Longevity Update – Supplements

On my trip to Paris, I found myself in an extended conversation about longevity and health strategies with a lovely person I met on my first day! It reminded me how much interest (and confusion) exists around supplements to extend health span. I’ve been digging into the data for several years and offer this concise summary of minerals, compounds, and medications worth considering.

None of these are magic bullets. They work best as part of a comprehensive lifestyle that includes exercise, good nutrition, and adequate sleep, topics I’ll explore in an upcoming post.

Cellular Energy and Mitochondrial Support

Magnesium / Riboflavin (B2)
Foundational for energy metabolism and nerve function. Magnesium (400–600 mg/day) and B2 (400 mg/day) have evidence for reducing migraine frequency and supporting overall cellular efficiency.

Commonly used for migraine prevention and cellular energy support. Magnesium aids nerve and muscle function; riboflavin enhances mitochondrial energy metabolism.

• Dose: Magnesium 400–600 mg/day (citrate, glycinate forms best absorbed); Riboflavin 400 mg/day.
• Evidence: Moderate. Supported by several RCTs for migraine frequency reduction; generally safe.

Magnesium L-Threonate
A brain-penetrant form that may improve memory and synaptic plasticity.

A form of magnesium that crosses the blood-brain barrier more effectively than others. Studied for improving memory and synaptic density, though evidence is limited.

• Dose: 1–2 g/day (delivering ~144 mg elemental Mg).
• Evidence: Emerging. Early human and animal data suggest improved memory via synaptic density; larger trials needed.

NAD / Nicotinamide Riboside / Resveratrol
Support mitochondrial function by replenishing NAD⁺, a key cellular energy cofactor.

These compounds target mitochondrial and sirtuin pathways, aiming to enhance cellular repair, metabolic efficiency, and cognitive function. Human data are preliminary but promising for aging-related decline.

• Dose: Nicotinamide riboside 250–500 mg/day; Resveratrol 150–500 mg/day.
• Evidence: Emerging. Improves NAD+ levels and some markers of mitochondrial function; no clear cognitive or lifespan proof yet in humans.

Ubiquinol (CoQ10)
The reduced form of Coenzyme Q10 improves mitochondrial ATP production and may enhance cardiac output and exercise tolerance, particularly in statin users or those with heart failure.

• Dose: 100–300 mg/day with meals (fat-soluble).
• Evidence: Moderate. Improves cardiac output and fatigue in small heart failure and statin-intolerance trials; mixed primary prevention data.

Cardiovascular and Metabolic Health

Vascepa (icosapent ethyl)
A purified EPA omega-3 derivative shown to reduce triglycerides and lower risk of cardiovascular events in high-risk patients. Some data suggest benefits for brain perfusion and mild cognitive protection.

• Dose: 2 g twice daily with food.
• Evidence: High. REDUCE-IT trial showed 25% relative risk reduction in major CV events; cognitive benefit data limited.

Ezetimibe
Inhibits intestinal cholesterol absorption, lowering LDL by 15–25%. Often combined with statins for additive lipid control.

• Dose: 10 mg once daily.
• Evidence: High. IMPROVE-IT trial validated LDL reduction and additive benefit with statins.

Glucose Control Probiotic
Probiotic strains may improve insulin sensitivity and glycemic variability by modulating gut microbiota and reducing inflammation. Evidence remains modest and strain-specific.

• Dose: Highly strain-specific; common formulations 1–10 × 10⁹ CFU/day (Lactobacillus, Bifidobacterium, Akkermansia).
• Evidence: Limited. Meta-analyses show mild A1C and fasting glucose improvement; results inconsistent.

Sulforaphane
A compound in broccoli sprouts that activates Nrf2 pathways, boosting endogenous antioxidant and anti-inflammatory defenses. Studied for neuroprotection and metabolic resilience.

• Dose: 20–40 mg sulforaphane equivalents daily (typically from 100–200 mg glucoraphanin extract).
• Evidence: Emerging. Human studies show activation of Nrf2 and reduced oxidative stress; long-term outcome data limited.

Brain and Eye Health

L-Theanine
An amino acid from green tea that promotes relaxation without sedation. May improve attention and working memory, especially under stress.

• Dose: 100–200 mg once or twice daily.
• Evidence: Moderate. Multiple small RCTs show reduced stress and improved attention, particularly combined with caffeine.

PreserVision AREDS2
Formulation with antioxidants, zinc, copper, lutein, and zeaxanthin shown to slow progression of intermediate to advanced age-related macular degeneration (AMD).

• Dose: Lutein 10 mg, Zeaxanthin 2 mg, Zinc oxide 80 mg, Copper 2 mg, Vitamin C 500 mg, Vitamin E 400 IU daily.
• Evidence: High. AREDS2 confirmed slowed progression of intermediate/advanced AMD; not preventive for early disease.

Bone Health and Immune Response

Vitamin D3
Regulates calcium balance, immune response, and vascular integrity. Deficiency is linked to bone loss, fatigue, and increased cardiometabolic risk.

• Dose: 1,000–2,000 IU/day typical maintenance; 5,000 IU/day for deficiency correction (target serum 40–60 ng/mL).
• Evidence: High for bone and immune support; Moderate for cardiovascular benefit.

Coming Next: Exercise and Workout Update