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MARCH 2022 TABLEHOPPING ARTICLE

A big topic amongst many people concerned with longevity and “health gevity” is the use of supplements. I’m not talking about Vitamin D or fish oil. I am talking about more controversial supplements like NR, NMN, and Fisetin. Will these supplements prolong your life and increase your health or will they cause cancer and wreck your metabolism?

We are talking about medications / supplements that affect metabolic pathways of aging including mTOR, but work primarily by affecting the Sirtuin Pathway. This pathway was discovered in the 1970’s and is a major anti-aging force. Aging is not just a date on a calendar …it’s a progressive loss of certain nutrients and an accumulation of certain toxins that ultimately affect basic cellular function including the mitochondria…the powerhouses of your cells.

Let’s start with the basic Niacin or B3. This water soluble vitamin is the backbone of one of the most basic and necessary energy molecules ..NADH that is only second to ATP as an energy store in the body. You can make niacin from the amino acid tryptophan but you can also get it from leafy veggies , liver, most meats, etc. There are several steps in between Niacin and NADH including a compound called Nicotinamide riboside which has been commercially available as a product since 2014. This , in turn, is turned into nicotinamide mononucleotide also called NMN. Two of these NMN molecules make up one unit of NAD which can now act as a hydrogen transporter / energy generator. We know that when we supplement yeast and mice with these agents they are healthier and live longer than unsupplemented animals. What about humans? Well we just don’t have enough answers for me to recommend any of these supplements except Niacin which I recommend people get as a B Complex or B Complete . Dr David Sinclair at Harvard is currently experimenting with all these compounds as well as Resveratrol and other senolytic molecules like ficiden and quercetin which may improve health and extend lifespan..quercetin reduces fatty liver and other markers of poor health/ inflammation. …ficiden is a plant molecule found in grapes, apples and is available as a supplement. Resveratrol also activates the sirtuin pathway but you would need to drink more than a hundred bottles of red wine a day but you can get 250 mg as a daily supplement which should be taken with some olive oil or other fat to improve absorption.

There are clinics in Florida and California where people are going for injections of NAD which they claim helps with depression, addiction and hangovers.

Now there are other classes of drugs that have promise. The drug rapamycin and its analogs have shown benefit of extending life span in every species studied so far it acts to inhibit mTOR it mimics fasting and mimics the effects of a low protein diet.This drug is available as an immunosuppressant for transplant patients so it its commercially available but it’s a stretch I’m not willing to make to take it now for possible health benefits.

Ok, How about spermadin ? These are crystals found in sperm , oddly enough by the inventor of the microscope Antoine Van Leeuwenhoek, and it stimulates autophagy and stabilizes the epigenome…1.2 grams a day improved memory in one trial…you can get it in wheat germ if you like.

What about metformin? This is an AMPK activator drug which is used worldwide for diabetes. Its so safe that in half the world its available over the counter. The drug lowers ATP and produces an increase in mitochondria….its an mTOR inhibitor and raises NAD levels so what’s not to like? Well it’s still artificial and I would like to age as naturally as possible but I am looking forward to better studies and certainly respect people who want to try these compounds.

Which leads us to Berberine which is a plant molecule similar to metformin…it can mimic metformin…it reduces chemical reactions in the body and the body responds by making more energy and mitochondria. You have to use 1-2 grams a day. I plan to try the Berberine for a month and see if it improves any metrics of my health and see how I feel but I will hold off on the others until I see more study results. I am sure there are many more compounds I have left out but that leaves fodder for another column. Until then ….work on the basics of diet and exercise….don’t expect any supplement to be as beneficial as eating health and getting a workout. You know the drill but have to find the motivation to do it. Someone once said change comes from inspiration or desperation ….which will it be for you? Until next month Get Well and Stay Well

JT BARRY MD