Runners, don't waste your money on NAD⁺ supplements
- Maryke Louw
- Nov 30, 2025
- 5 min read
NAD+ supplements are mostly marketed to people who want to combat ageing, but some of them also claim that they boost exercise performance. Not so fast. Here’s what the people in the white lab coats found when they put NAD+ supplements to the test for exercise performance, post-exercise recovery, and recovery from injury.
Remember, if you need help with an injury, you're welcome to consult one of our physios online via video call.
In this article:
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What are NAD⁺ supplements?
NAD⁺ (full name: nicotinamide adenine dinucleotide) is a coenzyme found in every cell in our bodies and plays an essential role in energy production, mitochondrial function, DNA repair, and cellular metabolism.
Because NAD⁺ levels decline with age, many supplements claim to “boost” NAD⁺ to support energy, recovery, and longevity. “Supports exercise efficiency to help meet your fitness goals,” claims one supplement company on Amazon.
Since our bodies do not absorb pure NAD⁺ well when taken orally, most of these supplements are precursors that our bodies then convert into NAD⁺. They are mainly:
NMN (nicotinamide mononucleotide)
NR (nicotinamide riboside)
Niacin (vitamin B3)
Nicotinamide (NAM).
Among these, only NMN and NR have been tested in human exercise studies.
Why might NAD⁺ supplements help runners?
There is a theoretical biological rationale for why NAD⁺ might matter for endurance athletes:
NAD⁺ is central to mitochondrial ATP production, meaning it plays a direct role in the aerobic energy system used during running.
Ageing reduces NAD⁺ availability, and animal studies show that restoring NAD⁺ can support muscle health and regeneration.
These ideas make NAD⁺ boosters sound promising – but going beyond the theory, the key question is whether increasing NAD⁺ with supplements actually helps runners perform better or recover faster 🤷♂️
NAD⁺ supplements and running performance
NMN: One positive study – but with important limitations
The most widely cited positive human performance study is a 2021 trial involving 48 amateur runners, some of whom took NMN (nicotinamide mononucleotide) in various dosages for 6 weeks while following a structured endurance training programme.
Findings:
NMN (600 or 1200 mg/day) improved ventilatory thresholds (the point where your breathing starts to get noticeably harder) and oxygen use at submaximal efforts compared to the runners who didn’t take the supplement.
No improvements were seen in:
VO₂max
Peak power
Maximal aerobic capacity
Any actual running performance metric (no time trials were performed).
Interpretation: At best, NMN might help runners exercise more efficiently at moderate intensities. But there’s no evidence it makes you faster or improves race outcomes. Also, this study included only 48 subjects – the results might look different if you were to perform a larger scale trial.
NR: Consistently disappointing results
NR raises NAD⁺ levels, but
Does not improve performance, muscle metabolism, fuel use, or cardiorespiratory efficiency during exercise.
A 2022 review focusing specifically on exercise adaptation concluded that NAD⁺ boosters do not improve muscle metabolism or exercise performance in healthy humans.
NAD⁺ supplements and recovery from exercise
What about helping runners to recover faster after a hard session?
There are no human trials showing that NMN or NR reduces DOMS or fatigue between training sessions.
A 2022 study gave NR supplementation to a group of older adults and then used neuromuscular electrical stimulation (NMES) to fatigue their quad muscles and cause exercise-related muscle damage. They then compared the results with a group whose quads got the same treatment, but without giving them the supplement.
Results:
No improvement in muscle soreness
No faster recovery of strength
No acceleration of muscle regeneration
No improvements on MRI markers of muscle healing
No change in muscle stem-cell behaviour.
NAD⁺ supplements and injury recovery
For sports injury rehabilitation, the evidence is very weak:
Muscle injury: the 2022 study mentioned above found no benefit for regeneration or function related to the muscle damage caused by the exercise.
Tendon injury: no human studies available.
Cartilage or joint injury: no human studies available.
Bone/stress-fracture healing: no human studies available.
Animal studies suggest NAD⁺ is biologically important for muscle repair, but translating this into meaningful clinical improvement in humans has not been demonstrated.
👉 From a physiotherapy standpoint, I would not recommend an NAD⁺ supplement for injury healing at this time.
Safety and side effects
Human trials of NMN and NR report good short-term tolerability. The most common mild effects include:
Nausea
Digestive discomfort
Headache.
Unknowns:
Long-term safety
Use in people with cancer or pre-cancerous conditions
Interactions with chronic disease.
For healthy runners, risks appear low – but so do the benefits.
How to increase your NAD⁺ naturally
Good news for runners: endurance as well as resistance exercise will increase your body’s natural production of NAD⁺.
💡 So, for healthy runners already training regularly, this boost likely far outweighs anything that supplements can provide.
Summary
NAD⁺ supplements raise NAD⁺ levels, but:
Do not improve VO₂max or running performance
Do not accelerate recovery
Do not help muscle healing
Have no evidence for tendon or bone injury healing.
Your time and money are better spent on:
Structured training
Adequate carbohydrate and protein intake
Sleep optimisation
Strength work
Evidence-based ergogenic aids such as caffeine, nitrates, and bicarb of soda.
Here is our collection of research-based articles on which supplements for runners work and which ones … not so much.
How we can help
Need help with an injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.
References
Goody MF, Henry CA. A need for NAD⁺ in muscle development, homeostasis, and regeneration. Skelet Muscle. 2018;8:9.
Katsyuba E, Auwerx J. Modulating NAD⁺ metabolism, from bench to bedside. EMBO J. 2017;36:2670–2683.
Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD⁺ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22:119–141.
Costford SR, et al. NAMPT expression is induced by exercise in human skeletal muscle. Am J Physiol Endocrinol Metab. 2010;298:E117–E120.
Liao B, et al. Nicotinamide mononucleotide supplementation enhances aerobic capacity in amateur runners: a randomized, double-blind trial. J Int Soc Sports Nutr. 2021;18:54.
Stocks B, et al. Nicotinamide riboside supplementation does not alter whole-body metabolic responses to exercise in humans. J Physiol. 2021;599:1513–1531.
Dollerup OL, et al. Nicotinamide riboside does not improve muscle mitochondrial function or exercise capacity in type 2 diabetes. J Physiol. 2020;598(4):731–754.
Martens CR, et al. Chronic nicotinamide riboside supplementation raises NAD⁺ but not performance in older adults. Nat Commun. 2018;9:1286.
Campelj DG, Philp A. NAD⁺ therapeutics and skeletal muscle adaptation to exercise in humans. Sports Med. 2022;52:91–99.
Jensen TS, et al. Nicotinamide riboside and pterostilbene supplementation does not improve muscle recovery after injury in older adults. JCI Insight. 2022;7:e155334.