Chris Kresser and the Grift of Nootropics Supplements

Who Is Chris Kresser

Chris Kresser is a licensed acupuncturist and self-identified proponent and practitioner of functional medicine and ancestral health.  He has his own website with lots of health information, articles, and links to various businesses, many his own. It’s important to know that he doesn’t have any formal training in medicine or research.

ACSH recently published an explainer piece on nootropics briefly touching on the idea that prominent wellness influencers often have their own lines of supplements that may include nootropics. Kresser is a prime example. In a 2024 article about nootropics on his website, Kresser discusses his favorite caffeine-free nootropics to help you “enhance your brainpower, sharpen your focus, and protect your cognitive health as you age.” They include citicoline, lion’s mane mushroom, phosphatidylserine, Bacopa monnieri, ginkgo biloba, uridine monophosphate, and alpinia galanga. Let’s go through these one by one.

Citicoline –“the Brain cell rebuilder”

Kresser claims that citicoline improves “attention, memory, information processing, and mood, especially in middle-aged and older adults.” The basis for this statement is one study of 100 people.

The Alzheimer’s Drug Discovery Foundation published a review of the evidence on citicoline early in 2024 and concluded,

“Short-term treatment with citicoline has shown benefits in individuals with lower cognition at the beginning of the studies, but due to discrepancies across studies, there is insufficient evidence that it is beneficial to healthy people with otherwise good cognition.”

Their conclusion is based on multiple studies across various populations and, includes the study referenced by Kresser. When not cherry picking studies and data, but rather considering the entirety of evidence, Kresser’s conclusion and recommendation falls apart on citicoline.

Lion’s Mane Mushroom –“the nerve growth enhancer”

According to Kresser, this mushroom improves memory, mental clarity, and mood. He bases this recommendation on one study from 2009 of 30 people.  

In another small clinical trial of 34 people, results were mixed. Of three measures of cognitive performance, an increase was seen on only one designed to measure dementia. The question remains as to how relevant this measurement is for healthy individuals.

Basically, the results are very preliminary and mixed at best in healthy people for lion’s mane mushroom - no recommendations should be made based on 64 people. The most we can say is that further study is needed.

Phophatidylserine- “the memory molecule”

Phophatidylserine apparently improves memory, attention, learning, and overall cognitive function, particularly in middle-aged and older adults with cognitive impairment or dementia. This is based on a 1992 study of 149 people and another article Kresser claims is based on golfers but is actually a review of athletes from 2007 (i.e., runners, cyclers, and weight lifters). The review is old, looking at muscle recovery not cognitive function.

The Alzheimer’s Drug Discovery Foundation reviewed the evidence on phophatidylserine and concluded that it’s potentially promising, but difficult to provide solid guidance. This is because

• It’s unclear if supplements increase phosphatidylserine in the brain
• Trials are difficult to directly compare due to different sources of phophatidylserine having different chemical makeups
• Effects haven’t been large enough to be clinically relevant
• Long term use has not been studied

A systematic review and meta-analysis looking phophatidylserine as a possible treatment for ADHD concluded that,

“Preliminary evidence suggests that phosphatidylserine may be effective for reducing symptoms of inattention in children with ADHD, although the quality of the evidence is low and additional research in this area is warranted.”

Take home message: potentially promising but needs more research.

Bacopa Monnieri – “Ayurvedic Brain Tonic”

This purportedly sharpens the intellect, enhances learning, and calms the mind based on a 2014 meta-analysis and a 2008 study of 48 people. The meta-analysis concludes

“B. monnieri has the potential to improve cognition, particularly speed of attention but only a large well designed ‘head-to-head’ trial against an existing medication will provide definitive data on its efficacy on healthy or dementia patients using a standardized preparation.”

A 2021 study concluded that,

“On the whole, currently, there are only limited studies to establish the memory-enhancing and neuroprotective effects of B. monnieri. More studies have to be done in the future by comparing the effect with standard drugs in order to establish there effects clinically in the plant and corroborate the preclinical data.”

Translation: promising but more research is definitely needed.

Kresser also claims that combining B. monnieri along with phophatidylserine may assist neuronal communication, citing this 2014 study as evidence. The problem with that study is it tested a supplement that contained B. monnieri, phophatidylserine, vitamin E, and astaxanthin. Thus, you cannot state that that any effects were due to the combination of those two substances alone. Additionally, it was a study of 104 people with mild cognitive impairment who were assessed based on the Alzheimer’s Disease Assessment Scale-cognitive subscale (i.e., not healthy individuals). We cannot conclude from this study that the combination of these two substances does anything for anyone.   

Ginkgo Biloba – “a memory booster”

According to Kresser it “improves attention, memory, and mental processing speed, with effects most pronounced in older adults with dementia.” He then cites two studies from 2010 and 2008.

If you were to base your judgement on these two studies alone, ginkgo sounds amazing. Unfortunately, taking into consideration the bulk of the evidence provides us with yet again, a contradictory conclusion. The Alzheimer’s Drug Discovery Foundation again conducted a review of the literature and concluded,

“Multiple clinical trials involving thousands of patients have conclusively shown that treatment with ginkgo biloba for up to six years does not prevent cognitive decline or dementia, including Alzheimer’s disease. This is disappointing since preclinical studies indicated that gingko biloba contains several components that improve brain blood flow and mitochondrial function.”

This is a classic example of how a substance may have promising preclinical trials and not pan out. Ginkgo is a bust.

Uridine Monophosphate –“a brain energy booster”

This can ostensibly improve cognitive performance and mood, specifically memory and verbal fluency based on this 2009 study, which was conducted on rodents. Rodents are notoriously, not people. Making recommendations about the effectiveness of a substance in people based on animal studies is not responsible science. And the rodents were given both uridine and omega-3 fatty acids, so any findings cannot be attributed to uridine alone.

Kresser also claims that uridine monophosphate can help alleviate the symptoms of depression based on a study from 2005 and a study from 2010. The first study is in rats. The second study did not measure depressive symptoms. These are extremely weak, old studies to be basing any recommendations on.   

Alpinia Galanga

Kresser claims this is used for mental energy, alertness, and attention. The evidence he provides for this is a study of 69 people and another of 62 people. Kresser does acknowledge that this line of research is still "emerging” but that doesn’t stop him from recommending it. The research on A. galanga is so fledgling, no one should be recommending it for anything other than further study.

Conclusion

Kresser makes wild recommendations (e.g., specific dosages) often based on old, cherry picked studies and data from rodents. Kresser shows his lack of training and understanding of science through his recommendations of nootropics. Buyer beware, this stuff is not backed by science.