Question explored with the scientific record
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- 1 NAC 600mg + NAD Would this help ex smoker and someone with COPD
- 2 Would NMN be a good supplement for a 60 year old
- 3 Do NMN doses 250–900 mg affect insulin resistance in COPD patients?
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Do NMN doses 250–900 mg affect insulin resistance in COPD patients?
The short version: no retrieved study tests NMN in COPD patients, and the only dose-ranging trial in healthy adults found HOMA-IR rose at the doses you are asking about.
The 2022 dose-ranging trial in 80 healthy middle-aged adults is the closest match. It tested 300, 600, and 900 mg/day for 60 days and found that HOMA-IR, a marker of insulin resistance, rose significantly within the 600 mg and 900 mg groups [2]. The 300 mg group did not show the same increase [2]. That matters because COPD patients already have a high burden of metabolic problems: a 2025 meta-analysis of 42 studies found that about 37 in 100 COPD patients have metabolic syndrome, with elevated blood glucose in 43 in 100 [3]. Adding a supplement that may worsen insulin resistance is a real concern.
The same trial found NMN improved walking distance at 600–900 mg [2], which could be relevant for COPD patients who struggle with exercise capacity. But the trial excluded anyone with lung disease. No retrieved study tested NMN in COPD patients at all. The 2021 commentary on the Yoshino trial in prediabetic women pointed out that the groups were imbalanced in liver fat, which confounded the reported muscle insulin sensitivity improvement [1]. That means even the positive metabolic signal in prediabetic women is uncertain.
| Dose (mg/day) | HOMA-IR change (within group) | Walking distance change |
|---|---|---|
| 300 | No significant change [2] | Trend toward improvement [2] |
| 600 | Significant increase [2] | Significant improvement [2] |
| 900 | Significant increase [2] | Significant improvement [2] |
My call: NMN at 250–900 mg has not been studied in COPD patients. The doses that improved walking distance in healthy adults also raised a marker of insulin resistance, which is a real risk for a population where metabolic syndrome is already common. Confidence: low for any COPD benefit; moderate that the higher doses worsen insulin resistance in healthy adults, and the same may apply to COPD patients.
Sources used 3
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Comment on “Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women”
A critical commentary arguing that Yoshino et al.'s NMN trial in prediabetic women is confounded by imbalanced hepatic lipid content between groups, calling into question the reported muscle insulin sensitivity improvements.
DOI: 10.1126/science.abj1696 -
The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial
In a 60-day double-blind dose-ranging trial in 80 healthy middle-aged adults, oral NMN (300-900 mg/day) raised blood NAD, improved walking distance, and prevented biological-age increase while being safe, although HOMA-IR rose in the 600 and 900 mg groups.
DOI: 10.1007/s11357-022-00705-1 -
The prevalence of metabolic syndrome in chronic obstructive pulmonary disease: A systematic review and meta-analysis
A comprehensive systematic review and meta-analysis assessing the prevalence of metabolic syndrome in COPD patients, showing a pooled MetS prevalence of 37% with high heterogeneity and variation by sex, diagnostic criteria, and COPD severity, and highlighting the need for standa…
DOI: 10.1177/14799731251346194