What supplements are recommended for improving poor concentration?

Supplements for Poor Concentration

For otherwise healthy individuals experiencing poor concentration, there is no strong evidence supporting routine supplementation with vitamins, minerals, or other supplements to improve cognitive function. 1

Evidence-Based Recommendations

What NOT to Recommend

The strongest guideline evidence explicitly advises against routine supplementation for cognitive enhancement:

• Do not recommend omega-3 fatty acids for correction of cognitive impairment or prevention of cognitive decline 1
• Do not recommend vitamin B6, B12, or folic acid unless there is documented deficiency 1
• Do not recommend vitamin E for cognitive enhancement 1
• Do not recommend selenium, copper, or vitamin D for prevention or correction of cognitive decline 1
• Do not recommend special medical foods or other nutritional products for cognitive improvement 1

These recommendations come from the 2015 ESPEN Guidelines on Nutrition in Dementia, which systematically reviewed evidence for cognitive enhancement through supplementation and found no benefit in multiple high-quality studies. 1

When Supplementation IS Appropriate

Only supplement when there is documented deficiency, as deficiencies can impair concentration:

Vitamin B12 Deficiency

• Cognitive difficulties and concentration problems are specific symptoms of B12 deficiency 2
• Standard total B12 tests may miss functional deficiency; consider measuring active B12 (holotranscobalamin) or methylmalonic acid (MMA) if clinical suspicion is high despite normal B12 levels 2
• Certain medications (metformin, H2 blockers, anticonvulsants) can impair B12 absorption 2
• Treatment: 1000-2000 μg daily orally when deficiency is confirmed 2

Vitamin D

• Measurement and supplementation (800 IU daily) is recommended for individuals ≥65 years or those with specific risk factors, but not specifically for cognitive enhancement 1

Other Micronutrients

• Up to 40% of individuals aged 65+ have inadequate intake of vitamins or minerals (ascorbate, folate, B12, thiamine, riboflavin, magnesium, iron, zinc) 1
• Supplement only when deficiency is documented through appropriate testing 1

Clinical Approach

First Steps

1. Rule out underlying causes of concentration problems before considering supplements:

   • Depression (concentration problems are a core symptom) 3
   • Medication side effects 2
   • Sleep disorders 4
   • Thyroid dysfunction 1
   • Metabolic disturbances 1

2. Test for deficiencies only when clinically indicated:

   • Age ≥60 years, vegetarian/vegan diet, malabsorption conditions, or specific medications warrant B12 testing 2
   • Consider active B12 or MMA testing if total B12 is borderline and symptoms persist 2

Important Caveats

Relying solely on serum levels can be misleading: Up to 50% of patients with "normal" serum B12 may have metabolic deficiency when measured by MMA. 2 However, this does not justify routine supplementation without documented deficiency.

Natural remedies may be perceived as more acceptable by patients than pharmaceuticals, but lack strong evidence for efficacy in healthy individuals. 5

Antioxidant supplements (vitamins C, E, selenium, beta-carotene) have failed to show benefit in large placebo-controlled trials and may cause adverse effects at high doses. 1