Guest writer @PdxSag shares his supplement regimen

[From our guest correspondent, @pdxsag. See his previous thoughts on his stack and physical fitness.] 

Since Covid hit the headlines the running gag among myself and a couple online friends has been that everything on my vitamin and supplement shelf is eventually shown to treat Covid.

The first OTC Covid recommendation was vitamin D and zinc as immune boosters, and NAC to keep the lungs clear. I thought to myself, “Wow, didn't know that about zinc or NAC. Cool!”

I was taking them based on what I'd read in P.D. Mangan's “Best Supplements for Men.” It was a pleasant surprise that they would be associated with improved immune function. As time went on, more and more of my “stack” got mentions as Covid prophylaxes: selenium, berberine, citrulline, iodine.

While it's a little bit funny, it shouldn't be too surprising. Everything's correlated. It stands to reason that the supplements that lead to strong, vigorous health are going to benefit the immune system. In fact, there is a school of thought that believes the causality mostly goes the other way: sub-clinical pathogens lead to a loss of health and vigor, which leads to the things we associate with aging. Keep the immune system strong, and good health will follow.

So, what is on my vitamin and supplement shelf? I divide it into three tiers.

Tier 1 are the supplements I categorically recommend to everyone. You really should get your diet and exercise fixed as well, but tier 1 supplements compensate for a lot of the short-comings in the modern diet. From the Pareto stand-point Tier 1 fixes 80% of your health for 20% of the cost and effort. These are my “Big 5 plus 1,” (now plus 2).

• Omega-3: 600mg 1 or 2 times a week. I should probably double this. My wife and kids take 600mg almost daily during the school year.
• Vitamin D: 8000 IU once a week summer, twice a week winter. I also do a Vitamin D Hammer the week before Thanksgiving. (Note: I strongly recommend you take it along side a magnesium supplement.)
• Vitamin K2: 0.5 g once a week summer, twice a week winter.
• Magnesium: I used to take 600 mg 2-3 times a week. I've kind of lost interest and take 600 mg once a week more recently. (I sort of listen to my body in that when I feel like I've lost interest in a supplement I don't force myself to stick to a schedule with it.) Do not take magnesium oxide, it is biologically inert.
• NAC: 600mg 1 or 2 times a week (FDA has cracked down on this for reasons inscrutable. Sourcing is a little tough at present. I absolutely believe in it and may end up trying to source it in bulk powder form if necessary. It doesn't have a good shelf-life though. Hopefully this eases up now that other covid treatments are becoming popular.)
• Zinc: 50mg 2-3 times a week, again not the oxide.
• Selenium: 200mcg 2-3 times a week

Tier 2 are supplements that I don't often mention because most normal people are barely going to be able to muster tier 1. As such, there's little point in me discussing the virtues of tier 2. Additionally, most people I meet that talk a lot about vitamins and supplements are weird. It seems like they are often suffering from some sort of health problem that can't easily be distinguished from a psychosomatic disorder. I don't want to put myself in that category among my friends and acquaintances so I keep these to myself. They are important and effective, so they are definitely a part of my usual routine, even if I seldom talk about them.

• Iodine: 300mcg daily (I mix it into the milk when I'm making yogurt which I eat for lunch almost every day)
• Citrulline: 1 tsp daily, for vascular health
• Collagen: 10g 1-2 times a week, for everything in the epithelium, which is a lot of things.
• Whey protein isolate: 24g protein (5.5g BCAA's) only on work-out days; 1-2 times a week, if at all. This is popular with gym bros, which gave it a bad name in my book for a long time. However, as I have aged I have come to appreciate the body's endogenous anabolic effect get attenuated, so taking supplements that compensate for that becomes important.

Tier 2.5 are supplements I take because I've seen a lot of people talk about them positively, but I've never been quite sure they do anything noticeable. I usually take them for a while, then stop, then restart. Except for CoQ10, they are cheap enough I don't care too much that I might be wasting my money on them. If I'm wasting my money, I'm not wasting a lot of it, anyway.

• CoQ10: 200mg 2-3 times a week, for mitochondrial health and possibly brain function
• DHEA: 50mg 2-3 times a week, for sex hormones
• Berberine: 500mg daily before lunch, for glucose and insulin control – insulin is pro-aging so anything you can do to attenuate insulin is good for longevity. This is probably a low-budget, lower-efficacy cousin to rapamycin. If one is old enough to pursue a rapamycin prescription that is probably the better choice. Rapamycin is not OTC, so berberine gets the nod here.

One thing to keep in mind is that as we age our bodies become less efficient absorbing and synthesizing nutrients. Tier 2.5 might be completely unnecessary for one in their 20's and 30's, of middling importance in one's 40's, and crucial in one's 50's and beyond. I also subscribe to the idea that an ounce of prevention beats a pound of cure, so if I can take occasional small amounts of these supplements in my late 40's and early 50's hopefully I will be way ahead of the curve in my 60's and 70's.

Tier 3 are supplements that I don't presently take, but am considering adding them in some fashion because I see autists on the Internet whom I respect advocating them.

• Choline: for liver health and clearing lipofuscin from neurons. These are both really important for longevity. This may end up being a tier 2 for me. Likely to gain importance supplementing as one advances into and beyond mid-life.
• Niacin: the “flushing reaction” is my wild guess at an immune system response, which I believe a strong immune system is crucial. Probably going to be a tier 2.5.
• Curcumin: chelates iron. Iron is the rate-limiting nutrient for many pathogens. Across the board, low iron levels correlate with greater health and longevity. Tier 2.5.
• Lactoferrin: chelates iron, perhaps better than curcumin. It's expensive so I will need to study more. May chose to cycle this a couple times a year. It's most abundant in breastmilk, which from a first-principles stand point, speaks highly for this supplement.
• Quercetin: another iron chelator. I had ignored this one previously because it seemed like yet another plant-based hormetic agent along side berberine and resveratrol. It has come up as a Covid prophylaxis, probably owing to its iron chelating ability. Whether it's better than curcumin or lactoferrin I have no idea. I'm not sure anyone else does either. They all seem to do the same thing. Maybe one chooses to cycle among all three, say, taking one for 8-12 weeks then switching to one of the others. Maybe one chooses whichever of the three is most cost efficient. Actually, if you really want cost efficiency, donate blood. That's free!
• Stinging Nettle Root Extract: prostate health is pretty important to men over 50. I'm not there yet, but 50's are on the radar. While on the subject, let me say I have no intention of letting a urologist any where near my body unless I develop some sort of painful, acute condition. I believe their anti-cancer diagnostics are counter-productive. The nonagenarians I've known personally I cannot imagine allowed a proctologist anywhere near themselves either.
• Fenbendazole and Ivermectin: On the same day I sat down to begin writing this post a mutual on twitter hypothesized that the over-reaction to ivermectin by the Chekas in the mainstream media might go deeper than Covid propagandizing. Ivermectin and fenbendazole are in the class of drugs, anthelmintics, which are quietly being studied for their anti-cancer properties. Prior to Covid I had actually heard of fenben and had it in the back of my mind as maybe something to take once a year as a cheap cancer prophylaxis for me and the Missus. As I said, an ounce of prevention... Seeing the gross over-reaction aimed at ivermectin piques both my skepticism and my orneriness that now I'm thinking these anthelmintics are, in fact, important enough to be serious about taking.

In closing, please be aware I'm just a humble guy with an audacious goal (another post for another time) that is skeptical about everything. If it were easy everyone would do it. If it were obvious we'd know it by now.

I've never met anyone that roundly beat Mother Nature and Father Time through sheer force of pharmacological will. My guides are the Pareto Principle: 80% of the results come from (read: can be had for) the first 20% of your cost and effort; and an ounce of prevention beats a pound of cure. Almost anything you do is going to put you an order of magnitude above and beyond the average these days. You don't need to over-think it.

You definitely should not be worrying if you're doing it right. There is no right. There's only do no harm.

Be mindful of how your body feels. Do those things that feel like they make a positive difference. Maybe especially if they make you feel a positive difference. At the same time, be skeptical and don't let marketing materials sway your judgement. The supplement industry if full of snake oil and broken promises.

In the early 90's there was a hugely popular management book that introduced the concept of the technology adoption life cycle. It was "Crossing the Chasm," by Geoffry Moore. Briefly, its premise was there are innovators that are on the bleeding edge and don't care -- in fact, rather enjoy -- getting cut as it's the proof of being first and in front. Behind them are the early adopters that sift through the stuff that actually works and solves real-world problems. Even further behind them is a fickle mass market that adopts the Big Winners but almost never based on merit alone. That dislocation between what the early adopters embrace and what makes it into the mass market they called the chasm, hence "Crossing the Chasm."

I try hang out and among the early adopters to see what works for them and ought to make it to the mass market, if the mass market operated on merit. (Anthelmintics are a perfect example here of merit being insufficient to cross the chasm.) On the other hand, it's not lost on me that I am inserting my judgement as to merits and what passes them, a fraught exercise to be sure. Which takes us full circle to my original statement: be humble. Also known as strong convictions, loosely held.

Good luck and I wish you well.