n-acetylcysteine + l-carnitine tartrate + nicotinamide riboside + serine

A combination of four metabolic cofactors—N-acetylcysteine (NAC), L-carnitine tartrate (LCAT), nicotinamide riboside (NR), and L-serine—developed primarily by ScandiBio Therapeutics to target mitochondrial dysfunction and oxidative stress. Often referred to as Combined Metabolic Activators (CMA or CMA2), the formulation acts by increasing levels of nicotinamide adenine dinucleotide (NAD+) and glutathione, while facilitating mitochondrial fatty acid uptake and oxidation. The combination is designed to address metabolic abnormalities associated with neurodegenerative diseases such as Alzheimer's and Parkinson's, as well as metabolic disorders like non-alcoholic fatty liver disease (NAFLD) and infectious diseases like COVID-19. Clinical studies have demonstrated improvements in cognitive function (ADAS-Cog and MoCA scores) and metabolic markers (ALT, uric acid) following oral administration.

Brand names

Niagen (for nicotinamide riboside component)no unique brand name for the full combination identified

Other names

Combined Metabolic ActivatorsMetabolic Cofactor SupplementationCombined Metabolic Activator Supplementation