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NADH

Supporting mitochondrial energy production and addressing symptoms of Chronic Fatigue Syndrome (ME/CFS).

Systematic review availableHuman trial evidenceTraditional useNeeds more research

NADH is a vital coenzyme involved in cellular energy production (ATP) and mitochondrial function. It is primarily studied for its potential to reduce fatigue perception in individuals with chronic fatigue syndrome.

Last reviewed June 13, 2026 · AI-assisted, human-reviewed
NADH, or reduced nicotinamide adenine dinucleotide, is a naturally occurring coenzyme found in every living cell. It is the reduced form of nicotinamide adenine dinucleotide (NAD+) and serves as a critical electron donor in mitochondrial function. Its primary physiological role involves various biological processes including oxidative phosphorylation and the production of adenosine triphosphate (ATP), which is the principal energy currency of the cell. Beyond energy metabolism, NADH is implicated in DNA repair, calcium signaling, and gene expression regulation. In clinical research, exogenous supplementation is primarily investigated for its potential to support metabolic health and address symptoms related to cellular energy deficits, such as those observed in chronic fatigue states.

Quick answer

What it is: NADH, or reduced nicotinamide adenine dinucleotide, is a naturally occurring coenzyme found in every living cell.

May support:Chronic Fatigue, Chronic Fatigue Syndrome

Evidence Summary

Clinical evidence from a 2021 randomized, double-blind, placebo-controlled trial involving 104 participants suggests that coenzyme Q10 combined with NADH supplementation may improve fatigue perception and health-related quality of life in individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Additionally, a 2024 systematic review of human studies (n=489) supports the role of NAD-related compounds in essential biological processes, including oxidative phosphorylation and DNA repair, suggesting a broad metabolic utility.

Last reviewed · Jun 2026

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Why It Works

NADH acts as a key cofactor in the mitochondrial electron transport chain, facilitating oxidative phosphorylation and the synthesis of ATP. It also plays roles in DNA repair and cell signaling.

How it works in more detail

NADH functions as a critical pyridine nucleotide cofactor. Within the mitochondria, it participates in the electron transport chain by donating electrons, which creates a proton gradient required for the synthesis of adenosine triphosphate (ATP). This process is essential for maintaining cellular energy homeostasis. Furthermore, NADH is involved in redox reactions and serves as a substrate for enzymes linked to DNA repair mechanisms and the modulation of secondary messengers like calcium, which influence gene expression and cellular survival.

How to use

Always consult a qualified clinician.

Editorial guidance

Suggested dosage
Dosages are determined by clinical research protocols; no universal standard dosage has been established.
Research dosage range
Commonly studied in clinical settings as part of antioxidant combinations, often alongside 200mg of Coenzyme Q10.
Typical onset
Clinical trials for chronic fatigue typically observe outcomes over an 8-week period.
Typical forms
capsule, tablet

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Suggested dosage

Dosages are determined by clinical research protocols; no universal standard dosage has been established.

General guidance — discuss specifics with a clinician.

Active medicinal compounds

Nicotinamide adenine dinucleotide hydride

Traditional use

NADH is a naturally occurring biomolecule and does not have a history of traditional use as a standalone remedy in herbal medicine or traditional healing systems.

Safety

Safety warnings

Systematic reviews generally characterize NAD-related compounds as safe for clinical use; however, high-quality data on long-term toxicity or interaction profiles remain limited. Individuals should consult a healthcare professional before use.

General guidance — discuss specifics with a clinician.

Evidence ecosystem

Scientific literature, clinical guidance, government sources, ongoing research, traditional use, and lived experience — grouped by source type and quality.

Overall grade

Clinical evidence from a 2021 randomized, double-blind, placebo-controlled trial involving 104 participants suggests that coenzyme Q10 combined with NADH supplementation may improve fatigue perception and health-related quality of life in individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Additionally, a 2024 systematic review of human studies (n=489) supports the role of NAD-related compounds in essential biological processes, including oxidative phosphorylation and DNA repair, suggesting a broad metabolic utility.

Filter by source type

Systematic Reviews(1)

Structured reviews of the full body of evidence (incl. Cochrane).

Very High Quality

  • Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review.

    Gindri IM, Ferrari G, Pinto LPS, Bicca J, Dos Santos IK, Dallacosta D · American journal of physiology. Endocrinology and metabolism · 2024 · n=489

    Nicotinamide adenine dinucleotide (NAD+) is an essential pyridine nucleotide cofactor that is present in cells and in several important biological processes, including oxidative phosphorylation and production of adenosine triphosphate, DNA repair, calcium-dependent secondary messenger and gene expression. The purpose of this systematic review is to examine whether the coenzyme formulae NAD+ and NADH are safe and effective when acting as a supplement to humans. This systematic review of randomized clinical trials performed a search in six electronic databases: PubMed, MEDLINE (ovid), Embase, Cochrane CENTRAL (clinical trials), Web of Science, and Scopus. Secondary search included the databases (e.g., Clinical trials.gov, Rebec, Google Scholar - advance). Two reviewers assessed and extracted the studies independently. The risk of bias in studies was performed using version 2 of the Cochrane risk of bias tool for randomized trials. This review includes 10 studies, with a total of 489 part

    Systematic ReviewPubMedVery High Quality

Randomized Human Trials(1)

Controlled human studies with random assignment.

High Quality

  • Effect of Dietary Coenzyme Q10 Plus NADH Supplementation on Fatigue Perception and Health-Related Quality of Life in Individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial.

    Castro-Marrero J, Segundo MJ, Lacasa M, Martinez-Martinez A, Sentañes RS, Alegre-Martin J · Nutrients · 2021 · n=104

    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystem, and profoundly debilitating neuroimmune disease, probably of post-viral multifactorial etiology. Unfortunately, no accurate diagnostic or laboratory tests have been established, nor are any universally effective approved drugs currently available for its treatment. This study aimed to examine whether oral coenzyme Q10 and NADH (reduced form of nicotinamide adenine dinucleotide) co-supplementation could improve perceived fatigue, unrefreshing sleep, and health-related quality of life in ME/CFS patients. A 12-week prospective, randomized, double-blind, placebo-controlled trial was conducted in 207 patients with ME/CFS, who were randomly allocated to one of two groups to receive either 200 mg of CoQ10 and 20 mg of NADH (n = 104) or matching placebo (n = 103) once daily. Endpoints were simultaneously evaluated at baseline, and then reassessed at 4- and 8-week treatment visits and four weeks after treatme

    Randomized TrialPubMedHigh Quality

Limitations: While positive trends are noted, many studies investigate NADH in combination with other substances like CoQ10, making it difficult to isolate the effects of NADH alone. Larger, long-term clinical trials are needed to standardize efficacy across diverse populations.

This page is educational. Statements use phrases like "may support" and "has been studied for"because no remedy here is approved to cure, treat, or reverse any condition. Discussion happens on the ailment pages — community statistics here are derived from those reports. Always consult a qualified clinician.

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