Supplements

Sinclair does not take a multivitamin because he wants to avoid excess iron and unnecessary antioxidants.

Sinclair says quercetin activates sirtuins and may help kill senescent cells. He groups it with compounds that should be taken with something fatty for absorption and may add it to his olive oil-resveratrol mixture.

Sinclair says antioxidants are not harmful unless taken in megadoses; he specifically warns against overdoing vitamin C and vitamin E.

Kava may help reduce anxiety, with studies using roughly 100 mg of extract in some cases and active kavalactones around 150 mg, with a broader studied range of 50–300 mg. Effects were seen after about 3 weeks; no hepatotoxic signals were reported in the studies reviewed, but it is still advisable to check with a doctor.

Look for probiotic products with independent validation, since labels may not match contents; prefer reputable brands with stronger quality control; when possible, choose the exact probiotic used in a well-designed study for your target symptom or indication, then experiment personally to see whether it works for you.

Mentioned as a substance that can augment the glucose-lowering effects of berberine via AMPK pathways; framed as a very potent, sharp-blade tool.

General magnesium target of 400 mg/day; noted that many people are deficient in magnesium.

Presented as a supplement that can increase sexual desire and function in certain populations, particularly females, with mixed findings on testosterone and libido. Study protocols mentioned include 750 mg/day divided into 3 equal doses for 120 days, which increased free and bioavailable testosterone in postmenopausal women but not libido in that study, and 6 g/day of Tribulus root for 60 days, which was associated with a clear significant increase in libido in a separate study.

Often used to increase bioavailability of turmeric/curcumin; also described here as a 5-alpha-reductase inhibitor, so avoid if DHT is already low or androgen receptor sensitivity is low.

Weak anti-estrogen and antiandrogen that many women should consider, especially in PCOS-related contexts.

Suggested for vegans to avoid deficiencies in healthy fats relevant to hormone balance.

Injectable form is 100% bioavailable; can be injected intramuscularly to reduce burning compared with subcutaneous injection. Minimally efficacious injectable dose is probably around 200 mg; 500 mg to 1 g/day was also discussed.

May help significantly with the nervous system, especially if copper deficient; discussed as synergistic with BPC and thymosin beta-4 analogs, but only if needed and not for longer than necessary.

Take about 300–600 mg; can increase circulating serotonin by roughly 30–39%; may be useful for appetite and weight control; may need cycling, though exact schedule is unclear.

Low-dose adjunct medications often prescribed alongside SSRIs for some OCD patients when first-line treatment is insufficient; also referred to here as antipsychotics. Haloperidol was given as an example, with the caveat that dopamine-reducing drugs can have motor side effects.

Mentioned as an OCD medication; noted to be less selective and able to affect neurotransmitter systems beyond serotonin, including epinephrine.

Foundational health support; obtain sufficient essential fatty acids either from food sources or supplements. Fish oil can be taken in liquid or capsule form.

100 mg every third or fourth night, in addition to the standard sleep stack, to enhance ability to get into sleep. Not recommended every night, because taking it too often seems to make the overall sleep stack less effective for him.

Discuss with a board-certified psychiatrist for bipolar disorder; requires careful blood monitoring due to toxicity, especially in the first three months. Presented as effective for reducing manic symptoms in many patients, but not something to self-administer casually.

Antipsychotic sometimes prescribed as a sedative to allow sleep during manic episodes; requires careful monitoring because of side effects related to white blood cells.

May be prescribed to help induce sleep during manic episodes by reducing neuronal excitability through the GABA system.

Used only when estradiol gets too high; Attia says it must be real microdoses, compounded at 0.1 mg, perhaps 0.1 mg two to three times per week. He aims for estradiol roughly 30–50 and avoids suppressing below 25. Also referred to as Arimidex/Aromidex.

Attia uses injectable testosterone cypionate for TRT, usually at low physiologic doses; typically not more than 100 mg/week. He prefers splitting dosing twice weekly rather than large infrequent doses, and uses subcutaneous rather than intramuscular injection.

Liver-specific cholesterol synthesis inhibitor; Attia uses it especially when statins cause adverse effects.

Protein supplement taken after high-intensity resistance training; mentioned as a protein drink, with protein-containing food as an alternative.

Do not use CBD during pregnancy or while lactating/breastfeeding; includes smoked or edible forms. He explicitly includes CBD in the warning because cannabinoid exposure can interfere with endogenous cannabinoid signaling important for fetal development.

Palmer says he would specifically avoid trazodone in this context because it is an antidepressant and the patient is already hypomanic, so he does not want to push that further.

Mentioned among prescription sleep medicines Palmer may use short-term as a stopgap for keto-related hypomania or insomnia.

For selected patients without a history of addiction, short-term Ativan may be used to restore sleep and help break hypomania. Ativan is often preferred because it is shorter-acting.

Palmer says he may use something like Klonopin short-term to restore sleep and break hypomania in selected patients without addiction history.