HealthRX.com · Printable lab tracker
Starting NMN or NR at 65 or older: baseline, 4-week and ongoing check sheet
Take this to the clinician who agrees to supervise. Tick the risk factors from this page's framework, record the baseline tests and lying and standing blood pressure, then log the 4-week recheck and any symptom that needs a prompt call.
Higher-concern factors from this page's framework (tick any that apply)
The page suggests that two or more ticks are a reason to defer until a physician has reviewed it, or to start only with structured monitoring.
- eGFR below 45 mL/min/1.73m²
- Warfarin or a direct oral anticoagulant
- Blood pressure medicine, with systolic readings near or below 110 to 120
- A statin, with past muscle symptoms
- Weight loss, gastroparesis, or known low B12 or folate
- 5 or more daily medicines
The product and the plan
Product, ingredient and amount per capsule
Daily amount and start date
Supervising clinician
Agreed reason to reduce or stopfor example, a fall in eGFR from baseline
Tests before starting, at about 4 weeks, and later
| Test | Before starting (date, result) | About 4 weeks (date, result) | Later (date, result) |
|---|---|---|---|
| eGFR and creatinine | |||
| Complete blood count | |||
| Liver tests (ALT, AST) | |||
| Uric acid | |||
| Blood pressure lying down | |||
| Blood pressure standing | |||
| B12 or homocysteine, if advised |
Symptom check between visits
| Date | Dizziness on standing | Bruising or bleeding | Nausea or eating less | Change in urine output | What you did |
|---|---|---|---|---|---|
What trials in older adults checked
- Healthy men aged 65 or older, NMN 250 mg a day for 12 weeks: no difference from placebo in blood chemistry, including liver and kidney markers.[1]
- Men with diabetes aged 65 or older, NMN 250 mg a day for 24 weeks: no severe adverse events.[2]
- Adults aged 65 or older, NMN 1,250 mg a day for 24 weeks: generally well tolerated, with the authors advising careful safety monitoring.[3]
- NR 500 mg twice a day for 6 weeks in adults with an average age of 65: no meaningful differences in kidney or liver blood markers.[4]
Call a clinician promptly, rather than just stopping and waiting, for
- New or worse dizziness when you stand up
- Unexplained bruising or bleeding
- A marked change in how much urine you pass
- Nausea that stops you eating or drinking normally
- Any new symptom that began when you started or increased the dose
Questions for the supervising clinician
- Is my kidney function stable enough to start, and when will we recheck it?
- Should we measure my blood pressure standing as well as sitting, given my medicines?
- Which of my medicines most needs watching alongside this supplement?
- What change in my results would make us reduce or stop it?
- Should B12, folate or homocysteine be checked before I start?
Sources for the facts on this sheet
- Igarashi M, Nakagawa-Nagahama Y, Miura M, et al. Chronic nicotinamide mononucleotide supplementation elevates blood nicotinamide adenine dinucleotide levels and alters muscle function in healthy older men. NPJ Aging 2022. PMID 35927255. https://pubmed.ncbi.nlm.nih.gov/35927255/
- Akasaka H, Nakagami H, Sugimoto K, et al. Effects of nicotinamide mononucleotide on older patients with diabetes and impaired physical performance: A prospective, placebo-controlled, double-blind study. Geriatr Gerontol Int 2023. PMID 36443648. https://pubmed.ncbi.nlm.nih.gov/36443648/
- npj Aging, Nature Portfolio. Sustained NAD⁺ augmentation by high-dose nicotinamide mononucleotide supplementation in older adults: a 24-week randomized, double-blind, placebo-controlled trial. Accessed 2026-10-18. https://www.nature.com/articles/s41514-026-00482-7
- 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. Nat Commun 2018. PMID 29599478. https://pubmed.ncbi.nlm.nih.gov/29599478/
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.