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The risks of taking NAD (NMN)
Nicotinamide mononucleotide (NMN) is generating a lot of buzz in the field of longevity and wellness. But what is its actual safety? With a surge in…
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Look, if you want the kick of a pre-workout, NAD⁺ isn’t where you’ll find it, and you’d only be disappointed. Its territory is background energy and recovery, especially as the years add up. NMN and NAD⁺ are drawing more and more interest from athletes, and rightly so, but for good reasons that need separating from the inflated promises. Let’s look at what this molecule really brings to endurance and recovery, which kind of athlete has a real reason to care, and how to use it without kidding yourself.
NMN, NAD⁺ and sport: what to expect (and what not to)
The basics in one sentence: NAD⁺ is a central coenzyme in your cells’ energy production, and NMN, like NR, is a precursor that helps raise its level. The link with sport is logical: the more NAD⁺ your mitochondria have to work with, the better they produce the energy needed for prolonged effort. But let’s be clear straight away: NAD⁺ isn’t a stimulant, it won’t send your peak strength through the roof and it doesn’t replace a real pre-workout. Its action is quieter, deeper, and it plays out over time.
What the studies say about NAD⁺ and endurance
The most quoted data comes from a trial on amateur runners (Liao et al., 2021): six weeks of NMN supplementation improved markers of aerobic capacity, in a dose-dependent way. That’s an interesting result, and I’d rather give it to you as it is than turn it into a slogan. It’s one study, on a specific profile, with gains that are measurable but modest. It’s not the “+30% performance” you may have read, including on this very page in the past. The signal exists, it’s encouraging, and it still needs confirming on a larger scale.
The 2026 meta-analysis: a signal on endurance, and serious caveats
In September 2026, a network meta-analysis published in Frontiers in Nutrition (Gao et al.) pooled 27 studies and 1,599 people around four molecules in the NAD⁺ pathway: NR, NMN, NADH and nicotinamide. It doesn’t only cover endurance, but that’s where it gets interesting for an athlete.
On endurance (14 studies, 540 people), NMN is what stands out, and the effect rises with the dose: a standardised mean difference (SMD) of 0.66 at medium dose, 1.02 at high dose, and nothing at low dose. To picture that 1.02: take one person at random from each group, and the one on NMN does better about three times out of four. On paper, that looks flattering. Here’s why caution is needed.
- Small studies: fewer than 40 people on average. And a big effect found in small samples tends to shrink as studies get larger.
- A result that rests partly on indirect comparisons: keeping only the trials that compare high-dose NMN directly with placebo, the SMD falls to 0.80 and the confidence interval (-0.01 to 1.61) touches zero.
- Endurance that has nothing to do with a half marathon: this is mostly a six-minute walk test. Participants are largely middle-aged or older, with hardly any athletes among them.
- One trial counted twice: of the seven NMN studies, two are the same trial, published in 2023 then reanalysed in 2024. It was entirely funded by two NMN manufacturers.
- Gaps in the collection: of 231 reports sought, 194 could not be retrieved.
The rest of the study is blunt. No precursor beats placebo on perceived fatigue (16 studies, 1,126 people), nor on strength (20 studies) or sleep. So the signal is narrow: measured endurance, not perceived energy.
And in athletes? Liao’s trial, which isn’t part of this meta-analysis, remains the only direct argument: the runners’ VO₂max didn’t move, but their first ventilatory threshold improved, meaning the intensity you can hold for a long time while still breathing easily. With 12 runners per group, an NMN supplied by its manufacturer and no replication to date, the door remains open, but nobody has walked through it yet.
Two points before you apply these numbers to your own case. NMN is not authorised for sale as a food supplement in the EU (the UK, outside the EU, has its own novel food system), and its result doesn’t automatically carry over to NR: with 12 trials and 459 people, NR doesn’t stand out on any of these outcomes, and its trials often involve patients (Parkinson’s, kidney disease, cognitive disorders) without targeting performance. Finally, this meta-analysis excludes combined formulas: it says nothing, good or bad, about a complex like ours.
Endurance, energy and recovery: the real effects
Endurance and aerobic capacity
This is the most promising ground. By supporting mitochondrial energy production, NAD⁺ helps push back slightly the moment when effort becomes too costly. There’s nothing spectacular about it in a single session, but over regular endurance volumes, it can be felt in your background fatigue.
Strength and power: don’t expect much
Better to defuse this right now. NAD⁺ isn’t a strength ingredient. It won’t raise your one-rep max or your explosiveness. For that, training, creatine and the right nutrition do the work. NAD⁺ plays elsewhere.
Recovery and fatigue
This is the benefit users report most often: slightly lower background fatigue and recovery that feels smoother between sessions. Take it for what it is, a common impression, not established clinical proof. It does fit the molecule’s metabolic role, though. And the 2026 meta-analysis doesn’t find this effect against placebo.
Which athletes is NAD⁺ best suited to?
Not everyone will get the same benefit. These are the profiles for whom the interest is clearest.
Endurance athletes
Runners, cyclists, triathletes: those whose performance depends on producing energy over time are best placed to get something out of it, since that’s exactly where NAD⁺ acts.
Athletes who race back to back
When events come one after another and recovery becomes the limiting factor, supporting your energy metabolism makes sense. NAD⁺ fits into that long game, not into a one-off flash of brilliance.
Masters athletes (40 and over)
This is probably the profile with the most at stake. NAD⁺ declines with age, and that’s also when recovery slows down. In ageing athletes, supporting NAD⁺ meets a real physiological need, whereas a young, healthy athlete will get a more marginal benefit.
How to take NAD⁺ for sport
Nothing complicated, and above all no need to “load” as you would with creatine. You take your NAD⁺ precursor in the morning, with a meal containing fat, which supports your energy through the day. Consistency matters more than the dose: this is background supplementation, judged over weeks, not a last-minute booster before a session. For questions on exact dosage, safety and contraindications, everything is covered in our reference guide on the dangers and side effects of NMN and NAD⁺.
If you want to judge for yourself, Cyril Certain suggests a simple method: 8 to 12 weeks at a constant dose, with an objective measure, such as your time on a usual route or your heart rate at a given pace. If nothing has moved after three or four months, you may be a non-responder. Keep your priorities in order too: training already acts on this pathway. Athletes have about twice as much NAMPT, the enzyme that recycles NAD⁺, as sedentary people (Costford 2010), and ten weeks of resistance training raised muscle NAD⁺ by 127% in adults around 60 (Lamb 2020).
A detail that matters: NMN or NR?
One thing to know before you buy, because it changes everything. NMN is not authorised for sale as a food supplement in the EU, unlike NR (nicotinamide riboside), a closely related precursor that’s just as effective at raising NAD⁺. So for sport as for everything else, NR is the one to go for. That equivalence concerns the rise in blood NAD⁺, measured as comparable for NR and NMN in a 2026 trial (Christen et al.). It says nothing about performance.
DIX NAD⁺ for athletes
I could see this coming: “and now you’re going to sell me your product”. So let’s own it. Our DIX NAD⁺ complex is built around NR, the precursor authorised in the EU, backed by a small dose of NADH for more immediate energy and by vitamin B3. It comes in DRcaps® gastro-resistant capsules and is made in France. I’ll stay honest to the end: this isn’t a product that will win you a race on its own. It’s background support for your energy metabolism, particularly relevant for endurance and for athletes getting older. The rest is written by training and consistency.
NAD+
Exclusive 3-in-1 Complex: Synergy NR -NADH and Vitamin B3 for a rapid and lasting elevation of NAD+ levels.…
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Frequently asked questions about NAD⁺ and sport
Does NMN really improve endurance?
A trial on amateur runners (Liao 2021) showed a dose-dependent improvement in aerobic capacity over six weeks. The 2026 meta-analysis (Gao) also finds a dose-linked signal. These results are encouraging but fragile: small studies, partly indirect comparisons, very few athletes. We’re a long way from the “+30%” sometimes claimed.
Do NAD⁺ precursors reduce fatigue?
Not according to current data: in the 2026 meta-analysis, no precursor beats placebo on perceived fatigue. The authorised health claim is for vitamin B3: niacin contributes to the reduction of tiredness and fatigue. It doesn’t apply to NMN, NR or NAD⁺.
Does NAD⁺ increase muscle strength?
No. NAD⁺ acts on energy metabolism and endurance, not on peak strength or explosiveness. For strength, training and creatine remain the levers.
Which athletes is it most useful for?
Mainly endurance athletes, those who race back to back, and athletes aged 40 and over, whose NAD⁺ has already declined. A young athlete in full health will get a more marginal benefit.
Should I take it before training?
No, it isn’t a pre-session booster. You take it in the morning with a meal, as background supplementation. What counts is consistency over several weeks, not timing around your session.
NMN or NR for sport?
NR, no hesitation: same effectiveness at raising NAD⁺, but it’s authorised for sale in the EU, unlike NMN.
Scientific publications
- “Nicotinamide mononucleotide supplementation enhances aerobic capacity in amateur runners” (Liao et al., randomised controlled trial) DOI: 10.1186/s12970-021-00442-4
- “Oral Administration of Nicotinamide Mononucleotide Is Safe and Efficiently Increases Blood NAD⁺” (safety and bioavailability) DOI: 10.3389/fnut.2022.868640
- “Chronic nicotinamide riboside supplementation elevates NAD⁺ in healthy middle-aged and older adults” (Martens et al., the precursor NR) DOI: 10.1038/s41467-018-03421-7
- “Domain-specific effects of NAD+ precursors on fatigue and functional performance: a systematic review and network meta-analysis” (Gao et al., 2026, network meta-analysis of 27 studies) DOI: 10.3389/fnut.2026.1890335
- “The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults” (Yi et al., trial funded by NMN manufacturers) DOI: 10.1007/s11357-022-00705-1
- “Towards personalized nicotinamide mononucleotide (NMN) supplementation: nicotinamide adenine dinucleotide (NAD) concentration” (Kuerec et al., 2024, reanalysis of the same trial) DOI: 10.1016/j.mad.2024.111917
- “The differential impact of three different NAD+ boosters on circulatory NAD and microbial metabolism in humans” (Christen et al., 2026, NR and NMN compared) DOI: 10.1038/s42255-025-01421-8
- “Skeletal muscle NAMPT is induced by exercise in humans” (Costford et al., 2010) DOI: 10.1152/ajpendo.00318.2009
- “Resistance training increases muscle NAD+ and NADH concentrations as well as NAMPT protein levels and global sirtuin activity in middle-aged, overweight, untrained individuals” (Lamb et al., 2020) DOI: 10.18632/aging.103218
This content is for information only and does not replace the advice of a health professional.
