Supplements, graded.

Creatine is the rare supplement with decades of consistent human data. Meta-analyses show that creatine plus resistance training produces greater gains in lean mass and strength than training alone, including in older adults — exactly the population losing 1–2% of muscle per year. Muscle is the closest thing aging research has to a retirement account: grip strength and lean mass predict mortality better than most blood tests.

Brain effects are earlier-stage: small trials suggest modest cognitive benefits under stress (sleep deprivation, vegetarian diets), but the aging-brain data remain preliminary — a bonus, not the reason to take it.

How to take it: 3–5 g/day of plain creatine monohydrate, every day, no loading phase needed. Expect ~1 kg of intracellular water weight in the first weeks — that is muscle hydration, not fat.

Safety: among the most studied supplements in existence; benign in healthy people. Reports of kidney harm at normal doses have not held up, but discuss it with a clinician if you have kidney disease.

Total protein intake is the foundation the rest of this page stands on. A meta-analysis of trials in older adults supports protein supplementation combined with resistance training for lean mass and strength. European intake surveys consistently find adults over 50 clustering near the old minimum (0.8 g/kg) — set for avoiding deficiency, not for aging well.

Target: ~1.2–1.6 g/kg of body weight per day for adults focused on tissue maintenance, spread across meals of 25–40 g. Whey is the best-supported supplement form because of its leucine content; food-first works equally well if you actually hit the numbers.

Collagen peptides are a special case — a lower-quality protein for muscle, but with their own skin/joint evidence. They get a full guide of their own.

It is almost embarrassing that the best "longevity supplement" is fiber. The landmark Lancet series (185 prospective studies and 58 trials, ~135 million person-years) found 15–30% lower all-cause and cardiovascular mortality at the highest fiber intakes, with the best risk reduction at 25–29 g/day and a dose-response beyond. Psyllium is the pragmatic supplement form when food falls short, and modestly lowers LDL cholesterol as a bonus.

Fermented foods are earlier-stage but interesting: in a Stanford RCT, six daily servings increased microbiome diversity and lowered 19 inflammatory proteins over 10 weeks — a tiny trial (n=36), but cheap, safe, and food-first.

How to take it: count your food fiber first; add 5–10 g of psyllium daily with plenty of water if you're short. Ramp up slowly to spare your gut the surprise.

Vitamin D illustrates the difference between fixing a deficiency and chasing a number. In trials that did not select for deficiency, supplementation failed its endpoints — the 25,000-person VITAL trial found no reduction in cardiovascular events or cancer incidence, and its fracture analysis in NEJM was flatly null. Correcting genuine deficiency, by contrast, remains standard medicine — and deficiency is common at European latitudes, especially October to April.

How to take it: test first (a 25-OH-D blood test), then 800–2,000 IU/day of D3 if you're low. Retest once after 3–4 months.

Avoid megadoses: annual or monthly boluses have increased falls in trials, and chronic intakes above ~4,000 IU/day raise hypercalcemia risk. More is not better; sufficient is better.

The omega-3 story is genuinely mixed. High-dose purified EPA cut cardiovascular events 25% in REDUCE-IT, while the similar STRENGTH trial with a different formulation found nothing — leaving even cardiologists arguing about mineral-oil placebos. At ordinary supplement doses (~1 g/day EPA+DHA), effects on triglycerides are real and effects on events are modest.

The honest downside: meta-analyses of the large trials show a dose-dependent increase in atrial fibrillation, mainly above 1 g/day. Claims about "biological aging" and telomeres rest on soft endpoints and should not drive a purchase.

How to take it: 1 g/day combined EPA+DHA — or simply eat oily fish twice a week. Buy fresh (check TOTOX/freshness where published); rancid fish oil is worse than none. A history of AF is a reason to talk to your doctor first.

CoQ10 has one context with genuinely impressive data: chronic heart failure. In the Q-SYMBIO randomized trial (420 patients, 2 years), 300 mg/day roughly halved major adverse cardiac events, and a meta-analysis of 14 trials found lower mortality (RR 0.69). That is "discuss with your cardiologist" evidence, not a reason for healthy people to supplement.

Statin muscle aches: evidence is genuinely mixed — some meta-analyses find modest relief, others none. A 100–200 mg/day trial for a few weeks is cheap and low-risk if statin aches bother you; keep expectations low.

Skin and "cellular energy" claims: no convincing outcome trials, including for the mitochondria-targeted analog MitoQ. Take with fat for absorption; mild caution with warfarin.

Both halves of this are worth knowing. Within the COSMOS trial platform, three cognition substudies plus a meta-analysis across >5,000 participants found a daily multivitamin slowed global cognitive aging by the equivalent of about two years over 2–3 years of use — a replicated, if modest, effect in adults 60+.

Against the longevity claim: an NIH analysis of three prospective cohorts — 390,124 healthy adults followed over 20 years — found no reduction in all-cause, cancer, or cardiovascular mortality from daily multivitamin use. It is inexpensive insurance for older adults with narrowing diets, not a longevity drug.

Caveat: the cognition finding comes from one trial platform testing one product (Centrum Silver, donated by its manufacturer). Consistent within itself; not yet replicated elsewhere.

A meaningful share of European adults eats below the recommended magnesium intake, and status is hard to measure (serum misses tissue stores) — so supplementation is a reasonable, cheap hedge. The famous sleep benefit is thinner than its reputation: a meta-analysis in older adults found just three small trials showing sleep-onset ~17 minutes faster, with the evidence rated low-to-very-low quality. Newer positive trials of glycinate and threonate forms are sponsor-run.

How to take it: 200–400 mg elemental magnesium in the evening; glycinate or citrate are better tolerated than oxide. Threonate is expensive with the least outcome data.

Safety: loose stools at higher doses; caution with kidney impairment; separate from some antibiotics and bisphosphonates by a few hours.

Hydrolyzed collagen has the deepest trial base of any oral skin supplement — reviews of dozens of randomized trials show measurable improvements in skin elasticity, hydration, and wrinkle depth over 8–12 weeks, plus joint-stiffness and bone-density effects on longer horizons. The effects are real and moderate; many trials are industry-funded.

We maintain an entire evidence guide on it — mechanisms, forms, doses, safety, and how it stacks against clinical treatments: the collagen guide.

Astaxanthin is the carotenoid that makes salmon pink, and the best-studied of the "internal photoprotection" supplements. A 2021 meta-analysis (11 studies) found improved skin moisture and elasticity and reduced wrinkle measures; a 10-week RCT showed a higher UV dose was needed to redden supplemented skin.

The caveats are structural: trials are small (tens of participants), short (6–16 weeks), largely run in Japan by manufacturers, and measure instrument-level changes — visible-in-the-mirror is not the standard here.

How to take it: 4–6 mg/day with a meal containing fat. Benign; at very high carotenoid doses skin can tint slightly orange. It supplements sunscreen — it never substitutes for it.

Oral HA was long dismissed ("it's just digested") — the 2025 literature says otherwise. A meta-analysis of 7 placebo-controlled RCTs (379 participants) found statistically significant improvements in skin hydration, elasticity, and wrinkle depth, and a 150-person double-blind RCT reported hydration and barrier improvements.

Strength of evidence is comparable to collagen's early days: small, mostly Asian, heavily manufacturer-funded trials with instrument endpoints. A reasonable add-on for dry, crepey skin at 120–240 mg/day — with expectations calibrated to "measurable", not "transformative".

The commercial center of the longevity market is the multi-ingredient blend: a sprinkle of resveratrol, some NMN, "senolytic botanicals", a proprietary label hiding per-ingredient doses. Three problems compound: no blend has ever been tested in an outcome trial; the listed ingredients usually appear below their (already unsuccessful) trial doses; and the proprietary label makes verification impossible by design.

If you want to experiment at the frontier, buy the single molecule at the trial dose from a third-party-tested brand. A blend is a portfolio of underdosed bets sold at a premium.

Detox supplements name no specific toxin, measure no validated endpoint, and have no controlled trials — there is literally nothing to cite, which is the point. The organs that clear metabolic waste (liver, kidneys) are not supplement-responsive filters, and "toxin buildup" as marketed does not correspond to a measurable clinical state.

The one legitimate nearby idea is reducing intake of harmful exposures: alcohol, smoking, ultra-processed food. That costs nothing.

Epithalon (a synthetic tetrapeptide) and its "bioregulator" siblings are marketed online as telomerase-activating anti-aging injections. Essentially all supporting data come from the originating Russian research group; no large peer-reviewed double-blind human trials exist. Products ship as "research chemicals" — a label that waives every quality standard — with documented purity and contamination problems from unregulated vendors, plus a theoretical telomerase–cancer concern nobody has resolved.

For an EU consumer this category is an unambiguous do-not-buy: unproven, unregulated, and injectable.