Kosher Evidence Card — EPA/DHA Omega-3

Evidence Tier

Tier 1

Human Evidence Type

Large RCTs + meta-analyses (REDUCE-IT, STRENGTH, ASCEND)

Kosher Status

OU · OK · Star-K certified products available

Pareve / Dairy / Fish

OU-Fish (fish oil) or Pareve (algal-derived)

Capsule Shell

Fish gelatin (OU-F), bovine kosher gelatin, or HPMC — verify on label

Medication Caution

Anticoagulants/antiplatelets (bleeding risk); discuss with physician before surgery

Test Before Use

Omega-3 Index (target 8–12%), triglycerides, ApoB

Retest Marker

Omega-3 Index at 3–4 months; lipid panel at 3 months

Ask Your Rav About

Fish gelatin acceptability for your community; whether fish-derived oil may be eaten alongside meat meals

Human RCTREDUCE-IT · 4 g/d icosapent ethyl · n=8,179 statin-treated adults with elevated triglyceridesN Engl J Med 2019 · primary endpoint: composite of cardiovascular death, nonfatal MI, nonfatal stroke, coronary revascularization, unstable angina25% relative reduction in major adverse cardiovascular events vs. placebo over a median 4.9 years of follow-up.REDUCE-IT used purified icosapent ethyl (EPA only) at a prescription-strength dose. Standard over-the-counter mixed EPA/DHA fish oil at 1 g/d has not shown the same MACE benefit in trials like STRENGTH or ASCEND.

Kosher Evidence Card — Creatine Monohydrate

Evidence Tier

Tier 1

Human Evidence Type

500+ RCTs; multiple meta-analyses in older adults

Kosher Status

OU, OK, and Badatz-certified options available (synthetic, non-animal origin)

Pareve / Dairy / Fish

Pareve (synthetic)

Capsule Shell

Most users take powder — no shell. Capsule forms: prefer HPMC or kosher-certified gelatin

Medication Caution

Caution with nephrotoxic drugs; hydrate well; not for advanced CKD without supervision

Test Before Use

eGFR / creatinine baseline (creatine raises serum creatinine without harming kidneys)

Retest Marker

Grip strength, lean mass, eGFR at 3–6 months

Ask Your Rav About

Use on Shabbat (powder vs. capsule); Pesach kitniyot-derivative status if synthesized from corn-derived intermediates

Meta-analysis2025 systematic review · creatine + resistance training in adults >50 · pooled across multiple RCTsPMC 2025 · outcomes: lean mass, grip strength, functional capacityConsistent improvements in muscle mass, strength, and physical function vs. resistance training alone. Decades of safety data in healthy adults at 3–5 g/d.No randomized trial has demonstrated a lifespan or all-cause mortality benefit in humans. Most older-adult trials are 12–52 weeks; very long-term outcomes are not characterized.

Kosher Evidence Card — Vitamin D3 (Lichen-Derived)

Evidence Tier

Tier 1

Human Evidence Type

VITAL trial + multiple meta-analyses; latency-adjusted mortality signal

Kosher Status

Lichen-derived D3 — OU/OK certified options available. Avoid lanolin-derived D3 if pareve required.

Pareve / Dairy / Fish

Pareve (lichen). Lanolin-derived = derived from sheep wool wax — ask your rav.

Capsule Shell

Softgel (often bovine or fish gelatin) or HPMC — verify; many lichen D3 brands use HPMC pareve

Medication Caution

Thiazide diuretics + high-dose D = hypercalcemia risk; monitor calcium

Test Before Use

Serum 25(OH)D, calcium, PTH

Retest Marker

25(OH)D at 3 months (target 40–60 ng/mL)

Ask Your Rav About

Acceptability of lanolin-derived D3 (most poskim permit; some communities prefer lichen); use of softgels containing non-kosher gelatin in choleh contexts

Human RCTVITAL · vitamin D3 2,000 IU/d vs. placebo · n=25,871 adults ≥50N Engl J Med 2019 · primary endpoints: invasive cancer, major cardiovascular events · median 5.3 yr follow-upNo reduction in primary endpoints. Latency-adjusted secondary analyses showed a signal for reduced cancer mortality after the first 2 years.VITAL enrolled mostly D-replete adults at baseline. Benefit in deficient populations (25(OH)D < 20 ng/mL) and on bone-fracture endpoints requires separate trials. D3 dose, target serum level, and duration to retest should be individualized with your physician.

Kosher Evidence Card — Magnesium Glycinate

Evidence Tier

Tier 1

Human Evidence Type

RCT meta-analyses for BP, sleep latency, insulin sensitivity

Kosher Status

OU / OK / Star-K commonly certified

Pareve / Dairy / Fish

Pareve

Capsule Shell

HPMC pareve is widely available; verify on bottle

Medication Caution

Use cautiously with renal disease, bisphosphonates, certain antibiotics (separate by 2 hours)

Test Before Use

RBC magnesium (more sensitive than serum); eGFR

Retest Marker

RBC magnesium at 3 months; sleep quality and BP self-tracking

Ask Your Rav About

Glycine source if fermentation-derived from non-kosher substrate — most certified brands clear this concern

Meta-analysisZhang 2016 · oral magnesium supplementation · 34 RCTs, n=2,028 adultsHypertension 2016 · median dose 368 mg/d · median duration 3 monthsPooled systolic BP reduction of −2.00 mmHg (95% CI −0.43 to −3.58) and diastolic −1.78 mmHg vs. placebo. Effect was greatest at ≥300 mg/d for ≥1 month.BP reductions are modest at the population level. Sleep and insulin sensitivity benefits come from separate, smaller trials — not from this BP meta-analysis. Glycinate form is preferred for tolerability but the meta-analysis pooled multiple magnesium salts.

Kosher Evidence Card — NMN

Evidence Tier

Tier 2 — promising; mortality endpoints not yet established

Human Evidence Type

Yoshino 2021 (Science) + smaller RCTs on insulin sensitivity and walking distance

Kosher Status

NutraBio and other brands carry OU/OK certification; verify on current label

Pareve / Dairy / Fish

Pareve (microbial fermentation)

Capsule Shell

Verify shell — HPMC preferred for pareve users

Medication Caution

Limited drug-interaction data; theoretical caution with active cancer; discuss with physician

Test Before Use

HOMA-IR, fasting glucose, ApoB, hsCRP

Retest Marker

HOMA-IR, fasting glucose at 12 weeks

Ask Your Rav About

FDA NMN-as-drug status (US) and whether your community treats it as nutraceutical vs. medication; fermentation substrate (corn = kitniyot question on Pesach)

Human RCTYoshino 2021 · NMN 250 mg/d vs. placebo · n=25 postmenopausal women with prediabetes · 10 weeksScience 2021 · primary endpoint: muscle insulin sensitivity (hyperinsulinemic-euglycemic clamp)25% increase in muscle insulin sensitivity vs. placebo. Improvements in muscle remodeling pathways on biopsy.Single small trial in a specific population (prediabetic, postmenopausal women). No mortality, longevity, or hard cardiovascular endpoints. Optimal dose, duration, and benefit in healthy adults remain unproven. Larger confirmatory RCTs are needed.

Kosher Evidence Card — GlyNAC (Glycine + NAC)

Evidence Tier

Tier 2

Human Evidence Type

Kumar 2023 RCT in older adults; pilot trials in HIV+ adults and youth metabolic syndrome

Kosher Status

Some brands certified; many uncertified — verify both glycine and NAC are kosher-sourced

Pareve / Dairy / Fish

Pareve (amino acids), assuming fermentation substrate is kosher

Capsule Shell

Often two large HPMC capsules per dose; verify shell on label

Medication Caution

NAC may interact with nitroglycerin and certain chemotherapies; ask physician

Test Before Use

hsCRP, fasting glucose, HOMA-IR; consider GSH/GSSG if available

Retest Marker

hsCRP and HOMA-IR at 12–16 weeks

Ask Your Rav About

NAC source (fermentation can be from non-kosher media); use during fasts (Tisha B'Av, Yom Kippur) where amino acids may be considered food rather than medication

Human RCTKumar 2023 · GlyNAC (glycine + N-acetylcysteine, 1:1) · 16-week RCT in older adultsJ Gerontol A Biol Sci Med Sci 2023 · outcomes: oxidative stress markers, mitochondrial function, insulin resistance, grip strength, gait speedImprovements in glutathione, oxidative stress, mitochondrial function, insulin resistance, body composition, and strength vs. placebo.Small single-center trial. No mortality or longevity endpoints. Long-term safety at the studied dose (~100 mg/kg of each amino acid) is not characterized. Independent replication is pending.

Kosher Evidence Card — Curcumin

Evidence Tier

Tier 3 — promising biomarker shifts; mortality endpoints not yet shown

Human Evidence Type

Multiple RCTs: hsCRP ↓, knee pain ↓ (Meriva); no long-term mortality trials

Kosher Status

OU / OK available; phytosomal forms require careful sourcing

Pareve / Dairy / Fish

Plant-derived — but phytosomal/lecithin formulations may be soy- or dairy-derived (often dairy lecithin). Read label.

Capsule Shell

HPMC or gelatin; phytosomal liquid filled in softgels — verify both shell and oil base

Medication Caution

Antiplatelets/anticoagulants; CYP3A4/2D6 substrates; iron absorption with high doses

Test Before Use

hsCRP, lipid panel; pain self-rating baseline if joint-focused

Retest Marker

hsCRP at 8–12 weeks; symptom diary weekly

Ask Your Rav About

Phytosomal carrier source (dairy lecithin = dairy status); piperine-containing combinations if pepper-blend kosher certification unclear

Human RCTMeriva osteoarthritis RCT · curcumin phytosome 1 g/d vs. standard care · n=100 with knee OA · 3 monthsPanminerva Med 2010 · outcomes: WOMAC pain/function score, hsCRP, mobilitySignificant reductions in pain, stiffness, and inflammatory markers (hsCRP) vs. control; improved walking distance.No longevity or mortality endpoints. Open-label design (not double-blind). Curcumin bioavailability varies enormously between brands and formulations — results do not transfer to plain turmeric extracts.