Dietary supplements are often marketed as “memory enhancers” or “brain boosters” that improve thinking ability and overall health. The term for this is “nootropic,” which means a substance that enhances memory and general cognition. Nootropics can sound appealing for people who are, or whose loved ones are, suffering from dementia. But do they work? Are they safe?
There are laws that say supplements must be honestly advertised as alternative treatments, not cures. And as treatments, there are reasons to believe supplements might help. Below is some general information about supplements, and a chart of the specific nootropics most often recommended for dementia and Alzheimer’s.
Organic sources of important elements in our bodies are sometimes not enough to maintain healthy levels, so we “supplement,” usually with pills sold over-the-counter. People who can’t get a type of food that’s rich in specific vitamins, or who don’t like the flavor of certain foods like fish, might also take supplements so their overall nutrition stays balanced and healthy.
There is no hard rule about supplements. The spectrum of pills runs from actively deceitful and harmful to worthless to safe and probably beneficial. Tens of thousands of supplements are available in a market that generates billions annually. Information here and elsewhere on the internet is useful, but remember always to consult with a doctor before beginning a supplement regime.
Rigorous studies to determine safety and effectiveness are required by the FDA before they’ll approve a medicine to be prescribed by doctors; supplements fall short of this standard. “Dietary supplements” or “medical foods” can be legally sold without FDA approval, but their health claims are typically backed by one-source testimonials, historical tradition, and a minimum of scientific research. For this reason, their effectiveness and safety can’t be truly known. Customers are trusting the manufacturer to be responsible when they claim to sell something like “Alzheimer’s prevention supplements,” and this has resulted in fraud including false advertising and even tainted pills.
Fortunately, reliable companies produce vitamins, minerals, enzymes, acids, etc., that are an alternative to pharmaceuticals. And just because a treatment hasn’t jumped through enough hoops to earn the stamp of FDA approval doesn’t mean they haven’t been studied. Even when supplements like Ginkgo Biloba don’t test better than a placebo in smaller-scale studies, this is not the same as saying there is no benefit. (The “placebo effect,” in fact, demonstrates that a patient’s belief in whether or not a medicine works can be as important for relieving symptoms as the medicine’s properties, so long as it’s not harmful.) Some of the supplements below have demonstrated effectiveness, in some cases for centuries.
Below we’ve listed supplements that are often available as pills or capsules, and there is evidence that omega 3 fatty acids, vitamin B12 and others can improve symptoms for people with dementia when taken in pill form. That evidence, however, is not as strong as the numerous studies that have clearly demonstrated the link between a healthy diet and improved health, including brain health. Everyone should consider eating nutritious foods daily to reduce the risk of cancer and stroke, to improve heart and bone health, and to boost mood.
lzheimer’s disease and other dementias usually affect people who are older than 60, and the way the body breaks down nutrients as we age is important to consider. The ability to absorb healthy vitamins and nutrients from food weakens as we age. Supplements can get more of these into our bodies, but it’s possible that a change of diet would be just as effective and cost less money.
Listed below are dietary supplements that can be purchased as pills or extracts, but the chart also notes which nutrients can be absorbed through food. Before buying supplements, consider your food choices.
As an example, consider coconut oil. Digested coconut oil turns to ketones that work like an energy source for brain cells. For this reason, it’s believed coconut oil is especially good for people with dementia. Coconut oil is available to take in pill form, but the refining process to make those pills may cost some of the therapeutic value. If you cook vegetables or some other healthy dish in coconut oil, however,
|Dietary Supplements for Alzheimer’s and Dementia|
|Name (Alternate Names)||Benefits and Evidence||Cons||Source / Description||Food or Pill?|
|Caprylic Acid (Ketasyn, Axona)||Improves brain function and memory. Caprylic acid breaks down into ketone bodies, an alternate energy source for brain cells that cannot process glucose (sugar) because of Alzheimer’s disease. Caprylic acid in a drug called Ketasyn was studied and demonstrated possible benefits.||Studies of caprylic acid drugs fell well short of proving effectiveness on a large scale, though there were promising results.
|Processed coconut oil or palm oil||Organic coconut oil taken by people with AD for the same memory and thinking benefits is popular as a natural alternative medicine, but has not been clinically studied.|
|Ginkgo Biloba||May improve sharpness and concentration by enhancing blood flow to the brain. Antioxidant and anti-inflammatory properties protect cell membranes and preserve neurotransmitter functions. Was better than placebo in studies of brain deterioration.
|It can interact badly with medications, causing side effects including brain bleeding.||Extracted from the Ginkgo tree as a medicine used in China for centuries.||Comes from the tree’s dried leaves, typically as a pill or capsule, but dried leaves can be used to make tea.|
|Huperzine A||Used to boost energy and alertness, and improve memory in people with Alzheimer’s. Studies show Huperzine A protects brain cells and improves cognition, with properties similar to FDA-approved Alzheimer’s drugs (cholinesterase inhibitors) Exelon and Aricept, with fewer side effects.
|It should not be taken with another cholinesterase. Side effects may include headaches, dizziness, and blurred vision.||Moss extract used in China for centuries.||Huperzine A was chewed as an herb for centuries, but is available as an extract.|
|Omega 3 Fatty Acids||Most often recommended for heart health and blood flow, Omega 3 may also strengthen brain cells to improve memory. Studies have shown good results for helping dementia symptoms.
|Evidence has shown benefits for early-onset, but experts insist more studies are needed. Side effects can include upset stomach and bad breath.||The “good fat” found in fish, walnuts, dairy, flaxseed, and other whole foods.||Experts recommend eating fatty fish like salmon twice a week for Omega 3, though it’s also available in pill form.|
|Coenzyme Q10||Used to boost energy and thinking. Our CoQ10 levels naturally decrease with age, but the decline in people with Alzheimer’s and dementia is much worse. Supplementing CoQ10 levels has demonstrated benefits for memory and thinking, and it may increase overall energy.
|Successful studies in rat brains have not been repeated with humans. There is more evidence that CoQ10 helps with blood pressure and heart failure than protecting the brain.||An antioxidant occurring naturally in the body.||There is not enough CoQ10 in food to measurably increase levels through diet, so it is typically taken in pill form.|
|Alpha Lipoic Acid||Antioxidant most often used for nerve damage from diabetes, ALA may also protect brain cells from symptoms of Alzheimer’s and dementia.||Preclinical studies have been mixed.||Lipoic acid is a natural antioxidant in plants and animals. ALA is a synthesized lipoic acid.||Foods containing alpha-lipoic acid in low amounts include spinach, broccoli, potatoes, yeast, tomatoes, carrots, beats, and brussel sprouts. However, supplements can deliver significantly more ALA than food sources, and side effects are insignificant.|
|Phosphatidylserine||Helps protect brain cells and enable their communication. Studies suggest it helps short-term memory, mood, and concentration.
|Benefits were only seen in people with less-severe memory and thinking problems. Experts say more study is needed. Sleeplessness and nausea have been observed in people who take large amounts (more than 300 mg).||Phosphatidylserine is a fatty substance that occurs in bodies naturally, but supplements are usually derived from soy.||Cow brains, liver, and kidneys (organ meats) have been found to contain phosphatidylserine, but soy beans and supplements in pill form are the best ways to take it.|
|Vitamin B12, Cobalamin||Vitamin B12 deficiency has been linked to symptoms including memory loss, and studies have indicated low B12 may be tied to increased risk of dementia.||Studies have linked low B12 and Alzheimer’s, but have not reliably established that supplementing B12 helps with symptoms.
|Naturally occurring vitamin bound to food proteins.||B12 is in food from animals (fish, meat, eggs, milk, etc.), and can be taken as an over-the-counter dietary supplement or by prescription.|
|Vitamin B1, Thiamine||May improve memory and concentration by increasing brain glucose metabolism, converting sugar into energy for cells.||More study is needed. Mild side effects of supplementing B1 include nausea and an itchy rash.
|Vitamin found in foods including yeast, cereal grains, beans, nuts, and meats; used by the body to convert carbohydrates into energy.||Meat, black beans, sunflower seeds, whole grains and oatmeal are good sources of B1. It’s also available as an over-the-counter dietary supplement. Intake should increase with age.|
|Zinc||Elderly people often lack adequate levels of zinc, and it is especially depleted in people with Alzheimer’s. Supplementing, therefore, may help symptoms including memory loss and inability to concentrate.||Experts have called for more clinical studies. Can cause upset stomach in some people.
|Trace element vital for growth, immune system maintenance, and communication between neurons.||Lamb, pumpkin seeds, grass-fed beef, chickpeas, dark chocolate, and cashews are good sources of zinc.|
|Apoaequorin (Prevagen)||A protein that binds to calcium and may prevent memory decline. Problems regulating calcium could be a factor in deteriorating memory and thinking ability.||Apoaequorin is not a human protein, so it may not work in humans. Prevagen has not been shown as effective in studies, and is expensive.||Found in jellyfish. Apoaequorin combines with other chemicals in the jellyfish to make them glow in the dark.||Taken as a pill or capsule. Usually 10 mgs once per day.|
|Cannabidiol (CBD)||Reduces the inflammation and oxygen buildup that cause symptoms including memory loss, and stimulates and protects brain cells. CBD may also improve mood and help with sleeplessness. More on CBD.
|CBD is not legal in every state, and lack of regulation makes it difficult to find the right dosage. Consulting with a doctor before use is therefore extremely important.||Compound in cannabis plants (marijuana), extracted for medicinal effects without the “high” typically associated with THC.||CBD comes in several forms and can be smoked, taken as an oil under the tongue or in pill form, or added to food and drinks.|
Insurance companies do not typically cover supplements and vitamins. Even with a demonstrated deficiency of specific essential vitamins, common for elderly people, insurance companies will not cover treatments that haven’t fully traversed the complicated process of obtaining FDA approval.
Medicare Part B (which covers medical services and supplies but not hospital stays) includes prescription plans that do not typically cover vitamins and supplements, though there are exceptions. “Enhanced alternative coverages” is an option that expands what’s covered under Medicare and may provide for alternative medicines.
Medicaid only covers specific over-the-counter drugs, and supplements and vitamins recommended for persons with Alzheimer’s or dementia are not included.
The costs of supplements can vary wildly, and because their quality is often unverified, consumers should be careful. Just because a supplement is more expensive, that doesn’t mean it’s better (and it may mean it’s a scam). Consumerlab.com, for instance, found that a quality-verified source of Coenzyme Q10 can be bought for nine cents per day, but other versions of the same supplement are available for 10 times as much. (Click here for that and other cost comparisons.)