This blog deals with the very complex topic of Supplements.
These are not regulated by the FDA. Patients think a “natural compound” is safer or better than something generated by pharma. This is often not correct, as pharma generated compounds are in a known quantity, tested, and typically only affect one pathway or receptor.
The supplements listed below can have real affinity for receptors or generate levels of potentially important chemicals or minerals in your blood stream. They can interact with medications and could cause harm or benefit.
One reason to take supplements can be to try to generate a pharmacological effect that isn’t available by a prescription medication. When a specific evidence-based medication is produced by a pharmaceutical company –it is unlikely that any naturally occurring compound is going to yield an equivalent effect or be “safer.”
This issue often comes into play with lipids or blood pressure. We can advise some specific agents that are supplements that can treat those conditions. However, if your ApoB is 125 mg/dL or your systolic blood pressure is 180 mmHg, it is unrealistic, in most cases to get these numbers optimal without the use of standard prescription drugs. Mixing the “natural” items with the “pharma” items isn’t necessarily a brilliant move as both will be hitting the same receptors and it is much akin to taking 2 medications of the same drug class. The naturally occurring one will just be much “dirtier” in that it will have potential other effects and interactions. However, in cases of mild abnormalities, treatment can often be successful with supplements. Obviously lifestyle modification can be a big factor to address for those conditions.
The good news is that Dr. Fraser understands supplements and can give advice, which is often difficult to get in the context of integrating supplements into standard and longevity medicine care.
One of the many risks with taking supplements, is a need to understand the impact of the FDA failing to regulate this area. A good example, which is worth looking at the table in the article (click on the link below), is a review by the company NOW, which is a reputable supplement company, looking at a common supplement, Astaxantin. Please look at the NOW HPLC Results of how much of the compound was actually in a given brand of the supplement, and how much was listed on the label. Some had none, but what isn’t answered is what was actually in the capsules? Is it a toxic substance that could harm you? It is very important to take care and only purchase third party tested products.
The supplements listed are not going to include evidence or even indication for their use. There are some that have brief comments. A selection of these supplements is commonly used by patients interested in longevity. We aren’t suggesting that one should take any or all of these, but these are ones worth looking at. I’ve deliberately not listed many items, generally because the focus here is on supplements that are commonly used and seem to have some degree of evidence of benefit in some individuals.
In my list below, most supplements are available cost effectively on Amazon. I’ve taken care to list those that are 3rd party tested. Some are still expensive.
If a deficiency is present (Vitamin D, B12, Omega 3) – treating this is very sensible. These are at the top of the list. The other items are worthy of a search on PubMed, and each individual can consider the pros and cons, and certainly discuss this with Dr. Fraser. Taking 50 drugs and supplements isn’t the goal! Supplements and drugs are usually tested in isolation, not with 20 other simultaneous compounds being taken.
We worry about the current “click-bait” culture of influencers having their next best item to take. Naturally with their brand being the best. Further complicating this is a “unique mix of items” that only their product has, to fix a problem that they feel is very important. This hype is confusing to healthcare consumers. Simply don’t waste your time on such things. This approach of looking at one after another presentation each arguing for their supplement can result in people taking an incredible number of compounds. Being sensible in this space can be hard todo. Dr. Fraser can help.
If Vitamin D Deficient (demonstrated on a blood test) then a good starting point is to supplement Vitamin D, but also Vitamin K2 which protects bone/vascular calcifications. If on warfarin, discuss with your doctor, NP, PA or Pharmacist. You should recheck your Vitamin D level after 3 months of supplementation.
If Vitamin B12 is not optimal – a good starting point is to supplement with Vitamin B12. A high percentage, not only of vegans, and vegetarians are deficient, but also meat eaters. This needs to be tested – typically at 1 month of supplementation.
Omega 3 Fatty acid supplementation. If Omega 3 index is less than 8%, then a good starting spot for supplementation can be one of the two options below. Recheck of the Omega 3 index in 3 months is sensible.
1 softgel of their DHA product which is 325 mg of DHA PLUS
1 softgel of their EPA product which is 275 mg of EPA OR
Taurine 1000mg 4000 mg once daily (some sources recommend 6000 mg once daily) (Nutricost)
Note this is an mTOR inhibitor, but has a very short half-life. This is worth doing a search on PubMed as it may be one of the more useful supplements.
For NAD optimization carefully investigate - PROBABLY NO VALUE! But if still not convinced and will to spend $$ Select 1 of the following 2
a) NMN (can still get on Bulk Supplements or other proprietary brands) 1000 mg daily OR
b) NR (Niagen or similar) 500-600 mg daily [If Money is of no concern!]
Some individuals prefer using Urolithin A –Mitopure 500 mg daily [If Money is of no concern!]
Some individuals will take NMN or NR and take Urolithin A.
One supplement that has some evidence is AKG. It seems that this may not be a good thing to take simultaneously with the items above. So if wanting to take AKG, think about alternating weeks with using AKG one week then either NMN/NR/Urolithin the alternate week.
This should be in response to testing. Many individuals have decreasing DHEA-S with time. Either blood or salivary testing (usually in combination with a cortisol +/- melatonin curve) is available.
This substance is used to improve age related declines in glutathione and nicely crosses the blood brain barrier. We find that individuals with “brain fog” often get symptomatic improvement with this, plus an NAD booster plus phosphatidylserine or D-Serine. This would be something to discuss with Dr. Fraser.
Creatine monohydrate powder (XPRS Vegan) 0.1-0.15 grams/kg/day, possibly in split doses, and likely best immediately after workout.
This has reasonable evidence for being safe in most patients (discuss with Dr. Fraser) and seems to decrease age related muscle loss and also help build muscle. However, this is only really in the setting of the individual working out, and especially doing weight training.
Nuance – probably Not take these all the time – cycle on a week a month, and probably not take simultaneously with Rapamycin. There is some discussion that Quercetin is inferior to Fisetin – so I usually favor this– especially if over age 60 years.
This isn’t a replacement for having cruciferous vegetables, but can help with nitric oxide generation, which declines with age. This also can help with the liver’s ability to conjugate and excrete toxins (as can glutathione optimization and multiple other approaches). Here is one interesting article on this supplement.
Typically probiotics are of little value. The answer is, improve your dietary fiber (gradually) and improve the plant-based diversity of your diet. This item may be the exception. There is plenty of information one can seek out to understand this particular, not inexpensive probiotic.
This may be a wonderful supplement – BUT the vast majority of information seems to be based on cell biology, not anything with human outcomes, and primarily funded by the manufacturer. It is also concerning that they have recommended ceasing supplementation of Omega 3’s, without any clear evidence that their product results in the needed outcomes. This product is probably not harmful – and if money is no concern – you may choose to take this – but the claims made seem to be overstated. Until there is clear evidence, I’d make sure Omega 3 index is optimized using standard agents as above.
· This blog provides general education only and should not be used to diagnose or replace the advice of a qualified medical professional. This content is not intended to be a substitute for consultation with a qualified and licensed physician or other medical provider. Readers should consult a medical professional for advice, diagnosis and treatment relating to their individual case.
· You should discuss any supplement being considered with your medical professional before starting it.
· This post contains affiliate links. I may receive a small commission if you click on the links of the products and make a purchase
Monthly Newsletter
Sign up to receive updates from our research, success stories, and upcoming events.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
