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Supplement

Beetroot / Nitrate

Herbs · Beetroot, nitrate, NO booster

Beetroot juice is one of the few supplements that the International Olympic Committee counts among the well supported. The reason is the nitrate, which the body turns into nitric oxide via a detour through the mouth. The result is a small but real performance gain and a slight reduction in blood pressure.

In short

Nitrate from beetroot is converted by bacteria in the mouth into nitrite and in the body into nitric oxide, which dilates blood vessels and makes muscle work more efficient. A meta-analysis of 80 studies found a clear but small performance gain in young, healthy recreational athletes. In people with high blood pressure, systolic office blood pressure fell by 5.31 mmHg in a meta-analysis. There are two catches: in highly trained endurance athletes the effect largely fizzles out, and an antiseptic mouthwash can block the conversion. For performance, nitrate was mostly taken 2 to 3 hours before exercise.

What it is

Nitrate is a natural component of many vegetables. Green leafy vegetables and root vegetables such as spinach, rocket, celery and beetroot are particularly rich in it. Beetroot juice is the form most often used in studies, often as a concentrated shot with a defined nitrate content. There are also powders, extracts and pure sodium or potassium nitrate, which some studies used instead of juice.

How it works

The pathway is unusual and well traced in humans. Nitrate passes from the gut into the blood and is collected again by the salivary glands. In the mouth, bacteria convert it into nitrite. This nitrite is swallowed, enters the blood and serves there as the starting material for nitric oxide. Nitric oxide dilates the blood vessels.

Two experiments show how central the oral bacteria are. When 7 volunteers gargled with a chlorhexidine mouthwash before a nitrate dose, no more nitrite formed in the saliva, and the rise in the blood was considerably weaker. In a second study with 19 healthy people, one week of mouthwash reduced nitrite formation in the mouth by 90 percent, and blood pressure rose by 2 to 3.5 mmHg, from the very first day.

In muscle, according to the IOC consensus, nitrate is thought mainly to strengthen the fast type II fibers, lower the energy cost per unit of force, make the mitochondria more efficient and improve blood flow.

What users report

An Australian survey of 1,404 active adults gives an impression of everyday use. 11.9 percent had taken nitrate at some point, most often as beetroot juice. Only 3.9 percent of users reported side effects. Something else was more striking: 69.4 percent did not know when to take it before exercise, and 82.3 percent were unsure about contraindications. So anyone who feels nothing may simply have drunk it at the wrong time.

What is well supported

The performance data are broad and consistent. Senefeld and colleagues evaluated 80 placebo-controlled crossover studies and found a clear improvement (d = 0.174). A second meta-analysis of 73 studies with 1,061 participants found 4.6 watts more power and 25.3 seconds more to exhaustion. The 2018 IOC consensus puts the gain at 4 to 25 percent for time to exhaustion, 1 to 3 percent for time trials under 40 minutes and 3 to 5 percent for intermittent team-sport efforts of 12 to 40 minutes. For blood pressure, beetroot juice lowered systolic office blood pressure by 5.31 mmHg in a meta-analysis of 11 studies with 349 people with hypertension, without any habituation appearing over time. A broader analysis of 47 studies with 1,101 participants, including healthy people, found 2.91 mmHg lower systolic and 1.45 mmHg lower diastolic pressure with intake over at least 3 days. And the benefit extends beyond endurance: a 2026 meta-analysis of 33 studies also saw improvements in high-intensity interval sprints (SMD 0.38) and mean power (SMD 0.43), but itself regards its results as a hypothesis that further studies must confirm.

What the studies show

NITRATE-BP: four weeks in high blood pressure

68 patients with high blood pressure, 34 without and 34 with blood pressure medication, drank 250 milliliters of beetroot juice daily for 4 weeks or the same juice without nitrate. The design was double-blind. Office blood pressure fell by 7.7 versus 2.4 mmHg, 24-hour blood pressure by 7.7 versus 5.2 mmHg, home blood pressure by 8.1 versus 3.8 mmHg. Vascular function improved by about 20 percent. The study was funded by the British Heart Foundation.

How much juice is needed?

Wylie and colleagues gave 10 healthy men 70, 140 or 280 milliliters of concentrated juice with 4.2, 8.4 and 16.8 mmol nitrate. Nitrite in the blood peaked after 2 to 3 hours. 70 milliliters did not change the exercise response. 140 and 280 milliliters extended the time to task failure by 14 and 12 percent. More than 8.4 mmol brought no additional advantage.

Meta-analysis of 80 studies

Senefeld and colleagues screened 2,033 articles and included 80 randomized, placebo-controlled crossover studies in young healthy people. The overall effect was small but clear. In 26 studies with well-trained endurance athletes, from a maximal oxygen uptake of 65 milliliters per kilogram per minute, no effect could be detected anymore. Only 6 studies examined women exclusively, too few for a clear statement.

Where the data stop

The effect is real, but small, and it depends on the person. In highly trained athletes, the largest meta-analysis found no advantage; the IOC considers longer intake over more than 3 days a possible strategy in this group. Women have barely been studied. In time trials of 5 to 30 minutes, the overall effect was only trivial, and over several weeks of training nitrate did not additionally improve training adaptation. Efforts under 12 minutes are inconclusive according to the IOC. For blood pressure, the authors of the meta-analysis rated the certainty of evidence as low; no significant effect could be detected for diastolic pressure or the 24-hour average. A meta-analysis with pure sodium nitrate in people over 50 found no significant reduction. Whether the juice prevents heart attacks or strokes has not been studied; all data concern blood pressure and vascular function.

Status, approval and legal

Beetroot and beetroot juice are foods; concentrated shots and powders are sold as food supplements. For nitrate as a food additive, an acceptable daily intake of 3.7 milligrams per kilogram of body weight applies, which EFSA retained in 2017. At the same time, EFSA noted that this amount is exceeded in all age groups at average and high intake when all nitrate sources, including vegetables, are taken into account. Nitrate and beetroot are not on the WADA 2026 Prohibited List; the IOC consensus counts nitrate among the few supplements with good evidence for performance enhancement.

Safety

In the studies, nitrate from beetroot was well tolerated, including in older people over 12 weeks with 20 grams of extract daily. The IOC mentions possible gastrointestinal complaints and advises trying the juice in training before a competition. Reddish urine after beetroot is harmless and affects 10 to 14 percent of the population, more often in iron deficiency. Beetroot is one of the very high-oxalate foods; anyone prone to kidney stones with elevated urinary oxalate should discuss the amount with a physician. Antiseptic mouthwashes inhibit the conversion of nitrate to nitrite. EFSA considers the formation of methemoglobin and of N-nitroso compounds from nitrate at the assessed amounts to be clinically not relevant or of low concern, respectively. In NITRATE-BP, the juice lowered blood pressure even in patients who were already taking medication. Anyone taking blood pressure medication should therefore discuss regular intake with a physician beforehand.

BK-Score Supported, with caveats

Human evidence7
Mechanism9
Safety data7
Hype gap5
Track record of use7

The best-understood mechanism among supplements: the pathway from nitrate via nitrite to nitric oxide has been traced directly in humans; an antiseptic mouthwash abolishes nitrite formation in the mouth and raised blood pressure in healthy people by 2 to 3.5 mmHg (Free Radic Biol Med 2013). For performance, a meta-analysis of 80 crossover RCTs shows a small, clear effect (d = 0.174) that disappears in well-trained endurance athletes (Med Sci Sports Exerc 2020); the 2018 IOC consensus counts nitrate among the few well-supported supplements. For blood pressure, beetroot juice lowers systolic office blood pressure by 5.31 mmHg in 349 people with hypertension in 11 RCTs, with no significant effect on diastolic pressure or the 24-hour average, at low certainty of evidence (Nutr Metab Cardiovasc Dis 2024); the RCT NITRATE-BP also found -7.7 mmHg in ambulatory measurement over 4 weeks. Hard cardiovascular endpoints are lacking.

The score rates the state of knowledge, not the substance. “Safety data 9” means well studied – not harmless.
Subjective assessment by Biohacking Kompakt based on published scoring rules – not a scientific rating and not a medical recommendation. Rules and all ratings (German)

Frequently asked questions about beetroot / nitrate

When should you drink beetroot juice before exercise?

In the studies, acute effects mostly appeared 2 to 3 hours after intake. In a dose study, nitrite in the blood peaked after 2 to 3 hours. According to the IOC, intake over more than 3 days also appears beneficial.

How much nitrate was used in studies?

The IOC consensus cites 5 to 9 mmol nitrate for acute effects, which corresponds to 310 to 560 milligrams. In a dose study, one shot with 4.2 mmol had no effect, two shots with 8.4 mmol did. More than 8.4 mmol brought no additional benefit.

Does beetroot also work in trained athletes?

Considerably less. In a meta-analysis of 80 studies, no effect could be detected anymore in well-trained endurance athletes. The IOC considers longer intake over several days a possible strategy in this group.

Why should you not use mouthwash?

The nitrate is converted into nitrite by bacteria in the mouth. In studies, an antiseptic mouthwash abolished this conversion and even raised blood pressure slightly in healthy people. Normal toothbrushing was not studied in these experiments.

Does beetroot juice lower blood pressure?

In people with high blood pressure, systolic office blood pressure fell by 5.31 mmHg in a meta-analysis, but the certainty of evidence is low. In a four-week study, 24-hour blood pressure also fell. It does not replace blood pressure treatment.

Is red urine after beetroot dangerous?

No. The discoloration is called beeturia, comes from the red pigments of the root and affects 10 to 14 percent of the population. It occurs more often in iron deficiency. Anyone who notices reddish urine without having eaten beetroot should have it checked by a physician.

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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-26.