Nootropics still exist largely in an unregulated gray area, which makes users somewhat hesitant to discuss their regimens. But I did speak to several people who told tales of increased productivity and sharpened focus. Bob Carter, a financial analyst for a start-up called LendingHome, says that nootropics have replaced his other morning stimulant. “I basically think of it as a substitute for coffee,” he says. “I think the problem with a cappuccino from Starbucks is that it gives you the feeling of being jittery. Whereas with this particular supplement, I feel more calm.”
Brain consumption can result in contracting fatal transmissible spongiform encephalopathies such as Variant Creutzfeldt–Jakob disease and other prion diseases in humans and mad cow disease in cattle. Another prion disease called kuru has been traced to a funerary ritual among the Fore people of Papua New Guinea in which those close to the dead would eat the brain of the deceased to create a sense of immortality.
Much of what she says is standard health advice. Avoid trans fats. Eat fresh vegetables and fruit. Avoid processed foods. Limit red meat consumption. It’s better to get your nutrients from food than from supplement pills. Exercise, get adequate sleep, and avoid stress. Since the brain runs on glucose, she wouldn’t agree with the low-carb diet folks; she says we need adequate sources of glucose in our diet, and recommends complex carbs, paying attention to the glycemic index.
How exactly – and if – nootropics work varies widely. Some may work, for example, by strengthening certain brain pathways for neurotransmitters like dopamine, which is involved in motivation, Barbour says. Others aim to boost blood flow – and therefore funnel nutrients – to the brain to support cell growth and regeneration. Others protect brain cells and connections from inflammation, which is believed to be a factor in conditions like Alzheimer's, Barbour explains. Still others boost metabolism or pack in vitamins that may help protect the brain and the rest of the nervous system, explains Dr. Anna Hohler, an associate professor of neurology at Boston University School of Medicine and a fellow of the American Academy of Neurology.
The main concern with pharmaceutical drugs is adverse effects, which also apply to nootropics with undefined effects. Long-term safety evidence is typically unavailable for nootropics. Racetams — piracetam and other compounds that are structurally related to piracetam — have few serious adverse effects and low toxicity, but there is little evidence that they enhance cognition in people having no cognitive impairments.