A Foundational Approach to Supplementation
Peter Attia's perspective on supplementation is anchored in a "Medicine 3.0" philosophy that extends healthspan—the period of life spent in good health—rather than merely prolonging lifespan. He is vocal about his belief that supplements are not a shortcut to health but are tools to complement a solid foundation of lifestyle habits. He consistently prioritizes proper nutrition, strategic exercise, and restorative sleep before considering exogenous molecules. This hierarchy is a core tenet of his longevity strategy, emphasizing that no supplement can overcome the neglect of fundamental health behaviors.
Attia's Framework for Evaluating Supplements
To navigate the complex and often murky world of supplements, Attia employs a rigorous, evidence-based framework, which he has shared on his podcast, The Drive. This structured approach helps him and his patients at Early Medical make informed decisions based on scientific data, not marketing hype.
- Define the Objective: Before considering a supplement, Attia identifies the specific health goal it is meant to address. Is it to improve sleep, support cardiovascular health, or reduce inflammation? Having a clear target is essential.
- Measure Biomarkers: A supplement's efficacy is gauged through measurable biological indicators, or biomarkers. For example, Omega-3 intake can be measured by red blood cell concentration, and B vitamins can be tracked by their effect on homocysteine levels. If a supplement does not move the relevant biomarker, it is likely ineffective for that individual.
- Analyze the Risk-to-Benefit Ratio: Attia carefully weighs the potential upsides against any short- or long-term risks. He evaluates the scientific evidence, assesses the substance's mechanism of action, and considers potential side effects before integrating it into a protocol.
A Closer Look at Specific Supplements
Supplements Attia Considers Proven or Promising
Attia's personal and clinical recommendations are based on a body of research and his own biomarker tracking. His list includes several well-studied compounds:
- Magnesium: Given its role in over 300 bodily functions, Attia considers magnesium a cornerstone supplement. He often takes multiple forms to maximize benefits, including Magnesium L-threonate for cognitive function and Magnesium Glycinate for sleep.
- Omega-3 Fatty Acids (EPA & DHA): To combat inflammation and support cardiovascular and cognitive health, Attia takes high doses of fish oil. He monitors his red blood cell Omega-3 levels to ensure they remain in an optimal range.
- Vitamin D3: Attia recognizes the low-risk, high-reward nature of Vitamin D3, especially for individuals with low sun exposure. He advocates for personalized dosage based on regular blood testing, aiming for a specific serum concentration.
- Creatine Monohydrate: Valued for its impact on muscle strength, power, and even cognitive function, Attia takes a consistent 5-gram daily dose. He considers it one of the most well-researched and beneficial supplements for both athletes and aging adults.
- Ashwagandha & Glycine: Both are used for sleep enhancement and stress reduction. Ashwagandha acts as an adaptogen to lower cortisol, while glycine is an amino acid that promotes relaxation and deeper sleep.
- Protein Powder & Collagen: To maintain and build muscle mass (a key longevity metric), Attia emphasizes high protein intake. Protein powder, particularly whey isolate, helps meet these goals, while collagen is used to support joint and connective tissue health.
Caution on Hype-Driven and Experimental Supplements
Attia maintains a high degree of skepticism toward supplements with insufficient human clinical data, especially those pushed by aggressive marketing.
- NAD+ Boosters (NMN/NR): Despite significant industry hype, Attia does not take or recommend NAD precursors like NMN or NR for longevity purposes. He cites the lack of compelling, reliable evidence from human randomized controlled trials (RCTs) showing a lifespan benefit.
- Metformin (for longevity): While a prescription drug, not a supplement, Attia's experience with metformin for longevity is illustrative of his approach. He found it blunted exercise benefits and ultimately stopped, highlighting that even promising interventions must be weighed against personal effects and data.
Comparison: Attia's View vs. Common Approaches
| Feature | Peter Attia's Approach | Conventional/Market-Driven Approach |
|---|---|---|
| Starting Point | Foundational lifestyle habits first (diet, exercise, sleep). | Supplements are often seen as the starting point or a standalone solution. |
| Justification | Based on measurable biomarkers, clinical evidence (ideally RCTs), and risk-benefit analysis. | Based on anecdotal claims, testimonials, or animal studies alone. |
| Personalization | Rigorously personalized based on blood tests and unique needs. | One-size-fits-all recommendations based on general trends. |
| NAD+ Precursors | Skeptical; deems the evidence for human longevity benefits as very low probability. | Promoted as a top-tier anti-aging or energy-boosting supplement. |
| Multivitamins | Generally avoids due to lack of dosage control and variable absorption. | Often promoted as a baseline for overall health, regardless of individual needs. |
The Power of Personalization and Testing
Attia emphasizes that blindly copying his or anyone else's supplement regimen is a mistake. What works for him, based on his specific genetics, health markers, and training regimen, may not be appropriate for another person.
He strongly advocates for regular testing to create a truly personalized and effective plan. This involves more than just a standard cholesterol panel, and can include advanced lipid analysis (ApoB), inflammation markers (hsCRP), and comprehensive hormone and vitamin level assessments.
"If you're not measuring, you're guessing—and guessing doesn't cut it when your healthspan is on the line."
Conclusion: Supplements as Precise, Evidence-Based Tools
Peter Attia's opinion on supplements is deliberate and highly pragmatic. He views them not as a panacea but as precise, science-backed tools to address specific, measured deficiencies or to achieve targeted physiological outcomes. His core message is that supplements are secondary to foundational health practices and must be evaluated with a rigorous, personalized, and evidence-based framework. By prioritizing lifestyle interventions and using supplements judiciously, individuals can build a robust, long-term health strategy rooted in data, not hope. For more detailed insights, listeners can find extensive resources on his podcast, The Peter Attia Drive.
Navigating Supplement Quality and Risks
Beyond efficacy, Attia stresses the importance of supplement quality, purity, and dosage. The supplement industry is largely unregulated, meaning products can contain undisclosed ingredients, fillers, or lower-than-advertised potencies. He advises seeking products from reputable brands that use third-party testing to verify purity and potency. Finally, he stresses that starting any new supplement, particularly at higher doses, should be discussed with a healthcare provider, especially for those with existing health conditions or who are taking other medications.
