Summary

(research articles with TLDRs are at the end of this document)

Vitamin D

• Get at least 30 minutes of summer sun (or "equivalent") each day, without sunscreen**, to allow the body to produce proper levels of Vitamin D and other chemicals (nitric oxide/etc) naturally.
• If must supplement, get at least 5,000 IU/day, combine with K2 to prevent calcium accumulation in the blood, and consume with a fat to ensure proper absorption.
• Target: 50-75ng/ml blood level.
• We don't need to worry much about overdosing on D3
  • No LD50 (median lethal dose) has been calculated for humans but researchers use dog values as estimates, which means we would need to take 3,500 50,000IU capsules within 24 hours to have a 50% chance of dying.
  • However most researchers conclude 10,000IU per day is a reasonable tolerable upper limit. I've experienced heart arrhythmia at this level.

L-Arginine (LIMIT/AVOID)

• Vasodilator -- "male supplements" often include 1,000-2,000mg of it.
• Had good effects on brain fog -- vasodilation seemed to help.
• Vasodilation bad for POTS, reduces BP on top of existing BP meds.

L-Glutamine

• Amino acid
• Good for:
  • Reducing muscle soreness (confirmed) and possibly arthritis pain (per Amazon reviews)
  • Reducing sugar cravings (untested) - ake 1 in morning 1 in evening, takes about a week to start working (Amazon review)
  • Reduces indigestion for GERD patients (Amazon review)
  • Reduces joint pain/stiffness? (an Amazon review)
  • Improves mood (supposedly)

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Examine.com's Supplement Stack Guides - short list of supplements by topic

Need to verify each against the stack guide in Dropbox.

If it's not on the list below they don't recommend it.

vegan/vegetarian supplements:

• creatine w/ l-carnitine & beta-alanine
• iodine
• natural vegan protein supplement: hemp, pea, rice

testosterone boost:

• Magnesium
• Vitamin D

sleep quality:

• magnesium
• melatonin
• lavender oil

skin & hair quality:

• polypodium leucotomos (calaguala)
• vitamin A
• coconut oil

40+/Seniors:

• blueberries
• blueberry anthocyanins
• acetyl-L-carnitine (ALCAR)
• creatine
• cdp-choline
• protein supplements: grass-fed whey or vegan protein

Muscle Growth:

• creatine
• nitrates
• protein
• carbohydrates
• beta alanine
• caffeine w l-theanine

Mood/Depression:

• S-adenosylmethionine (SAMe)
• fish oil
• st. johns wort
• adaptogens

Memory and Focus / Attention Span: (VERIFIED)

• blueberry / blueberry anthocyanins
• bacopa monnieri
• L-Theanine and caffeine
• nicotine gum

Liver Health:

• Methylation agent: Choline and trimethylglycine (TMG)
• N-acetylcysteine (NAC)
• Tauroursodeoxycholic acid (TUDCA)
• milk thistle

Libido and Sexual Enhancement:

• Yohimbine

Joint Health:

• Glucosamine
• Curcumin
• Boswellia serrata
• Fish Oil
• Chondroitin
• Vitamin C

Insulin Sensitivity & Glucose Uptake:

• Myo-inositol
• Berberine
• Cinnamon

Fat Loss:

• Caffeine w/ L-theanine
• White Willow Bark
• Coleus Forskohlii
• Yohimbine
• 5-HTP

Cardiovascular/Heart Health:

• Procyanidins: polyphenols in cocoa (dark chocolate), grape seed extract, and the brand name product Pycnogenol, also known as pine bark extract
• Garlic
• Nitrates: 500g (just over a pound) of fresh lettuce, rocket greens, swiss chard, crown daisy, spinach, kale, or beets a day
• CoQ10
• L-Carnitine
• Venotropic supplements: include Aesculus hippocastanum, Ruscus aculeatus,
• Pycnogenol, and Daflon
• Fish Oil
• Vitamin K

Bone Health:

• Calcium: milk, leafy dark greens, cheese
• Magnesium
• Vitamin D
• Vitamin K: K1 & K2 MK-7 (Kale/Natto) w/ iodine

Allergies/Immunity:

• Garlic
• Vitamin C
• Pelargonium sidoides
• Tinospora cordifolia
• Spirulina

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Research

The Big Vitamin D Mistake

TLDR: Vitamin D3 RDA was miscalculated in the 1960s, should be 8,000 IU/day for adults. This brings D3 consumption in line with routine daily sun exposure on the African savannah without sunscreen.

Cognitive Consequences of Vitamin D Deficiency

TLDR: D3 deficiency has significant negative effects on cognitive function to include dementia. D3 affects the central nervous system and general neurological function in addition to cognitive function.

This article defines "deficiency" as D3 at 20ng/ml or less and "sufficiency" at 30ng/ml or greater, but this has been replaced more recently with 50-75mg/nl as a target D3 level.

Is Sunscreen the New Margarine?

TLDR: Vitamin D supplements and other supplements repeatedly fail to reduce cancer/stroke/hypertension/etc. Natural sun is the cure. Fears of skin cancer are overblown by doctors who see it daily so their perception is skewed. We evolved to absorb natural sunlight and our bodies are great at regulating consumption if done properly. This builds up a tolerance to sun exposure and this tolerance is what allows us to regulate sun absorption without cancer risk. Cancer is caused by sudden intense exposure causing sunburn, which happens when we stay indoors all the time then spend hours in the sun once. Routine sun exposure reduces risk of many cancers, improves circadian rhythm, reduces inflammation and autoimmune responses, and improves nearly all mental conditions.

SUMMARY

• Nothing beats sun exposure.
• VitD pills show no benefit to reducing cancer/stroke/hypertension, while 30 minutes summer sunlight (or "equivalent", unspecified in the article but presumably detailed in the study) show dramatic benefits to the same.
• Dermatologists see skin cancer daily so their advice to avoid sun is skewed.
• Humans evolved on plains of Africa getting tons of sun and stayed remarkably healthy.
• New study will be published in 2019: 300,000 people tracked BP in 2,000 places in US -- conclusively shows sun not supplements lower BP.
• People who spend time in sun have higher incidence of melanoma but are eight times less likely to die from it.
  • Melanoma is also the rarest form of skin cancer, 1-3% of skin cancer -- "skin cancer" warnings lump basal-cell and squamous-cell carcinomas in with melanoma but the first two are almost never fatal.

  • In fact, says Weller, “When I diagnose a basal-cell skin cancer in a patient, the first thing I say is congratulations, because you’re walking out of my office with a longer life expectancy than when you walked in.” That’s probably because people who get carcinomas, which are strongly linked to sun exposure, tend to be healthy types that are outside getting plenty of exercise and sunlight.*

  • “Avoidance of sun exposure is a risk factor of a similar magnitude as smoking, in terms of life expectancy.”

  • Sunscreen has a similar effect on life expectancy as cigarettes!

• Sunlight triggers the release of a number of other important compounds in the body, not only nitric oxide but also serotonin and endorphins. It reduces the risk of prostate, breast, colorectal, and pancreatic cancers. It improves circadian rhythms. It reduces inflammation and dampens autoimmune responses. It improves virtually every mental condition you can think of. And it’s free.

• However, like margarine, early sunscreen formulations were disastrous, shielding users from the UVB rays that cause sunburn but not the UVA rays that cause skin cancer. Even today, SPF ratings refer only to UVB rays, so many [sunscreen] users may be absorbing far more UVA radiation than they realize.

  • This likely means that since people who don't normally spend time in the sun use sunscreen they feel they can spend more time in the sun at once since they don't sunburn as fast. But sudden long exposure like that is what causes cancer, so they are accumulating more cancer-causing UVA damage without having build up their skin's tolerance.
• Countries around the world are getting the message and changing their guidelines.

  • Australia’s official advice? When the UV index is below 3 (which is true for most of the continental U.S. in the winter), “Sun protection is not recommended unless near snow or other reflective surfaces. To support vitamin D production, spend some time outdoors in the middle of the day with some skin uncovered.” Even in high summer, Australia recommends a few minutes of sun a day.

  • New Zealand signed on to similar recommendations, and the British Association of Dermatologists went even further in a statement, directly contradicting the position of its American counterpart: “Enjoying the sun safely, while taking care not to burn, can help to provide the benefits of vitamin D without unduly raising the risk of skin cancer.”

The Paradox of Osteoporosis Irreversibility

TLDR: High calcium intake reduced or stopped bone loss in elderly osteoporotic patients but did not regenerate bone. However, high protein intake >= 1.2g/kg of body weight led to dramatic bone regrowth. Bone is 50% protein by volume. High protein intake also increases the body's ability to retain the extra bone calcium.

What we, and probably most clinical nutritionists, had failed to recognize, was that the adult RDA for protein is just barely enough to prevent muscle loss, and is not enough to support tissue building or rebuilding. But, as already noted, when calcium deficiency leads to bone loss, the bone protein is lost as well, and that has to be rebuilt to restore the lost bone.

This mutual dependence of calcium and protein provides a good illustration of two key (and often underappreciated) aspects of nutrition. The first is that nutrients almost always act together with other nutrients. The second feature is what Bruce Ames of the University of California, Berkeley, has called a “triage” system within nutrition. The body operates a triage mechanism, ensuring that the most vital functions receive the nutrients first and leaving the other tissues and systems of the body to get by on what is left over. It seems that this triage mechanism is at work with respect to adult bone rebuilding. With limited protein intake, the body ensures that its most vital functions are served first. Bone, in effect, gets the leftovers. We need a high protein intake precisely to ensure that there will be something left for bone.

Vitamin D Response Curve

TLDR: Vitamin D absorption varies from person to person. The only reliable method to manage Vitamin D levels is to measure serum levels and adjust dosage for that individual to bring the serum levels into the desired range.

Two people could both take 4,000 IU/day, they both measure their vitamin D levels and one could be below the recommended value at 10 ng/ml (25 nmol/L), while another could be way above – at 120 ng/ml (300 nmol/L) – a 10-fold variation in response to the same supplementation dose of 4,000 IU/day. When measuring vitamin D blood serum levels, supplementation response varies greatly person-to-person.

An Introduction to Nootropics

I found this video several years ago and it is a fantastic overview of the topic with recommendations.

Covers:

• How neurons work
• The role of neurotransmitters
• How nootropics like modafinil and piracetam work
• The potential negatives of using those types of supplements
• Alternatives
• His stack: creatine, lutein, vitamin D, omega 3, coconut oil, garlic extract
  • Creatine allows cells to recycle adenosine triphosphate for fuel -- increases attention & protects against neurodegeneration
  • Omega 3 fish oil increases cell membrane permeability -- brain is mostly fat so this feeds it & helps neurotransmitters pass through more easily = faster thinking
  • Coconut oil (MCT oil) -- increases ketone production which brain prefers to glucose and increases Omega 3
  • Luteine -- increases amount of AMPK in the brain which increases performance of mitochondria when taken in conjunction with full-fat milk -- mice were able to run much farther and lost fat
  • Garlic extract -- ??
  • CoQ10 -- ??

Main points:

• Brain supplements like piracetam work but researchers don't know why yet.
• Hormones and neurotransmitters don't work in a vaccum -- they are interrelated.
  • Increasing just one will likely not have much effect -- this is why stacks are used.
  • Ex: Increasing dopamine also increases norepinephrine -- dopamine = "this is important" so brain releases norepinephrine as well because "I need to focus on it"
  • Cortisol is often increased when dopamine/norepinephrine are released, which raises stress levels.
    • Cortisol is also often increased when taking caffeine or other similar nootropics which is why we get anxious/worried feeling when taking it.
• There is no one "best" way for the brain to work -- we need to be able to switch between modes.
  • Improving focus actually dampens creativity.
  • Creativity requires "diffuse mode" thinking -- this is in line with Learning How to Learn etc.
  • So increasing just one neurotransmitter is a fool's errand -- we need a combination that will have synergistic effects.
• The goal is to be able to have the brain switch from one task/focus to another and release the correct combination of neurotransmitters to ensure optimize that task.
  • This requires general broad-base supplementation rather than targeting the increase of individual neurotransmitters, i.e. focus on increasing the brain's ability to communicate internally and function efficiently rather than just trying to boost one or two neurotransmitters.
• Nootropics should not produce a "buzz" effect -- that is a sign of overdosing on individual neurotransmitters -- instead supplementation should focus on increasing overall brain and body health to give the brain enough energy to function optimally.

Do gut bacteria rule our minds?

TLDR: Research shows the gut biome is critically important to overall body and mind health.

Caffeine Naps

TLDR: Take 200mg or so of caffeine immediately before taking a nap. Set an alarm for 15-20 minutes. It takes 20 minutes for caffeine to kick in so the nap allows the brain to relax and take a break, then we wake up feeling energized.