Avoid These OTC Cognitive Supplements
And What to Take Instead
As a neuropsychologist, it’s common for my elderly patients to come into the office with a gallon-sized plastic bag full of supplements to ask me if they are effective. I don’t blame anyone for trying to find some way to preserve or improve their thinking abilities. The thing is, many of these people end up spending hundreds or thousands of dollars on supplements because the supplement industry is quite aggressive in its advertisement to older adults. In this post, I’d like to point out a few common over-the-counter supplements that are touted to improve cognitive abilities that you should avoid.
If you’d like to check out my entire “tier list” of cognitive supplements, feel free to watch my video below!
Supplements to Definitely Avoid
Gingko Biloba
Gingko Biloba, also known as maidenhair, is a tree native to China. It has been used for various purposes for literally thousands of years. In the US, it is commonly touted as a supplement to help boost memory through its antioxidant properties and its ability to increase blood flow.
In a large randomized controlled trial (Solomon et al., 2002) showed no benefit to memory functioning in people supplementing with gingko biloba as compared to placebo. Specifically, the study states:
The results of this 6-week study indicate that ginkgo did not facilitate performance on standard neuropsychological tests of learning, memory, attention, and concentration or naming and verbal fluency in elderly adults without cognitive impairment. The ginkgo group also did not differ from the control group in terms of self-reported memory function or global rating by spouses, friends, and relatives.
Aside from the lack of proven cognitive benefit, Gingko has been shown to increase blood flow, which can actually be a bad thing because it also increases risk of bleeding and risk of seizures in individuals with epilepsy. No thanks!
Antioxidants
We know that oxidative stress (damaged caused by imbalanced free radicals) is linked to brain aging and degeneration. Over the years, there have been so many different vitamins, supplements, and superfoods marketed on the fact that they have strong antioxidant properties.
Unfortunately, the research is just not there. In a review of numerous studies on antioxidant vitamins, any impact on cognition was small and inconsistent (Rutjes et al., 2018). Prevention of dementia was also not supported. For some vitamins like beta-carotene and vitamin C, there appeared to be some positive results, but again, the effect sizes were small, and this was after years of supplementation.
Cognitive Supplement Blends
This is the one that makes me the most upset. I’m using Prevagen as the prototypical example of a supposed cognitive health supplement. I often see it marketed during Jeopardy, presumably when people are trying to keep their brains sharp. It’s expensive as hell and sounds flashy because it uses a calcium-binding protein found in jellyfish (apoaequorin). As you may expect, the research does not support the idea that it improves memory. In fact, the FTC took the company behind Prevagen to trial and concluded that their statements about improving memory were unsubstantiated and misleading.
Aside from Prevagen, there are many other culprits. They are frequently guilty of “fairy dusting,” which is where they include very small amounts of potentially helpful substances so that they can include the name on the label. Many supplements also include caffeine or a derivative of caffeine, which is a well-known temporary cognitive booster.
Most of these cognitive blends are not necessarily going to be harmful for you. They are just going to give you very expensive pee without providing a significant benefit for your cognitive abilities.
Vitamins
Okay, this one isn’t necessarily a supplement to avoid. I just wanted to make a quick statement about vitamins. They are absolutely essential for healthy functioning of your brain and body in general. If you are low on B12, you may find yourself with memory problems. If you are low on vitamin D, you can experience lethargy or mood issues.
HOWEVER, vitamins are one of the biggest supplements that I see people wasting money on. If you are deficient in a vitamin, supplementing will absolutely help. But in the vast majority of cases, taking additional vitamins when your levels are already good does not provide an additional benefit beyond your healthy baseline. Your body is actually pretty good at regulating this, so you end up excreting it anyway. There are also some cases in which overdosing a vitamin can be harmful. So, get your levels check if you suspect you have a vitamin deficiency, and then follow your doctor’s (not your TikTok doctor’s) advice.
What Does Work??
So far, I’ve talked about a bunch of over-the-counter supplements that you should probably avoid. That leaves the question of which supplements can actually provide a benefit to your brain health or cognition. I’ll provide a very quick bulleted list here and if you’d like to learn more, you can check out the video I included above.
Creatine
Boosts working memory and processing speed, especially under stressful conditions.
Caffeine
Increases alertness and improves attention, vigilance, and reaction time.
Omega-3 fatty acids
Can slow cognitive decline in people with mild impairment and can improve attention and processing speed in older adults.
Citicoline
Improves attention and memory in older adults with memory problems. Prescribed in some countries for stroke recovery.
Curcumin
Improves memory and attention in older adults without dementia. In animal models, appears to also help reduce Alzheimer’s pathology.
L-tyrosine
Extensively studied by the military - helps maintain working memory and attention when under-rested and over-stressed.
Bacopa Monnieri
Improves memory recall and learning speed in healthy adults. Takes 2-3 months to ramp up.