You'll get all kinds of answers but most people I know don't wear anything below the waist. Speedos are really uncomfortable in a wet suit- sack attack if you follow my drift. I use a rash guard top because it stops chaffing where the arms rub while paddling. Other people claim it chafes more, so you need to experiment. If you do use a rash guard top, make sure it fits very snugly, so you don't bunch up material to rub. Some people in cold weather use polypropylene underwear - long johns. It makes getting into the suit much easier, but I don't think it did much for warmth.
Canoe / Kayak Anchors
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