I recently read an excellent research review published in the Journal of Clinical and Translational Research summarizing the evidence for 21 nutrients for cognitive function. In total, 21 categories of nutrients and phytonutrients were studied including:
α-lipoic acid,
Bacopa monnieri,
B vitamins,
cholinergic precursors,
vitamin D,
vitamin E,
Ginkgo biloba,
ginseng,
lion’s mane mushroom,
N-acetyl cysteine,
omega-3 fatty acids,
aloe polysaccharides,
Rhodiola rosea,
rosemary,
saffron,
tart cherries,
turmeric,
wild yam,
Withania somnifera,
xanthines, and
zinc.
The good news is that there are many nutrients with clinically significant effects on cognition in both healthy adults and people with dementia, brain injuries, or cognitive impairment. The challenge is that with so many promising therapeutics, how do you choose the ones that will be most impactful for your unique genetic and cognitive situation?
As my patients know, the key to my successful treatment protocols is starting with an accurate and in depth lab tests that help me understand what nutritional and metabolic pathways are relevant to the individual in question. So before starting a new handful of supplements, consider updating your micronutrient testing (if you are an existing patient, you may call my office to request this and we’ll follow up to discuss the results.)
In the meantime, here are a few highlights on the research paper.
Ginseng
One well-studied botanical medicine that I have under-utilized is Ginseng. Eight well-done human studies have found consistent improvement on tests of memory, focus, and cognition. While a number of species of ginseng were tested, it appears Panax ginseng dosed between 800mg-4g is most effective.
Lion's Mane
Lion’s Mane mushroom (Hericium erinaceus) has been getting a lot of press for good reason. Check it out at the La Jolla Farmer’s market! You can prepare it just like a crab cake! While there were only 2 lion’s mane studies reported in the review, they showed significant improvement in standardized cognitive testing in only 12-16 weeks.
Alpha Lipoic Acid
Antioxidants are the cornerstone of any brain health protocol because of their critical roles in quenching damaging free radicals. One of my favorites is alpha lipoic acid. This antioxidant readily crosses the blood brain barrier and increases acetylcholine. At least 3 clinical studies have shown meaningful stabilizing performance on standardized cognitive testing, and consistent slowing down of progression. Alpha lipoic acid was dosed at 600mg per day in all 3 trials.
B Vitamins
B vitamins are not antioxidants, but they have been shown to have an important impact on brain health. In a study of nearly 200 people with Mild Cognitive Impairment (MCI), a B vitamin combination of 0.8 mg folic acid, 0.5 mg B12, and 20 mg B6 per day was given for 2 years (those are not big doses). After 2 years, Executive function was maintained in the B vitamin group compared to placebo and in those with baseline homocysteine above the median value (11.3 mmol/L), global cognition (MMSE), episodic memory (Hopkins Verbal Learning Test–delayed recall), and semantic memory (Category Fluency) improved in the B vitamin group compared to placebo. Imagine what results might have been seen if they used optimal doses or improved routes of administration such as intravenous B vitamins.
Choline
I was also happy to see that some of my tried and true favorites continue to gather more research support. Choline precursors – citicholine, phosphatidyl serine, phosphatidyl choline, lecithin – continue to demonstrate their role in improving/slowing cognitive decline. These specialized fats are critical to the structure of the brain and neurotransmitters. Choline can be easily tested from whole blood samples which can guide us in determining whether or not adding more of these nutrients can be expected to improve function.
That’s just a snapshot of the 21 nutrients summarized in this research review. I encourage you to check it out, or bring me questions or your personal experiences about cognitive improvement with nutrients!