Confessions of a former supplement denier

Creatine, GlyNac, Taurine, and Vitamins B-12 & D3, Magnesium & Omega-3 PUFAs for aging vegetarians & vegans
Bob Dozor MD
My view on dietary supplements is evolving. I still firmly believe in exercise, plant-based diet, social connection and meditation as the foundations of health-span and lifespan, but my previous rejection of supplements is softening. Considering various supplement fads that have faded, such as high dose Vitamin C, Vitamin E, Selenium, Co-Q-10, etc. - that were not helpful and sometimes harmful - is a cautionary tale. Some supplements hurt people! Vitamin E in capsules for example might cause some cancers (at least as d-alpha-tocopherol), while vitamin E as a constituent of food is, well, vital for your health. It is worth noting that supplements are poorly regulated, with inconsistent quality control and may contain toxic contaminants. While there are very few placebo-controlled outcome studies demonstrating that supplements work, that does not mean they don’t work! It’s very difficult to perform the kind of studies that produce reliable evidence of effectiveness. So, spoiler alert, the bottom line is that with reasonable precautions supplements are very safe, and for a number of supplements there is good reason to think they are effective, including reliable studies in animals like worms, rats and monkeys. There are studies demonstrating improved biomarkers in humans, which of course is not as convincing as seeing improved outcomes in humans. ‘Very likely harmless,’ and ‘somewhere between being modestly beneficial to being extremely beneficial in humans’ is where the best evidence lies. (supine not prevarication!)

So why am I changing my tune? To be sure, my own aging process motivates me! Also, there is now much more scientific evidence about the aging process and what might slow it down. Aging per se has become a target of study. So maybe there is a middle ground; still depending on plant-based food as the main source of nutrition, something is to be gained by taking certain supplements. Faithfully minimizing animal foods, vegans are missing important nutrients. It’s much more than just vitamin B-12.  Are donuts and French fries vegan? Even non-junk plant-based foods lack certain key nutrients. Supplements may help. Considering my age, and the safety of quality supplements, I’ve decided not to wait until human studies 95% confirm their hypothesized effectiveness.

So, what important nutrients are missing or deficient when not eating meat? Creatine, Taurine, Vitamin B-12 and long-chain Omega-3 poly unsaturated fatty acids (pufas) are hard to find if you don’t eat meat, and really difficult if you are vegan.

Creatine was named after the Greek word for meat, kreas. Creatine is not creatinine; creatine is metabolized into creatinine, which is a biomarker of kidney function. Even doctors get confused by this: creatine is totally safe for kidneys, although it may raise your creatinine level. Creatine, an amino acid, is important in the production of ATP – the main currency of energy – in the mitochondria of (almost) all your cells. Creatine has been used safely and effectively by athletes for decades; however, its positive impact on cognition, a more recent finding, interests me more. Our brains burn more energy than our muscles; it's not surprising that creatine makes brains work better. Also, creatine increases the lifespan of animals! I’m taking 2 grams twice a day with breakfast and dinner.

Taurine is another important amino acid in short supply for vegetarians (although it is found in Seaweed). 
A deficiency of taurine—a nutrient produced in the body and found in many foods—is a driver of aging in animals, according to a new study led by Columbia researchers and involving dozens of aging researchers around the world. The same study also found that taurine supplements can slow down the aging process in worms, mice, and monkeys and can even extend the healthy lifespans of middle-aged mice by up to 12%.
The study was published June 8, 2023, in the prestigious journal SCIENCE. I am taking one gram twice a day between meals, and I have increased eating seaweed! Sea scallops and all shellfish are very rich in Taurine, too.

Vitamin D3, the active form of vitamin D, tells a story not specific to vegetarians. First of all, it's not a vitamin but rather a hormone. Vitamin D insufficiency is very common, related to inadequate sun exposure, worse in the winter. Vitamin D deficiency and insufficiency is correlated with many important health conditions: Ricketts and osteoporosis, increased risk of death from cardiovascular disease, cognitive impairment in older adults, severe asthma in children, cancer, and severe lung infections including Covid 19 and Influenza.  Research suggests that vitamin D could play a role in the prevention and treatment of type 1 and type 2 diabetes, hypertension, glucose intolerance, and multiple sclerosis. Whether Vitamin D supplementation reverses any of these is very contentious; however, it is very safe in doses below 5000 IU per day. Suggestive evidence abounds, but few of these benefits have been conclusively demonstrated in humans. I’m taking 5000 IU per day with 125mcg of Vitamin K2. It is easy to get a blood test for Vitamin D levels.

Omega-3 polyunsaturated fatty acids (PUFAS) can help prevent heart disease and stroke, may help control lupus, eczema, and rheumatoid arthritis, and may play protective roles in cancer and other conditions. Long chain omega-3 pufas - EPA (eicosatetraenoic acid) and DHA (docosahexaenoic acid) - are found in cold water fatty ocean fish which get their omega 3s from consuming krill and algae (which is vegan). Some foods, such as certain brands of eggs, yogurt, juices, milk, and soy beverages, are fortified with DHA and other omega-3s. The short chain omega-3 pufa, alpha linoleic acid (ALA), is found in flax, walnuts, chia seeds, soy, etc. Your body can convert ALA to EPA and DHA, but with variable efficiency and women do it better. Overall, research on ALA has been mixed. While omega-3 consumption has been linked with improving the body’s ability to reduce the risk of cardiac events; research has mostly focused on the long-chain omega 3 pufas - EPA and DHA. If you are vegetarian, you can get long chain omega-3s from eggs and with marine algae oil (which is vegan). You can get short chain omega-3s from walnuts and flax.  This might provide enough EPA and DHA by conversion of ALA. Two servings of Salmon per week, which has been shown to reduce the risk of cardiovascular disease, is likely sufficient. 2 pasture raised chicken eggs have comparable amounts of DHA and EPA as a serving of salmon. ‘Regular eggs’ have much less omega 3s. ‘Omega 3 eggs’ are in between (if you supplement chicken feed with omega 3’s their eggs will have more). Life Extension has a $99 fingerstick blood test for Omega 3 sufficiency:

Next is GlyNAC, which may be the most exciting story!  GlyNac is two amino acids Glycine and N-Acetylcysteine.  Glycine is commonly found in food. While NAC is not in food, its congener – Cysteine, is commonly found in plants and animals. NAC is converted into Cysteine in our bodies. Cysteine and Glycine are both precursors to Glutathione, the most important antioxidant inside of our body’s cells. Why do we need antioxidants? Mainly because we breathe oxygen, our bodies’ chemistry creates reactive oxygen species (ROS), aka free radicals, which are the main driver of the aging process, but are also important for the body's functioning. Unlike other antioxidants which have failed to live up to the hypothesized possibility of slowing aging (such as vitamins E and C, and Co-Q-10),  GlyNac may be the best one because it works with the body to maintain the balance of ROS and antioxidant potential.  Carotenoids – also antioxidants – do slow aging, but not as much as GlyNac. If you are eating a plant-based diet, it's hard to not get plenty of carotenoids (or vitamins C & E). Are your palms a little yellow? NAC also acts as a direct scavenger of toxins such as aldehyde – a metabolite of ethanol - which may be the main reason that alcoholic beverages cause cancer and hangovers. B-vitamins also help limit the toxicity of ethanol. Very complicated!  The bottom line is that NAC and Glycine produce multiple beneficial outcomes!
A randomized, double blind human clinical trial conducted by researchers at Baylor College of Medicine reveals that supplementation with GlyNAC – a combination of glycine and N-acetylcysteine – improves many age-associated defects in older humans and powerfully promotes healthy aging. This is relevant because until now, there have been no solutions toward improving many of these age-related declines in people.

Published in theJournal of Gerontology: Medical Sciences, the study shows that older humans taking GlyNAC for 16-weeks improved many characteristic defects of aging. This includes oxidative stress, glutathione deficiency and multiple aging hallmarks affecting mitochondrial dysfunction, mitophagy, inflammation, insulin resistance, endothelial dysfunction, genomic damage, stem cell fatigue and cellular senescence. These were associated with improvements in muscle strength, gait speed, exercise capacity, waist circumference and blood pressure.
Another study, also from Baylor: 
When mice reach an age of 65-weeks, they typically begin to show a drop in glutathione levels and develop mitochondrial dysfunction and oxidative stress. At this age, Sekhar's team switched the diets of half of the mice to receive GlyNAC, and the other half continued their diet without the supplement. Except for the GlyNAC supplementation, the diets of both groups were the same regarding the content of protein, fat and carbohydrates. Then, the researchers let the mice continue aging undisturbed and recorded how long they lived.

"We were excited to find that the mice that received GlyNAC lived 24% longer than those that did not receive GlyNAC."
Glycine also improves sleep: 
Glycine also has the property to enhance the quality of sleep and neurological functions.
I take 1 gram of NAC and 1 gram of Glycine, two times per day on an empty stomach. 
A word or two about Magnesium: 
About 57% of the US population does not meet the US RDA for dietary intake of magnesium. (Wikipedia) 
Magnesium is not found in junk food but is found in good foods: chocolate, avocados, nuts, legumes, tofu, seeds, whole grains, fatty fish, bananas, and leafy greens (which pretty much describes my diet). You might consider getting either Magnesium Glycinate (which provides Glycine) or Magnesium Taurate (which provides Taurine).