As we grow older, we may grow wiser, but we can also experience age-related memory impairment (ARMI). ARMI is relatively common¹ and should not be confused with Alzheimer’s or other dementia, while ARMI is simply mild memory problems associated with normal aging (e.g. “Where did I put my keys?”). Even so, the memory loss and cognitive slowing associated with ARMI can interfere with our daily routines.² In fact, according to a national survey, worries over retaining mental sharpness with age was the number two health concern among consumers (second only to worries about continuing with normal activities with age).³

So what can we do to help maintain mental sharpness with aging? Aside from eating a healthy diet and getting regular exercise (which is good advice for everybody in all age groups), there are some very specific nutraceuticals (i.e. vitamins, herbs, amino acids), which have been shown to be effective for just this purpose. These include Bacopa monnieri leaf extract, Panax ginseng root extract, Rhodiola rosea root extract, natural caffeine and L-theanine, folic acid and vitamin B12.

Bacopa monnieri leaf extract
The leaves of the Bacopa monnieri plant have been used for centuries in the traditional East Indian system of healthcare (i.e. Ayurveda) for purposes of promoting “healthy longevity, and strengthening life, brain, and mind.”⁴ While that is certainly impressive, it is even more impressive that several modern, human clinical studies have been conducted showing that supplementation with Bacopa helped:

• Improve occasional, age-related absentmindedness.
• Promote a healthy memory.
• Improve some measures of delayed recall.
• Promote cognitive function.

Most of these studies^{5,6,7,8,9,10,11} found that daily supplementation with 300 mg of Bacopa monnieri leaf extract (standardized for 50 percent total bacosides), provided significant benefits by week 12—although progressive benefits in Total Memory Score were also seen during week four and eight as well.¹²

It should also be noted that these studies were conducted in men and women who were at least 40 years old, and in most cases more than 55 years old. That means that you’re more likely to experience similar benefits if you’re middle-aged and older, rather than if you’re in your 20s or 30s.

If you’re wondering how Bacopa works, research¹³ suggests that it helps to maintain healthy levels of acetylcholine, a compound your body makes that works in your brain to help facilitate memory, learning ability and cognitive performance.

Panax ginseng root extract
Panax ginseng root, or ginseng for short, is a traditional Chinese herb, which has been used for thousands of years for various aspects of healthcare. It is also one of the most widely-researched herbs in modern science with over 5,000 published studies. Ginseng belongs to a category of herbs known as adaptogens. Adaptogens are herbs that help stabilize physiological processes and promote homeostasis (i.e. stable, healthy functioning of the body), especially in the case of stress and fatigue. This property was seen in two human clinical studies^14,15 examining the effects of ginseng on mental performance. The results demonstrated that 200 mg of ginseng root extract daily:

• Improved speed of mental performance within 60 minutes.
• Enhance performance of mental arithmetic within 60 minutes.
• Reduce feelings of mental fatigue within 60 minutes.
• Quickly reduced feelings of mental fatigue during sustained mental activity.
• Quickly improved some measures of mental performance.

While many nutraceuticals may take weeks to work, these studies found that ginseng root extract provided beneficial results in as little as 60 minutes.

Rhodiola rosea root extract
Like ginseng, Rhodiola rosea root is an adaptogen. This plant has been used for centuries in the traditional systems of healthcare throughout Russia, Scandinavia, and other countries where it was used to increase physical endurance, work productivity, longevity, and to treat fatigue, mood and promote a healthy nervous system.¹⁶ Currently, there are over 500 studies on Rhodiola demonstrating the value of this plant. The reason for its inclusion in Ageless Memory is that human clinical research^17,18,19 shows that supplementation with Rhodiola:

• Improved capacity for mental work during stress.
• Supports healthy cognitive function during stress.
• Reduced fatigue during stress.

These benefits were seen when 370 mg of Rhodiola root extract was used daily, and when it was standardized for 3 percent salidroside and 1 percent rosavins—key compounds in Rhodiola. This standardization is particularly important since most Rhodiola extracts have the opposite standardization: 1 percent salidroside and 3 percent rosavins. Consequently, products with this opposite standardization are not providing the correct balance of Rhodiola compounds used in these cited studies.

Natural Caffeine and L-Theanine
Black tea leaf extract provides natural caffeine as well as the amino acid L-theanine. This is an important distinction because not all sources of caffeine are natural, and not all sources provide L-theanine as well. Consider that if you buy one of those popular energy shots that are supposed to last a few hours, they contain caffeine anhydrous. That’s a synthetic form of caffeine. And while coffee certainly contains natural caffeine, we all know about the jittery effect on your nerves if you get too much—and some of the freshly brewed coffee you get from popular coffee houses can contain hundreds of milligrams of caffeine. Tea, on the other hand, also provides L-theanine, which has a calming effect. That’s likely the reason why drinking tea isn’t typically associated with caffeine jitters like coffee—it contains L-theanine, which helps sooth over-stimulated nerves. Now to be clear, the amount of caffeine used in research with L-theanine is only 50 mg—that’s the amount of caffeine you’d typically find in one-half cup of moderately brewed coffee. Furthermore, 100 mg of L-theanine was used alongside the caffeine. When this combination was used together, human clinical research^{20,21,22,23,24,25} has shown that supplementation:

• Helped maintain focus.
• Helped with mental flexibility, the ability to shift attention from one task to another and efficiently adapt to different situations.
• Helped improve focus on the information while filtering out other stimuli.
• Helped improve focus during cognitively demanding tasks.
• Helped improve speed and accuracy of cognitive performance.
• Helped improve mental alertness.

Folic Acid and Vitamin B12
Folic acid and vitamin B12 are both critical B vitamins that perform a variety of functions in the human body. Among those functions are the roles they play in cognitive performance. For example, in one study²⁶ older adults were supplemented with 400 mcg of folic acid and 100 mcg of vitamin B12 daily. The results showed that this combination:

• Supported healthy cognitive function in older adults.
• Promoted healthy memory performance in older adults.

Furthermore, vitamin B12 deficiency can result in memory loss, and supplementation can help prevent it.^27,28 Since vitamin B12 deficiency is estimated to affect 10 –15 percent of individuals over the age of 60,²⁹ supplementation is certainly worthwhile.

What to Expect When Taking Ageless Memory
It should be noted that the aforementioned nutraceuticals tend to provide their effects at different times, so even if you use all of them your results will be progressive rather than instantaneous. Essentially, here’s how it will likely work (although everyone is different and results and timing may differ for you as well):

Endnotes:

1. Hanninen T, Koivisto K, Reinikainen KJ, Helkala EL, Soininen H, Mykkänen L, Laakso M, Riekkinen PJ. Prevalence of ageing-associated cognitive decline in an elderly population. Age Ageing. 1996 May;25(3):201–5.
2. Hedden T, Gabrieli JDE. Insights into the ageing mind: a view from cognitive neuroscience. Nat Rev Neurosci. 2004;5:87–96.
3. Sloan AE, Hut CA. Reading the Compass: Up-and-Coming Market Trends. Nutraceuticals World. October 1, 2013. Retrieved November 9, 2015 from http://www.nutraceuticalsworld.com/issues/2013-10/view_features/reading-the-compass-up-and-coming-market-trends/.
4. Engels G, Brinckmann J. Bacopa. HerbalGram. 2011;91:1–4.
5. Morgan A, Stevens J. Does Bacopa monnieri Improve Memory Performance in Older Persons? Results of a Randomized, Placebo-Controlled, Double-Blind Trial. J Altern Complem Med. 2010; 16(7): 753–9.
6. Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Effects of a Standardized Bacopa monnieri Extract on Cognitive Performance, Anxiety, and Depression in the Elderly: A Randomized, Double-Blind, Placebo-Controlled Trial. J Altern Complem Med. 2008;14(6):707–13.
7. Roodenrys S, Booth D, Bulzomi S, Phipps A, Micallef C, Smoker J. Chronic effects of Brahmi (Bacopa monnieri) on human memory. Neuropsychopharmacology. 2002 Aug;27(2):279–81.
8. Stough C, Lloyd J, Clarke J, Downey LA, Hutchison CW, Rodgers T, Nathan PJ. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology (Berl). 2001 Aug;156(4):481–4.
9. Stough C, Downey LA, Lloyd J, Silber B, Redman S, Hutchison C, Wesnes K, Nathan PJ. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008 Dec;22(12):1629-34.
10. Raghav S, Singh H, Dalal PK, Srivastava JS, Asthana OP. Randomized controlled trial of standardized Bacopa monniera extract in age-associated memory impairment. Indian J Psychiatry. 2006 Oct-Dec; 48(4): 238–42.
11. Pase MP, Kean J, Sarris J, Neale C, Scholey AB, Stough C. The cognitive-enhancing effects of Bacopa monnieri: a systematic review of randomized, controlled human clinical trials. J Altern Complement Med. 2012 Jul;18(7):647–52.
12. Raghav S, Singh H, Dalal PK, Srivastava JS, Asthana OP. Randomized controlled trial of standardized Bacopa monniera extract in age-associated memory impairment. Indian J Psychiatry. 2006 Oct-Dec; 48(4): 238–242.
13. Stough C, Lloyd J, Clarke J, Downey LA, Hutchison CW, Rodgers T, Nathan PJ. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology (Berl). 2001 Aug;156(4):481–4.
14. Reay JL, Kennedy DO, Scholey AB. Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. J Psychopharmacol. 2005 Jul;19(4):357–65.
15. Reay JL, Kennedy DO, Scholey AB. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained ‘mentally demanding’ tasks. J Psychopharmacol. 2006 Nov;20(6):771–81.
16. Brown RP, Gerbarg PL, Ramazanov Z. Rhodiola rosea: A Phytomedicinal Overview. HerbalGram 2002; 56:40–52.
17. Darbinyan V, Kteyan A, Panossian A, Gabrielian E, Wikman G, Wagner H. Rhodiola rosea in stress induced fatigue—a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine. 2000 Oct;7(5):365–71.
18. Spasov AA, Wikman GK, Mandrikov VB, Mironova IA, Neumoin VV. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine. 2000 Apr;7(2):85–9.
19. Shevtsov VA, Zholus BI, Shervarly VI, Vol’skij VB, Korovin YP, Khristich MP, Roslyakova NA, Wikman G. A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine. 2003 Mar;10(2–3):95–105.
20. Einöther SJ, Martens VE, Rycroft JA, De Bruin EA. L-theanine and caffeine improve task switching but not intersensory attention or subjective alertness. Appetite. 2010 Apr;54(2):406–9.
21. Kelly SP, Gomez-Ramirez M, Montesi JL, Foxe JJ. L-theanine and caffeine in combination affect human cognition as evidenced by oscillatory alpha-band activity and attention task performance. J Nutr. 2008 Aug;138(8):1572S–1577S.
22. Foxe JJ, Morie KP, Laud PJ, Rowson MJ, de Bruin EA, Kelly SP. Assessing the effects of caffeine and theanine on the maintenance of vigilance during a sustained attention task. Neuropharmacology. 2012 Jun;62(7):2320–7.
23. Owen GN, Parnell H, De Bruin EA, Rycroft JA. The combined effects of L-theanine and caffeine on cognitive performance and mood. Nutr Neurosci. 2008 Aug;11(4):193–8. 24. Giesbrecht T, Rycroft JA, Rowson MJ, De Bruin EA. The combination of L-theanine and caffeine improves cognitive performance and increases subjective alertness. Nutr Neurosci. 2010 Dec;13(6):283–90.
24. De Bruin EA, Rowson MJ, Van Buren L, Rycroft JA, Owen GN. Black tea improves attention and self-reported alertness. Appetite. 2011 Apr;56(2):235–40.
25. Walker JG, Batterham PJ, Mackinnon AJ, Jorm AF, Hickie I, Fenech M, Kljakovic M, Crisp D, Christensen H. Oral folic acid and vitamin B-12 supplementation to prevent cognitive decline in community-dwelling older adults with depressive symptoms—the Beyond Ageing Project: a randomized controlled trial. Am J Clin Nutr. 2012;95:194–203.
26. Food and Nutrition Board, Institute of Medicine. Vitamin B12. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, vitamin B12, pantothenic acid, biotin, and choline. Washington, D.C.: National Academy Press; 1998:306–56.
27. Healton EB, Savage DG, Brust JC, Garrett TJ, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine (Baltimore). 1991;70(4): 229–45. [ABSTRACT ONLY]
28. Baik HW, Russell RM. Vitamin B12 deficiency in the elderly. Annu Rev Nutr. 1999;19:357–77. [ABSTRACT ONLY]

So here's how to get started.
The key point to realize is that our brain is like our body's motor. It consumes 10 times as much energy for its size as the rest of our body. So what we feed it determines whether it purrs like a Ferrari, or runs in fits and starts, leaving us with "brain farts" through the day.

So what are the key fuels that our brain needs, as they relate to diet?

1. Eggs. One of the key memory molecules is called acetylcholine. To make this, our body requires that we take in about 500 mg of choline daily. Interestingly, when a woman does not have enough estrogen, as occurs during perimenopause and menopause, they are more likely to develop memory problems when they don't get enough choline. http://ajcn.nutrition.org/content/92/5/1113.full. This can be aggravated by certain genetic defects and can be a major player in cognitive dysfunction. The solution? Simply eat one or two eggs a day. Each egg supplies 680 mg of choline. Be sure to eat the egg yolk, as this is the part that has the choline. More good news? Numerous studies have now shown that eating eggs does not increase cholesterol or increase risk of heart disease. In fact, eggs have been shown to be a very healthy food.
2. Fatty fish such as salmon, tuna, herring, sardines or mackerel. Most of our brain is made of the omega-3 oils found in fish.
3. B vitamins and magnesium. These are the key nutrients needed to make energy. They can be found in whole unprocessed foods. For example almonds are a good source of magnesium, and you want your fresh veggies for the B vitamins.
4. Up to two cups a day of coffee and tea, along with up to an ounce of chocolate daily also can have wonderful benefits for mental clarity.

For the neurotransmitters, the choline for acetylcholine and to a lesser degree tyrosine to make dopamine would be most important for memory.

It is especially important give the body the basic raw materials that it normally needs.

In terms of supplements, the key items that I would recommend (and personally take myself ) are:

1. Omega 3's—as upwards of 90 percent of the oils in most fish oil products are not Omega 3's, and are more likely to be toxic than helpful, I take one of Vectomega (EuroPharma) daily. This replaces seven large fish oil pills giving optimal support with one small pill.
2. Energy Revitalization System (Enzymatic Therapy) vitamin powder. This supplies optimal levels of B vitamins, magnesium, amino acids (approximately 950 mg of tyrosine) and other nutrients needed to optimize brain function (including choline) in one low cost simple drink daily.
3. I add one scoop (5 g) of SHINE ribose powder to the vitamin powder. For the first six weeks, I recommend taking it three times daily. Then it can often be dropped to 1–2 times a day. In our published study, ribose dramatically improved cognitive function in people with fibromyalgia by an average of 30 percent.
4. I also add CuraMed 750 milligrams once daily for its overall brain and immune system benefits. So basically, for supplements the one Energy Revitalization System (Add a 5g scoop of SHINE Ribose) drink a day and one Vectomega is the best 30 seconds people can spend all day to optimize cognitive function.

Cognitive Function Intensive Care
For those with CFS and fibromyalgia, once the above aspects are addressed, the next step is to use the SHINE Protocol to optimize sleep, thyroid and adrenal function and orthostatic intolerance, as well as candida and other infections. The free Energy Analysis Program at www.vitality101.com can tailor the SHINE Protocol to your specific case with a simple 10-minute quiz. It can even assess pertinent lab tests if you have them available.

Love and blessings,
Dr. T