Brain supplements and nootropics: what the evidence really says
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- Omega-3 fish oil softgels. Best for: People who eat little fish. See options on Amazon
- B-complex vitamin. Best for: Adults who want B vitamins long term after talking with a doctor. See options on Amazon
- Single-ingredient phosphatidylserine. Best for: Older adults with memory complaints comparing options. See options on Amazon
What the evidence says by ingredient
| Ingredient | NCCIH summary |
|---|---|
| Ginkgo biloba | No conclusive evidence for preventing or slowing dementia |
| Omega-3 fatty acids | Most consistent findings come from fish in the diet; supplements not convincing for Alzheimer's treatment |
| Vitamin E | Did not prevent progression to dementia; may slow functional decline in Alzheimer's (one study) |
| Curcumin | Few, limited, inconsistent trials |
| B vitamins | No short-term help; longer use may slow decline |
| Multivitamins, selenium, calcium and vitamin D | No clear benefit in well-nourished people |
| Coconut oil | Not supported by large rigorous trials |
This summary comes from the National Center for Complementary and Integrative Health's 2022 review of dietary supplements for cognitive function, dementia and Alzheimer's disease.
The most promising leads
Omega-3s from fish. Among nutrition factors studied for preventing cognitive decline, omega-3 fatty acids, often measured as how much fish people eat, have the most consistent positive findings. But several high-quality reviews found no convincing evidence that omega-3 supplements treat mild to moderate Alzheimer's disease.
B vitamins over the long term. Short-term studies found B12, B6 and folic acid supplements did not help thinking in adults 50 and older. However, a meta-analysis of 95 longer-term studies, lasting more than 12 months, suggests B vitamin supplementation may be associated with slower cognitive decline.
Vitamin E. A 2017 Cochrane review found no evidence it prevents mild cognitive impairment from progressing to dementia, but one study suggested it may slow functional decline in Alzheimer's.
Curcumin. Lab studies show effects on inflammation and amyloid, but the few clinical trials in Alzheimer's are limited and inconsistent.
Coconut oil. Researchers are interested in coconut oil for Alzheimer's, but only small trials exist and its use is not supported by large, rigorous studies. Coconut oil appears safe short term at 10 mL two or three times a day for up to 12 weeks.
Red flags from the FDA
The FDA warns that marketers target older adults with products that claim to prevent, treat or delay Alzheimer's disease. These products are often falsely labeled as dietary supplements, have not been evaluated by the FDA for safety and effectiveness, may interact with essential medicines, and can delay proper care.
- Claims to reverse mental decline in a week
- Claims of wiping out Alzheimer's or cutting its risk by half
- Products promising to treat many unrelated diseases
- So-called scientific breakthroughs
The FDA notes that no treatment has been shown to stop or reverse Alzheimer's progression, though approved prescription drugs can slow some symptoms for a time. You can report misleading products on the FDA website.
The FDA says most approved Alzheimer's medicines work best in the early or middle stages, and that people interested in investigational drugs can access them legally through clinical trials.
Safety concerns with brain supplements
- Too much selenium can cause hair and nail loss, skin and nerve problems, nausea, diarrhea, fatigue and irritability.
- Too much calcium can cause kidney stones and other problems, and high intake can cause constipation.
- Excess vitamin D is toxic and raises blood calcium.
- Melatonin did not improve major sleep outcomes in people with Alzheimer's in a 2014 Cochrane review; long-term safety is unclear.
- Medicine interactions. The FDA warns unproven products may interfere with essential medicines.
How to choose a brain supplement
- See a doctor first for new or worsening memory problems.
- Prefer single, clearly labeled ingredients so you know what and how much you are taking.
- Avoid disease claims. Skip any product promising to prevent or reverse dementia.
- Food first. Eating fish has the most consistent link with better cognitive outcomes.
- Check vitamin totals across all supplements to avoid excess selenium, calcium or vitamin D.
What to look for when you buy
Omega-3 fish oil softgels
Best for: People who eat little fish
Omega-3s from fish have the most consistent positive findings for cognitive decline, though supplements have not been shown to treat Alzheimer's.
Watch out: Not a dementia treatment. Ask your doctor if you take medicines.
See options on AmazonB-complex vitamin
Best for: Adults who want B vitamins long term after talking with a doctor
Longer-term studies suggest B vitamin supplementation may be associated with slower cognitive decline.
Watch out: Short-term studies showed no benefit. Avoid megadoses.
See options on AmazonSingle-ingredient phosphatidylserine
Best for: Older adults with memory complaints comparing options
A single labeled ingredient is easier to track than a multi-ingredient blend. See our phosphatidylserine guide for its evidence.
Watch out: Evidence is limited. Not a treatment for dementia.
See options on AmazonQuestions people ask
- Do brain supplements work?
- Mostly no. The NCCIH found no conclusive or clear benefits for ginkgo, multivitamins and most single vitamins in well-nourished people.
- What is the best supplement for memory?
- No supplement is proven. Omega-3s from fish have the most consistent findings, and long-term B vitamins may help slow decline.
- Are nootropics safe?
- It depends on the ingredients. The FDA warns unproven products may interfere with medicines.
- Can supplements prevent Alzheimer's?
- No supplement has been shown to stop or reverse Alzheimer's. The FDA warns against products making such claims.
- Does ginkgo improve memory?
- The NCCIH says there is no conclusive evidence ginkgo prevents or slows dementia or cognitive decline.
Sources
- Dietary Supplements and Cognitive Function, Dementia, and Alzheimer's Disease: What the Science Says (nccih.nih.gov), National Center for Complementary and Integrative Health
- Watch Out for False Promises About So-Called Alzheimer's Cures (fda.gov), U.S. Food and Drug Administration