Gindri, Izabelle de Mello, Ferrari, Gustavo, Pinto, Luiz Paulo S et al. · American journal of physiology. Endocrinology and metabolism · 2024 · DOI
This review examined whether taking NAD+ or NADH supplements (molecules that help cells produce energy) are safe and helpful for people with different health conditions, including chronic fatigue syndrome. Researchers looked at 10 clinical trials involving 489 people and found that these supplements were generally well-tolerated, with some people reporting improvements in fatigue, quality of life, and sleep. The most common side effects were mild and included muscle pain, headaches, and sleep disturbances, but nothing serious.
For ME/CFS patients, this review is important because it specifically examined NAD/NADH supplementation in people with CFS and reported improvements in fatigue intensity and quality of life—two core symptoms that significantly impact daily functioning. The finding that these supplements are generally safe with minimal serious side effects may inform patient and clinician discussions about potential therapeutic options, though more targeted research is still needed.
This review does not prove that NAD/NADH supplements are definitively effective for ME/CFS specifically, as the included studies evaluated diverse conditions with varied outcome measures and dosing protocols. It also does not establish optimal dosing, duration of treatment, or which ME/CFS patient subgroups might benefit most. The studies reviewed were heterogeneous, making it difficult to draw disease-specific conclusions.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Gindri, Izabelle de Mello, Ferrari, Gustavo, Pinto, Luiz Paulo S, Bicca, Juliana, Dos Santos, Isis Kelly, Dallacosta, Darlan, et al. (2024). Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review.. American journal of physiology. Endocrinology and metabolism. https://doi.org/10.1152/ajpendo.00242.2023
BibTeX
@article{mecfsatlas-gindri-2024-evaluation-safety,
author = {Gindri, Izabelle de Mello and Ferrari, Gustavo and Pinto, Luiz Paulo S and Bicca, Juliana and Dos Santos, Isis Kelly and Dallacosta, Darlan and Roesler, Carlos Rodrigo de Mello},
title = {Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review.},
journal = {American journal of physiology. Endocrinology and metabolism},
year = {2024},
doi = {10.1152/ajpendo.00242.2023},
note = {PubMed: 37971292},
url = {https://www.mecfsatlas.com/evidence/gindri-2024-evaluation-safety},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/gindri-2024-evaluation-safety
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