Beetroot extract has gained popularity as a dietary supplement, particularly for cardiovascular support and exercise performance. Derived from Beta vulgaris, this concentrated form delivers higher doses of dietary nitrates than whole beetroot consumption. Understanding how much beetroot extract per day is appropriate depends on your health goals, existing medical conditions, and the specific product formulation. Whilst there is no official UK Reference Nutrient Intake for beetroot extract, clinical research provides evidence-based guidance on safe and potentially effective dosing. This article examines recommended dosages, individual factors affecting requirements, safety considerations, and when to seek medical advice before supplementation.

What Is Beetroot Extract and Why Is It Used?

Beetroot extract is a concentrated supplement derived from Beta vulgaris, the common beetroot vegetable. The extract is typically available in various forms including capsules, powders, and concentrated juices, with the active ingredients extracted through processes that preserve the nutritional components whilst removing fibre and water content. Product composition varies widely, and not all supplements are standardised for nitrate content.

The primary reason individuals use beetroot extract relates to its nitrate content. Once consumed, dietary nitrates are converted in the body to nitric oxide through the enterosalivary pathway, involving oral bacteria that reduce nitrate to nitrite. Nitric oxide plays a crucial role in vasodilation—the widening of blood vessels. This mechanism has led to interest in beetroot extract for supporting cardiovascular health, with research suggesting potential modest benefits for blood pressure management (typically short-term systolic reductions of 4-8 mmHg in some adults, though results vary considerably between individuals). The nitric oxide pathway is well-established in cardiovascular physiology, though the clinical significance of supplementation continues to be investigated.

Beyond cardiovascular applications, beetroot extract is popular among athletes and fitness enthusiasts. The nitrate-to-nitric-oxide conversion may enhance oxygen delivery to muscles and improve mitochondrial efficiency, potentially supporting exercise performance and endurance. Additionally, beetroot contains betalain compounds with antioxidant and anti-inflammatory properties, though human research on these specific benefits remains preliminary.

It is important to note that whilst beetroot extract is derived from a common food source, concentrated supplements deliver significantly higher doses of active compounds than dietary consumption alone. This distinction is relevant when considering appropriate dosing and potential interactions with medications or existing health conditions.

Recommended Daily Dosage of Beetroot Extract

There is no established UK Reference Nutrient Intake (RNI) or Nutrient Reference Value (NRV) for beetroot extract or dietary nitrate, as it is classified as a food supplement rather than a medicine in the UK. However, clinical research and manufacturer guidelines provide useful frameworks for safe and potentially effective dosing.

For nitrate-related benefits, research studies have typically used doses providing between 300–500 mg of dietary nitrates per day (approximately 5–8 mmol). This is the active component responsible for cardiovascular and performance effects, not the total extract weight. This nitrate dose might be found in approximately 500 ml of standard beetroot juice, though nitrate content varies considerably between products. Some concentrated beetroot shots (approximately 70 ml) can provide 350-400 mg of nitrate.

Many commercial capsule formulations list the total beetroot extract weight (often 500–1000 mg per serving), but this does not indicate the nitrate content. When selecting a supplement, it is essential to check whether the product specifies nitrate content or standardisation.

For general health purposes, lower nitrate doses in the range of 250–300 mg daily are commonly recommended. For exercise performance, some athletes use higher doses—up to 500 mg of nitrates—typically consumed 2–3 hours before physical activity to coincide with peak nitric oxide production. Consistent daily supplementation over several days may be more effective than single-dose use, as the body's nitrate-nitrite-nitric oxide pathway appears to respond to sustained intake.

Key considerations:

• Always follow the manufacturer's dosing instructions on the product label

• Start with the lower end of the dosage range to assess tolerance

• Consider the concentration and standardisation of your chosen product

• Be aware that whole beetroot juice contains additional nutrients but also natural sugars

The European Food Safety Authority (EFSA) has established an Acceptable Daily Intake (ADI) for nitrate from all sources at 3.7 mg/kg body weight per day. While occasional higher intakes from vegetable sources have not shown clear harm, long-term consumption above this level is not advised.

Factors That Affect How Much Beetroot Extract You Need

Individual requirements for beetroot extract can vary considerably based on several physiological, lifestyle, and health-related factors. Understanding these variables helps determine an appropriate personalised dosage within safe parameters.

Body weight and composition influence how dietary nitrates are distributed and metabolised. Larger individuals may require doses at the higher end of the recommended range to achieve similar plasma nitrate concentrations as smaller individuals. However, there is no official link between body weight and specific dosing adjustments for beetroot extract, and standard doses appear effective across varied body sizes in research settings.

Baseline cardiovascular health is particularly relevant. Individuals with elevated blood pressure may experience more pronounced effects from beetroot extract compared to those with optimal blood pressure readings. Some research suggests that the blood pressure-lowering effects are more apparent in those with hypertension, though this should never replace prescribed antihypertensive medications without medical supervision.

Oral bacteria composition significantly affects nitrate metabolism. The conversion of dietary nitrates to nitrites occurs primarily through bacterial reduction in the mouth. Use of antibacterial mouthwash can substantially reduce this conversion, potentially diminishing the effectiveness of beetroot extract. If using beetroot extract for blood pressure or performance benefits, avoid antibacterial mouthwash for several hours before and after taking the supplement.

Dietary nitrate intake from food sources should be considered. Those consuming diets rich in leafy green vegetables, rocket, and other nitrate-containing foods may require less supplementation. Conversely, individuals with limited vegetable intake might benefit from consistent supplementation.

Medication considerations can influence appropriate dosing. Beetroot extract may have additive effects with certain medications, particularly:

• Antihypertensive drugs (blood pressure medications)

• Nitrate-containing medications for angina

• Phosphodiesterase-5 inhibitors (e.g., sildenafil) – while the formal contraindication is with prescribed organic nitrates rather than dietary nitrate, monitoring for potential blood pressure effects is advisable

Exercise intensity and frequency may warrant adjusted timing and dosing for those using beetroot extract specifically for performance benefits. Competitive athletes often use higher doses before significant training sessions or events, whilst recreational exercisers may benefit from consistent moderate daily doses.

Age-related changes in nitric oxide metabolism and kidney function may also influence individual responses, though there is currently insufficient evidence to recommend specific age-based dosing modifications.

Potential Side Effects and Safety Considerations

Beetroot extract is generally well-tolerated, as it is derived from a commonly consumed food. However, concentrated supplementation can produce side effects, particularly at higher doses or in susceptible individuals. Understanding these potential effects enables informed decision-making and appropriate monitoring.

Beeturia is the most common and harmless effect—the passage of red or pink-coloured urine or stools following beetroot consumption. This occurs due to betalain pigments and is common, particularly in some individuals. Whilst harmless, it can be alarming if unexpected and should not be confused with haematuria (blood in urine) or melena (blood in stools), which require medical assessment.

Gastrointestinal symptoms may occur, especially when initiating supplementation or using higher doses. These can include:

• Mild stomach upset or discomfort

• Bloating or flatulence

• Loose stools or diarrhoea

• Nausea (particularly with concentrated beetroot juice)

Starting with lower doses and gradually increasing can minimise these effects. Taking beetroot extract with food may also improve gastrointestinal tolerance.

Hypotension (low blood pressure) is a theoretical concern, given beetroot extract's potential to lower blood pressure. Individuals already taking antihypertensive medications should exercise caution, as additive effects could cause excessive blood pressure reduction, leading to dizziness, light-headedness, or fainting. Regular blood pressure monitoring is advisable when combining beetroot extract with blood pressure medications.

Kidney stone risk warrants consideration, as beetroot is high in oxalates—compounds that can contribute to calcium oxalate kidney stone formation in susceptible individuals. Those with a history of kidney stones should consult their GP before using beetroot extract regularly, and maintaining adequate hydration is essential. Note that oxalate content varies between product forms, with juices typically containing more than some standardised extracts.

Contraindications and special populations:

• Pregnancy and breastfeeding: Whilst dietary beetroot is safe, concentrated extracts lack sufficient safety data. Pregnant and breastfeeding women should seek medical advice before supplementation.

• Kidney disease: Impaired nitrate excretion may lead to accumulation; medical supervision is recommended. The potassium content of beetroot juice may also be relevant for those on potassium-restricted diets.

• Glucose metabolism: Beetroot contains natural sugars, though extract forms vary in sugar content. Individuals with diabetes should monitor blood glucose when initiating supplementation.

In the UK, food supplements are regulated as foods (not medicines) by the Food Standards Agency, Food Standards Scotland, and the Department of Health and Social Care, with enforcement by local Trading Standards. Quality and concentration can vary between manufacturers, making it essential to choose reputable brands with third-party testing where possible.

If you experience any suspected adverse reactions to beetroot extract, report them through the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).

When to Consult Your GP About Beetroot Extract

Whilst beetroot extract is available without prescription, certain circumstances warrant medical consultation before commencing or continuing supplementation. Proactive discussion with your GP ensures safe use, particularly when existing health conditions or medications are involved.

Before starting beetroot extract, consult your GP if you:

• Take medications for high blood pressure (antihypertensives) or heart conditions

• Use nitrate-containing medications for angina or other cardiovascular conditions

• Take phosphodiesterase-5 inhibitors (such as sildenafil, tadalafil) for erectile dysfunction or pulmonary hypertension – these medications are formally contraindicated with prescribed organic nitrates, and caution is advised with high-dose dietary nitrate

• Have a history of kidney stones or current kidney disease

• Have chronic kidney disease or impaired renal function

• Are pregnant, planning pregnancy, or breastfeeding

• Have diabetes requiring medication management

• Have low blood pressure (hypotension) or experience frequent dizziness

Seek prompt medical advice if you experience:

• Persistent or severe gastrointestinal symptoms that don't resolve after discontinuing the supplement

• Signs of hypotension: severe dizziness, fainting, blurred vision, or confusion

• Unexplained fatigue or weakness that develops after starting supplementation

• Allergic reactions: rash, itching, swelling, or difficulty breathing

For urgent concerns, contact NHS 111. For severe symptoms such as difficulty breathing or severe allergic reactions, call 999 or go to A&E immediately.

Regular monitoring may be appropriate if:

You use beetroot extract long-term alongside cardiovascular medications. Your GP may recommend periodic blood pressure checks or renal function tests to ensure safe continued use. This is particularly relevant for individuals with multiple cardiovascular risk factors or those taking multiple medications.

Important safety principles:

Beetroot extract should complement, not replace, prescribed medications or evidence-based lifestyle modifications. If you are managing hypertension, cardiovascular disease, or other chronic conditions, continue all prescribed treatments and attend regular NHS health checks. NICE guidelines for hypertension management (NG136) emphasise lifestyle factors including diet, exercise, and smoking cessation alongside appropriate pharmacotherapy.

Finally, inform your GP about all supplements you take, as this information is relevant for comprehensive medication reviews and when prescribing new treatments. The potential for interactions exists even with food-derived supplements, and your healthcare team can provide personalised guidance based on your complete medical history and current health status.

Frequently Asked Questions