NADH
TL;DR
The reduced form of NAD+, a coenzyme central to cellular energy production. Early research hints at benefits in chronic fatigue and Parkinson's, but evidence is preliminary and NADH's stability and absorption are problematic.
Ideal For
- People with chronic fatigue interested in an experimental but plausibly mechanistic option
- Biohackers exploring mitochondrial support who accept the limited evidence base
Avoid If
- Pregnancy and breastfeeding — safety data insufficient
- People on dopaminergic drugs or with bipolar mania — theoretical caution
Frequently Asked Questions
What is NADH?
Does it help fatigue?
What dose is used?
Is it absorbed?
How does it compare with NR or NMN?
Is it safe?
Overview
NADH (nicotinamide adenine dinucleotide, reduced form) is the electron-carrying coenzyme at the heart of mitochondrial energy production — it donates electrons to the electron transport chain that generates ATP. Supplemental NADH is marketed for fatigue, cognitive performance, and neurodegenerative disease. The clinical evidence is genuinely early-stage: a small randomized trial in chronic fatigue syndrome found that 10-20 mg/day of stabilized oral NADH reduced symptom severity compared with placebo, and open-label Parkinson's studies from the 1990s suggested motor benefits possibly linked to NADH's role as a cofactor for tyrosine hydroxylase (the rate-limiting enzyme in dopamine synthesis). However, these findings await replication in larger modern trials. A practical challenge is that NADH degrades rapidly when exposed to light, heat, and stomach acid, so enteric-coated, stabilized formulations matter considerably.
How It Works
- Serves as the primary electron donor to mitochondrial Complex I, driving ATP production
- Cofactor for tyrosine hydroxylase, the rate-limiting enzyme in dopamine synthesis
- Participates in redox reactions that regenerate glutathione and other antioxidants
- May stimulate endogenous dopamine production, hypothesized basis for Parkinson's effects
Supporting Research11 studies
Emerging Role of Nicotinamide Riboside in Health and Diseases
Sharma C, Donu D, Cen Y
Oral NAD precursors reliably raise blood NAD+ levels, but trials have failed to show consistent functional benefits.
Effect of coenzyme Q10 plus NADH supplementation on fatigue perception and health-related quality of life in myalgic encephalomyelitis/chronic fatigue syndrome
Castro-Marrero J, Segundo MJ, Lacasa M
Eight weeks of CoQ10 plus NADH significantly reduced fatigue perception and improved sleep and quality of life.
A randomized placebo-controlled clinical trial of nicotinamide riboside in obese men: safety, insulin-sensitivity, and lipid-mobilizing effects
Dollerup OL, Christensen B, Svart M
An NAD+ precursor did not improve insulin sensitivity, mitochondrial function or body composition over 12 weeks.
Effect of coenzyme Q10 plus nicotinamide adenine dinucleotide supplementation on maximum heart rate after exercise testing in chronic fatigue syndrome - A randomized, controlled, double-blind trial
Castro-Marrero J, Saez-Francas N, Segundo MJ
CoQ10 plus NADH reduced maximum heart rate during exercise and improved fatigue scores versus placebo.
Therapeutic effects of oral NADH on the symptoms of patients with chronic fatigue syndrome
Forsyth LM, Preuss HG, MacDowell AL
31% of chronic fatigue syndrome patients responded to NADH versus 8% on placebo over four weeks.
Effects of NAD+ precursor supplementation on glucose and lipid metabolism in humans: a meta-analysis
Zhong O, Wang J, Tan Y +1 more
The main research terms of NAD+ precursors were Nicotinamide Riboside (NR), Nicotinamide Mononucleotide (NMN), Nicotinic Acid (NA), Nicotinamide (NAM).
Nicotinamide adenine dinucleotide (NADH)--a new therapeutic approach to Parkinson's disease. Comparison of oral and parenteral application
Birkmayer JGD, Vrecko C, Volc D +1 more
About half of treated Parkinson's patients improved in an uncontrolled open-label NADH evaluation.
Effects of Nicotinamide Mononucleotide Supplementation on Muscle and Liver Functions Among the Middle-aged and Elderly: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Wang JP, Wang L, Wang T +1 more
Based on changes in gait speed (SMD: 0.34 m/s, 95%CI [0.03, 0.66] p = 0.033), NMN had significant effects on muscle mass.
Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults
Martens CR, Denman BA, Mazzo MR +5 more
Chronic supplementation with the NAD+ precursor vitamin, nicotinamide riboside (NR), is well tolerated and effectively stimulates NAD+ metabolism in healthy middle-aged and older adults.
The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis
Prokopidis K, Moriarty F, Bahat G +1 more
Current evidence does not support NMN and NR supplementation for preserving muscle mass and function in adults with mean age of over 60 years.
Effects of Nicotinamide Mononucleotide on Glucose and Lipid Metabolism in Adults: A Systematic Review and Meta-analysis of Randomised Controlled Trials
Chen F, Zhou D, Kong AP +1 more
Short-term supplementation of NMN of 250-2000 mg/d did not show significantly positive impacts on glucose control and lipid profile.
Safety Information
Potential Side Effects
{"Mild insomnia or jitteriness at higher doses — take in the morning","Unstabilized products degrade rapidly; enteric-coated blister packs matter","Expensive relative to the strength of evidence"}
Drug Interactions
- Levodopa and dopaminergic drugs: theoretical additive effects via tyrosine hydroxylase cofactor activity
- Stimulants: possible additive alerting effects
Pregnancy & Breastfeeding
Pregnancy: Not enough evidence to judge
Breastfeeding: Not enough evidence to judge
Dosage Guidelines
Dosage Used in Studies
Consult healthcare provider
Dosing by Goal
| Goal | Dose | Notes |
|---|---|---|
| General | 5-20 mg/day used in cognitive and athletic studies | |
| Chronic fatigue | 10-20 mg stabilized oral NADH daily, empty stomach, in the morning | |
| Notes | Take 30-45 minutes before food; choose enteric-coated blister-packed products |
Forms Compared
Enteric-coated stabilized NADH
Standard research form; protection from stomach acid is essential. Bioavailability: moderate
Sublingual NADH
Bypasses stomach degradation; used in some fatigue research. Bioavailability: moderate
IV NADH/NAD+
Clinic-administered; not a supplement and outside oral dosing evidence. Bioavailability: high
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.