How is your hippocampus today? This funny-sounding yet very important structure deep in your brain is your memory center, and it’s very vulnerable. When it thins (atrophies), it may lead to memory loss, mild cognitive impairment (MCI, a kind of pre-dementia), and possibly even Alzheimer’s.
So being good to your hippo-campus is important. As we get older, the hippocampus shrinks, and it appears that obesity, diabetes, brain injury, sleep apnea, depression, and many other factors contribute to the shrinkage.
Yet exercise and other heart-healthy behaviors as well as mental stimulation could make it grow! Some supplements may be able to protect your hippo-campus from shrinking, but there isn’t a single pill out there right now that works better than making aggressive heart-healthy changes. The combination, however, has the potential to prevent memory loss.
What is Memory Loss?
The memory issues that someone with MCI or dementia experience are usually chronic and very noticeable to others, while the memory loss discussed in this section is the type that is occasional and more subjective. It’s forgetting where you put your keys, the name of your neighbor, or your doctor’s appointment.
Most people experience these lapses as they get older, and some might have them more frequently or to a larger degree than others. Aging is the primary culprit, but medications, a heart-unhealthy lifestyle, alcohol abuse, depression, head trauma, genetics/family history, illness, low thyroid levels, HIV infection, and many as yet unknown factors can contribute to it. Even if you always know where your keys are, you can probably still benefit from reading this section!
What are the Best Supplements For Treating Memory Loss?
1. (tie) Bacopa monnieri (Brahmi or bacopa) 300 milligrams a day
This is an alternative Ayurvedic medicine that in preliminary clinical trials reduced stress and anxiety better than a placebo. Although this plant has been used in India and Pakistan for various ailments (especially related to the lungs and vascular system), the real focus lately has been on its potential for memory enhancement.
Many of the components of bacopa were isolated years ago and include alkaloids, saponins, sterols, bacopa saponins, and bacosides. The bacosides appear to be involved in nerve cell repair, production, and signaling, and they also appear to have some antioxidant benefit in different areas of the brain, including the hippo-campus, frontal cortex, and striatum. The specific compounds garnering attention and research for their effect on the brain are bacosides A and B.
In one 12-week trial, a 300-milligram daily dose (55 percent combined bacosides, meaning a combo of A and B) resulted in a significant improvement in memory, learning, and speed of information processing.
The results were observed in the latter weeks of the study, suggesting it needs to be taken long term to potentially see a change; no benefits have been seen in studies lasting fewer than 12 weeks. In a study published in the Journal of Alternative and Complementary Medicine, Australian researchers reviewed six clinical studies and found that bacopa extract at 300 to 450 milligrams per day (containing 40 to 55 percent bacoside content) appeared to improve memory, but not other areas of cognition. (Always look for a product that has been standardized to a minimum of 25 percent bacoside A or ideally 50 percent bacosides.)
There are two products that have an impressive history of clinical studies and quality control. The first is BacoMind, which is an alcoholic extract of bacopa (20:1 herb-to-extract ratio) and one of the only bacopa products to be tested in older adults and children.
At 225 milligrams twice a day, researchers found significant improvements in short-term and long-term memory in older adults and in kids (225 milligrams once per day) there was a significant improvement in working and logical memory, as well as memory as it relates to personal life. The other is Keen-Mind (also known as CDRI 08), another bacopa extract product that appears to help improve the processing and storing of new information. (It’s standardized to a minimum of 55 percent total bacosides and is extracted with 50 percent ethanol.)
The most common side effect of bacopa, especially at higher doses, is mild gastrointestinal upset, such as abdominal cramps, increased stool frequency, and nausea, so take it with a meal.
1. (tie) Panax ginseng (extract G115) or Korean red ginseng 200 to 400 milligrams a day
The primary active ingredients in ginseng are ginsenosides, and there are seven main ones found in many dietary supplements: Rb1, Rb2, Rc, Rd, Re, Rf, and Rg1. Some of them have shown an ability in the laboratory to reduce levels of a compound called amyloid beta peptide, which is found in the brains of patients with Alzheimer’s.
Ginsenosides can also reduce the production of some inflammatory compounds and improve bloodflow. One trial using 4,500 milligrams of Panax ginseng per day (ginsenoside content of about 8 to 8.5 percent) showed cognitive improvements within 12 weeks that were significantly better than a placebo. A smaller trial with Korean red ginseng found that 9,000 milligrams per day over 12 weeks worked better than 4,500 milligrams to improve cognition in Alzheimer’s patients.
Although these doses would be appropriate for patients with MCI or Alzheimer’s, I would never recommend such high amounts for healthy individuals who just want to improve memory; I just included them to make a point.
At least five randomized trials (from a meta-analysis published in the Cochrane Database of Systematic Reviews) have found improvements in cognitive function with low daily doses of ginseng—200 to 400 milligrams. Many of the trials were done with a product called G115 from Pharmaton (a.k.a. Ginsana), a 4 percent ginsenoside extract. The quality control with this product is very good, which is another reason I like it.
Gastrointestinal side effects are rare, but you should still take it with food to minimize them. Also, in my experience this supplement can increase energy levels and reduce fatigue (this was demonstrated in a large Mayo Clinic clinical trial with cancer patients), so taking it in the late afternoon or evening could disrupt sleep.
2. Huperzine A (Huperzia serrata) 50 to 100 micrograms a day
Derived from club moss (a well-known Chinese herb), huperzine A is used to treat Alzheimer’s disease in China and other countries. More studies are needed, but there have been at least 20 randomized clinical trials with this herb, so it’s worth looking at.
Researchers believe it works in a variety of ways, including increasing acetylcholine levels in the brain, which is also how some of the prescription drugs for Alzheimer’s and MCI work (that’s why it’s been called a natural cholinesterase inhibitor), and improving bloodflow to areas of the brain that impact memory (reduced bloodflow is a leading cause of dementia).
Preliminary results in clinical studies (both in China and the United States) suggest that at dosages of up to 400 micrograms per day it can improve mental health, including memory, and other symptoms of Alzheimer’s.
Huperzine A has also been used in a combination supplement in some preliminary trials looking at former NFL players with brain injury and cognitive impairment. It appeared to increase bloodflow to specific areas of the brain, but whether this leads to an improvement in memory needs more study.
Regardless, memory loss is becoming an epidemic in former football players, and since there are very few treatment options, this is one (along with others in this section) that needs more attention. Now, the clinical evidence compared to bacopa and ginseng is much weaker, but since it has a track record with dementia, it’s possible that small amounts of this product (50 to 100 micrograms per day) over time could improve memory in people who have had some noticeable memory loss, or up to 200 micrograms for those who have been diagnosed with MCI or dementia.
Side effects in clinical trials were low, but nausea, dizziness, gastrointestinal symptoms, headaches, and reduced heart rate have been reported. Drug interactions are not well known, so this may be a supplement to watch instead of try until more research is conducted. This herb should not be combined with FDA-approved cholinesterase inhibitors (donepezil, galantamine, rivastigmine) because the side effects in combination could be serious.
What Supplements Are Useless For Memory Loss?
Ginkgo biloba (also known as EGb 761 in Europe)
I know ginkgo is prescribed in some parts of the world to help preserve memory, but I’m skeptical for a couple of reasons. First, there are serious quality-control issues with it. And second, as the clinical trials have become more rigorous, the results with ginkgo have become less impressive.
The largest US study of this supplement, called the Ginkgo Evaluation of Memory (GEM) trial, looked at whether ginkgo could reduce the risk of Alzheimer’s in elderly patients with either normal cognition or MCI. The researchers found no impact despite using one of the finest ginkgo products available in terms of quality control and research. What they did notice is that the ginkgo group had twice the number of hemorrhagic strokes. Even though this was not statistically significant, it emphasizes a point about this supplement that definitely worries me: It has extreme blood-thinning potential.
Researchers saw similar results (including the increased incidence of strokes and no impact on memory) in the second-largest ginkgo and memory study, known as GuidAge, which was an Alzheimer’s prevention study.
Phosphatidylserine and phosphatidylcholine
These tongue twisters are fatty compounds found naturally in cell membranes, especially in the brain. Lots of “experts” recommend these supplements for improving memory or cognitive function, but based on my experience and the lack of good research, I say save your money. (Choline, which is a primary component of phosphatidylcholine, is essential for brain development, but supplementation beyond diet has not been effective.)
High doses of B vitamins
These actually made depression worse in patients with Alzheimer’s in the large Alzheimer’s Disease Cooperative Study (published in the Journal of the American Medical Association). Researchers tested 5 milligrams of folic acid, 25 milligrams of vitamin B6, and 1 milligram of vitamin
B12 over 18 months and found that the combination reduced a blood marker called homocysteine that had been associated with cognitive decline (when it’s at high levels).
However, this is a case where improving the blood test results doesn’t necessarily translate to improving the actual symptoms (the homocysteine levels dropped, but researchers didn’t see any cognitive improvement).
It was also concerning that almost 28 percent of patients in the B- vitamin group experienced depression, compared to 18 percent who took a placebo. If it has no hint that it helped, and even made things worse, with Alzheimer’s patients, I can’t get excited about it for memory loss.
This extract from the periwinkle plant increases bloodflow to the brain, which could be helpful, but there is no adequate research that the supplement by itself improves memory. It’s begging for more research, though.
What Lifestyle Changes Can Help With Memory Loss?
Heart healthy = memory healthy
Almost anything that has been found to reduce the risk of cardiovascular disease (exercising and maintaining normal cholesterol, blood sugar, and blood pressure levels and a healthy weight) can also help lower the risk of memory loss. A leading cause of dementia is reduced blood-flow to the brain, so lowering your stroke risk is hugely important in preventing vascular dementia.
Find the right protein, fat, and carb balance. New studies are suggesting that a diet high in lean protein and healthy fats may protect against MCI, while a high-carbohydrate diet may promote it. I think what’s really going on is that people who have problems controlling their blood sugar, such as those with prediabetes and diabetes, may have a greater risk of memory loss in general. There is a theory that the brain may experience its own diabetes-like condition, where its ability to absorb sugar (your noggin’s number one fuel source) is compromised, increasing the risk of memory problems.
Be more active
New exercise studies demonstrate that as you lose weight, you also experience dramatic changes in bloodflow to the brain and improvements in cognition. Research has shown that aerobic exercise actually expands the hippocampus and staves off the shrinking seen with age (it typically shrivels by 1 to 2 percent per year).
A 1-year study of non-exercisers versus more active people found that the couch potatoes had a 1.4 percent reduction in hippocampus size. The walking group, who hoofed it for 40 minutes 3 days a week, increased hippocampus size by 2 percent! The walkers with the biggest boost in hippocampus size also had the best rise in test scores. And here’s a case where more is better: More intense or frequent exercise appears to have even more profound effects on hippocampus size (a 10 percent size difference). Of course, exercise also reduces depression, stress, and anxiety, which is also good for memory.
Flex your mental muscles
Cognitively demanding exercises—such as crossword puzzles, Sudoku, playing cards, and reading—appear to reduce the risk of memory loss for some people. Activities that challenge the mind also help strengthen and protect it. In fact, that “use it or lose it” saying was initially coined in this area of research.
Take time to de-stress
Chronic stress can increase the amount of stress steroids produced in the body, which can block brain activity and may increase the risk of memory loss. Whether this turns out to be true is not so much the issue because it is already known that chronic stress is damaging to the human body in general, so you should minimize it as much as possible.
Caffeine is your friend—in moderation. It stimulates a variety of areas in the brain, including memory centers, and protects the hippocampus from damage that can be caused by stress or aging. We usually only hear about the dangers of ingesting massive amounts of caffeine; it just never gets the credit it deserves.
What Else to Know About Treating Memory Loss?
Because there are so many causes of memory loss, it is important to see your doctor or a specialist if you’ve noticed consistent memory problems. Some are easily fixed, and some can result in permanent losses if untreated. Here’s a partial list of potential causes.