Joanna Helmuth, M.D., a neurologist at the University of California San Francisco’s Memory and Aging Center, is concerned. She’s worried about vulnerable people like vapenaysh6969, a Reddit user who recently asked for advice on the Nootropics subreddit, a message board where more than a quarter of a million people are trying to sort their way through all of the allegedly brain-boosting chemicals on the market. “Ordered some phenylpiracetam,” vapenaysh6969 wrote. “In desperate need of some motivation after being unemployed for a year now.”
Dr. Helmuth has studied the rise of pseudomedicine in products for brain health, and she believes that the industry—worth a startling $7.2 billion—preys on people desperate for solutions. It reminds her, in fact, of the days when nostrums were sold to cure cancer, before science-backed treatments became available. People who are worried about their memory, stress level, or employability can be particularly susceptible, but anyone can get caught up in the hype, especially as the pandemic’s endless-loop burnout and Covid brain fog drag on. Piracetam and its analog phenylpiracetam, for example, were used in the 1980s to help Russian cosmonauts combat stress and fatigue on missions. They’re not approved by the FDA, and there is no evidence that they’ll help you get a job during a pandemic. (At least not on earth.) But that doesn’t stop people like vapenaysh6969 from betting their hopes, their brains, and their money on unproven treatments just like them.
However, there are still plenty of science-backed options available for the would-be brain hacker. So instead of getting sucked into a fake-meds black hole, discover the best ways to push your brain’s performance.
Hack your focus at work
There’s no shortage of supplements promising to help you think and focus better. First, the bad news on products like these: In 1994, Congress passed an act that allowed supplement makers to basically police themselves when it came to label claims. Companies could say pretty much whatever they wanted, provided they didn’t promise to cure a specific disease. Ever since, there’s been essentially “no vetting process whereby these products are screened by the FDA,” says Harvard University’s Pieter Cohen, M.D., who studies adulterants and mislabeling in the supplement market. What that means is that no matter how loudly supplements claim to “reduce procrastination” or “fuel focus, accuracy, memory, literacy, learning and concentration,” they haven’t been proven to do that in healthy people.
So what should you take to hyperdrive your brain at work? “Caffeine, hands down,” Dr. Cohen says. He recommends getting it from tea and coffee, which humans have been using for centuries. Taking breaks, going for walks, and looking at nature scenes are also well-researched productivity hacks. But the future of focus isn’t entirely bleak—eventually we may have a suite of tested digital therapeutics. The first game-based treatment for kids with ADHD, Akili’s EndeavorRX, was FDA approved in June 2020 and essentially created a new category for nondrug attention-modifying games.
Hack your memory
Memory loss, including the loss caused by dementia, is a particularly demoralizing area of brain science, where proposed solutions have failed again and again, many during the transition from animal research to real-world application. This is why you should beware of “bioplausible” ideas: theories that make sense based on studies conducted on cells or animals but that may not work in complicated human brains.
It can be exhausting to sort through the research and figure out what it all means. That’s why the Alzheimer’s Drug Discovery Foundation created a database of drugs evaluated by neuroscientists called the Cognitive Vitality ratings. It has all kinds of purported memory boosters, such as rapamycin, citicoline, and huperzine A, which can be sorted by their benefits, their safety, and how much evidence there is for their effectiveness. But we can save you a visit, because—surprise—the main steps the foundation recommends for preventing Alzheimer’s remain to sleep well, eat a Mediterranean-style diet, maintain social ties, lower stress, use your brain in new ways, manage chronic illnesses, and exercise.
A sci-fi-sounding option, however, may be coming. Cognito Therapeutics, a company based on research out of MIT, is studying the use of light and sound to treat Alzheimer’s. By using these stimuli to evoke gamma waves in the brain, they’ve seen the type of activated immune response that can reduce plaques common in the disease. Sounds like another case of bioplausible science, but the difference is: Rather than marketing the stimuli directly to consumers, Cognito has launched three randomized, controlled clinical studies in people with Alzheimer’s and has seen positive results.
Hack your performance
The idea of zapping the brain through the scalp to enhance specific abilities makes pretty much everyone excited. According to the search engine PubMed, there have been more than 5,500 scientific papers on transcranial electrical stimulation (TES) since 2011. One common target of TES machines in labs is the motor cortex, located at the top of the skull, where the band on a pair of headphones would go. In studies, stimulating this area has been used to boost motor learning and help motor recovery after brain injuries. So, of course, companies have jumped to suggest that you could strap a stimulator to your head at home and, for instance, improve your running performance. Be wary. There’s some credible research, including U. S. Air Force research, on TES and skill acquisition. But whether home devices actually help you perform—or it’s the practice you do while wearing them that helps—isn’t yet clear. Duke University neuroscientist Murali Doraiswamy, M.D., an MH advisor, also cautions that home TES devices aren’t calibrated well enough, and they certainly aren’t sport-specific. “Every millimeter in the brain is precious territory,” he says. “So if you’re off by even a millimeter, you may be stimulating a wrong circuit with unintended consequences.” Those could run from burned skin on your scalp to seizures.
Instead of paying hundreds of dollars for one of these systems, a better option would be a product that uses your own mental effort to improve performance, such as a meditation app that encourages focus or a training enhancer such as Rewire. An app and button system coming out in May, Rewire is based largely on research by the scientist Samuele Marcora, Ph.D., who has shown that physical fatigue and cognitive fatigue exhaust the same circuit. By training them simultaneously—say, by identifying different sounds with buttons while running—you can strengthen your sports performance, or at least your ability to multitask. Training your brain to help your body may give you an edge in competition.
Hack your brain health
If you can afford to try to maintain your biological hardware by shelling out $15 for a box of IQ protein bars, loaded with supposedly brain-boosting nutrients, or $18 for an organic lion’s mane mushroom, purported to increase nerve growth factor in the brain, they probably won’t hurt you, according to preclinical studies. But consider how often ideas about the benefits of red wine, chocolate, and low-fat diets have shifted over the past few decades. In science, an effect isn’t proven until it’s shown to be statistically significant and it’s replicated in large groups of people. A couple of studies in animals or small groups may be the start of something big, or it could reverse and fizzle.
Instead of gorging on processed foods or powdered extracts, it’s almost certainly better to get your nutrients from whole foods. One way to help your brain may be in your gut: Bacteria living in the intestines may promote the production of neurotransmitters, including, according to some data, about 45 percent of the body’s serotonin. Other research has linked gut microbes to the production of calming GABA. Evidence suggests that the health and diversity of your gut bacteria may play a role in the development of Parkinson’s, Alzheimer’s, anxiety, and depression, among other problems. Personalized gut-microbiome modulators are not yet available, although researchers are working on them. For now, a man’s best bet is to get 30 to 38 grams of fiber a day, which feeds the body’s helpful bacteria, says Drew Ramsey, M.D., an MH advisor and author of Eat to Beat Depression and Anxiety. Fiber-rich options include oatmeal, beans, lentils, avocados, cruciferous vegetables, fermented foods, and fruit.
Above all, remember that our current situation has placed historic and unusual pressure on human brains. You can’t blame anyone for wanting to optimize themselves. Brain scientists just suggest you’d do well to keep that old healer’s oath in mind when considering the latest fads: First, do no harm.
This story originally appeared in the May issue of Men's Health magazine.
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