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  • Writer's pictureAlexander Lebedev

Which nootropics are truly worth your money? | By Psychiatrist-Neuroscientist

Updated: Sep 30, 2023



Introduction


The world of nootropics is both mysterious and vast. Many of you might be wondering: should we trust these trendy supplements? Here's my perspective.


I'm not here to tout miracle concoctions or claim they'll transform you into a superhuman. You won't find endorsements for the latest fads like TUDCA, coenzyme Q10 with NAD+, or microdosing psychedelics from me. Why? Simply put, their efficacy remains under scrutiny. Instead, I aim to provide a balanced perspective, free from commercial agendas, highlighting accessible and proven nootropics often overshadowed by the marketing blitz.


My assessment criteria


The scientific foundation is of crucial importance to me. I adopt similar approach to the one I use when evaluating any biomedical evidence. Let's simplify it as a 5-point scale based on the persuasiveness of the evidence base. It's simple - the larger the sample size, the more research centers involved, and the more independent the study, the higher the score.



(Note: We'll steer clear of prescription drugs, like methylphenidate).

My curated picks


1. Caffeine (5)



Natural Sources: Coffee, Tea

Mechanism: Central nervous system stimulant; antagonist to adenosine receptors that typically signal the body to relax.

Evidence: A meta-analysis of 13 randomised studies confirmed caffeine's positive effects on attention, reaction speed, accuracy, and fatigue perception.


2. Ginkgo Biloba (5)




NB: Data mainly from elderly patients.

Mechanism: Improves blood circulation in the brain and protects nerve cells, enhancing concentration and memory.

Evidence: Two meta-analyses (Liao et al., 2021 & Li et al., 2023) revealed that Ginkgo Biloba supplements improve cognitive functions in patients with Alzheimer's-related memory impairments.


3. Bacopa Monnieri (4.5)*



Mechanism: Neuroprotective; amplifies cholinergic transmission.

Evidence: A meta-analysis of 9 studies demonstrated significant improvements in attention and decision-making speed following Bacopa Monnieri extract intake.

*0.5 points deducted due to the absence of large-scale studies.


4. Creatine (5)



Typically, of synthetic origin

Natural Sources (small amounts): Fish, Meat

Mechanism: Enhances the brain's energy potential by increasing ATP stores, the body's universal energy source.

Evidence: A meta-analysis of 10 clinical trials discovered that creatine supplements significantly improve memory, especially in the elderly.


5. B Vitamins (5)

(B1, B2, B3, B5, B6, B7, B9, B12)



Natural Sources: Mediterranean Diet

Mechanism: Extensive effects on the nervous system's metabolism, including neurotransmitter synthesis.

Evidence: A meta-analysis of 95 studies showed that B vitamin supplements slow cognitive aging, especially with early onset and prolonged intake. High folic acid intake correlates with a reduced dementia risk.


6. Vitamin D (5)


Natural Sources: Fatty fish, Sunlight exposure on skin

Mechanism: Regulates the exchange of essential ions for the nervous system, with immunomodulatory and neuroprotective effects.

Evidence: According to a meta-analysis of 24 trials, Vitamin D intake considerably improves cognitive functions, especially in risk groups and populations with Vitamin D deficiency (most northern countries). Vitamin D intake is also clearly linked to reduced dementia risks.


7. Probiotics: 4*



Natural Sources: Fermented foods (Kefir, Yogurt, Kombucha, Sauerkraut, Miso)

NB: Data primarily from elderly Alzheimer's patients.

Mechanism: Modulates the gut-brain system; contributes to neurotransmitter synthesis.

Evidence: A meta-analysis of 10 trials revealed that probiotics significantly improve cognitive functions in individuals with Alzheimer's-related impairments.

*1 point deducted due to limited data on other demographics.


8. Sport (5)



Yes, not all nootropics are edible!

Mechanism: Physical activity offers a multitude of positive effects on our mental well-being. It elevates blood flow, spurs neurogenesis, and releases endorphins. Moreover, exercise enhances the expression of neurotrophic factors, increases the bioavailability of serotonin and norepinephrine, positively impacts the hypothalamic-pituitary-adrenal axis, and reduces systemic inflammation.

Evidence: A plethora of research underscores exercise's benefits, which, among other things, also include improving cognitive functioning. For example, a meta-analysis of 36 studies supported benefits of aerobic and resistance exercises in older individuals. Needless to say, the benefits of sports for mental health and wellbeing are extensive, but that's a topic for another conversation.


Conclusion


Our brain is an incredibly complex organ that deserves special attention and care. Just like any other part of our body, it requires proper nutrition, exercise, and rest. Some supplements and nootropics can indeed provide a boost or help fill certain nutrient gaps. However, it's essential not to forget the holistic approach to mental health care. Our brains function best when we have a healthy lifestyle: eating right, engaging in physical activity, and ensuring quality sleep.


From my experience, some individuals find the path to emotional balance by starting with relatively simple steps to change their diet and activity, laying a positive foundation for further psychological and spiritual work. For others, lifestyle changes begin with deep, sometimes crisis-driven psychological transformations.


Share your experience in the comments. Also, if you're ready to embark on your journey to mental well-being, book your first consultation with me. Remember, investing in your mental health is an investment in your future.


© Dr. Alexander Lebedev | MD PhD


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