The Ultimate Supplement Guide: What the Evidence Actually Says (Creatine, BPC-157, NMN & More)

The global wellness industry is a 6.8-trillion-dollar business — more than four times the size of global pharma — and it runs on supplements. But how much of it actually has evidence behind it?In Episode 14 of Overheard in the Emergency Room, Dr Adrian Cois — a board-certified Emergency Physician — walks through the published systematic reviews and meta-analyses for the nine most common supplements of 2026. Which ones have genuine evidence? Which ones are selling you a story? And how should you make decisions in a regulatory environment where, under DSHEA, supplements do not have to be proven safe or effective before they hit the shelf?The episode is anchored by two clinical stories: a coworker asking whether any supplement will stop her from getting sick, and an older man on Social Security spending his limited income on a herbal product while eating free meals at a senior centre. In between, Dr Cois breaks down creatine, vitamin D, omega-3, magnesium, and multivitamins — the five with reasonable evidence — and then takes apart NMN, berberine, collagen, and "detox" supplements — four with very thin evidence and very large marketing budgets.The episode also takes on the February 2026 FDA peptide reclassification, explains why BPC-157's evidence base is 35 rat studies and one uncontrolled case series, and closes with a blinded randomised-trial comparison between the Pfizer-BioNTech mRNA COVID vaccine trial and the retatrutide phase 2 obesity trial — revealing why influencers who dismissed the first while promoting the second are holding incoherent evidentiary standards.•  Supplements are Tier 2 by definition. They cannotsubstitute for diet, movement, sleep, stress management, and a primary carephysician.•  Five supplements with reasonable evidence in specificpopulations: creatine (resistance training), vitamin D (deficiency, older adults, prediabetes, pregnancy), omega-3 (specific cardiovascular contexts), magnesium (blood pressure, migraines), multivitamins (older adults with imperfect diets).•  Four with large marketing and small evidence: NMN, berberine (outside metabolic syndrome), collagen, and "detox" protocols.•  The BPC-157 evidence base is 35 preclinical animal studies and one uncontrolled case series in 12 humans. Reclassification by the FDA in 2026 restored access; it did not validate evidence.•  The three-question cabinet audit: Is there a medical reason? Can I name the evidence? What could this money do elsewhere?Note: Final timestamps to be filled in after recording. Use the YouTube chapter block above as the master, then synchronise to Spotify.Companion blog post with full references, evidence tables, and clinician-facing notes at drcois.com.Educational content only. Not medical advice. Always consult your own physician before starting, stopping, or modifying any supplement or medication regimen.