Written by the Nuvirox Research Team
Key points
- Mayo Clinic and university researchers ran a randomized trial testing whether nicotinamide riboside raises brain NAD+ in collegiate athletes, measured directly via brain imaging.
- Preclinical (animal) studies show NAD+ precursors reduce brain damage and improve neurological outcomes after simulated traumatic brain injury.
- There is no published evidence yet that this translates into fewer or milder concussion symptoms in people.
Short answer: there's a genuine, purpose-built research program here, but as of now it has established that NR can reach the brain — not that it reduces concussion symptoms.
Why would NAD+ matter for concussion recovery?
Traumatic brain injury, including concussion, triggers a cascade of oxidative stress, mitochondrial dysfunction, and NAD+-consuming DNA repair activity in brain tissue. Animal models of TBI have repeatedly shown that boosting NAD+ — through nicotinamide riboside, nicotinamide mononucleotide, or plain nicotinamide — can reduce neuronal death, brain edema, and cognitive impairment after injury. This preclinical signal is strong enough that it prompted real human research specifically in athletes at elevated concussion risk.
What does the evidence actually show?
A randomized, placebo-controlled, double-blind trial sponsored through Mayo Clinic, the University of Minnesota, and industry partners enrolled healthy collegiate athletes in high-contact sports (football, rugby, soccer, hockey, volleyball) to take 750 mg/day of nicotinamide riboside or placebo for 84 days, with pre- and post-intervention 31-phosphorus MRI brain imaging to directly measure whether NR raises brain NAD+ levels. This design tests the necessary first step — can an oral supplement meaningfully raise brain NAD+ in living humans — before any claim about symptom reduction could be tested. Separately, a 2024 trial of a different B-vitamin-based combination (inosine-nicotinamide-riboflavin-succinic acid, not the same product as NR alone) found improved outcomes after acute mild traumatic brain injury in a 166-patient international trial, an interesting but distinct data point since it tested a multi-ingredient formula, not nicotinamide riboside by itself.
Study snapshot: NR and brain NAD+ in college athletes (Mayo/UMN trial)
| Design | Randomized, double-blind, placebo-controlled |
| Population | Healthy collegiate contact-sport athletes |
| Dose/duration | 750 mg NR daily, 84 days |
| Primary measure | Brain NAD+ via 31P-MRS imaging, pre/post |
| What it tests | Whether oral NR measurably raises brain NAD+ — not yet concussion symptom outcomes |
The honest counterweight
The strongest human evidence available is a trial designed to answer a feasibility question (does NR reach the brain), not an efficacy question (does it reduce concussion symptoms or speed recovery). The encouraging animal data on NAD+ and TBI recovery has not yet been matched by a published human trial showing symptom or outcome improvement from nicotinamide riboside specifically. The separate positive INRSA (multi-ingredient) trial is genuinely interesting but isn't evidence for NR alone, since it tested a different combination of ingredients.
When to see a doctor
Concussions and traumatic brain injury require proper medical evaluation and monitoring, including baseline and follow-up cognitive testing where available, and a structured, gradual return-to-activity protocol. Repeat concussions before full recovery carry serious risk, so this is not an area to manage with supplements in place of medical guidance and clearance.
What's actually proven to help concussion recovery
Cognitive and physical rest in the acute period, followed by a gradual, symptom-guided return to activity under medical supervision, remains the evidence-based standard. Sport-specific concussion protocols, baseline neurocognitive testing, and proper equipment and rule enforcement for injury prevention all have strong supporting evidence.
How does this fit with other NAD+ and brain-injury research?
Concussion research connects to the broader DNA-repair rationale covered in NAD+ and DNA repair, since genotoxic stress from head injury is thought to rapidly consume cellular NAD+ in ways similar to other forms of tissue injury covered in our overview of NAD+ and muscle/tissue recovery. The same molecule being tested in the Mayo/UMN athlete trial, nicotinamide riboside, is covered in general terms in our overview of what nicotinamide riboside is, which is useful context for understanding what's actually in the supplement being studied.
Separately, preclinical spinal cord injury research provides an interesting parallel: elevating NAD+ with nicotinamide riboside has been shown to spare spinal cord tissue from injury and promote locomotor recovery in animal models, following a similar logic to the brain-injury research — genotoxic stress from injury depletes NAD+, and replenishing it may protect vulnerable neural tissue before permanent damage sets in. This broader pattern across different types of nervous system injury is part of why researchers remain interested in the concussion question specifically, even though the definitive human answer isn't available yet.
It's also worth understanding the trial design choice here: using 31-phosphorus MRI to directly measure brain NAD+ (rather than relying on blood levels, which don't necessarily reflect brain tissue levels) is a more rigorous approach than many earlier NAD+ studies used, and mirrors the same imaging technique used in the NADPARK Parkinson's trial. That methodological rigor is a good sign for how seriously this research question is being taken, even though results aren't published yet.
If you're a parent, coach, or athlete specifically interested in this research area, it's worth keeping an eye on publications from the Mayo Clinic/University of Minnesota research group over the coming months to years, since this specific trial was designed with a defined 84-day intervention period and should eventually report results on whether brain NAD+ was successfully raised in this population.
It's also worth noting that this trial specifically enrolled healthy athletes without a history of more than three prior concussions, meaning its findings, whenever published, may be most directly relevant to concussion prevention or resilience research rather than to treating an athlete already experiencing acute concussion symptoms right now.
Until published efficacy results exist, evidence-based concussion protocols — rest, gradual return to activity, and medical clearance — remain the standard of care that shouldn't be set aside for any supplement, however promising the underlying research direction looks.
Frequently asked questions
Has NAD+ been shown to help concussion recovery in people?
Not yet published. The completed human research establishes that NR can raise brain NAD+ in athletes; it doesn't yet show a reduction in concussion symptoms or faster recovery.
Is this the same as the B-vitamin trial that showed improved TBI recovery?
No — that trial (INRSA) tested a different multi-ingredient combination, not nicotinamide riboside alone, so its positive result doesn't directly transfer to NR supplements.
Should an athlete take NAD+ supplements to prevent concussion effects?
There's no evidence yet supporting that use; concussion prevention and recovery protocols should follow current sports-medicine guidelines and a physician's guidance.
From Nuvirox
Why we formulated NAD+ Restore
To be direct: NAD+ Restore is a general wellness supplement, not a treatment for this condition, and it shouldn't be used as a substitute for medical care. If you're separately interested in cellular energy support once your care team is in the loop, here's what's in it.
- 500 mg Nicotinamide Riboside Chloride (NR) — one of the two most-researched NAD+ precursors, within the dose range used in published human trials
- 150 mg trans-resveratrol (Japanese Knotweed) + 50 mg quercetin (Sophora japonica) — polyphenols studied alongside NAD+ pathways for cellular health support
- 10 mg galactomannans from fenugreek — to support absorption
- 60-day money-back guarantee — long enough to actually evaluate it the way the research says you should
The bottom line: this is a real, carefully designed research program moving through the necessary early steps — establishing that NR reaches the brain before any claim about concussion symptoms can be tested. It's promising groundwork, not proof of a concussion-recovery benefit yet.
References
- Niacinamide and Niacin and Nicotinic Acids in Concussion, Mild. ClinicalTrials.gov NCT02721537.
- A multicenter, international, randomized, single-blind, placebo-controlled study of INRSA in the acute period of traumatic brain injury. PMCID: PMC12807964.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This article is for informational purposes only and is not a substitute for professional medical advice.