#393 ‒ AMA #85: A guide to medications and supplements: determining what to take, what to skip, and how to know if they're working for you

Peter Attia

May 25, 2026

Episode description

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In this "Ask Me Anything" (AMA) episode, Peter explores how to think critically about medications and supplements by focusing not on whether an intervention is inherently "good" or "bad," but on whether it makes sense for a specific person with a specific problem. He explains why clearly defining the problem matters more than choosing the intervention itself, how the intended purpose of a medication or supplement should influence the standard of evidence required, and why mechanistic reasoning alone is rarely enough to justify taking something. Peter also examines how baseline risk shapes the true benefit of an intervention, why relative risk statistics can be misleading without proper context, and how to weigh not only side effects, but also cost, inconvenience, and opportunity cost when deciding whether something is worth taking. Additionally, he discusses practical ways to evaluate whether a supplement is actually having a meaningful effect, how to think about discontinuing therapies, why supplements deserve far more skepticism than they often receive, and the small group of over-the-counter supplements he believes may offer a reasonable risk-reward trade-off.

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We discuss:

  • How to properly define health problems before considering medications or supplements [1:45];

  • How the intended purpose of an intervention should determine evidence standards and risk tolerance [5:00];

  • Understanding the hierarchy of evidence for medications and supplements

Mindsip insights from this episode:

Prioritize validated biomarkers like APOB for risk reduction

For risk reduction, rely on well-validated surrogate biomarkers like APOB, not vague markers often cited for things like detoxification.

Distinguish longevity optimizations from risk reductions

Most longevity interventions are really 'optimizations' masquerading as 'risk reductions,' borrowing the language of prevention but lacking strong evidence.

Set specific metrics for health goals to measure success

A proper health goal must include a specific metric, a target threshold, and a time horizon to know if an intervention is actually working.

Evaluate consequences of inaction before interventions

Before starting any intervention, ask what the consequence of doing nothing is to separate real problems from things that just feel actionable.

Classify supplements and medications by their intervention jobs

Classify any supplement or medication into one of four jobs—disease treatment, symptom relief, risk reduction, or optimization—as each requires a different level of evidence and risk tolerance.

Define specific problems before considering supplements or medications

Do not start with a supplement or medication you've heard about; start by defining a specific problem you want to solve.

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