Dear Dr. Roach: I read your recent response to a question about the efficacy of brain supplements. You note there is a paucity of published data, and that there is “no consistent evidence” that supplements help, except perhaps vitamin E.
Fair enough. However, the lack of data may indicate simply that there is too little information, rather than the conclusion that supplements do not help. I do not believe the medical community has yet tested adequately the impacts of combined strategies to address dementia over time. It appears likely that Alzheimer’s disease and other dementias develop over periods of time, and that multiple therapies, over time, may be needed.
At 69, and over a number of years, I use moderate-strenuous consistent exercise, a plant-based diet, and cognitive activity, with the following supplements: multi-vitamin, fish oil, turmeric, CoQ10 and vitamins C, D and E. My research indicates this has potential to help. My physician agrees none of this will hurt me. My father was diagnosed with Alzheimer’s. Since testing lags and is understandably expensive, why shouldn’t people trust their own research to try to head off this horrible disease?
I agree even though scientists can’t prove supplements helpful, they may still be helpful. I also agree that multiple interventions may have a more beneficial effect than just one, and that testing multiple different types of regimens is difficult, expensive and time-consuming. However, unless a person has an unusual dedication to pure research, it is very difficult to be objective when looking at the confusing mass of conflicting research in these supplements. To take just one, omega-3 fish oil, there are no randomized controlled trials showing a benefit in preventing dementia, and a study combining three trials that studied the impact of omega-3 supplementation on cognitive performance found no effect of treatment after six to 40 months of supplementation.
Ultimately, it comes down to a balance of potential benefits against potential harms. Of all the supplements you named, none is likely to cause much harm — with an exception being vitamin E in smokers having a possible and small increase in risk for lung cancer. There may also be an increased risk for prostate cancer. With some potential for benefit, and small potential for harm, the major downside is likely to be financial.
However, the original column was not about these well-studied and low-cost supplements, but about highly advertised supplements costing $30-$50 per month with no good research to back their claims. It makes me angry that vulnerable people can be misled into thinking these products have been proven useful, when they have not.
Dr. Roach writes: A recent column invited readers to comment on whether they would want to know about minuscule risks for cancer — such as in the appendix that had to be removed anyway. About half of those who wrote me said they would want to know ANY risk, while the other half would not want to know if there was nothing to do about it until the diagnosis was made. Interestingly, all the physicians who wrote in agreed that warning patients of rare possibilities would cause more harm than good. The one attorney who wrote in felt it was “imperative that the physician alert the patient to possible cancer while tests are pending” for medical-legal reasons.
As always, I appreciate the responses.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu