Nicotinamide adenine dinucleotide (NAD+) plays critical roles in energy metabolism as an electron transferring agent. Nicotinamide riboside (NR) is an NAD+ precursor that can be used as a dietary supplement, but it has several drawbacks. Giroud-Gerbetant, Joffraud, et al. identified NRH, a reduced form of NR, as a new NAD+ precursor. NRH shows an unprecedented ability to increase NAD+ in cultured cells and mice, as it is more potent and faster than NR. Despite the minor chemical modification, NRH utilizes a different path than NR to synthesize NAD+. The authors also demonstrate that NRH is protected against degradation in the plasma and can be detected in circulation after oral administration. Finally, NRH also demonstrates therapeutic efficacy against cisplatin-induced kidney injury.