Jellyfish on the brain: a critical look at Prevagen

I’ve been asked many times over the years if stem cell injections at for-profit clinics can help brain function, but recently the more common query is whether brain supplements such as Prevagen actually work. I’m skeptical of both unproven stem cell injections and supplements that are supposed to somehow help the brain, but some of us have stem cells on the brain and I guess others have jellyfish on the brain.

Marketing of brain supplements like Prevagen

If you ever turned on your TV in the last few months, you’ve probably seen many ads for these kinds of supplements. In fact, the number of Prevagen commercials and ads for competitors like Focus Factor seem to have jumped recently, suggesting that more people may be taking brain supplements.

crystal jellyfish aequorea victoria, Prevagen brain supplement
Crystal Jellyfish or Aequorea victoria is source of ingredient in brain supplement Prevagen. Creative Commons image, source Tony Hisgett from Birmingham, UK

What is in Prevagen? Could it work?

So can something like Prevagen work? The commercials suggest brain supplements can do big things like maintain mental sharpness as we age.

As a biologist, I’m highly skeptical of these marketing claims. Some quick searches including on the web found other potential issues about this product (more below) that includes a substance from the jellyfish Aequorea victoria (pictured above).

The claims related to brain function center on a substance from jellyfish called “apoaequorin”.

A jellyfish protein to help the human brain?

It’s not necessarily impossible in theory, but I wasn’t able to find data (e.g. here on Pubmed) that convinced me that apoaequorin helps the brain or memory in a significant way over placebo controls.

The general theory I could make out seems to be that apoaequorin protein may impact calcium signaling in jellyfish. So in some vague way it could help the human brain? In terms of the function of the protein, when apoaequorin binds calcium, blue light is emitted.

Note that as best as I could figure out the apoaequorin protein in Prevagen is manufactured in a lab, not harvested as a natural product from actual jellyfish.

FTC and NY AG action

The Federal Trade Commission and NY State have taken note of brain supplements. From the great Maggie Fox at NBC News we have this headline on FTC action: Jellyfish Memory Supplement Prevagen Is a Hoax, FTC Says. Also, check out the video above from NBC News on this story.

Here’s the actual action by the FTC and a statement by the Commission. I’m not an attorney, but it seems after some ups and downs, the FTC case remains unresolved. The COVID pandemic has really slowed down many courts.

Some of what is at issue seems to be interpretation of results from a subset of people who took brain supplements in a study. Check out this piece from Science Based Medicine for more on that study and the biomedical research issues at hand. In my view, there are reasons for concern about the science.

Prevagen safety, FDA

Wired Magazine just recently put out a helpful piece by Chiara Eisner on Prevagen. The piece estimates that 3 million people have taken the supplement:

“since it was first launched by Quincy Bioscience, a Wisconsin-based manufacturer, in 2007. Sales reached $165 million by mid-2015, and the company claims Prevagen is now a “best-selling branded memory supplement in chain drug stores across the United States.” A month’s supply of the “extra strength” variety retails for about $60 at Walgreens, CVS, and Walmart.”

That’s big money.

It seems many customers assume that supplements must be safe and effective, but the Wired investigation found a lot more to digest:

“An investigation by WIRED now shows that for years officials at the FDA questioned the basis for the company’s claims. Multiple FDA inspections, most of which have not been reported before, found significant issues with Quincy’s manufacturing processes, complaint handling, and the quality control testing that was supposed to ensure its products were safe.”

Eisner also notes possible adverse events that customers have reported, which “worried FDA officials” she writes. However, it seems that aside from an FDA warning letter in 2012 after a 2011 inspection, the agency hasn’t taken much further action. Wired describes some of what the FDA found during that inspection (emphasis mine):

“When FDA inspectors showed up at Quincy Bioscience’s Madison headquarters in 2011, they found records of “more than 1,000 adverse events and product complaints” that had been reported to the company since May 2008. Only two adverse events had been relayed to the FDA or investigated further by Quincy. In an inspection report known as a Form 483, which documents significant potential violations, or “observations,” investigators listed 18 cases that Quincy had decided not to classify as serious and didn’t share with the FDA. They included five reports of seizures, three of strokes or mini-strokes, and four of vertigo, dizziness, or falling that merited medical attention.”

The Wired piece also includes a statement from the maker Quincy Bioscience noting that the FDA issued a close-out letter in regards to the warning letter and that “Prevagen has been thoroughly tested and has GRAS [Generally Recognized As Safe] status.”

It’s hard to gauge where things stand now with the FDA specifically related to brain supplements like Prevagen. The agency did hold a broader meeting on responsible innovation in supplements last year.

Brain supplements more generally

From Harvard Medical School: FDA curbs unfounded memory supplement claims. The author Dr. Robert Shmerling starts off this broader piece by highlighting Prevagen:

“I must have seen the commercial for Prevagen 50 times. Perhaps you’ve seen it, too: “You might take something for your heart… your joints… your digestion. So why wouldn’t you take something for the most important part of you… your brain? With an ingredient originally found in jellyfish! Healthier brain, better life!”

His piece is mainly about more general recent FDA steps to address supplements, which is an important topic.

So is Prevagen worth it? Other brain supplements?

I don’t believe Prevagen or similar brain supplements are worth the money. Also, as with any supplement or drug, there are going to be some risks. Note this quote from a Consumer Reports piece on brain supplements:

“Our experts also recommend avoiding the many supplements, such as FocusFactor and Prevagen, whose labels may claim they can boost brainpower.”

I agree with them. While taking a brain supplement pill is unlikely to be as risky as getting unproven, living stem cells injected into your nervous system, I personally wouldn’t do either.

Some notes

As a biologist I can’t help but wonder for a moment: could it be that taking Prevagen is more likely to make your body glow imperceptibly blue given that light-emitting jellyfish protein in it than the odds that it will safely help your brain function? That’s not likely given that any protein we ingest is likely broken down by your digestive tract.

An interesting side note is that the scientist who first isolated apoaequorin from jellyfish, Osamu Shimomura, also did work on the widely used fluorescent protein called GFP and along with 2 others won the Nobel Prize for work on these proteins.

Note that this post is not intended to be medical advice. When in doubt, always talk to your physician.

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