Evidence-based supplementation

  • The Athlete Stack

    Providing you with supplements that are proven to work is one of the core beliefs at EVR Health. The Athlete Stack will take your performance to the next level. Dive into our evidence below.

    Supported by OpenEvidence.

Creatine Monohydrate

Creatine supplementation is most strongly supported for healthy younger adults, who engage in resistance training, where it significantly improves muscular strength, power, and lean body mass.[1][2] Meta-analyses demonstrate statistically significant gains in compound lifts (bench/chest press, squat), vertical jump, and peak power.[1][2] The International Society of Sports Nutrition states that creatine is one of the most effective and well-studied ergogenic aids for athletes, with a strong safety profile at recommended dosages (typically 3–5 g/day or 0.1 g/kg/day).[3][4]

Older adults also benefit from creatine supplementation, particularly when combined with resistance training, with evidence for augmented gains in lean tissue mass and strength.[5][6] However, the magnitude of benefit is less than in younger populations, and effects are most robust when creatine is paired with structured resistance exercise.[6]

Vegans and vegetarians, who have lower baseline creatine stores due to dietary patterns, may experience improved physical and cognitive performance with supplementation.[7][8] Women may benefit due to lower baseline intramuscular creatine, with potential improvements in fatigue and cognitive function.[7][8]

Emerging evidence supports creatine’s utility in clinical populations, including those with sarcopenia, cachexia, neurodegenerative diseases, and certain cardiovascular conditions, though further high-quality trials are needed for definitive recommendations.[7][8][9]

Creatine monohydrate is the preferred form due to its extensive evidence base and safety profile.[3][4] Adverse effects are rare at recommended doses, and concerns about renal dysfunction or muscle cramping are not supported in healthy individuals.[3][4]

Vitamin D3

Vitamin D3 supplementation provides clear benefits for musculoskeletal health, including prevention and treatment of rickets and osteomalacia, improved bone mineral density, and reduced risk of osteoporotic fractures and falls in individuals with deficiency or increased risk.[1][2][3] There is modest evidence for improvement in mood, particularly depressive symptoms, in those with low baseline vitamin D status.[1] For the immune system, vitamin D3 acts as an immunomodulator and may reduce the risk of autoimmune diseases and respiratory infections in deficient populations, with the strongest evidence for reduced risk of multiple sclerosis and some infections.[4][5][3] Additionally, vitamin D3 supplementation is associated with a reduction in cancer mortality, especially when early follow-up years are excluded from analysis.[1][3]

Evidence for benefits in cognitive decline or dementia is limited; supplementation may offer small cognitive benefits in deficient individuals, but does not robustly prevent dementia in the general population.[1][6] Vitamin D3 may also modestly improve muscle strength in older adults with deficiency, but does not consistently improve muscle mass or power.[1][3] Supplementation reduces markers of inflammation in deficient individuals, but the clinical significance remains under investigation.[5]

Recommended dosing for adults at risk or with deficiency is 800–2000 IU of vitamin D3 daily, with up to 4000 IU/day considered safe for those with increased requirements or severe deficiency.[7][8][1][4] The Endocrine Society and the National Academy of Medicine recommend maintaining serum 25(OH)D above 50 nmol/L (20 ng/mL) for bone health, with some experts advocating for levels above 75 nmol/L (30 ng/mL) for broader health benefits.[1][4]

Magnesium

Magnesium supplementation provides modest benefits for recovery, particularly by reducing muscle soreness and supporting muscle health in the context of exercise, but its effects on sleep and overall exercise performance are limited.

For exercise recovery, several systematic reviews and clinical trials demonstrate that magnesium supplementation can reduce delayed onset muscle soreness, improve perceived recovery, and exert anti-inflammatory effects (e.g., lowering IL-6 after strenuous exercise) in physically active individuals and athletes.[1][2][3][4][5] These effects are most pronounced in those with increased magnesium requirements due to high training loads, with suggested intakes 10–20% higher than sedentary individuals.[1][5] However, improvements in objective performance measures (e.g., maximal force, VO₂max, sprint power) are inconsistent, and some studies report no benefit in well-nourished, non-deficient populations.[6]

Regarding sleep, observational data suggest an association between higher magnesium intake and better sleep quality and duration.[7][8] Randomized controlled trials and meta-analyses show a small reduction in sleep onset latency (about 17 minutes) but no significant increase in total sleep time or consistent improvement in sleep quality scores.[9][10]

In summary, magnesium supplementation may reduce muscle soreness and modestly support recovery in athletes and physically active individuals, but its benefits for sleep and exercise performance are limited.[1][4][2][3][5][9][10][6]