Supplement analysis backed by scientific evidence · PT

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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.

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.

Scientific references

Where to buy

Codeage, Sport, Liposomal NADH+, 60 Vegetable Capsules

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