Dripping With Deception: The Hard Truth About Supplements

I cycled through Berlin a few weeks ago, cargo bike loaded with my kids, Harry Potter audiobook blasting from the speaker. Normal morning routine. Then, something caught my eye that made me hit the brakes.

A drip clinic. Brand new. Sleek exterior. Promises plastered across windows.

For the uninitiated, these are places where you pay $150+ to have vitamins and minerals injected directly into your bloodstream via IV. The names alone tell you everything: "Myers' Cocktail Drip," "Beauty Glow Drip," "Longevity Drip," "Megaboost." I'm not making this up.

Berlin now has multiple companies offering these services across the city. Every major city has them. And they're packed.

It got me thinking about how we got here. Supplements have escaped the gym and invaded the boardroom. The longevity hype machine has put the industry into overdrive. But what actually works? What's worth your money? And what's just expensive urine?

Let's cut through the noise.

The Supplement Landscape: Marketing vs. Reality

The supplement industry is massive—about $100 billion globally and growing. Unlike pharmaceuticals, supplements don't require proof they work before hitting shelves. The FDA and EFSA can only react after problems emerge.

This creates a Wild West where marketing trumps science. One JAMA investigation found many supplements contained unlisted pharmaceutical compounds. Another study showed that 59% of tested products didn't match their labels.

The industry thrives on your insecurities—fear of aging, fear of underperforming, fear of missing out.

The reality? Most supplements do nothing. The few that work aren't magical. And the truly effective ones address specific deficiencies or needs.

Let's break them down by the evidence.

Tier 1: The Actually Effective (Evidence-Backed)

These supplements have robust research behind them. They work, but with caveats.

Creatine Monohydrate

Everyone has an opinion on creatine. The gym bros swear by it. Health influencers debate it. But here's the truth: it's one of the most studied supplements ever, with over 500 peer-reviewed papers.

Creatine improves high-intensity performance, increases strength, and even shows cognitive benefits in some studies. It increases phosphocreatine stores in muscles, allowing faster regeneration of ATP—your energy currency—during intense activity.

The effective dose is simple: 3-5g daily (up to 5-10g for larger individuals). No loading phase needed. No cycling required. Just consistency.

Who needs it? Anyone doing resistance training or high-intensity exercise. Vegetarians may see even bigger benefits since meat is the primary dietary source of creatine.

Vitamin D

Most people are deficient without knowing it. Modern indoor life, sunscreen use, and northern latitudes create the perfect storm for deficiency. About 1 billion people worldwide have inadequate levels.

Vitamin D isn't just for bones. It functions more like a hormone, influencing immune function, mood, and overall inflammation. A 2017 meta-analysis in the BMJ showed that correcting deficiencies can reduce the risk of respiratory infections and improve athletic recovery.

The effective approach: Get your levels tested. Generally, aim for 1,000-2,000 IU daily in winter months if you're in the northern hemisphere. Those with a severe deficiency may need 5,000 IU under medical supervision. Take it with fat for better absorption.

Magnesium

Another victim of modern life. Intensive farming depletes soil magnesium. Processing strips it from food. Stress depletes what little we get.

Magnesium is involved in over 300 enzymatic reactions in your body. It supports sleep, stress response, and muscle function. A systematic review in the journal Nutrients confirmed that supplementation can improve sleep quality, reduce stress, and prevent those middle-of-the-night calf cramps.

Form matters here. Magnesium oxide is cheap but poorly absorbed. Citrate, glycinate, or malate forms are superior. Effective dose: 200-400mg daily, often best taken before bed.

Omega-3 Fatty Acids

The evidence is clear for heart health and inflammation. Omega-3s improve lipid profiles, particularly by lowering triglycerides. They also support cognitive function—DHA is a structural component of brain cell membranes.

The catch? Quality varies dramatically. Most fish oil is oxidized before you even open the bottle. Look for brands that test for oxidation and heavy metals (IFOS or NSF certified in the US, International Fish Oil Standards in Europe).

Effective dose: 1-2g combined EPA+DHA daily. Check the label—most capsules contain far less EPA/DHA than the total oil amount.

Protein Supplements

Not a supplement in the traditional sense, but worth mentioning. Protein powders are just convenient, processed food. They're valuable if you struggle to hit protein targets through diet alone—something I covered in detail in my protein-focused newsletter edition.

Whey protein is fast-absorbing and leucine-rich, making it ideal around workouts. Casein provides a slower release and is suitable before fasting periods like sleep. Plant proteins work, too, but may require larger doses to get equivalent amino acids.

Effective approach: 20-30g per serving, 1-2 times daily, to reach your protein target (1.6-2.2g/kg or ~0.7–1 g/lb body weight for active individuals).

Tier 2: The "It Depends" Category (Promising Evidence)

These supplements show potential but have incomplete evidence or work only for specific populations.

NAD+ Precursors (NMN, NR)

The most hyped longevity supplements of the moment. NAD+ levels decline with age, and boosting them improves mitochondrial function in animal models.

Human research is still catching up. These precursors reliably increase blood NAD+ levels, but whether that translates to clinical benefits remains unclear. Early trials show mixed results on muscle function and metabolism.

If you're exploring this category, recognize you're in experimental territory. Data is promising but preliminary. The effective dose is unclear, but studies use 250-1000mg daily.

Ashwagandha

This adaptogenic herb has decent evidence for stress reduction. Studies on standardized extracts show it can reduce cortisol by about 27% in chronically stressed adults.

Some research suggests modest testosterone support in men, particularly those with elevated stress or suboptimal levels. It won't turn you into a hormone powerhouse, but 600mg daily might help with chronic stress.

Tier 3: The Skip It List (Save Your Money)

These supplements have either been debunked or lack meaningful evidence despite widespread marketing:

Greens Powders and Multivitamin Blends

Products like Athletic Greens AG1 come with impressive marketing and celebrity endorsements. They're expensive multivitamins with a sprinkle of plant extracts. At $3+ per serving, they're a luxury, not a necessity. You'd get more nutritional value from actually eating vegetables.

"Testosterone Boosters"

Tribulus, D-Aspartic Acid, fenugreek—the evidence is clear. They don't significantly increase testosterone in healthy men. A systematic review concluded tribulus has no effect on testosterone in humans, despite what the supplement industry claims.

"Superfoods" and Antioxidant Supplements

Acai, goji berries, resveratrol, turmeric supplements—you're better off eating real, varied food. Studies repeatedly show isolated antioxidants don't deliver the same benefits as whole foods.

Glutamine, BCAAs, and Most Amino Acid Supplements

Once bodybuilding staples, research has debunked their effectiveness. Multiple studies show they do not significantly affect muscle mass, strength, or recovery if you eat adequate protein.

Off-Label Pharmaceuticals for Longevity

An emerging trend worth addressing is using prescription medications for longevity.

Metformin

The diabetes drug that somehow became a longevity superstar. Its claim to fame? A single observational study shows diabetics on metformin often lived as long as non-diabetic controls.

Metformin activates AMPK—improving insulin sensitivity and reducing glucose production. But here's what the longevity crowd misses: it may blunt exercise adaptations, interfering with muscle gains and mitochondrial improvements.

Here's the ultimate irony about metformin: That famous TAME study everyone cites? It hasn't even started yet. Despite FDA approval in 2015, it's stuck in funding limbo because metformin is off-patent—no profit potential. The entire longevity community is betting on a diabetes drug based on a study that doesn't exist. Peak supplement industry absurdity.

For those seeking non-prescription alternatives, berberine works through similar mechanisms. Some studies show comparable benefits for blood sugar control, though with less research behind it.

Rapamycin

The newest darling of the longevity world, rapamycin inhibits mTOR—a pathway regulating cell growth and metabolism. It extends the lifespan in nearly every species tested—from yeast to mice. In one landmark study, mice given rapamycin lived 9-14% longer, even when treatment started in middle age.

But there's a catch. As an immunosuppressant, rapamycin increases infection risk. It can cause mouth sores, alter glucose metabolism, and mess with wound healing. The dosing question remains unsolved: transplant patients take it daily, but longevity researchers are exploring intermittent protocols.

The most important point: we have zero long-term human data for its use in healthy people. Those taking it for longevity are running a self-experiment, betting on animal research that might not translate to humans.

Is it ready for widespread use? Absolutely not. This is cutting-edge territory, and most people's risk-benefit equation remains unbalanced.

Honorable Mention: Sulforaphane

I've kept a secret from you—I'm quietly obsessed with sulforaphane. This broccoli-derived compound activates Nrf2, our body's master regulator of antioxidant response, unleashing a cascade of anti-inflammatory and detox enzymes. Unlike most supplements, it has legitimately impressive research—improving cellular defense mechanisms, supporting brain health, and showing genuine cancer-preventive effects in human trials. Most supplements deliver the inactive precursor without the enzyme needed to activate it, rendering them useless. The real deal requires myrosinase enzyme through fresh broccoli sprouts or specific supplements that combine both components. This is one of the few supplements where the mechanism, the dosing, and the human outcomes actually line up. If you're interested in diving deeper into sulforaphane or any other supplements worth considering, let me know—I can dedicate an entire newsletter to the compounds that deserve your attention.

The Decision Framework: Four Questions Before Supplementing

Instead of chasing the next miracle pill, ask yourself these questions:

1. Is there robust evidence it works? Look for systematic reviews and meta-analyses, not single studies or testimonials.
2. Do I have a specific deficiency or need? Target supplements to address your particular situation. Generic "wellness" is too vague.
3. Can I get this through diet or lifestyle changes? Supplements should supplement, not replace fundamentals.
4. Is the quality reliable? Find third-party tested products (NSF, USP, or Informed Choice certified in the US; European Food Safety Authority (EFSA) compliant products in Europe).

The truth about supplements is unsexy: the fundamentals still matter most. Sleep, nutrition, movement, and stress management give you 95% of results. The right supplements might add another 5%—if you're already doing everything else right.

Back to the Drip

I haven't tried a drip clinic yet, and I'm not planning to anytime soon. I know for a fact that shortcuts in health rarely exist.

I stick to what's proven—creatine, protein, fish oil, vitamin D in the winter months, sulforaphane to be edgy. I might try other compounds when evidence becomes compelling, but I'm not paying for "Beauty Glow" to be dripped into my veins based on marketing alone.

I'm not against healthcare innovation—quite the opposite. I oppose selling quick fixes to less informed people, deceiving them with fancy names for basic vitamins delivered through unnecessarily invasive methods.

Until the next miracle molecule has actual evidence, I'll continue putting in the work: optimizing my sleep, engaging my body in physical activity, eating well, and managing stress.

No shortcuts. No drips. Just fundamentals.

Stay healthy.

Andre

---

A note for new readers:

I’m a trained reconstructive facial surgeon, medical doctor, and dentist by training. Before launching my newsletter, I had a varied career: I was a competitive freestyle wrestler, a management consultant (McKinsey), an entrepreneur (Zocdoc, Thermondo, and docdre ventures), and a corporate executive (Sandoz). Today, I’m a Managing Director and Partner at BCG.

If this is your first time here, welcome. I’m excited to share what I’ve learned—and will continue to learn—with you.

---

DISCLAIMER:

Let’s get one thing straight: None of this—whether text, graphics, images, or anything else—is medical or health advice. This newsletter is here to inform, educate, and (hopefully) entertain you, not to diagnose or treat you.

Yes, I’m a trained medical doctor and dentist. No, I’m not your doctor. The content here isn’t a replacement for professional medical advice, diagnosis, or treatment.

If you have questions about your health, talk to your physician or a qualified health professional. Don’t ignore their advice or delay getting care because of something you read in Health, Redefined. Be smart. Do your research. And, as always, take care of yourself.