Do brain supplements work? Even though they’re sold in grocery stores and endorsed by celebrities, science does not support most claims made by nootropic brands.
What if you could augment your brain — becoming smarter, more focused, and more aware — for the price of $50 a month? Or, even prevent or overcome cognitive impairment and dementia altogether? With few other options available for the treatment of Alzheimer’s, these “smart pills” or “nootropics,” endorsed by celebrities from Mayim Bialik, to Joe Rogan, to Gwyneth Paltrow, can be incredibly appealing.
Nootropics — from the Ancient Greek words νόος (nóos) meaning “mind” and τροπή (tropḗ) meaning “a turning” — refers to any supplement or compound purported to improve cognition, boost learning or improve memory, without significant adverse effects. Nootropics may include vitamins and minerals — though not all vitamins and minerals are nootropics.
But beneath the hype, nutritional supplements are poorly regulated in North America. Supplement makers are not required to prove their products are effective — or even safe — before they are marketed and sold to consumers.
“Supplement manufacturers are legally allowed to make misleading claims that may not have the greatest degree of scientific integrity,” Dr. Joanna Hellmuth, a neurologist at the University of California San Francisco Memory and Aging Center, told Being Patient.
Part of the problem is that the compounds in many of these supplements are important micronutrients, vitamins and minerals, for healthy cellular and bodily functions. But the majority of people get an adequate amount of these nutrients from diet alone, while there is little to no evidence in support of taking the supplements themselves.
In addition to being unnecessary, there is a chance some supplements could even have a negative impact on one’s health. After reviewing evidence from several large studies, the writers of an editorial in The Annals of Internal Medicine titled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements” concluded: “Supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful.”
Dr. Pieter Cohen, physician and associate professor at Harvard Medical school, found that at least 10 such supplements contain off-label illicit or unapproved ingredient. “Consumers need to avoid this whole category of brain-boosting supplements for two reasons,” he told Being Patient. “Number one, I’m not aware of any supplement ingredient that’s legal [and] can improve memory and cognitive function,” he said. “The second thing is that they may contain potent pharmaceutical drugs that are not approved for use in the United States.”
What Does the Data Say?
In addition to questions about safety, there is little unbiased evidence supporting the use of many supplements, minerals, and vitamins that are purported to improve cognitive function in mild cognitive impairment or Alzheimer’s. Based on the existing research, brain-boosting supplements, nootropics, and other over-the-counter formulations are unlikely to provide any cognitive benefits.
Why don’t any of these supplements meet the stringent burden of proof? Many supplement companies don’t actually test their products in humans, relying on studies performed on cells in a dish or by citing out-of-context evidence for individual ingredients. Other times, the studies conducted on supplements aren’t rigorous, unbiased, or gold-standard studies. Even if a study is done well, other researchers must be able to replicate the work, showing that the findings are reliable. Then, they can look across multiple gold-standard trials — with qualities like double-blind placebo controls, and peer review processes — to determine whether there is sufficient evidence to support the claims.
The Regulatory Landscape is the Wild, Wild West
This lack of regulation stems from legislation enacted in 1994, reclassifying many existing nutritional and dietary products as food rather than drugs. Lax regulation fueled the growth of the supplement industry to a whopping $140 billion worldwide. Supplements are only retroactively regulated through fines and lawsuits if their claims are demonstrably false or their product isn’t safe.
Recently, the manufacturer behind Neuriva Plus settled a lawsuit barring them from making unproven scientific claims. Last year, the manufacturers of another brain-boosting supplement called Prevagen settled a class-action lawsuit that alleged that the product’s scientific claims were unfounded.
Summary of Evidence for Different Classes of Supplements
Regulatory issues aside, the scant research on nootropics and mild cognitive impairment or dementia that does exist doesn’t paint such an attractive picture.