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Monday, June 26, 2023

Can Supplements Help You Focus? - The New York Times

Can Supplements Help You Focus?

"Some manufacturers claim certain formulations can sharpen the mind, but experts say the evidence behind that idea is lacking.

A slightly out-of-focus photograph of three white pill bottles against a light gray background. Pills of different colors surround the bases of the bottles.
Derek Brahney

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If a single supplement could boost your mental performance — by increasing alertness and focus, clearing brain fog, sharpening your memory and reducing the urge to procrastinate — you might feel as if you stumbled upon a revolutionary hack for productivity.

“This is something people have been searching for since the dawn of civilization,” said Dr. Joshua Cahan, a cognitive neurologist at Northwestern Medicine.

Yet despite claims by many supplement makers that their brain-boosting capsules, gummies and powders do just that — with one company saying its “smart pill” promotes mental skills including “focus, learning, clarity, alertness, cognitive improvement, logical reasoning, memory recall, overall energy and more” — all of the experts we spoke with said they were not aware of convincing evidence that a supplement could improve the mind in such a way.

“The brain is kind of the final frontier of medical science,” said Dr. Joanna Hellmuth, a neurologist at the University of California, San Francisco. While you could ask a cardiologist for a medication to make your heart function better, she said, far less is known about how to improve the brain.

What’s in these supplements?

Any substance that may positively influence mental skills, whether it’s a prescription drug like Adderall or a dietary supplement like fish oil, is generally referred to as a nootropic.

Many nootropic supplements that purport to heighten focus and productivity contain an array of so-called brain-healthy ingredients. These can include substances from plants, such as Ginkgo biloba or lion’s mane mushroom; nutrients, like B vitamins or choline; amino acids, like L-theanine or taurine; and antioxidants, such as those found in citrus fruits, ginseng, green tea and red wine.

The Facts Behind 5 Supplements

Collagen. Collagen, is one of the most abundant proteins in the body and helps form our skin, bones, muscles, tendons and ligaments. As we age, we naturally start reducing its production. Some studies show that taking collagen supplements can reduce signs of aging, increase bone density and improve joint, back and knee pain. But many of these studies are small and funded by the companies behind such products, increasing the opportunity for bias. Certain products also have flaws that reduce the likelihood of their efficacy: Topical creams, for example, are unlikely to make it into the deeper level of the skin where collagen is produced.

Some supplements also contain caffeine, which in moderation can help with concentration, Dr. Cahan said, though too much can make you jittery and reduce your ability to focus, depending on your tolerance.

Jessica Caldwell, the director of the Women’s Alzheimer’s Movement Prevention Center at the Cleveland Clinic, said that there was some evidence of short-term cognitive benefits for certain ingredients in focus supplements, particularly for caffeine. But, she said, the formulations themselves have largely not been well studied in human clinical trials.

Some older studies on patients with dementia, for instance, found associations between Ginkgo biloba supplementation and better cognitive function, including improved memory. But more recent research did not replicate those results — and, in fact, it found that ginkgo supplements did not seem to help any health condition.

The same could be said for L-theanine, an amino acid found in green tea that is added to some supplements because of its association with better concentration and lower stress. No large, rigorous trials have shown that L-theanine improves cognition, said Dr. Pieter Cohen, an associate professor of medicine at Harvard Medical School.

Some studies have found links between better cognitive performance and high consumption of dietary choline, an essential nutrient that occurs naturally in fish, eggs, poultry and dairy and is added to some cognitive enhancing supplements. But no thorough studies have proven that supplemental choline itself directly leads to cognitive benefits.

“There’s obviously a lot of marketing attached to these things, which makes it sound like they have an air of scientific credibility,” said D. Craig Hopp, a deputy division director at the National Center for Complementary and Integrative Health. “If you dig deeper into that science, it’s sometimes rather shaky — and a lot of it is more testimonial than it is science.”

In addition, some blends that market brain-boosting benefits may even contain unapproved or unlisted stimulant drugs, Dr. Cohen said.

In a study published in 2021, for example, Dr. Cohen and his colleagues tested 10 over-the-counter dietary supplements that were said to contain certain forms of the pharmaceutical drug piracetam. This substance is not approved in the United States but has been prescribed in other countries to treat traumatic brain injury and mood disorders and to improve learning, memory and attention.

Of the eight supplements they tested that advertised cognitive-enhancing benefits, two contained brain-stimulating drugs that were not listed on the product’s labels. These included phenibut and picamilon, which have been used in Russia to treat certain mood disorders and alcohol withdrawal. Phenibut has the potential to be addictive, Dr. Cohen said.

Are they regulated and safe?

The Food and Drug Administration does not test or rigorously regulate supplements for safety and effectiveness.

But if the agency finds that a supplement “is unsafe or otherwise violates the law,” an F.D.A. representative wrote, “the agency takes regulatory action as appropriate, based on public health priorities and available resources.”

Manufacturers are allowed to attach all kinds of claims to supplements that haven’t been proven with human clinical research, Dr. Cohen said, leaving consumers with no guarantees that the products do what they say.

Dan Freed, the co-founder of Thesis, a company that sells supplement blends marketed as focus enhancers, said that while internal testing had found that its products were effective, no independent clinical trials confirmed these results. When asked, Mr. Freed did not supply the internal data for review.

A representative from Bright Brain, which sells a “smart pill” supplement that contains three unapproved brain-stimulating drugs, wrote that its products similarly had not been evaluated in clinical trials. “Consumers are advised to consult their physician before use, as supplements may have risks.” the representative said.

“I understand the desire for exceptionalism, but I think that at this point the science isn’t really there,” Dr. Hellmuth said. “People are just making a lot of money.”

What can actually help you focus?

Rather than reaching for a supplement, experts recommend, turn to the pillars of overall health.

A lack of sleep can seriously sink concentration, so make sure you get enough, Dr. Hellmuth said.

Exercise is also associated with better long-term brain health, she said. Federal health officials recommend 150 minutes of moderate-intensity physical activity and two days of muscle-strengthening activity every week.

There’s also some evidence that following a balanced diet, particularly one that emphasizes colorful fruits and vegetables, fish, whole grains and leafy greens, is linked with better brain health in the long term, though more research is needed.

If you are deficient in vitamin B12, which isn’t common but is more likely if you’re vegan or older, taking a supplemental dose might help improve your focus, Dr. Cahan said. If you are exercising, eating and sleeping properly and still struggling to concentrate, you may want to consult your doctor.

Nootropic supplements for focus remain largely unproven at helping concentration.

“If this was effective and widespread, we’d all be doing it,” Dr. Hellmuth said."

Can Supplements Help You Focus? - The New York Times

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