Supplements tend to create two extremes: people who take nothing “on principle,” and people with an endless stack. The underlying problem is the same: no clear decision framework. A supplement can be useful, useless, or even counterproductive depending on dose, product quality, and your context (diet, medications, lab results). This article gives a practical framework and then applies it to five common supplements.
A simple framework to decide
Before asking “does it work?”, ask “what do I want it for?”. Most decisions get clearer with four questions.
1) Am I fixing a deficiency or chasing an extra?
- Deficiency: e. g., low vitamin D or low B12. The goal is to return to an adequate range
- Performance/support: e. g., creatine for strength or muscle. The goal is an incremental improvement
The strategy and risk tolerance are not the same.
2) What’s the evidence and what effect size should I expect?
In supplements, many effects are modest. If you expect a 50% change, you’ll be disappointed. If you expect a 5–15% improvement in specific outcomes (reps, strength, sleep, biomarkers), that’s more realistic.
3) How good is the product?
Purity matters. Some products have fillers, wrong doses, or rancid oils. A “good” supplement typically has:
- A clear label and a short ingredient list
- A sensible dose
- Third‑party quality testing when possible
4) How will I measure it and when will I stop?
Decide upfront:
- What you’ll track (energy, sleep, performance, labs)
- How long you’ll run it (e. g., 8–12 weeks)
- What side effect would make you stop
How to clean up your stack in 10 minutes
A useful trick is the “empty the bucket” approach: write down everything you take (supplements, hormones, medications) and ask, one by one:
- What problem does this solve?
- How do I know it solves it?
- What happens if I stop it for 2–4 weeks?
This doesn’t mean stopping everything at once. It means removing items that have no purpose and no measurement.
Case 1: creatine
Creatine monohydrate is one of the best‑supported supplements for strength and performance. In many people it improves the ability to do more reps, sprints, or high‑intensity work.
Practical tips:
- It’s commonly used as a consistent daily dose; consistency matters more than timing
- Look for “creatine monohydrate” as the only or primary ingredient
- Mix it with water or a drink; you don’t need expensive formulas
- If you have kidney disease or concerns, ask your clinician first. And if you do lab work, tell them you take creatine: it can affect markers used to estimate kidney function
Case 2: omega‑3 (fish oil)
Omega‑3 is used for its relationship with inflammation and cardiometabolic health. Not all products are equal.
Key points:
- Quality is critical: oxidized oil isn’t helpful. If it smells rancid, toss it
- Focus on EPA and DHA content (what you’re really buying), not only “milligrams of fish oil”
- Many people prefer products with strong traceability and, generally, oil from smaller fish
- Store it well (heat and light accelerate oxidation)
If you take blood thinners or have surgery coming up, ask before using it.
Case 3: vitamin D
Vitamin D is a classic “it depends.” If you’re deficient, correcting it can support bone health and other outcomes. If you’re already adequate, more isn’t always better.
Practical notes:
- Testing makes sense if deficiency is likely or sun exposure is low
- Dose should match your level and follow‑up, not trends
- Sunlight can help, but it isn’t always enough (latitude, season, skin, schedule)
Case 4: B vitamins
B vitamins show up in many complexes. The common case is B12, which can be low due to diet, age, or absorption issues.
Practical points:
- If symptoms fit (fatigue, tingling) or risk is high, testing and correction are reasonable
- Oral supplementation is often enough, but it depends on the situation
- More isn’t always better: avoid megadoses without a reason
Case 5: ashwagandha
Ashwagandha is used for stress and sleep. Evidence varies by extract and dose. If you try it, treat it like an experiment:
- Use a clear dose and a standardized product
- Set a defined period (e. g., 6–8 weeks)
- Track something specific: sleep latency, night awakenings, perceived stress
If you notice excessive drowsiness, digestive discomfort, or unwanted changes, stop and reassess.
Priority order
If your foundation is weak, no supplement will fix it. Prioritize in this order:
- Reasonable sleep
- Whole foods and enough protein
- Strength training and walking
- Then supplements with a goal and measurement
A checklist before you buy
- Goal: deficiency or performance?
- Evidence: what realistic change do I expect?
- Interactions: medications or medical conditions?
- Quality: minimal ingredients, reputable supplier
- Measurement: what I track, how long, and what makes me stop
Conclusion
Supplements aren’t inherently “good” or “bad.” They’re tools. With a simple framework (goal, evidence, quality, and measurement), you can reduce noise and make better decisions. If you’re unsure, return to the basics: whole foods, sleep, and training. Supplements—when they help—sit on top of that foundation.
Knowledge offered by Dr. Peter Attia