Which supplements help to improve energy and decrease fatigue?

Answer:

Getting adequate sleep, eating a healthy, well-balanced diet, and regular exercise are the best ways to maintain your energy. However, we all have times when we could benefit from an energy boost, and certain supplements may help.

Medical conditions such as anemia, heart failure, anxiety, cancer and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can cause fatigue. It's important to consult with your doctor if you feel tired frequently. In some cases, certain supplements may be beneficial, but be aware that some supplements can cause fatigue.

Use the links below for more information about each supplement, including ConsumerLab's test-based reviews and Top Picks among marketed products.

Treating nutrient deficiencies that can cause fatigue

B vitamins are involved in the metabolism of food to release energy, and deficiency in vitamin B-12 is known to cause fatigue. However, if you already get an adequate amount of the B vitamins in your diet and are not deficient in them, supplementing with additional amounts of B vitamins is not known to improve performance.

Be aware that energy drinks often contain much higher doses of B vitamins than needed — sometimes amounts above tolerable limits. Energy drinks also commonly contain significant amounts of caffeine or ingredients that naturally contain caffeine such as guarana and cola nut. Although caffeine does not actually provide energy, it acts as a stimulant and can reduce fatigue. Be aware that energy drinks can increase blood pressure, and stroke and liver injury have been reported in people consuming certain energy drinks.

Magnesium deficiency can also fatigue, among other symptoms. Increasing magnesium intake from foods or a supplement, can reverse this.

Iron deficiency can result in anemia, causing fatigue. Consequently, correcting iron deficiency with iron supplementation can reduce related fatigue. Interestingly, iron supplementation has even been shown to reduce fatigue in women who are not anemic but have ferritin levels in the lower end of normal range.

Supplements that may decrease occasional fatigue

Curcumin (from turmeric) has been shown to reduce fatigue in older men and women using a particular branded formula.

Cocoa flavanols were shown in one study to cause a short-term improvement in self-reported mental fatigue, but there was no improvement in other aspects of cognitive performance, mood, or cardiovascular functioning.

Energy bars, or nutrition bars, can be a good source of real energy (calories), especially if you are on the go and haven't had a chance to eat a real meal, and also provide vitamins and minerals. It's important to choose carefully as some are high in sugar, or contain sugar substitutes that may upset your stomach. Some also contain caffeine.

If your fatigue is caused by difficulty sleeping, melatonin or other supplements for sleep may be helpful. (Note that taking high-dose vitamin D may reduce your body's natural production of melatonin).

Ginseng is a popular ingredient in supplements promoted for increasing energy and vitality. Limited evidence suggests Asian ginseng may slightly reduce fatigue experienced by healthy adults. Ginseng may also have benefit among people with cancer (see below).

Supplements that may decrease fatigue associated with specific conditions

CoQ10, which plays a role in energy production in cells, has been shown to decrease fatigue in people with conditions such as heart failure and Gulf War Illness. One small study suggested it may increase self-assessed "vitality" in older adults. (Be aware that taking CoQ10 in the evening can cause insomnia in some people.)

Ashwagandha may reduce fatigue in middle-aged adults with moderate to severe anxiety according to preliminary studies.

American ginseng may increase energy in people with cancer-related fatigue.

Taking a combination of ginkgo and cistanche extracts appeared to modestly improve physical and mental fatigue in people with chronic fatigue syndrome (CFS), although the amount of improvement was below what would be considered to be clinically significant. CFS is a condition marked by extreme, persistent fatigue and at least four of the following symptoms: joint pain, muscle pain, headache, tiredness after physical activity, impaired short-term memory or concentration, sore throat, tender lymph nodes, and unrefreshing sleep. The study, which took place in China, used a tablets providing 120 mg of ginkgo extract and 300 mg of cistanche extract, or a dose that was 50% higher, or placebo (Kan, Front Nutr 2021).

Preliminary evidence suggests that supplementing with anhydrous enol-oxaloacetate (also called simply oxaloacetate) might modestly reduce physical and mental fatigue in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but more research is needed to confirm. An uncontrolled clinical study among 76 people with ME/CFS showed that taking 1,000, 2,000 or 3,000 mg of anhydrous enol-oxaloacetate daily for 6 weeks reduced fatigue by about 23%, 28%, and 23% compared to baseline. When analyzed by type of fatigue (physical or mental) the 1,000, 2,000, and 3,000-mg daily doses reduced physical fatigue by about 17%, 30% and 24% compared to baseline. Mental fatigue was reduced by 18%, 26%, and 19%, respectively. Four of the 76 participants in the study reported dyspepsia and one reported insomnia (Cash, J Transl Med 2022). While these results are promising, there was no placebo group in the study, which is needed to prove a benefit. Research on animal muscle has suggested that oxaloacetate may enhance the production of ATP within the mitochondria of the cells (Nogueira, FASEB J 2011).

Supplements that do not seem to decrease fatigue

Supplements that provide iodine, such as kelp supplements and potassium iodide, are often promoted to increase energy. However, there is little evidence for this effect unless they are being used to treat hypothyroidism due to iodine deficiency.

L-theanine does not seem to reduce fatigue symptoms in healthy young adults.

Rhodiola rosea and maca supplements are sometimes promoted to increase energy or reduce fatigue, however, there is not enough evidence to support these supplements for this use.

A supplement that may cause fatigue

Be aware that St. John's wort can cause fatigue when you take it, or if you abruptly stop taking it.