Taking 2000 mg of nicotinamide riboside every day might be hard for people with long-COVID because more than half stopped taking it within 20 weeks, mostly because they felt worse or got sick again.

What we've found so far is that taking 2000 mg of nicotinamide riboside daily may be difficult for some people with long-COVID to stick with over time. Our analysis of the available research shows that more than half of the participants stopped taking the supplement within 20 weeks [1]. We looked at one assertion from the data, and it supports the idea that high dropout rates occur in long-COVID patients on this dose. The main reasons people stopped were feeling worse or experiencing a return of symptoms [1]. This suggests that while the supplement is being studied for potential benefits, tolerability could be a challenge for many. Our current analysis does not tell us why people felt worse, nor does it compare this dropout rate to a placebo or lower dose. We don’t have data on how many people had side effects versus those who stopped for other reasons. Also, we don’t know if the dropouts were due to the supplement itself or the natural course of long-COVID. The evidence we've reviewed leans toward this dose being linked with high discontinuation rates in this group. However, we have only one assertion to base this on, and no studies refuting it. That means our understanding is limited and could change as more data becomes available. We cannot say whether 2000 mg/day causes symptoms to worsen, nor if lower doses might be better tolerated. This is simply what we’ve found so far. Practical takeaway: If you're considering nicotinamide riboside for long-COVID, starting with a lower dose and monitoring how you feel may help you stay on track. Always talk to your doctor before starting or changing a supplement.