We have five categories:

1. No Brainer: Everybody should take this.

2. Pretty Good: It has good benefits, but not for everyone.

3. Neutral: Probably doesn’t do much to help you, but it doesn’t hurt you.

4. Overhyped: Trendy, but overrated.

5. I would not do that: Bad for metabolic health.

In this article, you will learn my rankings on a popular list of supplements. Let’s start with the ones I love, all the way to the ones I would stay away from.

No Brainer

Creatine

This is the number one no-brainer; everybody should be doing this! Okay, everybody over 45.

Creatine is not just for bodybuilders. Yes, it helps with muscle contractility by supporting the phosphocreatine system, which is one of the fastest ways your cells recycle ATP. ATP is the body’s energy currency, and muscles burn through it quickly during short bursts of effort. Creatine helps recharge that system faster, which is why it can improve strength and muscle performance.

But the more important use case is that creatine also supports the brain. The brain is an energy-hungry organ that relies on ATP to function. When the brain is under stress, such as during poor sleep, aging, or traveling across time zones, having more available creatine may help brain cells maintain energy more efficiently. That is why I like creatine for cognition, brain performance, and even jet lag. Compared to many other supplements, the literature on creatine is unusually positive. Research shows creatine can affect brain energy markers and may improve cognitive performance under sleep-deprivation conditions, which is why I think of it as a brain-energy supplement, not just a gym supplement.

Now, I do warn people against powdered supplements if they are fighting against insulin resistance, but creatine is an exception. I have seen patients, including patients in their 80s, use creatine while wearing continuous glucose monitors without seeing a blood sugar spike! As far as I have seen, creatine does not elicit the same insulin response as many other powdered supplements.

That makes creatine one of the few powders I feel comfortable recommending for insulin-resistant patients.

K2D3

Vitamin D is not just another vitamin floating around in the bloodstream. It functions more like a hormone, helping regulate important systems in the body, including immune function, inflammation, bone health, and metabolism. K2 works alongside vitamin D in calcium regulation, helping direct calcium toward bones and away from places where we do not want it to accumulate, such as blood vessels.

I pay close attention to vitamin D levels on lab results because low vitamin D can be a canary in the coal mine, signaling metabolic problems. Vitamin D is a fat-soluble vitamin, and low levels of vitamin D can suggest the body is not absorbing or using fat efficiently. In my experience, low vitamin D levels often accompany poor metabolic health.

My family takes Vitamin K2+D3 and tests vitamin D levels regularly; yours should too.

BHB

BHB (beta-hydroxybutyrate) also falls into the no-brainer category, especially for anyone trying to follow the ketogenic diet. I especially like BHB salts because they act as a bridge into Ketosis. If you have had too many carbs and need help getting back into Ketosis, BHB can help. Or if you are severely insulin-resistant and trying to kickstart your metabolic engine, BHB can also be helpful.

Those circulating BHBs from the supplement are not just energy; they also act as signaling agents, teaching your liver to make its own ketones.

I made my own BHB to help my Mom battle cancer, and my family takes this regularly as well.

Magnesium

I teach patients the Ketogenic diet, and one of the most predictable things that happens during the first couple of weeks is fluid loss. It’s like clockwork: as insulin drops, the body releases fluid, and with that fluid go electrolytes. This process is called diuresis, and it can hit people hard. When the body realizes it cannot extract any more magnesium from the bones, patients may experience brain fog, fatigue, low blood pressure, and muscle cramps. This is where magnesium comes to the rescue: once we add the magnesium back, they all start to recover.

I also think many people are already living on the edge of low magnesium. Welcome to the world of low soil and poor nutritional quality. That is why I take magnesium supplements every day myself. When I feel especially low, I use magnesium float therapy: it’s like getting a whole bottle of magnesium by soaking in highly concentrated magnesium-rich water for an hour. This is fantastic and fixes lots of life’s problems!

Pretty Good

Methylene blue

Now we have entered a more niche territory. I have oscillated between pretty good and no-brainer. Before looking into the research, I thought methylene blue was just junk science that came from some internet trend. But as I looked into this further, I realized that this molecule has been around forever, and since it is off-patent, research on it is kind of buried.

The original use of methylene blue was for malaria, which is caused by a parasite. In fact, methylene blue was used to inhibit this parasite (Plasmodium). One drop of methylene blue would kill these parasites without damaging the host.

But the reason I am interested in it today is not mosquitoes or malaria; it is the brain. When patients come to me struggling with brain function, I put them on the ketogenic diet, stabilize blood sugar, and lower insulin. Then, when they took just a few drops of methylene blue, their brains became more active and clearer. And dang, most supplements cannot even get past the blood-brain barrier, let alone make it all the way into the mitochondria responsible for brain energy!

The brain is an energy hog. Even though it accounts for only a small percentage of body weight, it burns a massive amount of energy. Methylene blue helps the mitochondria work more efficiently. When the mitochondria are struggling, the brain often feels foggy and fatigued. Methylene blue helps electrons move through the mitochondrial electron transport chain more efficiently, which can support ATP production and reduce oxidative stress in certain settings.

I love this one, but I will keep it in the “Pretty good” category until I do some more research because I just can’t believe how good it is.

Mitopure

My fascination with Mitopure took a month out of my life. A few years ago, I went down the rabbit hole trying to figure out whether this supplement is really doing something. And I have to give this company credit: they have done a lot of research.

The active ingredient in Mitopure is urolithin A. Urolithin A activates the mitochondrial cleanup process and supports mitochondrial health. It has a very interesting origin story because it starts with pomegranates. You do not just eat a pomegranate and automatically make urolithin A. Your gut bacteria have to convert those plant compounds into urolithin A, and not everyone can do that efficiently. So instead of hoping your gut bacteria can produce enough urolithin A from pomegranates, Mitopure delivers urolithin A directly to the body.

I love the company and the research; the only thing that is holding me back is the price. I have patients who really want to do some mitochondrial repair, but I wouldn’t put this supplement above an advanced ketogenic diet. Being in a state of ketosis and pushing that mitochondria to change over as rapidly as possible is far superior to the supplements of Mitopure in somebody who is still eating the wrong menu.

Neutral

AG1

AG1 gets a Neutral score from me. It probably won’t hurt people, but I am not convinced it is moving the needle the way people think it is.

AG1 is basically a powdered blend of vegetables, minerals, and vitamins. And I swear their business plan is to sponsor every podcast that has ever existed: I cannot escape the ads.

In theory, it’s a really good idea: just put your vegetables in a scoop. My patients hear that and say, “Well, I don’t eat vegetables. That is where I get my nutrients from.” When you take a food and powderize it, you change how the body experiences it. For my insulin-resistant patients, the powdered foods often create an inappropriate insulin response. So every time I consider powderizing something, I think carefully if it will be worth it for my patients.

With that said, it is not like those minerals and vitamins are bad for you; if you are healthy and don’t have insulin resistance, it is probably worth it. But personally, I want my nutrients to come from real food: bone marrow, chicken skin, and meat.

Upgrade your subscription to access the full article. Your subscription is an opportunity to support my work and help me continue creating honest, practical, science-backed keto education for this community.

In the next part of this article, I’ll help you protect your wallet (and your health) by exposing the supplements that promise miracles but deliver disappointment, and sometimes even harm.

Read more