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Limited evidenceGeneral health

NADH

NADH is sold for fatigue and "cellular energy" on the strength of a handful of small chronic fatigue trials, most of which used it in combination with CoQ10. It is also almost certainly digested into ordinary niacin metabolites before it ever reaches your cells.

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What the science says

  • Chronic fatigue syndrome evidence is thin and largely combination-based Limited evidence

    The most-cited trial is a 26-patient double-blind crossover using 10 mg/day stabilized oral NADH for 4 weeks, in which 31% responded favourably versus 8% on placebo — an encouraging pilot the authors themselves called preliminary, and one never convincingly replicated with NADH alone. A later randomized double-blind trial in ME/CFS gave 200 mg CoQ10 plus 20 mg NADH daily for 8 weeks and reported reduced fatigue perception and improved health-related quality of life, but that design cannot separate NADH's contribution from CoQ10's.

  • Oral NADH is probably not delivering NADH Moderate evidence

    NADH is an intact dinucleotide, not a small precursor. Ingested NAD(H) is extensively degraded in the gut lumen and enterocytes to nicotinamide riboside and nicotinamide before absorption. Functionally, a 5-20 mg NADH capsule is best understood as a very small dose of nicotinamide equivalents — a fraction of what a standard B-complex delivers, at many times the price.

  • Distinct from NR and NMN, and not a substitute for their evidence Moderate evidence

    Nicotinamide riboside and NMN are precursors with their own (also modest) human trial base showing they raise blood NAD+ levels. NADH does not inherit that evidence, and no trial has shown that oral NADH meaningfully raises tissue NAD+ in humans. Marketing that blends the three categories together is conflating different molecules.

Dosage & safety

Studied doseTrials used 5-20 mg/day of stabilized oral NADH (the ENADA form), typically taken on an empty stomach in the morning; the combination trial used 20 mg NADH with 200 mg CoQ10 for 8 weeks. Doses above 20 mg have not been shown to add benefit.
SafetyWell tolerated in short trials; occasional nervousness, insomnia (do not dose in the evening), loss of appetite and GI upset. The bigger practical issue is stability: NADH is degraded by light, heat, moisture and stomach acid, so product quality varies widely and label claims are difficult to verify — enteric-coated, blister-packed and refrigerated products are the ones with any chance of delivering what they state. No long-term safety data. Not established in pregnancy or breastfeeding. Theoretical interaction with levodopa and other dopaminergic drugs. Injectable and IV "NAD+" clinics carry all of these evidence gaps plus genuine infusion risks (flushing, chest tightness, infection) and are not supported by controlled trials. Not banned in sport.

How to take it

TimingMorning — it causes insomnia in some people, so never dose it in the evening.
With food?On an empty stomach, about 30 minutes before breakfast; stomach acid degrades NADH.
Worth knowingBuy enteric-coated, blister-packed product and check the expiry date — NADH is destroyed by light, heat and moisture, so a loose-capsule bottle may contain very little of what the label claims.

Interactions

With medications

  • levodopa and other dopaminergic drugs

    NADH is a cofactor in dopamine synthesis and could theoretically add to their effect. tell your neurologist before starting

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does NADH help chronic fatigue syndrome?

The evidence is limited: a 26-patient crossover pilot found 31% responded to 10 mg/day NADH versus 8% on placebo, but it was never convincingly replicated with NADH alone. A later trial combined NADH with CoQ10, so it cannot show what NADH contributes.

Does oral NADH raise NAD+ levels in the body?

Probably not. Ingested NADH is extensively broken down in the gut to nicotinamide riboside and nicotinamide before absorption, and no trial has shown oral NADH meaningfully raises tissue NAD+. A typical NADH capsule is effectively a very small dose of nicotinamide.

Is NADH the same as NMN or NR?

No. NMN and nicotinamide riboside are NAD+ precursors with their own modest trials showing they raise blood NAD+, and NADH does not inherit that evidence. Marketing that blends the three is conflating different molecules.

How and when should I take NADH?

NADH trials used 5-20 mg/day of stabilized NADH, taken in the morning on an empty stomach about 30 minutes before breakfast. Avoid evening doses because NADH can cause insomnia, and buy enteric-coated, blister-packed product since light, heat and moisture degrade it.

Scientific references

Where to buy

Codeage, Sport, Liposomal NADH+, 60 Vegetable Capsules

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