Video summary
Dr. Peter Attia identifies magnesium, creatine monohydrate, methylated B vitamins (specifically TMG), curcumin, and omega-3 fatty acids as the foundational supplements most individuals should consider for optimal performance, energy, and long-term health. Regarding magnesium, he emphasizes that there is no single best form; rather, one must select based on specific goals such as gastrointestinal regularity, muscle function to prevent cramping, or cognitive absorption. Attia personally utilizes a combination of slow-release magnesium citrate for minimizing PVCs during high activity in hot climates like Austin, magnesium oxide specifically for GI support, and Magnesium L-Threonate (referred to as "L38" in the transcript) for its superior ability to cross into brain tissue to enhance cognitive function. He notes that while he tracks total elemental intake, titrating different forms is crucial because absorption speeds vary significantly between organic and inorganic compounds depending on the desired benefit. Creatine monohydrate stands out as another essential supplement, with Attia recommending a daily dose of five grams for most people to reach saturation levels quickly without needing aggressive loading protocols that were common decades ago. He clarifies that while higher doses might be relevant for very large individuals (e.g., 260 lbs), they are generally unnecessary and can cause gastrointestinal upset in others, making the standard five-gram dose sufficient across a wide range of body weights including smaller women. For those concerned about brain health or cardiovascular disease risk factors like elevated homocysteine levels, Attia suggests using methylated B vitamins such as TMG (trimethylglycine) and methylcobalamin to normalize these markers. He explains that while direct evidence linking lower homocysteine specifically to reduced dementia rates is still being studied via proxy measures, the causal link between high homocysteine and cardiovascular endothelial damage is well-established, making this supplementation a prudent strategy for many. The discussion also covers anti-inflammatory agents like curcumin, which Attia favors in an activated liquid form rather than capsules due to its superior bioavailability, though he admits uncertainty regarding his exact dosage. He shares a personal anecdote about tearing the attachment of his Achilles tendon while playing cricket at age 35 after returning from retirement; despite the severity of the injury requiring twelve months of intense rehabilitation and additional work on the opposite leg to restore symmetry, he recovered fully with strength and mobility exceeding previous levels by two years post-injury. This experience serves as a cautionary tale for older athletes attempting high-impact sports they played in their teens without adequate warm-ups or gradual reintroduction, noting that many friends have suffered similar catastrophic injuries like MCL tears when returning to basketball after decades of gym-based training. Finally, Attia addresses the importance of omega-3 fatty acids, specifically favoring ethyl ester versions with high concentrations of EPA and DHA from brands like Carlson's Nordic Naturals or Caruso. He aims to maintain red blood cell membrane levels between 10% and 12%, adjusting his intake based on lab results rather than a fixed pill count. Since cooking seafood at home is infrequent for him, supplementation becomes critical, though he has recently developed an appreciation for oysters as a dietary source of these fats. Throughout the conversation, Attia stresses that compliance is paramount; therefore, he often times his supplements with meals or integrates them into existing routines like electrolyte drinks during workouts to ensure consistency. He concludes by highlighting the necessity of third-party testing and NSF certification for supplement brands, relying on companies like Momentus Trust which provide rigorous verification that what is listed on the label matches the contents inside the bottle.
Read the full video transcript
talk to me about what you consider to be
the basic supplements most people should
at least be considering I'm aware that
this is incredibly individualized but
most people want to perform better have
some good energy do well in the gym so
on and so forth what are the areas in
which most people should be at least
looking at supplementation or are there
any at all I mean I think most people
probably would benefit from magnesium so
you have to then decide on which which
ways to take it
um I did a whole podcast on this because
it is complicated and you want to talk
about the speed with which magnesium
gets absorbed are you talking about
organic inorganic are you taking it more
for performance and avoiding cramping
are you taking it more for GI regularity
are you taking it more for cognitive uh
benefits so all of those would be
different forms I actually take three
maybe four different forms of magnesium
so you're I'm keeping track of both the
total Elemental magnesium I'm getting
but more importantly the for getting it
in and how I'm kind of titrating each
one to these benefits and what are you
going for then um all of the above right
so it's it's it's GI function it's
muscle function which ones I'm taking
yeah so slow mag is my favorite for uh
as its name suggest slowly absorbing
magnesium so you know minimizing any
PVCs and cramping basically for a person
like me who's very active sweats a lot
you know live in
Austin um then I take uh me magnesium uh
oxide which is kind of more the GI
version of that and then I take
magnesium l38 which is the cognitive
part of that so that's the one that
gives you better cognitive absorption
I'm trying to think if I take a fourth
one I probably have some magnesium and
something else I'm taking but those are
the big three okay magnesium yeah uh
creatine monohydrate at five GS daily in
I usually again I don't think it matters
when you take it truthfully but the the
most predictable and routine time for me
to take it is during a workout so just
mixing it in with electrolytes and water
and drinking put it in with something
else that you're already drinking
exactly otherwise I'll forget to drink
it uh I can't remember was it I think it
was Tim Ferris who was talking about uh
some benefits from much higher doses of
creatine 10 to 20 grams a day have you
looked at any of this have you seen any
of this stuff uh yeah I mean look when I
was a kid that's how you dosed it you
would load it you would do 30 a day for
a week and you 30 gr a day for a week
and then down to five a day now
my last look at this literature said
that was not necessary at all and taking
five a day you'll very quickly get to
your saturation levels and you're
totally fine is there a size of human
for whom if you're 260 lb should that be
a little bit more that's possible I and
if you're
a20 woman 110 woman maybe would you keep
it at 5 I mean I do and and the only
time I sort of tell people to dial it
down is if they get GI upset from it
which some people do okay magnesium
creatin
um I think a lot of
people probably could use a little bit
of help with methylated B vitamins maybe
some TMG um again I what's TMG trimethyl
glycerate which is
um basically we would use these to
titrate homocystine levels so if a
person's homosysteine levels are
elevated um you can basically get their
homosysteine levels normalized with
methyl B vitamins now there we don't
really have trying to think we have one
study that speaks to the efficacy of
that for brain health
um but by but but we're what we're doing
is using a proxy which is we know that
homosysteine levels when elevated play
role in at least two diseases right
dementia and dementing diseases and
cardiovascular disease um and so by you
know asking the question if you lower
homocysteine levels do you address that
you're asking the question indirectly is
homocysteine causally related to those
diseases or not um and looking at the
neurodegenerative side it appears more
likely that it is and there's a very
clear mechanism for how homosysteine um
could be caused L related in
cardiovascular disease Visa its impact
on endothelial function and endothelial
health but I would say that like like
that's kind of a soft recommendation um
I've got one copy of
c677 RT or whatever I I I you know how
many people I've met in my life who have
the wild type for both MTHFR genes and
you have to keep in mind how many people
I've looked at in the past 15 years um
I've seen two people that have the wild
types so everybody has has one of the
Snips on these genes they're they're I
don't I actually think they should be
the wild type truthfully I don't even I
think we've got it backwards well we had
to when we for we recently did a
reformulation of of neonic the drink and
uh I was like guys can you just check
we're using natural folate for this
right they're like yeah we are I was
like we're using methyl cobalamine right
we're using methylated B12 yeah we are
but you just don't realize how many
especially if you are thinking about
homosysteine levels if you're thinking
about how taking B vitamins in you're
not thinking about that it's totally not
oh this could be like folic acid or this
could be the non-methylated version of
right of the B vitamins really
interesting um I take the cumin what's
that it's uh activated cumin curcumin
yeah it's basically a a more liberated
form of curcumin so more bioavailable
liquid no capsule yeah what do just more
expensive uh good question I don't I
don't remember the dose it might be 300
milligrams but I'm not sure okay
um it's amazing for how often I'm asked
this question you'd think I would know
this better
um there there's other things I just
don't recall them magnesium yep creatine
methylated B vitamins if appropriate to
bring homosysteine in line
yep cumin Orin thumin special cumin I
used an absolute ton of C in when I I
ried in Achilles 4 years ago and uh I
went through playing Cricket the the
British way and um uh I just threw the
kitchen sinking it was covid I had
nothing else to do uh so I asked every
person that I could how can I keep
inflammation down how can so uh
tb500 uh bpc
157 every tart cherry juice like any
waving Sage over the top of it making a
incant at the full moon all of that
stuff I did all of the things and uh the
recovery was actually actually really
really good if anyone ever considers
blowing out their Achilles doing it
during a pandemic is actually a really
good time to do it because there's
nothing else to do and I grew it back
nice it's probably the injury I'm most
afraid of it's 12 months of full very
intense so do you have a sense of why it
happened so I went back to as many
people I mean this should be a public
service announcement if you used to play
a sport when you were in your teens and
you're now 35 or something and you think
I'm going to pick that sport
backup very very slowly reintegrate it
the number of friends that during their
teenagers played basketball and then
decide to go and play basketball now
that they're 34 and they've spent the
last two decades gaining muscle in the
gym and they're nearly twice as heavy as
they were when they played this and
within the first couple of games they
blow out an MCL the number of friends
I've had there like a list of friends
that have done this just in my friend
group uh and for me I was did one
training session to play
cricket performed sufficiently well
during that session that I got invited
to play on the Saturday and then with a
very limited warm-up as normal sort of
Club Cricket is uh stepped out to bat
and was having so much fun it was great
the Sun was shining my dad was over the
far side we slowed the halt of wickets
that we were losing and I was like this
the first time I've picked up a bat
apart from the net that I did on the
Wednesday this is the first time I've
picked up a bat in over a decade I'm
like 35 not out I'm playing really good
shots and I just pushed a single through
the covers on the right hand side and
set off to run and then as I I felt
something weird did you hear it no but
there was shouting at the same time uh
from the the players on the the Fielding
team and then as I went to put my right
foot on the floor it was like if you
tried to step on a an infl flatable
water bed on water and it just went like
that and then the bastards ran me out so
while I was laid on the floor like this
in the middle of in the middle of the
pitch they went and picked the Bales off
which meant I didn't get like a uh
whatever it is an injured like DNC did
not complete or whatever uh they
actually ran me out which was fine
that's okay uh I think the reason that
it would have happened was we' done
shuttle runs on the wday I wasn't doing
a massive amount of like high PLO stuff
and then when I set off you're wearing
spikes on a very hard uh surface and
it's digging into packed dirt which is
what the strip is that you're bowling on
and I pushed this shot through the
covers and then set off with my back
foot heel would have been a little bit
off the ground so calf would have been
lengthening as I'm Contracting and then
it would have just hit the floor and
went and that was me for you know 12
months uh 13 days and then got uh did
you complete tear yeah folded attachment
fold attachment yeah so got carried back
over and I knew
within 3 seconds I was like I think
that's what that is and I just I didn't
know enough about it if I'd known more
about it I would have been more scared
um but on the flip side of that my uh
calf strength now and Mobility I've got
really insane dorsy flection but for
anyone that does do it or anyone that's
done it recently yeah it's going to be a
long rehab or if you if it happens in
future it's going to be a long rehab and
it's going to Su and you you're going to
feel a little bit unhappy about it but
my function strength power everything is
back to where it was including
muscularity so if you looked at my car
totally symmetric I overshot it on my
right on the one that I busted and then
had to go and do more work on the left
because I built that one back up and um
yeah I I think good rehab plan take your
time getting back to it and within 12
months you'll be doing everything that
you were able to do and within two to
two and a half years you won't know that
it's there the only way that you can
tell is if you look or if you give it a
squidge cuz it's it's a like a girthy
it's a girthy boy now but um one of the
things you haven't mentioned is Omega 3s
oh thank you I do take that as well I'll
keep you right um talk to me about
anything else I should be taking because
you're going to remind
me um Ronda Patrick is on the show big
on Omega-3s really Tu me through some
interesting stuff to do with uh eth
Esters versus
the
reactivated
version yeah I used to know this and I
have I don't know it anymore what are
you taking I take
Carlson's um I think there are a couple
of Brands out there Nordic Naturals car
using that are pretty good I and I've
gone back and forth with them and then
we you know you test your levels to kind
of see where you're getting the most
bang for your um By Buck I don't mean
dollar but how many of the things how
many of the horse pills you have to take
do you know how many you're taking day I
take three
of the most potent one that they make
which I think is called Elite or supreme
or something like that whatever the most
expensive one is presumably yeah but
it's got the most EPA and DHA in it are
you timing that par is it with a fatty
meal um yeah I I I mean because I'm my
compliance is the most important thing I
have an AM and PM slide of of things
that I take so I think I take one in the
am two in the PM or maybe it's the
reverse um so but the the point is I
just know what I'm I used to take two
and two but I've titrated it back a
little bit so I'm doing it based off
what the EPA and DHA levels are in the
red blood cell in the membrane yeah yeah
it's uh and I'm sort of trying to keep
it between 10 and 12% it's just for me
cooking seafood at home is so rare like
it's the it's all of the other thing red
meat ground beef even liver is more
likely to do that than for me to
actually think oh I should buy salmon
and I should it's just one of those
things that kind of doesn't really
appear to me and I often try and do it
when I go out for food one thing I've
fallen in love with over the last year
is oysters dude I love oysters now I've
become this is what being an adult is
you drink coffee and you have Oysters um
but I've really enjoyed that but at home
it just doesn't Factor so for me
supplementation when it comes to that I
think is probably really important I
think so in other news this episode is
brought to you by momentus trust really
is everything when it comes to
supplements and that is why
I rely on momentus they have the most
rigorous third-party testing of any
supplement company that I have ever
found everything that they make is NSF
certified for sport meaning that even
Olympic athletes can use it and that
ensures that what they say is in the
packet is actually in the packet their
sleep packs are one of my favorite
products which I use every single night
before bed they contain only the most
evidence-based ingredients at perfect
doses to help you fall asleep on a
nighttime stay asleep throughout the
night and wake up feeling more rested
and revitalized in the morning best of
all there is a 30-day money back
guarantee so you can buy it completely
risk-free try it for 29 days and if you
do not like it they will give you your
money back right now you can get a 20%
discount on everything sitewide by going
to the link in the show notes below or
heading to liv.com wisdom using the code
modern wisdom checkout that's Liv m o m
n
t.com mod wisdom the code modern wisdom
a check out