.

A limited number of human studies have examined the combined use of NR and related compounds. It's worth noting that some studies have used pterostilbene (a resveratrol analogue) rather than resveratrol itself in combination with NR. Some small-scale trials have reported improvements in markers of metabolic health, including modest changes in body composition, insulin sensitivity, and inflammatory markers in specific populations. For example, a 2017 study in Scientific Reports examined NR combined with pterostilbene in healthy adults. However, these studies have typically involved small sample sizes, short durations, and selected participant groups, limiting the generalisability of findings. Importantly, many studies showing positive results have been funded by supplement manufacturers, which may introduce potential bias.

Critical evaluation of the evidence reveals several important limitations. Firstly, there is considerable heterogeneity in study designs, dosages used, and outcome measures assessed, making it difficult to draw firm conclusions. Secondly, the bioavailability of resveratrol—the proportion that reaches systemic circulation in active form—is relatively poor, raising questions about whether oral supplementation achieves sufficient tissue concentrations to produce meaningful biological effects. Thirdly, long-term safety data for combined supplementation remains sparse.

At present, there is no official link established by regulatory bodies or clinical guideline organisations like NICE between taking these supplements and specific health outcomes. Whilst the compounds appear generally well-tolerated in short-term studies, the evidence base is insufficient to support routine recommendation for disease prevention or treatment. Individuals considering these supplements should discuss their use with a healthcare professional, particularly if they have existing medical conditions or take prescribed medications.

Safety Considerations and Possible Side Effects

Nicotinamide riboside and resveratrol are generally considered safe when taken at commonly recommended doses for short to moderate durations. However, as with any supplement, potential adverse effects and interactions warrant careful consideration. The long-term safety profile of these compounds, particularly in combination, has not been comprehensively established through rigorous clinical trials.

Common side effects associated with nicotinamide riboside are typically mild and may include:

• Nausea or gastrointestinal discomfort

• Headache

• Fatigue or dizziness

• Flushing (though less common than with niacin)

• Some studies have noted increases in plasma homocysteine levels, though the clinical significance is uncertain

Resveratrol supplementation may occasionally cause:

• Digestive upset, including diarrhoea

• Abdominal discomfort

• Allergic reactions in sensitive individuals

More significant concerns relate to potential drug interactions. Resveratrol may affect platelet function and could theoretically increase bleeding risk when combined with anticoagulant or antiplatelet medications such as warfarin, aspirin, or clopidogrel. It may also interact with certain cytochrome P450 enzymes involved in drug metabolism, potentially affecting the efficacy or safety of various medications. Products containing piperine (from black pepper) to enhance absorption may significantly increase these interaction risks. Nicotinamide riboside might influence blood glucose levels, warranting caution in individuals taking diabetes medications.

Specific populations should exercise particular caution. Pregnant and breastfeeding women should avoid these supplements, which is consistent with UK novel food authorisation conditions for both nicotinamide riboside chloride and trans-resveratrol. Individuals with hormone-sensitive conditions should note that resveratrol may have oestrogenic properties, though the clinical significance remains unclear. Those with liver or kidney disease should consult their GP before supplementation, as these organs play crucial roles in supplement metabolism and elimination.

When to seek medical advice: Contact your GP if you experience persistent gastrointestinal symptoms, unusual bruising or bleeding, or any unexpected symptoms after starting supplementation. Seek immediate medical attention (call 999 or go to A&E) if you experience signs of a severe allergic reaction such as difficulty breathing, throat/facial swelling, or severe dizziness. Always inform healthcare professionals about all supplements you are taking, particularly before surgery or when starting new medications. Suspected adverse reactions can be reported through the MHRA Yellow Card scheme. If you have existing medical conditions or take regular medications, discuss supplement use with your GP or pharmacist before commencing.

Dosage and How to Take These Supplements

Standardised dosing recommendations for nicotinamide riboside and resveratrol have not been established by clinical bodies like NICE. However, as authorised novel foods in the UK, they have specific conditions of use that should be followed.

For nicotinamide riboside chloride, the authorised novel food status in the UK comes with specific conditions. Clinical studies have commonly employed doses ranging from 250 mg to 1,000 mg daily, often divided into two doses. However, it's essential to adhere to the maximum daily intake specified on product labels and not exceed the authorised levels for this novel food.

Trans-resveratrol as an authorised novel food in the UK has a maximum daily intake level that should not be exceeded. While research has used widely varying doses, from 150 mg to 2,000 mg daily, many of these research doses exceed UK-authorised limits. Commercial supplements typically contain between 100 mg and 500 mg per serving. Always follow the recommended intake on product labels and do not exceed the authorised maximum daily intake for trans-resveratrol.

It's worth noting that the poor bioavailability of resveratrol means that only a small fraction of the ingested dose reaches systemic circulation in active form. Some formulations use micronised resveratrol or combine it with piperine (from black pepper) in attempts to enhance absorption. However, be aware that piperine can significantly alter the metabolism of many medicines, so consult a pharmacist or GP before using such combinations, especially if you take prescription medications.

Practical considerations for supplementation include:

• Take supplements with food to potentially reduce gastrointestinal side effects and improve absorption

• Maintain consistency in timing—many people prefer morning administration

• Start with lower doses initially to assess tolerance

• Store supplements in a cool, dry place away from direct sunlight

• Check expiry dates and purchase from reputable suppliers

• Never exceed the recommended dose on the product label

Quality and regulation: Food supplements in the UK are regulated under food law and must comply with food safety regulations. However, they are not subject to the same pre-market authorisation for efficacy as medicines. Quality can vary between manufacturers. Look for products that have been independently tested for purity and potency. Be cautious of exaggerated health claims, which may indicate unreliable products.

Before starting any supplementation regimen, consult with your GP or a registered dietitian, particularly if you have existing health conditions, take medications, or are considering long-term use. Remember that supplements should not replace a balanced diet and healthy lifestyle, which remain the cornerstone of health maintenance and disease prevention.

Frequently Asked Questions