Earth Elixir Urolithin A & NAD Review: Two-in-One Analysis

Reviewed by SOMA HEALTH's Medical Research Team

Earth Elixir pairs urolithin A with an NAD precursor in a single capsule, promising two cellular-aging pathways in one pill. This review unpacks what that combination actually does, where the human evidence is strongest, and how a blend compares with taking a focused, single-ingredient urolithin A on its own.

Combination longevity supplements are having a moment, and Earth Elixir's Urolithin A & NAD product is a clear example of the trend. Sold as a 90-capsule bottle, it delivers roughly 500 mg of urolithin A alongside nicotinamide riboside, a well-known precursor the body uses to make NAD+. The pitch is intuitive: if two ingredients each support cellular energy in a different way, why not take them together? The answer is more nuanced than the marketing suggests, and it comes down to dose, formulation, and what the published research can and cannot tell us. A quick note on transparency first: SOMA HEALTH sells a competing urolithin A product, so we hold ourselves to citing only published human and preclinical studies and we will not quote Earth Elixir's price or make dose claims we cannot verify. If a figure here differs from the bottle in your hand, check the current label.

Two ingredients, two very different evidence bases

The most important thing to understand about any urolithin A plus NAD blend is that the two compounds do not share a mechanism, and they do not share the same depth of clinical support. Treating them as interchangeable longevity boosters obscures real differences.

Urolithin A is a gut postbiotic. When you eat ellagitannins from pomegranate, walnuts, or certain berries, resident gut bacteria can convert them into urolithin A. Only some people carry the microbial machinery to do this efficiently, which is a major reason supplementation is of interest at all. Once absorbed, urolithin A is studied for its support of mitophagy, the housekeeping process by which cells identify and recycle worn-out mitochondria so fresher ones can take their place. If you want the deeper background, our urolithin A guide and our explainer on what mitophagy is walk through it step by step.

NAD+ is a different story. It is a coenzyme central to energy metabolism, and its cellular levels are thought to decline with age. Nicotinamide riboside is one of several precursors marketed to raise NAD+. The two ingredients are complementary in theory: one supports the quality of your mitochondrial pool, the other feeds a coenzyme those mitochondria rely on. But complementary in theory is not the same as proven in combination.

Proven human evidence for urolithin A

Here the urolithin A side of the blend stands on firmer ground. The first-in-human work, Andreux and colleagues in Nature Metabolism (2019), established that urolithin A was safe and well tolerated at single doses up to 1,000 mg per day and produced a mitochondrial gene-expression signature in older, sedentary adults. Building on that, Liu and D'Amico (JAMA Network Open, 2022) reported improvements in muscle endurance in older adults over roughly four months, and Singh and colleagues (Cell Reports Medicine, 2022) tested 500 mg and 1,000 mg arms in middle-aged adults over four months, observing changes in muscle strength and exercise performance. More recently, an eight-week randomized trial in resistance-trained men (Journal of the International Society of Sports Nutrition, 2024) and a 2025 trial in distance runners have extended the picture into fitter populations, and a 2025 Nature Aging randomized trial reported support for immune-cell mitochondrial health in midlife adults over about 28 days.

That is a meaningfully deep human record for a supplement ingredient, though a 2024 systematic review in Ageing Research Reviews is candid that the overall evidence for urolithin A as an anti-aging intervention is still emerging. The studied dose range is 500 to 1,000 mg per day, with 1,000 mg at the top of what has been tested. For more on that, see our page on urolithin A dosage.

Where the NAD precursor sits

Nicotinamide riboside has its own body of human research and is generally reported as well tolerated, but the two ingredients are not studied together in the clinical trials cited above. Every urolithin A trial listed here used a defined, isolated dose of urolithin A, not a blend. That matters, because when a capsule splits its capacity between two actives, the amount of each is necessarily constrained by pill size. A 500 mg urolithin A serving sits at the bottom of the studied range rather than the clinically tested 1,000 mg ceiling.

The case for a blend, honestly stated

There are legitimate reasons someone might choose a two-in-one capsule. Convenience is real: one bottle, one pill, one habit is easier to sustain than juggling separate products, and adherence is arguably the single biggest determinant of whether any supplement does anything at all. A blend can also be a reasonable way to sample two ingredients before committing to full doses of either. If your priority is simply exploring the category with minimal friction, a combination product is a defensible starting point.

The honest limitation is that convenience comes at the cost of control. You cannot independently adjust the urolithin A dose without also changing your NAD precursor intake, and vice versa. If you later decide you want the 1,000 mg urolithin A serving used in the strength and endurance trials, a fixed 500 mg blend cannot get you there without doubling everything else in the capsule too.

The case for pure, single-ingredient urolithin A

The opposite approach is to isolate the variable. A dedicated urolithin A product lets you dose to the level studied in humans, know exactly how much you are taking, and add other ingredients like an NAD precursor separately if and when you choose. This is the philosophy behind SOMA HEALTH's gummies, which provide 1,000 mg of urolithin A per daily serving and nothing competing for label space. It is worth repeating that SOMA HEALTH is a competitor to Earth Elixir, so weigh this section accordingly, but the structural argument stands on its own: single-ingredient formats trade a little convenience for a lot of precision.

Format matters too. Earth Elixir uses capsules; SOMA HEALTH uses gummies. Neither is inherently superior, but people who dislike swallowing pills often adhere better to a chewable. If you are weighing your options across the category, our roundup of the best urolithin A gummies and our overview of mitochondrial health put both formats in context.

Preclinical claims: read the fine print

Much of the excitement around urolithin A traces back to preclinical work, and it should be labeled as such. Ryu and colleagues (Nature Medicine, 2016) demonstrated that urolithin A induced mitophagy and extended lifespan in the worm C. elegans and improved muscle function in rodents. D'Amico and colleagues (Aging Cell, 2022) explored joint and cartilage endpoints in osteoarthritis models. These are animal and cell studies, not human trials, and areas like skin, gut, brain, and heart remain firmly in the early, exploratory stage. Any product, blend or single-ingredient, that leans on these findings to imply human benefits beyond muscle and cellular energy is getting ahead of the evidence.

None of this is a treatment for any medical condition. Urolithin A and NAD precursors are studied for how they may support normal cellular and muscle function, not to diagnose, treat, or prevent disease. If you are managing a health concern, take medications, are pregnant or nursing, or have questions about how a supplement fits your situation, talk with your doctor before starting.

Explore SOMA HEALTH Urolithin A Gummies

*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 guide is educational and is not a substitute for advice from a qualified healthcare provider.