NADH (reduced nicotinamide adenine dinucleotide)
Direct mitochondrial-electron-transport substrate with preliminary RCTs in chronic fatigue syndrome, distinct from NAD+ precursor approaches.
Why
Oral NADH (the reduced form of NAD+) is a direct substrate for mitochondrial electron transport. Small RCTs by Forsyth 1999 and Castro-Marrero 2015 in chronic fatigue syndrome report modest improvements in fatigue severity scores at 5–20 mg/day. Bioavailability of oral NADH is poor, sublingual and enteric-coated forms are intended to improve absorption. Distinct conceptually from NR (precursor) approaches.
How it works
Direct electron donor at complex I of the mitochondrial electron transport chain. Cofactor for hundreds of dehydrogenases. Modulates ATP availability in cells with mitochondrial dysfunction.
Expected onset · Fatigue effects over 4–12 weeks
How to take
Dosage
5–20 mg/day in stabilised sublingual or enteric-coated form, taken in the morning on empty stomach.
Timing
Morning, on empty stomach
On the label
Stabilised NADH in enteric-coated or sublingual form. Avoid unstabilised raw NADH (degrades rapidly).
Ideal for
Adults with chronic fatigue syndrome / myalgic encephalomyelitis exploring mitochondrial approaches.
Safety
Evidence
Castro-Marrero 2015 RCT (n=80 CFS): CoQ10 + NADH combination reduced fatigue (FIS-40) and improved heart-rate response vs placebo at 8 weeks. Forsyth 1999 pilot (n=26 CFS) reported 31% on NADH improved by 8 weeks vs 8% on placebo. Preliminary evidence, no Cochrane review, EMA HMPC monograph or EFSA-authorised health claim covers this indication; cited RCTs are small or in non-tier-1 journals. Useful as honest reference rather than evidence-grade recommendation.
Preliminary evidence, no Cochrane review, EMA HMPC monograph or EFSA-authorised health claim covers this indication; cited RCTs are small or in non-tier-1 journals. Useful as honest reference rather than evidence-grade recommendation.
- Castro-Marrero et al., Antioxid Redox Signal 2015, does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome? (RCT)
- Forsyth et al., Ann Allergy Asthma Immunol 1999, therapeutic effects of oral NADH on the symptoms of patients with chronic fatigue syndrome (RCT)
Where to get it
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