The Ergogenic Potential of Succinic Acid in Exercise Performance and Post-Exercise Recovery: A Systematic Review.

Six studies involving 153 participants met inclusion criteria for this systematic review of succinate supplementation and exercise performance.

• Mean participant age was 23 years across included studies.
• Studies were identified through searches of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar without date restrictions.
• The review was conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420251237042).
• Methodological quality was evaluated using the Cochrane Risk of Bias 2 tool.
• Substantial heterogeneity and overall methodological limitations precluded meta-analysis.

Five of the six included studies were rated as having a high risk of bias.

• Only one study was judged to be at low risk of bias.
• The single low-risk-of-bias study reported no beneficial effects on exercise performance outcomes.
• The Cochrane Risk of Bias 2 tool was used for quality assessment.
• The predominance of high-risk studies limits the reliability of conclusions drawn from this body of evidence.

Supplementation protocols across included studies used daily doses of 300–2040 mg for up to 21 days, as well as a single acute dose of 30 mg/kg.

• Most interventions administered succinate as part of multi-ingredient formulations rather than as an isolated compound.
• The use of multi-ingredient formulations makes it difficult to isolate the effects of succinic acid.
• Interventional studies assessing succinate-containing supplementation with outcomes related to exercise performance or recovery were included.
• Participants were described as healthy trained individuals.

Three studies reported ergogenic effects in direct performance metrics following succinate-containing supplementation.

• Reported improvements included maximal oxygen uptake, oxygen consumption, anaerobic threshold power, and total work performed.
• All three of these studies were among those rated at high risk of bias.
• These positive findings must be interpreted cautiously given the methodological limitations of the reporting studies.

Two additional studies demonstrated favorable physiological adaptations indirectly relevant to exercise performance, without assessing validated performance outcomes.

• Favorable adaptations included improved acid-base regulation, hematological markers related to oxygen transport, and antioxidant status.
• Validated performance outcomes were not assessed in these two studies.
• These findings represent indirect rather than direct evidence of ergogenic potential.

Succinic acid plays a central role in human energy metabolism as a key intermediate of the Krebs cycle.

• Succinate releases energy accumulated as guanosine triphosphate (GTP) in the Krebs cycle.
• Through its conversion via succinate dehydrogenase (SDH), succinate directly links the Krebs cycle to oxidative phosphorylation (OXPHOS), contributing to ATP production.
• Exercise induces pronounced changes in succinate concentrations in skeletal muscle, blood, and saliva.
• Succinate responses are influenced by training status, exercise modality, and intensity.

Well-controlled trials using isolated succinic acid are required before conclusions regarding efficacy can be drawn.

• Biologically plausible mechanisms exist for ergogenic effects of succinic acid.
• Interpretation is limited by the predominant use of multi-ingredient formulations across included studies.
• The authors concluded that current evidence 'does not provide reliable support for performance-enhancing benefits of succinate supplementation.'
• Future studies should use isolated succinic acid rather than multi-ingredient products to allow causal attribution.