Ask The Dr.: Brain Boosters

Nine things to know about optimizing brain function with nootropics.
Nootropics are substances that when ingested may enhance mental performance—they include caffeine, a nervous system stimulant. Photo: Omer Salom


By Dr Frank Lipman

Not sure I’ve ever met anyone who’s not interested in having a well-functioning brain, and as time marches on, we tend to desire it even more. There are a number of things you can do to keep your brain moving in a positive direction for as long as possible, like the usuals of high-quality sleep, whole foods, no sugar and plenty of movement, but another you may wish to add to the list is nootropics.

Though the name alone might stop you—it does have a bit of a ’50s sci-fi ring to it—the phrase comes from the ancient Greek and, literally translated, means “mind turning.” These are substances that when ingested may enhance mental performance. Nootropics have been a thing in Silicon Valley for some years now, this idea that healthy, younger people can “optimize” their brains with “smart drugs.”

While I would certainly stay far away from any pharmaceuticals claiming to hack brain function, what I’m more interested in are the nootropics derived from nutrient and herbal sources, which may sharpen cognitive function in those of us who aren’t necessarily trying to be mental masters of the universe. We just want to push back against the cognitive slowing down that often accompanies normal aging—deficits in memory, attention, problem-solving and so on. Admittedly, the research is mostly in the early stages—these supplements aren’t patentable and so Big Pharma isn’t throwing billions of dollars at them to get results—but it is promising. If you’re bothered by the nagging suspicion that you’re just not as sharp as you used to be, it may be worth your while to begin a conversation with an integrative health care practitioner about what nootropics can offer. Here’s a top line to help you get started:


My guess is that a majority of my readers have been “on” a nootropic for most of their adult lives. I’m talking about caffeine, the “active ingredient” in coffee and tea. We all know that caffeine is a nervous system stimulant—regular coffee-drinkers often come to depend on that mental energy jolt. But caffeine’s nootropic effects go beyond that—the drug makes the brain more sensitive to the neurochemical acetylcholine, which plays a vital role in short-term memory and learning. A number of caffeine studies have found increases in alertness and focus.

Keep in mind though that yes, you can overdo it in the caffeine department; the Food and Drug Administration recommends no more than 4 to 5 cups a day, which in my opinion, is way more than enough. I say try to keep it to 2 cups (8 ounce each) or less, and enjoy it as early in the day as possible to avoid sleep disruption.

The coffee plant’s health benefits also look like they extend beyond that cup of Joe. The plant’s fruit (which contains the bean that is ground into coffee) is loaded with antioxidants and phytochemicals. Lately, an extract from the fruit has generated some intriguing small-scale nootropic studies, and become a trendy supplement in the process. In one study, a group of research subjects with mild cognitive impairment had faster reaction times on brain performance tests after a month of consuming the coffee fruit extract.


Some of the safest and best understood nootropics are nutrients that we regularly consume in our food, and that we have the option of taking in more concentrated form as supplements. One great example is the amino acid theanine, found in green tea and mushrooms. In one study, a single dose improved performance on a test that measured short-term memory and reaction time. And because theanine has a generally relaxing effect (in one study, it was found to increase the brain’s production of alpha waves, associated with relaxed alertness), it combines well with caffeine, either naturally in the form of green tea, or by adding a theanine supplement to your cup of coffee.


It’s not surprising that amino acids should be connected with enhanced brain function. They are the building blocks of protein, and proteins are the building blocks of the stuff our bodies are made of, including the brain chemicals that help us do the heavy mental lifting. Two amino acid nootropics are tyrosine and carnitine (also sold in supplement form as acetyl-L-carnitine), which we consume in protein-heavy foods (animal or plant sources) and which our bodies also produce on their own. There’s some evidence, especially for older adults, that supplementing can slow down normal age-related cognitive decline.


You might also be wondering if there are other nutrients to be on the lookout for to help keep your brain in fighting shape, and the answer is yes. Topping the list is choline, also known as vitamin B4, which, despite its name, isn’t really a vitamin per se, but an essential nutrient. In its “essential” role, choline helps support optimal brain health and cognitive function as well as nervous system functioning, heart health, healthy metabolism, cellular messaging and a number of other vital bodily functions.

Because the body doesn’t produce much choline on its own, a diet rich in choline is your best bet, though you can also add to that a high-quality choline supplement as well. As far as food sources of choline go, you can get yours via high-protein foods like eggs (yolks, in particular), fish, and grass-fed meat and dairy products.


Let’s talk creatine. This brain booster may surprise you, as creatine supplements are usually thought of as the preserve of athletes looking to build muscles and Mr. Olympia bodybuilding competitions. But creatine, which the body makes by combining three different amino acids, is all about energy production, wherever that energy is needed, and that includes the brain, which incidentally, consumes about a fifth of the energy the body produces. One review of studies looking at creatine and cognitive function found good evidence that the supplement could enhance short-term memory and reasoning ability, particularly in older or highly stressed people.


The other macronutrient that plays a big role in brain function is fat, and that shouldn’t come as a surprise—up to 70% of the brain is made of fat. The fat gives the brain structure and is the raw material for the membranes that protect the brain cells and help them communicate with each other. The most important fat we can eat for our brains’ sake are the omega-3s, found in greatest concentration in oily fish like salmon, sardines and anchovies. If you’re not getting at least two servings of these fish every week, then I’d strongly recommend omega-3 supplements for brain health and every other kind of health. One important research review made a persuasive case that these fats can slow brain aging. Other studies have come up with more mixed results. Another type of brain fat that’s available in supplement form, phosphatidylserine, is not as well studied as the omega-3s, but has also shown some promise in pushing back against age-related cognitive decline.


Ketones can be an alternative fuel source for your body and brain, benefiting not only performance, but cognition and brain health. Ketones can cross the blood-brain barrier to provide an efficient source of fuel for neurons, enhancing cognitive ability with other beneficial effects.


For my money, the other important category of nootropics is herbals, as in the plants that humans have consumed for hundreds or in some cases thousands of years for the specific effect they have on our brains. Probably the best known is ginkgo biloba, a tree native to China, whose leaves and seeds, packed with powerful antioxidants, have long been used in traditional Chinese medicine. Modern supplements, made from an extract of the leaves, are popular as a memory enhancer, even though the research track record here is mixed at best. Gingko may be more beneficial as an all-purpose anti-inflammatory.

Bacopa monnieri comes from the Indian Ayurvedic medicine chest. The herb’s leaves traditionally have been used to treat a variety of ailments, but it’s most renowned as a brain tonic. While no one is sure exactly how or why it works, improvements in cognitive performance have been measured in a number of studies. But those improvements usually take a while to show up, typically a month or two.

Rhodiola rosea is an adaptogen that has a positive impact on stress levels and brain function. The two primary compounds that contribute to rhodiola’s effects are salidroside and rosavin. The ratios of these in rhodiola extracts will determine how it could affect you as some are stimulating, while others are calming. Nootropics Depot has a good explanation of this and various rhodiola supplements.

The lion’s mane mushroom is another staple of traditional herbalism, popular in East Asia. In the lab, they’ve shown an ability to stimulate nerve growth factor in the brain, which in turn pumps up some crucial neurochemicals. Studies have shown improvements in mental functioning in people with cognitive impairment after they added this mushroom to their daily diets. Although I am a fan, there are some people who experience side effects, so introduce it cautiously.

Over-the-counter “smart drugs” can be tricky. Increasingly, you’ll see synthetic or semisynthetic products sold over the counter that promise a mental lift: piracetam, oxiracetam, vinpocetine and the like. I’m not crazy about them due to possible interactions and downsides we may not even be fully aware of yet, as they are relatively new and haven’t been as widely studied. I’m more interested in the more natural and better-understood nootropic choices. If you’re going to experiment with these supplements, I would caution everyone to start very slowly, under your doc’s supervision, and do it on a one-at-a-time basis, so you can fairly gauge whether any particular ingredient is having a beneficial effect or not.

BOTTOM LINE: I see a growing role for nootropics—we’re all getting older and I’m sure we all want to maintain our mental edge as best we can. But nothing preserves and enhances mental function better than hewing to the lifestyle basics—healthy diet, sleep, exercise, stress management. If you’ve got those covered, there’s a nootropic universe out there waiting for you to add to the mix—and carefully explore.