tuneTypical Dose
Roughly 5 to 9.9 mmol nitrate per day in multi-day protocols, or 5 to 14.9 mmol taken at least 150 minutes before exercise
Botanical Derived
Beetroot Extract
Beta vulgaris extract
Evidence TierCWADA NOT PROHIBITED
watchEffect Window
Acute performance effects depend on pre-exercise timing. Chronic protocols often use several days of loading, while blood-pressure studies run longer.
check_circleCompliance
WADA NOT PROHIBITED
Overview
Clinical Summary
Nitrate-standardized beetroot can modestly improve some endurance outcomes and may lower systolic blood pressure, but the effect is small, context dependent, and often oversold.
Beetroot products are mostly marketed for nitric oxide, endurance, pumps, and circulation. The useful human evidence is real, but it is narrower than the marketing. Benefits are driven mainly by nitrate-rich beetroot juice or extracts with disclosed nitrate content, not by generic beetroot powders or pigment-focused products. The exercise effect is usually small and more reliable in some endurance settings than in real-world race performance, while the blood-pressure effect is modest and best treated as an adjunct rather than a substitute for standard care. The newer longer-duration studies in postmenopausal women are interesting but specialized and should not be generalized to all users.
The main clinically relevant mechanism is dietary nitrate delivery. Oral bacteria reduce nitrate to nitrite, which can then increase nitric-oxide signaling and affect blood flow, vascular tone, and exercise efficiency. That means nitrate-standardized beetroot products are not interchangeable with generic beetroot extracts that may emphasize pigments or flavor while delivering little nitrate.
Outcomes
What This Is Expected To Influence
Primary Outcomes
- Small improvement in some endurance-performance settings with nitrate-standardized products
- Modest reduction in clinic systolic blood pressure in some hypertensive adults
Secondary Outcomes
- Inconsistent benefit for real-world time-trial performance
- Generic beetroot extracts without nitrate standardization are less evidence aligned
Safety
Contraindications and Interactions
Contraindications
- Symptomatic hypotension
- Recurrent calcium oxalate kidney stones
- Severe uncontrolled gastroesophageal reflux or GI intolerance
Side effects
- Beeturia or red stool
- Mild GI upset
- Lightheadedness from blood-pressure lowering
Interactions
- Antihypertensive medications
- PDE-5 inhibitors
- Other nitric-oxide-targeting supplements
Avoid if
- You cannot verify nitrate content
- You are using it as a substitute for blood-pressure treatment
- You are already prone to low blood pressure or dizziness with vasodilators
Evidence
Study-level References
br-SRC-001Systematic review and meta-analysis
Sourceopen_in_newSilva KVC, Costa BD, Gomes AC, et al. Factors that Moderate the Effect of Nitrate Ingestion on Exercise Performance in Adults. A systematic review with meta-analyses and meta-regressions. Adv Nutr. 2022;13(5):1866-1881. doi:10.1093/advances/nmac054. PMID:35580578.
Population: Healthy adults enrolled in randomized controlled trials of inorganic nitrate supplementation from beetroot juice, nitrate salts, or nitrate-rich diets.
Dose protocol: Acute 5 to 14.9 mmol nitrate at least 150 minutes before exercise, or 5 to 9.9 mmol/day in multi-day protocols
Key findings: Small but significant exercise-performance benefit, with beetroot juice outperforming nitrate salts.
Notes: Best anchor source for practical ergogenic framing and timing.
Paper content
This large meta-analysis supports a real but small ergogenic effect for nitrate supplementation, with beetroot juice performing better than nitrate salts. The main practical lessons are that benefit depends on nitrate dose, exercise type, timing, and preservation of the oral nitrate-reduction pathway. This is strong support for nitrate-standardized beetroot products, but not for generic beetroot extracts that do not disclose nitrate content.
br-SRC-002Systematic review and meta-analysis
Sourceopen_in_newGrönroos R, Eggertsen R, Bernhardsson S, et al. Effects of beetroot juice on blood pressure in hypertension according to European Society of Hypertension Guidelines. A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2024;34(10):2340-2349. doi:10.1016/j.numecd.2024.06.009. PMID:39069465.
Population: Adults with hypertension meeting guideline criteria in randomized controlled trials of beetroot juice.
Dose protocol: 200 to 800 mg nitrate daily from beetroot juice in hypertensive adults
Key findings: Reduced clinic systolic blood pressure by about 5.3 mm Hg, with no clear pooled effect on diastolic or 24-hour blood pressure.
Notes: Best current blood-pressure summary, but low-certainty and heterogeneous.
Paper content
This 2024 meta-analysis is the best current source for blood-pressure framing. It found a modest reduction in clinic systolic blood pressure in hypertensive adults, but no clear pooled effect on diastolic or ambulatory blood pressure, and the certainty of evidence was low. That supports cautious, adjunctive use framing rather than treating beetroot juice as a replacement for antihypertensive therapy.
br-SRC-003Randomized controlled trial
Sourceopen_in_newSiervo M, Shannon O, Kandhari N, et al. Nitrate-Rich Beetroot Juice Reduces Blood Pressure in Tanzanian Adults with Elevated Blood Pressure. A double-blind randomized controlled feasibility trial. J Nutr. 2020;150(9):2460-2468. doi:10.1093/jn/nxaa170. PMID:32729923.
Population: Tanzanian adults aged 50 to 70 years with elevated blood pressure.
Dose protocol: Approximately 400 mg nitrate daily for 60 days
Key findings: Reduced 24-hour systolic and diastolic blood pressure in adults with elevated blood pressure in the nitrate-only arm.
Notes: Useful longer-duration supportive RCT for BP framing.
Paper content
This trial gives beetroot juice a more tangible blood-pressure result than many small acute studies because it used a placebo-controlled 60-day design in adults with elevated blood pressure. The nitrate-only arm showed meaningful 24-hour blood-pressure reductions, which supports the idea that nitrate-rich beetroot juice can have clinically relevant hemodynamic effects in some hypertensive settings. The study was still a feasibility trial with a small sample, so it should not be overgeneralized.
br-SRC-004Randomized controlled trial
Sourceopen_in_newHurst P, Saunders S, Coleman D. No Differences Between Beetroot Juice and Placebo on Competitive 5-km Running Performance. A double-blind, placebo-controlled trial. Int J Sport Nutr Exerc Metab. 2020;30(4):295-300. doi:10.1123/ijsnem.2020-0034. PMID:32470923.
Population: Recreational runners performing competitive 5-km time trials.
Dose protocol: 4.1 mmol nitrate 2.5 hours before a 5-km race
Key findings: No performance advantage over nitrate-depleted placebo in recreational runners.
Notes: Important negative trial that keeps race-performance claims honest.
Paper content
This negative 5-km running trial is useful because it keeps beetroot expectations honest. Acute nitrate-rich beetroot juice did not beat nitrate-depleted placebo in a competitive recreational running setting, even though both conditions improved versus baseline. It shows that beetroot does not reliably improve every real-world endurance task and that the ergogenic effect is smaller and more context dependent than supplement marketing suggests.
br-SRC-005Randomized, double-blind, placebo-controlled trial
Sourceopen_in_newRamos Junior OJF, de Souza Filho CA, Majeed S, Alvares TS. Long-Term Beetroot Extract Supplementation Improves Morphological Muscle Quality and Rate of Force Development in Postmenopausal Women: A Randomized Clinical Trial. Nutrients. 2026;18(5):860. doi:10.3390/nu18050860. PMID:41830030.
Population: Postmenopausal women averaging 21 years post-menopause.
Dose protocol: 548 mg nitrate per day from beetroot extract for 12 weeks
Key findings: Improved morphological muscle quality and rate of force development in postmenopausal women versus nitrate-depleted placebo.
Notes: Small sample (n=20) but provides evidence for longer-term musculoskeletal benefits beyond acute exercise performance.
Paper content
This 12-week RCT in 20 postmenopausal women found that nitrate-rich beetroot extract (548 mg nitrate per day) significantly improved morphological muscle quality and rate of force development compared with a nitrate-depleted placebo. Serum nitrate and nitrite levels rose significantly in the treatment group. The authors suggest potential clinical relevance for preventing structural and neuromuscular decline in postmenopausal women.
br-SRC-006Randomized controlled trial
Sourceopen_in_newAlvares TS, Pinheiro V, Proctor DN, Conte Junior CA, Soares RN. Twelve-week nitrate-rich beetroot extract supplementation improves lower limb vascular function and serum angiogenic potential in postmenopausal women. Am J Physiol Heart Circ Physiol. 2025;329(5):H1047-H1054. doi:10.1152/ajpheart.00592.2025. PMID:40939021.
Population: Postmenopausal women aged 60 to 85 years.
Dose protocol: 8.8 mmol nitrate per day from beetroot extract for 12 weeks
Key findings: Improved femoral artery endothelial function, microvascular reactivity, and serum angiogenic potential in postmenopausal women.
Notes: Small sample (n=16) but supports vascular benefits of chronic nitrate supplementation in older women.
Paper content
This 12-week RCT in 16 postmenopausal women found that daily nitrate-rich beetroot extract (8.8 mmol nitrate) significantly improved femoral artery endothelial function, skeletal muscle microvascular reactivity, and serum angiogenic potential compared with a nitrate-depleted control. The vascular improvements became evident by weeks 8 to 12 of supplementation.