I’ve been a surgeon for nearly 30 years, and I’ve spent much of that time listening to patients describe what they are doing to protect their health. Increasingly, that includes a long list of supplements. That’s not surprising, as we are bombarded by messages about the latest and greatest all day long. So am I… companies reach out to me all the time to promote their products. I’ll agree to it when I see their RCT data showing a clinically significant benefit.
Supplements are a messy space. Placebo effects, mechanistic data that sounds amazing, but very few with strong, high-quality supporting evidence. I just don’t think someone who sleeps five or six hours a night, walks 5,000 steps a day, rarely lifts weights, and eats mostly manufactured food should believe a handful of capsules will dramatically benefit them.
Supplements may have a role, perhaps an important one, but they sit well downstream from the fundamentals that actually shape how we age.
This was the most requested topic in our latest survey… This is a long, complicated post, and it took me a long time to write… so let’s do this.
My Primary ‘Supplements’:
I cannot overemphasize how important this section is. The interventions (supplements) that have had the greatest impact on my life include:
morning sun in my eyes,
a morning run or hike with my dogs before the world gets noisy,
a long trail run or hike in the woods,
lifting weights,
my strength coach,
eating real food that I prepared,
no food for 3 hours before bed,
sleeping for roughly seven hours,
sitting around a table with friends instead of talking to them through a screen,
zero cable news, minimal newspaper scrolling— too much cognitive inflammation.
staying off my phone and devices as much as possible,
waking up with work/hobbies important enough to pull me out of bed (a sense of purpose).
ICYMI: From Saturday: An incredible shoulder-building program. One that treats the shoulder as if it is connected to the rest of our kinetic chain— because it is!
Saturday Action Plan: Building Strong, Capable Shoulders
I’ve been a shoulder surgeon for 30 years. Our shoulders are remarkable joints. They allow us to reach overhead, push, pull, throw, climb, carry, catch ourselves when we stumble, and place our hands almost anywhere in space. That enormous freedom of movement comes with a tradeoff: the shoulder depends heavily on muscle strength and neuromuscular control to remain stable and useful.
It should be clear… I don't think any supplements will meaningfully improve my health or lifespan beyond the habits I have already listed. That doesn’t make every supplement useless. Some correct a deficiency, a few can slightly improve a measurable risk factor, and several can potentially support the adaptations I am already pursuing through training and nutrition.
They remain supplements, however, because they supplement a foundation rather than create one. And if I do think that a supplement ‘helps’ me, I recognize that it could be a placebo effect…and we’ll talk about that more below.
Too often, we reverse that order. We spend hundreds of dollars searching for the perfect capsule while neglecting the things that move the needle. We chase compounds that might improve one small corner of our biology while ignoring habits that influence nearly every organ system we have.
If every bottle in my cabinet disappeared, the important parts of my routine would remain intact. I would still train, walk, sleep, eat well, spend time outside, and stay connected to the people who matter to me.
Most supplement marketing runs very far ahead of the evidence. Mechanistic plausibility or a study in a rat cell does not guarantee success in a person. Human biology rarely cooperates that well. What follows is a very transparent look at what I take, why I take it, and where the human evidence is strong, modest, contradictory, or simply not there.
For Members, what follows below describes what I take and why; it’s not a protocol or a list of things you should buy. I am a physician, but I am not your physician, and supplements can interact with medications, medical conditions, surgery, and laboratory testing in ways that vary substantially from one person to another. My goal here is to show you how I think through these decisions, including where I lean on mechanism, personal experience, or an imperfect signal rather than a proven clinical benefit.