Nootropics are sometimes referred to as “smart drugs” or “cognitive enhancers” and the term has come to describe a much wider array of products than ‘nootropics’ was initially intended to represent.

The word was originally coined by Corneliu Giurgea in 1972 to describe “molecules that acted selectively towards the brain’s higher-level integrative activity” [1]. To be a true nootropic, a substance must fulfill Giurgea’s five criteria for the category: aid with improvement in working memory and learning, support brain function under hypoxic conditions or after electroconvulsive therapy, protect the brain from physical or chemical toxicity, enhance natural cognitive functions, and must be non-toxic to humans, without depressive or stimulative effects of the brain [1]. These criteria certainly exclude products with caffeine or synthetic sleep aids, yet there are still products on the market that advertise as nootropics and contain stimulants, and depressants.

It is clear that popular culture has loosened these criteria. The term is now used more broadly to refer to any natural or synthetic substance that may have a positive impact on mental skills or facilitate creativity and focus. In general, nootropics fall into three general categories: dietary supplements, synthetic compounds, and prescription drugs. 

Does Metabolic Maintenance offer any nootropics?

Metabolic offers many dietary supplements with true nootropic nutrients that support or protect brain cells and their functions. Two examples are acetyl L-carnitine and phosphatidylserine, which are available individually, or as components in our Brain Cell Support™ formula. Hyla Cass, M.D., a noted authority on integrative medicine and mental health, designed Brain Cell Support™ to be a potent combination of nutrients and herbs, all supporting normal memory, mood, and focus. The Brain Cell Support™ formula contains the powerful nutrient, Cognizin® citicoline, acetyl L-carnitine, DMAE, phosphatidylserine, and the brain supporting botanicals Ginkgo biloba and Gotu kola.  

Acetyl L-Carnitine

Acetyl L-carnitine helps your brain cells maintain a constant supply of energy for efficient productivity by converting fatty acids into energy. Acetyl L-carnitine is converted into Acetyl-CoA in the brain where it binds with choline to become acetylcholine. Acetylcholine is a neurotransmitter associated with important cognitive functions like learning and memory [2]. One study showed that daily, supplementary acetyl L-carnitine led to a significant increase in memorization power and other cognitive functions for older adults [2]. More than thirty scientific studies with Acetyl L-carnitine have supported its potential to prevent or slow age-related deterioration of mental function [2].

PS-100 (Phosphatidylserine)

Phosphatidylserine (PS) makes up a significant portion of the plasma membrane that surrounds and protects brain cells. It forms part of protein docking sites necessary for the activation of several key signaling pathways and modulates the release of some neurotransmitters and a number of synaptic receptors [3]. Deterioration of some of these structures is associated with deterioration of cognitive function as we age. Supplemental PS has been shown to be highly absorbable, it crosses the blood-brain barrier, and it can slow or even reverse some deterioration of nerve cells [4]. It supports cognitive functions such as short-term memory, the consolidation of long-term memory, creating new and retrieving old memories, the ability to learn and recall information, the ability to focus attention and concentrate, the ability to reason and solve problems, language skills, and the ability to communicate [4].

Brain Cell Support

Cognizin® is a branded version of the naturally occurring chemical citicoline. Citicoline is a dietary source of choline and is considered safer and more effective than taking choline directly [5]. Choline is an important protector and structural component of cell membranes. It also binds with acetyl-CoA to make the neurotransmitter, acetylcholine. Research has shown that choline levels are low in patients experiencing dementia and other cognitive impairments [6]. Taking a citicoline supplement may help balance these levels, thereby protecting brain cells and their functions [6]. Citicoline studies have linked this nutrient with improved memory, processing speed, speed in cognitive tasks, and improved executive function in healthy adults [7,8].

Ginkgo biloba, or Maidenhair tree, probably has the longest history of use out of all of these ingredients. And although it has been used for thousands of years in Chinese medicine, modern clinical trials are just now uncovering the mechanism of its actions. In terms of its nootropic value, Ginkgo extract supplementation has been shown to enhance certain neuropsychological/memory processes of healthy, older adults [9]. Another randomized, placebo-controlled study of healthy individuals showed that self-estimated mental health and quality of life improved after taking Ginkgo biloba extract for 4 weeks [10].   

Gotu kola is another herb with a history of use in Chinese and Ayurvedic medicines. More recent studies have shown that it may boost cognitive function and memory [11,12], and help with excessive worry and anxious feelings [13,14]. 


  1. Giurgea, Corneliu, and Maurice Salama. “Nootropic drugs.” Progress in Neuro-Psychopharmacology 1.3-4 (1977): 235-247.
  2. Tarfarosh, Shah Faisal Ahmad, Ufaq Tromboo, and Faizan Bhat. “Search for a perfect Nootropic supplement combination-Can we increase human intelligence by nutritional supplements.” Journal of Pharmacognosy and Phytochemistry 6.5 (2017): 1020-1024.
  3. Kim, Hee-Yong, Bill X. Huang, and Arthur A. Spector. “Phosphatidylserine in the brain: metabolism and function.” Progress in lipid research 56 (2014): 1-18.
  4. Glade, Michael J., and Kyl Smith. “Phosphatidylserine and the human brain.” Nutrition 31.6 (2015): 781-786.
  5. Synoradzki, Kamil, and Paweł Grieb. “Citicoline: A Superior Form of Choline?.” Nutrients 11.7 (2019): 1569.
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  7. McGlade E, Agoston AM, DiMuzio J et al. (2015) The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males. J Atten Discord.
  8. Knott V, de la Salle S, Choueiry J et al. (2015) Neurocognitive effects of acute choline supplementation in low, medium and high performer healthy volunteers. Pharmacology, biochemistry, and behavior 131, 119-129.
  9. Cieza A, Maier P, Pöppel E. Effects of Ginkgo biloba on mental functioning in healthy volunteers. Arch Med Res. 2003;34(5):373-381. doi:10.1016/j.arcmed.2003.05.001
  10. Lee, Helen, and Jacqueline S. Birks. “Ginkgo biloba for cognitive improvement in healthy individuals.” The Cochrane Database of Systematic Reviews 2018.8 (2018).
  11. Farhana, Kun Marisa, et al. “Effectiveness of gotu kola extract 750 mg and 1000 mg compared with folic acid 3 mg in improving vascular cognitive impairment after stroke.” Evidence-Based Complementary and Alternative Medicine 2016 (2016).
  12. Gray, Nora E., et al. “Centella asiatica modulates antioxidant and mitochondrial pathways and improves cognitive function in mice.” Journal of ethnopharmacology 180 (2016): 78-86.
  13. Sarris, J., McIntyre, E. & Camfield, D.A. Plant-Based Medicines for Anxiety Disorders, Part 2: A Review of Clinical Studies with Supporting Preclinical Evidence. CNS Drugs 27, 301–319 (2013).
  14. Lokanathan, Yogeswaran, et al. “Recent updates in neuroprotective and neuroregenerative potential of Centella asiatica.” The Malaysian journal of medical sciences: MJMS 23.1 (2016): 4.