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Fortifying Your Memory With Supplements

As we age, we all want to avoid memory loss. Can supplements like ginkgo and ginseng help?

From the WebMD Archives

Memory loss worries many of us as we get older. You might wonder whether you'll become one of the 10 million baby boomers who develops Alzheimer's disease. Or, maybe you're simply seeking ways to fortify your memory with memory supplements, memory vitamins, or memory games.

Will these brain boosters really help our memory? WebMD talked with the experts to find out whether -- and which -- memory enhancers really work.

(Note: if you suspect you or someone you love may have Alzheimer's, it's important to seek medical advice.)

The Need for Memory Enhancers

Finding new ways to slow memory loss could produce astounding results. For example, if the onset of Alzheimer's could be delayed in today's population by an average of just one year, there would be about 210,000 fewer people with Alzheimer's 10 years from now. And that would produce a cost savings of $10 billion.

"The problem with prescription drugs is that they're extremely expensive and often have limited effectiveness during a short window of time," says Evangeline Lausier, MD, assistant clinical professor in medicine, Duke Integrative Medicine, Duke University Medical Center in Durham, N.C.

Memory Supplements With Potential

Although there are a variety of "brain boosters" on the market -- many chockfull of multiple substances -- most are lacking research to support their memory-enhancing claims.

Ginkgo biloba is one that shows more promise than many others and is commonly used in Europe for a type of dementia resulting from reduced blood flow, Lausier says. "Ginkgo biloba tends to improve blood flow in small vessels."

"A couple of meta-analyses and systematic reviews show that ginkgo biloba is helpful for dementia in about the same range as drugs being pushed very heavily to treat Alzheimer's," says Adriane Fugh-Berman, MD, an associate professor in the complementary and alternative medicine Master's program of the department of physiology and biophysics at Georgetown University School of Medicine.

Unfortunately, that's not all that successful, she adds. Ginkgo doesn’t seem to help prevent dementia. But in people who already have dementia, it may either improve symptoms or stabilize symptoms so that they don’t get worse. In addition, some but not all studies show benefits in mood, alertness, and mental ability in healthy people who take ginkgo. More research needs to be done to be certain about these effects.

Here are a few other memory supplements that may also have some potential, but require much more study:

  • Omega-3 fatty acid. Omega-3 fish oil supplements have piqued great interest. Studies suggest that a higher intake of omega-3 fatty acid from foods such as cold-water fish, plant and nut oils, and English walnuts are strongly linked to a lower risk of Alzheimer's. However, thorough studies comparing omega-3s to placebo are needed to prove this memory benefit from supplements.
  • Huperzine A. Also known as Chinese club moss, this natural medicine works in a similar way as Alzheimer's drugs. But more evidence is needed to confirm its safety and effectiveness.
  • Acetyl-L-carnitine. Some studies suggest that this amino acid might help Alzheimer's patients with memory problems. It may provide a greater benefit to people with early onset and a fast rate of the disease.
  • Vitamin E. Although vitamin E apparently doesn't decrease the risk of developing Alzheimer's, it may slow its progression. Recent studies have raised concerns about an increased risk of deaths in unhealthy people who take high doses of vitamin E, so be sure to consult with your doctor before taking this supplement.
  • Asian (or Panax) ginseng. An herb that's sometimes used with ginkgo biloba, Asian ginseng may help with fatigue and quality of life, Fugh-Berman tells WebMD. But any benefit for memory, she says, has shown up mostly in a small group or subset of study participants.

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Ginkgo Biloba for Memory Loss? With Caution

One of the top-selling herbs in the United States, ginkgo biloba has been used for thousands of years in traditional Chinese medicine.

A National Institute on Aging (NIH) ginkgo trial of more than 200 healthy adults older than 60 showed no improvement in memory or concentration. It is possible that doses higher than the 120 milligrams used daily in this six-week trial could be effective. Look for results of current large, long-term trials, such as the National Center for Complementary and Alternative Medicine's study with 3,000 volunteers. These will help to confirm whether or not ginkgo biloba can help prevent dementia or enhance memory in healthy people.

Some research suggests that ginkgo biloba is effective for early-stage Alzheimer's disease. Ginkgo biloba may be as effective as acetylcholinesterase inhibitor drugs such as donepezil (Aricept). Studies have also indicated that ginkgo biloba may be helpful for cerebral insufficiency, a decreased flow of blood to the brain from clogged blood vessels.

However, a 2009 study in The Journal of the American Medical Association showed that compared with placebo, 120 mg twice daily of ginkgo biloba did not result in less cognitive decline in older adults with normal or only mild thinking impairment.

Ginkgo biloba is available in tablets, capsules, teas, and fortified foods. Do not use ginkgo biloba seeds, which can be very toxic. Tea bags often contain 30 milligrams of ginkgo biloba extract, while a typical dose used in ginkgo biloba studies is 80 to 240 milligrams of a standardized extract daily by mouth in two to three divided doses.

Although ginkgo biloba is generally safe, you should be aware of its blood-thinning properties. Stop using ginkgo biloba or use caution before surgery or dental procedures. Your risk for bleeding is also greater if you are taking blood thinners such as aspirin or warfarin. Also, it is possible that ginkgo biloba affects insulin or blood sugar. So be cautious if you have diabetes or hypoglycemia, or if you take substances that affect blood sugar.

Minor side effects of ginkgo biloba may include headache, nausea, or intestinal problems.

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Memory Enhancers That May Be Unsafe

Before adding any memory supplements to your diet, have a pharmacist check for potential interactions with any drugs or supplements you're taking, advises Lausier.

"And, remember that 'natural' isn't always safe," she says. "When you think about nature, you often think of beautiful and harmless. But think about a lion and a wildebeest -- that's nature, too."

  • Bacopa. Used for millennia in India, bacopa is an Ayurvedic herb that shows some promise for memory problems, says Lausier. But it is an example of a memory supplement that carries a higher risk of drug interactions. For this reason, she doesn't recommend using it until further study is conducted.
  • DHEA. A hormone that declines with age, DHEA has garnered lots of interest. Taken long-term or in high doses, however, it may increase the risk for certain types of cancer, as well as other serious side effects.

As you evaluate other potential memory supplements, keep in mind that the FDA does not strictly regulate herbs and supplements. It treats them like foods rather than medications. Unlike drug manufacturers, the makers of supplements don’t have to show their products are safe or effective before selling them on the market.

This makes it harder for you to assess their strength, purity, and safety. Fugh-Berman advises doing your own research on effectiveness and adverse effects, using reliable, unbiased sources.

Changing Your Lifestyle, Enhancing Your Memory

While there is no specific diet to prevent Alzheimer's, studies have shown that a healthy diet may help lower the risk. Research has shown that the Mediterranean diet may lower the risk of developing Alzheimer's, and may even help prolong life in people with Alzheimer's. The Mediterranean diet has very little red meat. The diet focuses on fruits, vegetables, and nuts, with moderate amounts of dairy, fish, and poultry. Olive oil is an important source of healthy fats. Moderate amounts of alcohol, particularly wine, may also lower the risk of Alzheimer's. However, doctors don't recommend that people start drinking alcohol to prevent disease.

Researchers speculate that there may be a small protective quality of caffeine from the risk of dementia. But more research needs to be done in this area. In the meantime, Lausier recommends the "common sense" steps for enhancing your memory, such as not smoking and avoiding too much caffeine or alcohol. "Some of these changes may make more difference in the outcome than a lot of expensive drugs or supplements."

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Challenging your brain to learn new things is another important way to prevent memory loss, she says. It might involve learning a foreign language, an instrument, or a computer program, for example. "It doesn't matter if you're successful," she says. "Just the act of trying turns on parts of your brain that are getting cobwebs."

Exercise apparently also can help enhance memory in a variety of ways. For example, it generates blood flow and formation of nerve cells in a portion of the brain called the dentate gyrus. And, it reduces other risk factors, such as cardiovascular disease, indirectly enhancing brain health.

One recent study underscored that it's never too late to reap the memory benefits of exercise. A trial of 152 adults with mild cognitive impairment, aged 70 to 80, compared the cognitive benefits of B vitamins with aerobic exercise. After one year, the walkers fared better with memory tests.

WebMD Feature Reviewed by David Kiefer, MD on December 16, 2010

Sources

SOURCES:

Natural Medicines Comprehensive Database web site: "Natural Medicines in the Clinical Management of Alzheimer's Disease."

The Cochrane Collaboration, Cochrane Reviews web site: "Omega 3 fatty acid for the prevention of dementia," "Ginkgo biloba for cognitive impairment and dementia."

MedlinePlus web site, "Ginkgo (Ginkgo biloba L.)."

National Center for Complementary and Alternative Medicine web site: "Herbs at a Glance: Ginkgo."

Adriane Fugh-Berman MD, associate professor, complementary and alternative medicine, department of physiology and biophysics, Georgetown University.

Evangeline Lausier, MD, assistant clinical professor in medicine, Duke Integrative Medicine, Duke University Medical Center, Durham, N.C.

Weinmann, S. et al. BMC Geriatrics, 2010; vol 10: pp 14.

Gorby, H. Nutrition Reviews, December 2010; vol 68: pp 697-718.

Santos, C. et al. Journal of Alzheimer's Disease, 2010; vol 20, Suppl 1: pp S187-S204.

Biessels, G. Journal of Alzheimer's Disease, 2010; vol 20, Suppl 1: pp S143-S145.

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