Fishtown Medicine•7 min read
Supplement Guides
TL;DR · 30-second take
This is the curated set of professional-grade supplements we reach for most often at Fishtown Medicine, organized by clinical use. Each entry links to its full clinical guide where you can read the evidence, dosing, who it is right for, and where to source it. Nothing here replaces a plan matched to your own labs and physiology.
Supplement Guides: What We Recommend Most, and Why
This is a guide library, not a checkout. The supplements below are the ones we reach for most often at Fishtown Medicine, organized by what they actually do. The buy-button for each item lives inside its own clinical guide, where the dose, the evidence, and the cautions sit alongside the link. A few things to keep in mind before you read:- You are never required to buy through us. The same products are usually available direct from the manufacturer (Designs for Health, Nordic Naturals, Pure Encapsulations, Thorne) or any reputable distributor. The convenience is access to the right product and dose at clinical pricing; the value is the clinical context behind the pick.
- This is not a personalized plan. The right supplement, dose, and duration depend on your labs, your medications, and your goals. Use this page to understand the landscape, then bring questions to a visit.
- Read this first. Before any specific supplement, the meta-questions matter: how we evaluate products, what counts as evidence, why most supplements do not work, and how to exit when something is not earning its place. Start with our framework for choosing a supplement and our Digital Health Literacy: why most supplements do not work guide.
- Transparency on incentives. Fishtown Medicine may earn a small margin on supplement orders, which subsidizes our platform costs. It never changes what we recommend or why. Read the full disclosures.
ℹ IMPORTANT
What we do not push. We do not actively manage patients with active cancer; for high-dose vitamin C, IV nutrient therapies, and supplement strategies tied to active oncology care, we defer to and co-manage with an integrative oncology team. Education on these topics belongs on this page because patients ask. Pushing them does not. The same restraint applies to anything without clear human evidence: we will explain what something is, what is being claimed, and what the data actually says - and we will tell you when the answer is "we don't recommend this."
How We Think About Supplements
Before any specific product, these are the essays that frame how we choose, dose, evaluate, and stop supplements.- How We Choose Supplements: Safety, Effectiveness, Cost - the three-gate filter we run every product through.
- Foundational Supplements - the small core that most adults benefit from before any condition-specific work.
- Supplement Strategy - matching the stack to the goal, not the trend.
- Personalized Supplement Logic - why a "best" supplement does not exist outside your labs.
- Precision Supplementation Guide - dosing to a target, not a label.
- Supplement Safety & Independent Testing - what third-party testing actually verifies.
- Supplement Exit Strategies - how to know when a supplement is not earning its place.
- The Greens Powder Delusion - what greens powders are and are not.
- The Prenatal Supplement Trap - what to look for and what to skip in prenatals.
- Why Most Supplements Do Not Work - the literacy piece that explains the rest.
- Supplement Quality and Contamination - what is actually in the bottle.
Sleep, Stress & Mind
The supplements we reach for when sleep is off, the nervous system is over-revved, or the cortisol curve has lost its shape.Melatonin (low-dose)
The hormone your brain naturally makes to begin the sleep cycle. We use the precise low-dose form (0.3 to 1 mg). The drugstore 5 to 10 mg gummies overshoot what biology actually uses. Consider it if you cross time zones, work shifts, or are over 50 with later sleep onset and earlier waking. Read the guide →L-theanine
Smooth, non-sedating calm. Takes the edge off without dulling focus. Consider it if you have situational anxiety, jaw-clenching afternoons, or want to soften your stress response without going to a prescription. Read the guide →Magnesium Glycinate
The form of magnesium that absorbs well and is easy on the gut. Involved in 300+ enzyme reactions including the ones that calm the nervous system and regulate blood pressure. Consider it if you have trouble falling or staying asleep, get muscle cramps, or run on coffee + stress. Read the guide →Phosphatidylserine
A phospholipid concentrated in nerve-cell membranes; helps modulate the cortisol response. Consider it if you are in a chronically high-stress role or noticing slower recall under cognitive load. Read the guide →Ashwagandha
An adaptogen with real human data for stress, sleep, and cortisol. Not a one-size pick. Consider it if you have chronic stress, mid-day cortisol spikes, or sleep that does not feel restorative. Read the guide →Rhodiola
An adaptogen better suited to fatigue + low motivation than anxiety. Works on the energy side of the stress axis. Consider it if you feel chronically drained rather than chronically wound up. Read the guide →Glycine
An amino acid with thermoregulatory effects that help deep sleep. Cheap, well tolerated. Consider it if your sleep is light, fragmented, or feels insufficient even at 7 to 8 hours. Read the guide →Chamomile
A traditional calmer with mild but real anxiolytic data. Useful as a tea or capsule. Consider it if you want a gentle, food-grade option for everyday tension. Read the guide →Valerian
A herbal sedative with a track record going back centuries. Bigger effect than chamomile, with a distinctive smell. Consider it for occasional insomnia or anxiety that you would rather not treat with a prescription. Read the guide →Cognition & Focus
Brain-side supplements with real mechanisms and decent human data.Citicoline
A choline donor that supports neuronal membrane integrity and acetylcholine. Consider it for focus, processing speed, and post-concussive recovery. Read the guide →Lion's Mane
A medicinal mushroom with NGF-stimulating data; one of the few nootropics with reasonable mechanism + human trials. Consider it if you are working on focus, mild cognitive slowing, or post-viral brain fog. Read the guide →L-tyrosine
The amino acid precursor to dopamine. Useful under high cognitive load or sleep deprivation. Consider it for short-term cognitive demand, not as a daily stack item. Read the guide →Ginkgo Biloba
A traditional vascular nootropic with mixed but real evidence for older adults. Consider it for age-related cognitive concerns, alongside vascular risk reduction. Read the guide →Medicinal Mushrooms
A category overview of the cordyceps / chaga / turkey tail / reishi / lion's mane family. Some have real human data, some are mostly tradition + bench science. We use specific mushrooms when the evidence supports the use, not as a generic "more mushrooms" recommendation. Read the guide for an honest read on what each one is and is not. Read the guide →Reishi
The calming mushroom. Adaptogenic, immune-modulating, modestly sleep-supportive. Consider it if you want a gentle daily adaptogen with sleep adjacency. Read the guide →Phosphatidylcholine
The major phospholipid in cell membranes; key for liver function and choline supply. Consider it for cognitive support and liver-health stacks. Read the guide →Heart, Cholesterol & Vascular
The cardiovascular core: the omegas, CoQ10, antioxidant defense.Omega-3 (EPA + DHA)
The single most-evidenced supplement for cardiovascular risk reduction. We dose to an Omega-3 Index of 8% or above. Consider it if you do not eat fatty fish 2-3x/week, have elevated ApoB or triglycerides, or are pursuing a measured Omega-3 Index target. Read the guide →Algae Oil
The vegetarian source of EPA + DHA. Cleaner for those who do not want fish oil; lower DHA per dollar so the dose plan changes. Consider it if you are vegetarian or vegan, or have a strong preference against marine sourcing. Read the guide →CoQ10 (Ubiquinol)
A mitochondrial coenzyme that statins lower. Consider it if you are on a statin, are over 50, or have unexplained muscle aches on cholesterol therapy. Read the guide →Metabolic & Blood Sugar
The supplements that move insulin resistance, glucose variability, or PCOS-related metabolic patterns.Berberine
A plant alkaloid that affects glucose handling at the AMPK level. Real metabolic effect; respect drug interactions. Consider it for prediabetes, PCOS, or as a metformin-alternative discussion when metformin is not tolerated. Read the guide →Inositol (Myo + D-chiro)
The most evidence-supported supplement for PCOS-related insulin resistance and ovulatory dysfunction. Consider it if you have PCOS, irregular cycles, or insulin-resistant fertility concerns. Read the guide →Chromium
A trace mineral with modest data for glucose control. Not a frontline pick but reasonable in some stacks. Consider it as an adjunct in metabolic stacks, not a primary lever. Read the guide →Curcumin
The active phytochemical in turmeric, with anti-inflammatory and metabolic effects. Consider it for inflammatory arthritis, metabolic inflammation, or as a daily anti-inflammatory. Read the guide →Inflammation, Detox & Cellular Defense
The phase-II detox cofactors, antioxidants, and inflammation modulators that show up in complex-care stacks.NAC (N-Acetylcysteine)
The glutathione precursor. The most-used antioxidant in our complex-care stacks. Consider it for chronic inflammation, environmental exposure work, post-COVID recovery, or oxidative-stress conditions. Read the guide →Sulforaphane
A phase-II detox activator derived from broccoli sprouts. Potent at low doses. Consider it for cellular detox work, environmental exposure mitigation, or as a daily Nrf2 activator. Read the guide →Milk Thistle (Silymarin)
The classic liver-support herb with real hepatoprotective data. Consider it if you have elevated liver enzymes, alcohol exposure history, or are on hepatotoxic medications. Read the guide →Quercetin
A polyphenol with mast-cell stabilizing and anti-inflammatory effects. Consider it for histamine-driven symptoms, seasonal allergies, or as an antioxidant adjunct. Read the guide →Green Tea (EGCG)
The cardiometabolic polyphenol with broad antioxidant data. Consider it as a tea or low-dose extract for daily antioxidant load. Read the guide →Black Pepper (Piperine)
A bioavailability enhancer that meaningfully changes the absorption of curcumin and certain other polyphenols. Consider it specifically as a co-factor with curcumin, not a standalone. Read the guide →Gut Health
The microbiome and gut-lining picks. Not everyone needs these; matching to the pattern matters.Multi-strain Probiotic
A Lactobacillus + Bifidobacterium blend selected for shelf-stability and acid survival. Consider it post-antibiotics, during travel, or for general gut + immune support. Not a first-line pick in suspected SIBO. Read the guide →PHGG (Partially Hydrolyzed Guar Gum)
A low-fermentation soluble fiber that is generally well tolerated even in IBS-pattern guts. Consider it for IBS, constipation, or as a starter fiber when most fibers cause bloat. Read the guide →L-Glutamine
An amino acid that fuels enterocytes and supports the gut barrier. Consider it for post-illness gut recovery, intestinal permeability work, or athlete recovery. Read the guide →Hormones - Men's Health
The supplements we use specifically in men's hormone, prostate, and sexual-health contexts.Saw Palmetto
A botanical with meaningful prostate-symptom data for BPH. Consider it for urinary symptoms from BPH, before or alongside prescription therapy. Read the guide →Beta-Sitosterol
A plant sterol with prostate-symptom and cholesterol-modulating effects. Consider it for BPH symptoms, alongside saw palmetto or as an alternative. Read the guide →DHEA
An adrenal hormone precursor. Lab-guided only; not a stack-it-in pick. Consider it only after lab confirmation of low DHEA-S, and in the right age + clinical context. Read the guide →Performance & Muscle
The performance stack: protein, recovery, strength.Creatine Monohydrate
The most-evidenced supplement in the entire performance literature. Also has cognitive and bone-density data. Consider it for strength training, age-related muscle preservation, or cognitive support. Read the guide →Whey Protein
A complete protein with the best leucine profile per dollar. Closes protein gaps when food alone misses the target. Consider it if you are not hitting 1.6 to 2.2 g/kg of protein daily through food. Read the guide →Foundations & Daily Essentials
The base layer: vitamins and minerals where deficiency is common or where the population intake is reliably short.Vitamin D3 + K2
Vitamin D is technically a hormone, with receptors in nearly every tissue. K2 partners by routing calcium into bone instead of arteries. Consider it if your D level is below 40 ng/mL, you get under 15 minutes of midday sun most days, or you have autoimmune, mood, or bone-density risk. Read the guide →Vitamin D3 (standalone)
The standalone D3 deep-dive for when K2 is not appropriate. Consider it when you need higher D3 dosing alone, often during pregnancy or with anticoagulation considerations. Read the guide →Vitamin K2
The fat-soluble vitamin that directs calcium to bone instead of vascular tissue. Consider it alongside vitamin D, or in cardiovascular calcification + bone-density work. Read the guide →B-Complex
The B-vitamin family covering energy production, methylation, and nervous-system function. Consider it for chronic stress, vegetarian/vegan diets, methylation work, or as part of a foundational stack. Read the guide →Vitamin C
The simplest antioxidant + immune cofactor. Dose-dependent and well-tolerated. Consider it for immune-stress periods, iron-absorption support, or as a daily antioxidant base. Note: high-dose IV vitamin C is an integrative oncology context that we do not actively manage; for active oncology patients we co-manage with an integrative oncology team. Read the guide →Zinc
A mineral cofactor for hundreds of enzymes; immune-critical. Common deficiency in older adults and vegetarians. Consider it for immune support, taste/smell concerns, slow wound healing, or as a daily mineral when intake is low. Read the guide →Iron Bisglycinate + Vitamin C
Highly bioavailable iron, gentler than ferrous sulfate, paired with vitamin C for absorption. Treat to a lab number, never blind. Consider it if you have lab-confirmed low ferritin. Heavy menstruators, vegetarians, frequent blood donors, endurance athletes. Read the guide →Calcium
Bone, muscle, nerve - the basics. Best from food first; supplement only when intake is genuinely short. Consider it if your dietary calcium falls below 800 to 1000 mg/day and food adjustment is not getting you there. Read the guide →Potassium
The electrolyte most adults are short on. Critical for blood pressure and muscle function. Consider it for blood pressure work, athletes, or if your potassium intake is well below 3500 mg/day. Read the guide →Biotin
A B-vitamin involved in hair, skin, nails, and metabolism. Marketed bigger than the data, but useful in specific contexts. Consider it for documented deficiency, certain pregnancy contexts, or hair-loss workups; not as a hair-growth promise. Read the guide →Skin, Hair & Connective Tissue
The structural support layer.Collagen Peptides
Hydrolyzed collagen with meaningful joint, tendon, and skin-elasticity data. Consider it for joint support, post-injury rehab, skin elasticity, or hair/nail support. Read the guide →Tallow
A traditional skin product with real fatty-acid biology. We cover it because patients ask about it; we do not actively promote it. Consider it for dry, barrier-compromised skin if the standard options have not worked, and read the guide for what the evidence does and does not say. Read the guide →Methylation & Genetics
MTHFR
A guide to the most-discussed methylation gene, with real but much smaller implications than the internet suggests. We do not run universal MTHFR testing and we do not chase MTHFR-led supplement protocols outside specific indications. Consider this guide if you have a known MTHFR variant flagged on labs, recurrent miscarriage, elevated homocysteine, or a methylated-folate dosing question - and read the guide for what the data actually supports versus what is marketed. Read the guide →Fishtown Medicine
A 90-minute conversation with Dr. Ash. A written plan you can actually follow.
Fishtown Medicine | About
Still have a question?
He answers personally. Usually within a few hours.
Related Intelligence
Longevity Strategies | Fishtown Medicine
Strategies to extend your healthspan and optimize lifespan in Philadelphia.
Read Deep Dive
Metabolic Health
Why you feel tired at 3 PM, and how to fix it.
Read Deep Dive
House Calls & Home Visits Philadelphia | Concierge Medicine
Experience physician-led care in your own environment. Home visits are included with your Fishtown Medicine membership across the Greater Philadelphia area.
Read Deep Dive
Talk it through with Dr. Ash.
If anything you read here raised a question, this is a free 20-minute Warm Invitation Call. Pick a time and we’ll work through it together.
HSA/FSA eligible
No initiation or cancellation fees
No copays
Loading scheduler...
Having trouble with the scheduler? Book directly on Dr. Ash’s calendar