Aerobic exercise and NBS superfood supplementation modulate iron-related biomarkers in methadone treated men in randomized double blind controlled trial

Methadone maintenance therapy effectively treats opioid addiction but disrupts iron metabolism and promotes ferroptosis. This study aimed to investigate the combined effects of aerobic exercise and NBS superfood supplementation on iron-related biomarkers in men undergoing methadone maintenance therapy. Fifty-eight participants were randomized into four groups: control, exercise, supplement, and exercise + supplement. The 8-week aerobic exercise protocol targeted 65% of peak heart rate. The supplement group received 4.5 g/day of NBS. Serum levels of GPX4, SLC7A11, hepcidin, and ferritin were measured via ELISA. Data were analyzed using repeated measures ANOVA in SPSS-26. Significant time × group interactions were observed for GPX4, SLC7A11, and ferritin (p < 0.05), with the largest reductions seen in the combined exercise + supplement group. Hepcidin levels did not change significantly in any group (p > 0.05). The combined intervention showed the greatest improvement in these biomarkers, though the magnitude of changes was moderate. Eight weeks of aerobic exercise combined with NBS superfood supplementation was associated with favorable changes in GPX4, SLC7A11, and ferritin levels in men undergoing Methadone maintenance therapy, suggesting a possible modulation of iron-related pathways. However, the clinical significance of these biochemical changes remains to be established. The study is limited by its relatively small sample size, male-only population, short duration, and lack of long-term follow-up. Larger and longer-term trials are needed to confirm these preliminary findings and to assess whether the observed biomarker changes translate into meaningful clinical benefits.