‘Brain-boosting’ Supplements To Avoid At All Costs

Discussion in 'Neurology' started by D. Sayed Morsy, Sep 29, 2020.

  1. D. Sayed Morsy

    D. Sayed Morsy Famous Member

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    Want to improve your memory and increase cognitive function? You could do what the evidence suggests and exercise, eat better, read, cultivate meaningful relationships, and find a fulfilling hobby. But why waste your time with the evidence when you can just take a “Shot of Genius,” or any of the hundreds of other products in the growing field of nootropics that promise to make you smarter—without all the effort?

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    Despite the fact that nootropic supplements pledge to help you “reach your neurological peak” by pumping you full of “true focus boosters,” the claims surrounding nootropics are unsubstantiated and often misleading.

    Here’s why: Because despite the fact that nootropic supplements like Genius Brands’ Shot of Genius pledge to help you “reach your neurological peak” by pumping you full of “true focus boosters,” the claims surrounding nootropics are unsubstantiated and often misleading.

    That hasn’t stopped millions from buying into the craze. The global nootropics market was valued at $2.17 billion in 2018, with an expected compound annual growth rate of 12.5% through 2025, according to Grand View Research. There’s one nootropic in particular that’s been receiving increased attention of late. It’s called Prevagen, an over-the-counter dietary supplement whose presence on store shelves is only rivaled by its ubiquity in television and online ads.

    Where Prevagen goes, the bold claims are sure to follow. According to its packaging and website, the supplement safely improves memory—specifically, the mild memory loss associated with aging. But each claim is followed by a tell-tale asterisk that leads you to the following fine print: “These statements have not been evaluated by the Food and Drug Administration (FDA). The product is not intended to diagnose, treat, cure, or prevent any disease.”

    There’s no shortage of hype around nootropics, but do they stand up to scientific scrutiny? And do the benefits outweigh the risks?

    Nootropics: The basics

    Also known as “smart drugs” and “cognitive enhancers,” nootropics are any substances designed or purported to enhance cognition, including memory, attention, creativity, or overall intelligence. Some are pharmaceutical drugs designed to treat conditions like excessive sleepiness and narcolepsy—these are only available by prescription and have endured rigorous FDA testing. But most of the nootropics you see in commercials or online—all or most of the smart drugs and cognitive boosters available over-the-counter—are designed for use in healthy individuals who want to improve cognitive performance.

    Nootropic supplements include certain B vitamins, fish oil, and herbal supplements like Ginkgo biloba. Studies suggest that all of these supplements can play a part in maintaining adequate nutrition and brain health, but none appear to have the superhuman brain-boosting power marketers often claim they do.

    For example, one review of four randomized controlled trials found that vitamin B supplementation in elderly patients was effective in reducing serum homocysteine levels (too much can increase risk for cardiovascular disease), but it did not translate to cognitive improvement.

    Another systematic review of studies with a total of 340 participants found that a regimen of high-dose vitamin B supplementation didn’t slow cognitive decline in people with mild-to-moderate Alzheimer’s disease. Fish oil supplementation has earned similarly underwhelming results, and while studies suggest Ginkgo biloba may help slow cognitive decline, there’s a lack of evidence to support the idea that it improves brain function in healthy people.

    How about Prevagen?

    Prevagen is another member of the nootropic supplement family. To support its bold marketing claims, Prevagen’s manufacturer, Quincy Biosciences, leans on a self-sponsored study, which found that “Prevagen demonstrated the ability to improve aspects of cognitive function in older participants with either normal cognitive aging or very mild impairment.” When the study was eventually published in Advances in Mind-Body Medicine, results suggested that participants who took Prevagen saw statistically significant improvements in verbal learning and recall compared to those who took placebo during the 90-day study.

    However, Pharmacy Today took exception to the results, publishing a report that stated, “human data on apoaequorin [the active ingredient in Prevagen] are limited-to-small,” and that “company-sponsored trials do not meet expected scientific standards.” The report’s author, Anne L. Hume, PharmD, pointed to serious methodological issues in the study, including open-label design, few participants, and non-standardized assessment questions.

    This wasn’t the first time Prevagen’s manufacturers rubbed the scientific community the wrong way. In 2012, the FDA issued a warning letter to Quincy Biosciences, charging the company with false advertising on several fronts.

    Robert H. Shmerling, MD, senior faculty editor of Harvard Health Publishing, also took exception to the bold claims Prevagen was making—particularly their hyping of apoaequorin, which Quincy Biosciences says was originally found in jellyfish.

    He wrote, “Like many heavily-advertised supplements, this one makes many claims. The bottle promises it ‘improves memory’ and ‘supports healthy brain function, sharper mind, clearer thinking.’ Never mind that the main ingredient in jellyfish (apoaequorin) has no known role in human memory, or that many experts believe supplements like this would most likely be digested in the stomach and never wind up anywhere near the brain.”

    The takeaway

    As the US population ages, we’re forced to confront a massively increasing burden of cognitive decline, Alzheimer’s disease, and other dementias. But there are two key challenges preventing us from adequately addressing this burden.

    First, the landscape of approved treatments is limited and new therapies are likely a long way from approval. Second, many Americans are choosing to look at cognitive decline through the distorted lenses of cognitive bias and cognitive dissonance—trusting dubious sources that confirm their anecdotal beliefs rather than understanding that science is still working toward an effective therapy for these conditions

    In the absence of a simple answer to the complex problem of cognitive decline, unproven nootropics like Prevagen continue to see widespread commercial success. Healthcare professionals have a responsibility to understand the motivations driving that success and make a consistent effort to provide an honest scientific interpretation of the evidence.

    For Prevagen, the evidence is clear—and it doesn’t match the hype.

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