Where Do The Warnings Come From?
Author: Dr. Stephen Chaney
Where Do The Warnings Come From?
It’s no secret that the medical-pharmaceutical industry is biased against supplements. They view supplements as useless at best and dangerous at worst. They minimize the benefits and emphasize the potential dangers.
So, it is no surprise that whenever a supplement becomes popular, you start to hear about its dangers and are warned to check with your doctor before using them.
That’s great advice, but you need to think about where your doctor is getting their information. If it is from a medical society or pharmaceutical rep, the information is likely to be negative.
If they do an online search, you need to know that AI provides the most popular answer, not necessarily the most accurate answer.
AI is getting a little better in that it usually provides links to the sources of its information – and some of those links are to published scientific studies. But your doctor is overwhelmed. Unless they are highly motivated, they are unlikely to read and evaluate the studies behind the scary warnings that AI provides.
NMN supplements are no different. They have become very popular because of their clear benefits for an ageing population and their potential benefits for longevity. So, warnings of their dangers are proliferating.
If you believe in all the warnings, it sounds like almost no one should use them, and everyone should consult their doctor before using them. So, in this issue of “Health Tips From the Professor” I will evaluate the studies behind the warnings and help you evaluate the safety of NMN supplements.
My purpose is not to discourage you from consulting with your doctor where appropriate, but to give you enough information so you can have an informed discussion with your doctor.
NMN Supplements And Cancer
You may have heard that NMN supplements may stimulate cancer cell growth, so you should not use them if you have or have had cancer. I covered this topic in detail in a previous issue of “Health Tips From the Professor”. Here is a “Cliff’s Notes” summary of that article:
- There are five studies utilizing cell culture and animal model systems, which are notoriously unreliable for predicting what happens in the human body
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- Two of those studies report that NMN may stimulate cancer cell growth. And one of those studies is an abstract from a presentation given at a scientific meeting. It has not yet gone through the peer review process required for publication.
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- Two of those studies report that NMN may inhibit cancer cell growth.
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- One study reported that NMN may reduce the side effects of chemotherapy.
- There are currently no published human clinical studies on NMN supplementation and cancer risk.
In summary, we currently have no idea whether NMN supplements increase or decrease cancer risk. Based on currently published studies, both possibilities are equally probable. And the little published data we do have is based on cell culture and animal experiments which are notoriously unreliable.
Without clear guidance from clinical studies, I only have two thoughts to share with you:
- If you currently have cancer or you have had cancer, you may wish to consult your health care provider before starting on an NMN supplement. Just understand that they have no reliable data on which to base their recommendation.
- Until more definitive data are available, I recommend avoiding NMN supplementation while undergoing cancer treatment. I am basing my recommendation on a single animal study suggesting that NMN may interfere with chemotherapeutic agents that damage DNA. And the fact that NADH is involved in DNA repair provides a theoretical rationale for this observation.
It is not clear whether this applies to cancer drugs that do not damage DNA. And it is balanced by animal models suggesting that NMN may improve the results of chemotherapy by enhancing the immune response.
I wish I could provide you with a more definitive answer to your questions about NMN and cancer risk. But, like your health care provider, I don’t have reliable data on which to base my recommendations. And unlike most bloggers and social media influencers, I value accuracy more than clicks.
NMN And Blood Pressure Medications
You have been warned that taking NAD+ precursors like NMN can significantly lower your blood pressure and increase your risk of developing dangerously low blood pressure. In this case we do have some clinical studies to guide us, but they are very small and should be considered preliminary.
One study with 24 subjects compared nicotinamide riboside (NR), another precursor to NAD+, to a placebo in a 6-week double blind study. It found:
- NR improved blood vessel dilation and modestly decreased both systolic and diastolic blood pressure.
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- The decrease in blood pressure was greater in individuals with stage 1 hypertension (systolic blood pressure between 130 and 139 or diastolic blood pressure between 80 and 89).
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- None of these differences were statistically significant because of the small size of the study. The same authors have begun enrolling subjects into a larger phase-II clinical trial, but the results of this study are not yet available.
Another study of 19 subjects with stage 1 hypertension compared NMN supplementation with lifestyle change in a 6-week double blind study. It found:
- NMN improved blood vessel dilation and modestly decreased both systolic and diastolic blood pressure in patients with mild hypertension.
A recent (2026) meta-analysis of data from 349 participants in 10 clinical studies reported:
- NMN supplementation was associated with a statistically significant but modest reduction in diastolic blood pressure.
- Overall, the reduction in systolic blood pressure was not statistically significant except for a modest reduction in participants over the age of 60.
In summary, the existing clinical studies are small and preliminary, but they all point toward the conclusion that NAD+ precursors like NR and NMN cause a modest reduction in blood pressure.
So, what does this mean for you?
- For most users of NMN supplements this represents a side benefit, something that can be combined with diet and lifestyle modification to help you control your blood pressure.
- The effect of NMN supplements on blood pressure is modest, so NMN supplements should not be considered an alternative to blood pressure medications.
- If you are currently on blood pressure medications, there is a slight chance that combining NMN with your blood pressure medication might cause your blood pressure to become too low. I say slight chance because the effect of NMN supplements on blood pressure is so modest.
At this point I should reveal my bias, as if you haven’t already guessed. I try to avoid medications and their side effects as much as possible. When confronted with a health challenge I try diet, lifestyle change, and supplementation first, and only consider medication as a last resort. And so far, it is working. I am on zero medications.
But if I were on a medication and was faced with a possible supplement-medication interaction, my choice would be to modify the drug dose based on the supplement I was using rather than modify my supplement use based on the medication.
Finally, what does this mean in terms of your informed discussion with your doctor? Now that you know the facts, my recommendation is to discuss a plan with your doctor where you will monitor your blood pressure on a regular basis and report any changes to them so they can modify your medication dose if appropriate.
You might also want to watch for symptoms of low blood pressure such as dizziness or lightheadedness when standing up quickly, blurred vision, fatigue, or confusion. Monitoring symptoms should not be considered an alternative to blood pressure measurements. But if the symptoms are new and persistent, you should report them to your doctor.
NMN And Diabetes Medications
You have been told that NAD+ precursors like NMN can interfere with blood-sugar lowering medications and reduce their effectiveness. Here the supporting data is very sketchy.
- One animal study reported that high doses of niacinamide (vitamin B3) caused insulin resistance.
- A clinical study with 8 subjects reported that a high dose (2 grams/day) of niacinamide for 2 weeks caused an increase in insulin resistance.
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- It should be noted that niacinamide is much less effective than NMN at increasing NAD+ levels and has metabolic effects that are different than NMN. It should also be noted that based on their molecular weights, this would be equivalent to a dose of 5.5 grams/day of NMN, which is considered an unsafe dose and greatly exceeds the dose found in NMN supplements.
- Another clinical study with 11 subjects who took 250 mg/day of NMN (a more realistic dose) for 12 weeks reported:
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- NMN supplementation enhanced the increase in serum insulin levels following a meal.
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- The effect of NMN supplementation on insulin secretion following a meal varied widely among individuals.
Again, the question is what this means for you:
- The studies are preliminary and conflicting. There is no good evidence on which to base recommendations.
- However, the second clinical study is more convincing because it was conducted with NMN at a dosage similar to that found in most NMN supplements. If that finding is confirmed by future clinical studies, it would suggest that NMN supplements may enhance insulin sensitivity and improve blood sugar control.
- For most users of NMN supplements that would represent a side benefit.
- For people on blood-sugar lowering medications it raises the slight risk that the combination of NMN with your medication may cause your blood sugar levels to fall too far, causing hypoglycemia.
What does this mean in terms of your informed discussion with your doctor?
Most people on blood sugar medications are monitoring their blood sugar levels on a regular basis. If that is you, I would recommend continuing what you are doing. If your blood sugar levels go below your doctor’s recommendations after adding an NMN supplement, it would be time for an informed discussion with your doctor about lowering the dosage of your blood sugar medication.
If you aren’t currently monitoring your blood sugar levels, I would recommend an informed discussion with your doctor where you propose a plan to regularly monitor your blood sugar levels and inform your doctor of any changes.
NMN Supplements And Blood Thinners
You may have been told that NAD+ precursors like NMN may affect the metabolism of blood thinners and alter your clotting time. In this case, the warnings are entirely theoretical. There are neither animal nor clinical studies that indicate this might be a problem with NMN. In short, we have no information about the effect of NMN on clotting time or whether NMN could alter the metabolism of blood thinning medications.
And we’ve seen this story before. We’ve been told that vitamin E, garlic, turmeric, and ginger should not be taken with blood thinners. In fact, the effect of each of these supplements on clotting time is insignificant at normal doses.
High-dose omega-3s represent the only supplement where the interaction with blood thinners is significant. And, as I mentioned above, if I were on a blood thinner, my preference would be to adjust the blood thinner dose based on my omega-3 intake rather than adjusting my omega-3 intake based on the blood thinner dose.
What does this mean in terms of your informed discussion with your doctor?
As I said above, there are no data that would suggest using NMN with blood thinners is a problem. However, if you are on blood thinning medication any effect on clotting time can have serious consequences.
So, if you wish to err on the side of caution, you might want to ask your doctor to test your clotting time before you start NMN supplementation and at an appropriate time after beginning NMN supplementation. That way, if there is a significant effect of NMN on your clotting time, you and your doctor can have an informed discussion about the best way to handle it.
Final Thoughts On NMN Safety
A meta-analysis on the overall safety of NMN supplements has recently (July 2026) been published. It extracted safety data from 10 placebo-controlled NMN studies of 12-24 weeks with a total of 336 subjects. The study reported that NMN supplementation:
- Did not cause any adverse side effects.
- Did not increase ALT or AST, which means that there was no indication of liver damage.
- Did not affect fasting blood glucose or HbA1C, and HOMA-IR, a measure of insulin resistance, showed a slight, non-significant decrease. In short, there was no evidence that NMN supplementation caused insulin resistance or had a significant effect on blood sugar control.
- Did not affect lipid profiles.
- Decreased diastolic blood pressure slightly but did not affect systolic blood pressure.
The authors concluded, “Short-term oral NMN or NMN-related supplementation showed favorable tolerability, with no clear increase in adverse events or hepatic biochemical abnormalities. Broad metabolic benefits [fasting blood glucose, HbA1c, and lipid levels] were not evident, but changes in diastolic blood pressure and HOMA-IE suggest preliminary [evidence of benefit], especially in older adults…Larger and longer trials should confirm efficacy and long-term safety.”
My comments:
- This meta-analysis strengthens the data I described above for the effects of NMN supplements on blood pressure and blood sugar control.
- Confirming these results with larger and longer clinical trials would be expensive. Food supplement companies don’t have the money for these kinds of studies, and pharmaceutical companies won’t touch them because they can’t patent NMN.
- Larger, longer studies are not likely unless.
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- The medical community decides that the safety and efficacy of NMN supplements is an important enough issue to design such a study.
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- And the government decides to fund such a study.
The Bottom Line
Whenever a supplement becomes popular and widely used, you start to hear about its dangers. NMN supplements are no different. They have become very popular because of their clear benefits for an ageing population and their potential benefits for longevity. So, warnings of their dangers are proliferating.
In this issue of “Health Tips From the Professor” I list the top four warnings you may have heard about NMN supplements, evaluate the data supporting these warnings, and recommend how you can have an informed discussion with your doctor about each of warning.
For more information on the pros and cons of this study and what it means for you, read the article above.
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.
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My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.
My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.
For more detail about FTC regulations for health claims, see this link.
https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance
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About The Author
Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years. Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.
Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.
Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.
For the past 54 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.
















































