Doctor Q&A: What are the best supplements for memory loss? Dr Renee Hoenderkamp answers all your burning questions

Can drinking alcohol increase my risk of dementia? If so, how much?  

I am going to start with my mantra: everything in moderation!

Alcohol is a drug that is as old as can be, changes how we feel, is relaxing for some in social circumstances and is enjoyed by many. As with any drug however, there are risks and benefits.

There is good evidence that regular excessive drinking can increase your risk of developing the most common forms of dementia, such as Alzheimer’s Disease and vascular dementia. Frequent early adulthood drinking may also increase your risk of early-onset dementia.

But before we panic, what is ‘excessive drinking’? Drinking more than the recommended weekly intake is defined as ‘excessive drinking’. The recommended intake is one to 14 units a week for men and women, ideally spread over three days with several alcohol free days. This is defined as ‘moderate drinking’. Drinking alcohol in moderation has not been conclusively linked to an increased risk of dementia.

But having said all of this, it is clear than drinking over this and binging are bad news for the brain and not only increase dementia risk but can also cause long term damage to the brain, known as alcohol related brain damage (ARBD). This occurs over time as drinking too much alcohol can bring about changes to the physical shape and structure of the brain. Caused by the direct toxic effects of alcohol to the brain and a lack of Vitamin B1 (thiamine), symptoms can include;

• Altered personality
• Volatile moods
• Difficulty thinking, learning and remembering
• Impulse control problems – leading to inappropriate or offensive behaviour

This can often be mistaken for conditions like Dementia/Alzheimer’s but, unlike these, it does not inevitably worsen over time. Recovery can be possible and stopping drinking combined with high-dose Vitamin B1 treatment can be good, with much brain damage potentially being reversed if early enough.

The weekly guidelines aim to outline a general framework, based on the latest science, to help you to make informed choices around drinking. Drinking no more than 14 units a week won’t guarantee that your health won’t be affected negatively, but conversely, drinking more than 14 units doesn’t mean you definitely get dementia or other health issues either. But the data shows that if drinking at low levels this keeps the risk of harm to low levels and remember, light drinkers live longer than teetotallers! So let’s finish as we started; everything in moderation.

Are there any supplements you would recommend for memory loss? I am not as sharp as I once was...

This is a really interesting question because the global brain boosting supplement market is estimated to be worth £6.2billion! And it is clear from my first delve, that I could write a book. So I will focus on the main ingredients that seem to be popular and have some evidence. Solid evidence is hard to come by, however, as there is little good research on supplements which are not regulated in the same way as medications and have little interest for big pharma (aren’t they silly!).

There is definitely some promising data on some supplements which show an improved cognitive performance versus placebo. See below:

L-Theanine

An amino acid found naturally in some mushrooms, green and black teas is linked to an improvement in mental performance and the ability to focus in some studies.

A small study in Neuropharmacology, participants who took 100 milligrams of L-theanine before a monitored two-hour task period made fewer errors during that time than those who received a placebo. There is no established dose recommendation but studies often use daily doses between 100 and 250 milligrams.

Vitamin D

Deficiency is linked to conditions including dementia, depression, autism and schizophrenia. One 2017 study in Current Gerontology and Geriatric Research suggests vitamin D helps maintain cognitive function in older adults2

Magnesium

A 2022 study of over 2,500 people ages 60 and older found those who consumed the highest amounts of magnesium through food and supplements had higher scores on cognitive tests compared to those who consumed the least. However, in both studies, it’s unclear whether low levels of magnesium increase the risk of dementia or if people with dementia have low levels of magnesium for some other reason.

Choline

An essential nutrient that helps your brain make acetylcholine (found in eggs), needed for memory and general cognition. In one study of 2,000 older adults, those who consumed high amounts of choline tended to have lower risk of cognitive decline.

Ashwagandha

Ashwagandha is used in the Ayurvedic system of medicine to help enhance memory and reduce stress. Emerging research suggests ashwagandha may help improve cognitive function. A small 2017 study in the Journal of Dietary Supplements, 50 adults with mild cognitive impairment received either 300 milligrams of ashwagandha root extract twice daily or a placebo for eight weeks. Those taking ashwagandha experienced significant improvements in memory, executive function, attention and information-processing speed compared to those who took a placebo. And a 2021 study in Evidence-Based Complementary Alternative Medicine, healthy adults who took 300 milligrams of sustained-release ashwagandha extract daily for 90 days experienced significantly improved memory and focus, compared to those who took a placebo.

Probiotics

Gut health is important for optimal cognitive function and general health. Your gut is your second brain and a healthy gut is a healthy body that can withstand the challenges of life.

In a 2021 study in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 12 weeks of supplementation with a probiotic combination of Bifidobacterium bifidum BGN4 and Bifidobacterium longum BORI specifically appeared to improve brain function and decrease perceived stress in healthy older adults.

So there are a few specific ingredients to be getting on with. There are many more and in a review of evidence in PubMed in 2021 some evidence was found for memory benefit from supplementation with ashwagandha, choline, curcumin, ginger, Lion's Mane, polyphenols, phosphatidylserine, and turmeric. Interesting to note that for many common supplements that make claims for memory/cognition, they could find no evidence.

I think it is also important to recognise that what we eat, throughout our lives, will impact how well our brain works in the moment and how well it lasts the test of time. In his new book, Patrick Holford, Consultant Neurologist, writes: “Less sugar, more activity, fish oil and B vitamin supplements may halve your dementia risk” and he makes the bold claim: “The Food for the Brain charity focuses on helping people make simple, positive changes that will give your brain and memory an upgrade and dementia-proof your diet and lifestyle in the future”. So worth a look there too.

It all comes back to you being what you eat and it's never too late to make changes and try some of these tricks. It is also advised that you speak to your doctor before starting any supplements.

I hope that helps. It’s a big area!

I have a pain in my breast that radiates to my armpit. I've noticed it for the last three days. I am a little worried but nervous about Googling. What could be causing it?  

I know how scary it can be to have anything going on with your breasts. Women are bombarded with information about breast cancer because it is the most common cancer in women with a lifetime risk of one in eight women.

However, today I am pleased to say that your question didn’t panic me at all, most commonly, breast pain is not cancer so no need to panic.

The cause of breast pain is varied and tends to be linked to the stage of life you are at; pre menopause, post menopause, pregnant or breast feeding.

The most common cause of breast pain in women before menopause is hormonal and mostly linked to periods and normally improves once the period starts. This type of pain is usually dull, heavy, aching and affects both breasts so it doesn’t sound like your issue. After menopause however, hormones can still be the cause but again, usually both breasts.

As your pain is one breast and armpit, we need to think first about muscle and ligament strains, either to the area itself or neck, shoulder or back. It could also be caused by arthritic pain in the chest cavity/neck/shoulder joints or trauma to the breast directly. Any injury or sprain in this area can be felt as breast/armpit pain. Some tell tale signs are knowing that you have had an injury, or pain increasing on certain movements or being eased by others. Time is also important as most strains will get better within a few weeks.

If you are breastfeeding, one sided breast pain can happen in mastitis (inflammation of the milk ducts) and this can be mild and as you carry on feeding, gets better on its own. However, if it is worsening, the skin is red and hot, you have a fever, you will need antibiotics so it is essential to call your GP. It is also important to carry on feeding baby and express when you can as well.

Having said all of the above, it is important to examine your breasts regularly and especially so when something new happens such as breast pain, change in size or shape, nipple changes. If you self-examine regularly, say monthly, then you will more easily notice anything new. And if you notice anything new, see your GP immediately.

There is a handy guide to self examination here.

So in terms of your pain, I would wait a few days and see if it improves, see if it is eased or made worse by movement, check your breast for any lumps and if so see your GP. If not, watch and wait for a few days and don’t panic, the odds are on it being something simple.