Essentials: The Biology of Slowing & Reversing Aging | Dr. David Sinclair
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In this episode of Huberman Lab Essentials, Dr. David Sinclair reframes aging not merely as a natural process but as a disease driven by the loss of information within cells due to entropy. He distinguishes between longevity and anti-aging terminology, favoring "aging as a disease" because it highlights that age-related conditions like heart disease and Alzheimer's are largely caused by the body deteriorating over time rather than being independent ailments. Sinclair explains that while DNA acts as digital code on a compact disc, the epigenome functions as the reader determining which genes are active or silent in specific cells at specific times. Aging occurs when these chemical markers, such as methylation, become "scratched" by factors like UV radiation and oxidative stress, causing cells to lose their identity and function correctly. This loss of information is measurable through biological clocks that track changes in the epigenome, often revealing that individuals age biologically faster or slower than their chronological years suggest. The conversation delves into actionable protocols centered on diet and fasting as primary tools for managing this cellular deterioration. Sinclair argues against the 20th-century dogma of constant feeding to protect the pancreas, noting instead that animals living longest are those with periods of hunger. He explains that low levels of insulin and glucose activate longevity genes known as sirtuins, while high nutrient availability triggers pathways like mTOR associated with growth but accelerated aging. To optimize this balance, Sinclair recommends skipping a meal daily to allow the autophagy system—specifically macroautophagy and chaperone-mediated autophagy—to clear out damaged proteins and cellular debris. He suggests that intermittent fasting for 24 hours is accessible for most people, while longer fasts of two or three days can trigger deeper cleansing mechanisms in animals, though he personally finds the latter difficult to sustain without electrolyte supplementation despite not requiring it himself. Supplementation plays a strategic role in Sinclair's longevity protocol, particularly regarding NAD+ levels and iron management. He identifies NMN (nicotinamide mononucleotide) as an effective precursor that can double blood NAD+ levels within two weeks of use, thereby fueling sirtuin activity to repair cells and improve energy production. Conversely, he warns against excess iron intake based on new research from Spain indicating that high iron loads increase senescent "zombie" cells, which drive inflammation and cancer risk. Sinclair emphasizes personalized medicine over average standards; for instance, individuals following his lifestyle often have slightly low hemoglobin or ferritin levels but maintain superhuman energy because their bodies are not burdened by excess inflammatory markers like C-reactive protein (CRP). Tracking metrics such as HbA1c and CRP is essential to monitor inflammation and ensure that one's biological clock remains slow, rather than simply adhering to generic medical advice. Finally, the discussion addresses behavioral modifications including exercise and their profound effects on reproductive health and hormonal balance. Aerobic exercise has been shown in animal studies to raise NAD+ levels and activate sirtuins, helping maintain muscle mass and hormone production like testosterone into old age. Surprisingly, Sinclair notes that caloric restriction can delay infertility in female animals by activating these same pathways, suggesting that the body retains remarkable regenerative powers even after menopause or periods of low fertility when returned to adequate nutrition. He cautions against burning "both ends of the candle" with excessive growth hormone use or extreme physical bulkiness, advocating instead for a balanced approach where cells perceive mild adversity through fasting and exercise without compromising quality of life. Ultimately, Sinclair concludes that while genetics set an initial trajectory, lifestyle choices involving diet timing, nutrient management, and movement can significantly alter the rate at which we age, effectively resetting biological systems to function more youthfully over time.
Read the full video transcript
Welcome to Huberman Lab Essentials,
[music] where we revisit past episodes
for the most potent and actionable
science-based tools for mental health,
physical health, and performance.
I'm Andrew Huberman, and I'm a professor
of neurobiology and ophthalmology at
Stanford School of Medicine. And now, my
conversation with Dr. David Sinclair.
Thanks for being here. I have a ton of
questions for you about aging,
longevity, lifespan, actionable
protocols to increase how long we live,
etc. I just want to start off with a
very simple question. What is
the difference between longevity,
anti-aging, and aging as a disease?
Because I associate you with the
statement aging is a disease. Right.
Well, so longevity is the more academic
way we describe what we research.
Anti-aging is kind of the same thing,
but it's got a bad rap because it's been
used by a whole bunch of people that
don't know what they're talking about.
So, I really don't like that term
anti-aging. But, aging as a disease and
longevity are perfectly valid ways to
talk about this subject. Um so, let's
talk about aging as a disease. Uh when I
started my research disease here at
Harvard Medical School,
it was considered if there's something
that's wrong with you.
Um and it's a rare thing. Has to be less
than 50% of the population.
That's definitely a disease. And then
people work their whole lives to try and
cure that condition.
And so, I looked up what's the
definition of aging. And it says, "Well,
it's a deterioration and it health and
sickness and you can die from it.
Typically, you do."
Um so, I'm thinking that sounds pretty
much like a disease. But, the caveat is
that if more than half the population
gets this condition, aging,
uh it's put in a different bucket. Which
is First of all, that's outrageous cuz
it it's just a totally arbitrary cutoff.
But, think about this, that we're
ignoring the major cause of all these
diseases.
Aging is 80 to 90% the cause of heart
disease, Alzheimer's. If we didn't get
old and our bodies stayed youthful, we
would not get those diseases. And
actually, what we're showing in my lab
is if you turn the clock back in
tissues, those diseases go away. So,
aging is the problem. And instead,
through you know, most of the last 200
years, we've been sticking Band-Aids on
diseases that have already occurred
because of aging, and then it's too
late.
Um so, there are a couple of things. One
is you want to slow aging down so we
don't get those diseases. And when they
do occur, don't just stick a Band-Aid
on. Reverse the age of the body and then
the diseases will go away. That
clarifies a lot for me. Thank you. Can
we point to one specific general
phenomenon in the body that underlies
aging? Fortunately, during the 2000s,
we settled on eight or nine major causes
of aging. These eight or nine causes, uh
at least for the first time, allowed us
to come around and talk together. We put
put them on a on a pizza. So, everyone
got equal slices. But, I think that
there's one slice of the pizza that is
way larger than the others. Uh and we
can get to that, but that's the
information in the cell that I call we
call the epigenome. But, tell us a
little bit more about the epigenome.
Frame it for us, um if if you will. And
um and then we'll get into ways that one
can adjust the epigenome in positive
ways.
Yeah, so in science, what what I like to
do, I'm a reductionist, is to boil it
down um and I actually ended up boiling
aging down to an equation, which is the
the loss of information due to entropy.
I know it's it's a hard thing to
overcome, second law of thermodynamics.
That's that's fair. But, this equation
um
really represents the fact that I think
aging is a loss of information in the
same way that when you Xerox something a
thousand times, you'll lose that
information. Or you try to copy a
cassette tape. Or even if you send
information across the internet, some of
it will get lost.
That's what I think is aging. And there
are two types of information in the
body. There is the genetic information,
which is digital, A, T, C, G, the
chemical letters of DNA. But, there's
this other part of the information in
the body that's just as important. It's
essential, in fact. And that's the
systems that control which genes are
switched on and off, in what cell, at
what time, in response to what we eat,
etc.
And it turns out that 80% of our future
longevity and health is controlled by
this second part, the epigenetic
information, the control systems. Uh I
liken the DNA to the the music that's on
a DVD or compact disc for the younger
people who used to use these things.
>> Yeah. Uh and then the epigenome is the
reader that says, "Okay, in this cell,
we need to play that set of songs. And
in this other cell, we have to play a
different set of songs." But, over time,
aging is the equivalent of scratching
the CD and the DVD so that you
you're not playing the right songs. And
cells, when they don't hear the right
songs, they get messed up and they don't
function well. And that is what I'm
saying is the main driver of aging. And
these other hallmarks are largely
manifestations of that process. What are
the scratches that you're referring to?
So, DNA is 6-ft long. It's like if you
join your chromosomes together, you get
that 6-ft per cell.
So, there's enough to go to the moon and
back eight times in your body. And it
has to be wrapped up to exist in inside
us. But, it's not just wrapped up
willy-nilly. It's not just a bundle of
string. It's wrapped up very carefully
in ways that dictates which genes are
switched on and off.
And when we're developing in the embryo,
the cell marks the DNA with chemicals
that says, "Okay, this gene is for a
nerve cell. You you cell will stay a
nerve cell for the next 100 years, if
you're lucky.
Don't turn into a skin cell. That would
be bad."
Uh and those chemicals, uh there are
many different types of chemicals, but
one's called methylation. Those little
methyls will mark which songs get played
for the rest of your life.
And there are other marks that change
daily. But, in total, what we're saying
is that the body controls the genome
through the ability to mark the DNA and
then compact some parts of it, silence
those genes, don't read those genes, and
open others, keep others open that
should stay open. And that pattern of
genes that are silent and open, silent
open, is what dictates the cell's type,
the cell's function. And then the
scratches are the disruption of that.
So, genes that were once silent,
and you could say it's a gene that is
involved in skin,
it's starting to come on in the brain.
Shouldn't be there, but we see this
happen. And vice versa, the gene might
get shut off over time during aging.
Cells over time lose these structures,
lose their identity. They forget what
they're supposed to do. And we get
diseases.
We call that aging. Uh and we can
measure that. In fact, we can measure it
in such a way that we can predict when
somebody's going to die based on the
changes in those chemicals. Are these
changes the same sorts of changes that
underlie the
outward body surface manifestations of
aging that most of us are familiar with?
Graying of the hair, wrinkling of the
skin, drooping of the uh of the face. Or
are we talking about people that are
potentially are going to look older, but
simply live longer? Uh well, it's
actually you you are as old as you look,
if you want to generalize. Um so, let's
start with centenarian families. These
are families that tend to live over 100.
When they're 70, they still look 50 or
less. So, it is a good good indicator.
It's not perfect because you can, like
me, grow up in Australia and accelerate
the aging of your skin.
Uh but in general, how you look. Uh no
one's ever died from gray hair. But,
overall, you can get a sense just from
the ability of skin to hold itself up,
how thin it is, the number of wrinkles.
Very interesting.
So, I started off in developmental
neurobiology. So, one of the things that
I learned early on that I still believe
uh wholeheartedly is that development
doesn't stop at age 12 or 15 or even 25.
That your entire life is one de- long
developmental arc.
Right.
So, in thinking about different portions
of that developmental arc, the early
portion of infancy, and especially
puberty, seem like especially rapid
stages of aging. And I know we normally
look at babies and children and kids in
puberty, and we think, "Oh, they're so
vital. They're so young."
And yet, the way you describe these
changes in the epigenome, and the way
you have framed aging as a disease,
leads me to ask,
are periods of
of immense vitality
the same periods when we're aging
faster? Yes. Really good question.
So, those chemicals we can measure. It's
It's also known as the Horvath clock.
It's the biological clock. It's separate
from your chronological age. There are
some people that are 10, 20 years
younger than other people um
biologically.
And it turns out if you measure that
clock from birth, or even before birth,
if you look at animals,
there's a massive increase in age on
based on that clock early in life.
So, [clears throat] you're right. That
So, that's a really important point that
you you have accelerated aging during
the first few years of life. And then it
goes linear towards the rest of your
life. But, there's another interesting
thing you brought up, which is that
we're finding that the genes that get
messed up, that get scratched, that are
leading to aging aging, are those early
developmental genes. They come on late
in life and just mess up the system. And
they seem to be particularly susceptible
to those scratches.
So, what are What's causing the
scratches? Well, we know of a couple of
things. In my lab, we figured out one is
broken chromosomes, DNA damage,
particularly cuts to the DNA breaks. So,
if you if you have an X-ray or a cosmic
ray, or even if you go out in the sun,
and you'll get your broken chromosomes.
That
accelerates the unwinding of those
beautiful DNA loops that I mentioned.
Um
we can actually do this to a mouse. We
can accelerate that process, and we get
an old mouse, 50% older. And it has this
bent spine, kyphosis. It has gray hair,
its organs are all So, we now can
control aging the forwards direction.
The other thing that accelerates aging
is massive cell
damage or stress. So, we pinched nerves
uh and we saw that their aging process
was accelerated as well. Incredible.
Yeah, the this is more of an anecdotal
uh phenomenon. It is an anecdotal
phenomenon, but this experience of in
junior high school, you know, going home
for a summer and you come back and then
some of the kids
like they grew beards over the summer or
they completely matured quickly over the
summer.
Do you think there's any reason to
believe that rates of entry into and
through puberty
have can predict overall rates of aging?
Well, yeah, I don't want to scare
anybody. Sure, that there are studies
that show that the slower you take to
develop, it also is predictive of having
a longer healthier life.
Um and it may have something to do with
growth hormone. We know that growth
hormone is pro-aging. So,
anyone who's taking growth hormone, you
know, for a short amount of time, you'll
build up muscle, you feel great, but
it's like burning your candle at both
ends. Ultimately, if you want to live
longer, you want less of that. And the
animals that that have been generated
um and mutants that have low growth
hormone, sometimes these are dwarfs,
um they live the longest by far. Can we
say that there's a direct relationship
between body size and longevity or it
duration of of of life?
>> Well, that there is, uh but that doesn't
mean that you're a slave to your
early epigenome nor to your genome. The
good news is that the epigenome can
change. Those loops and structures can
be modified by how you live your life.
No matter what size you are, you can
have a bigger impact on your life than
anything your genes give you. 80% is
epigenetic, not genetic.
So, let's talk about some of the things
that people can do. And uh I've kind of
batch these into categories um
rather than just diving right into
actionable protocols. So, the first one
relates to food, blood sugar,
insulin. This is something I hear a lot
about that fasting is good for us.
But rarely do I hear why it's good for
us. I think understanding the mechanism
will allow people to make better choices
and not simply to just decide whether or
not they're going to fast or not fast or
how long they're going to fast. I think
should be dictated by someone's
understanding of the mechanism. So, why
is it that having elevated blood sugar,
glucose, and insulin ages us more
quickly
and/or why is it that
having periods of time each day or
perhaps longer can extend our lifespan?
Well, let's start with with what I think
was a big mistake was the idea that
people should never be hungry. Some
people never experience hunger in their
whole lives. It's really, really bad for
them. It was based, I believe, on the
20th century view that you don't want to
stress out the pancreas
uh and you try to keep insulin levels
pretty steady um and not have this this
fluctuation.
What we actually found uh
my colleagues and I
uh across this field of longevity
is that when you look at first of all,
animals, whether it's a dog or a mouse
or a monkey,
the ones that live the longest by far,
30% longer, and stay healthy
are the ones that don't eat all the
time.
Um actually, it was first discovered
back in the early 20th century, but
people ignored it.
And then it was rediscovered in uh the
1930s. Clive McCay did caloric
restriction. He put cellulose in the
food of rats so they couldn't get as
many calories even though they ate. And
those rats lived 30% longer.
But then it it went away and then it
came back in the 2000s in a big way when
a couple of things happened. One is that
uh my lab and others showed that
there are longevity genes in the body
that come on and protect us from aging
and disease.
The group of genes that I work on are
called sirtuins. There's seven of them.
And we showed in 2005
uh in a science paper that
if you have low levels of insulin and
another molecule called insulin-like
growth factor,
those low levels turn on the longevity
genes.
One of them that's really important is
called sirtuin
and but by having high levels of insulin
all day,
being fed means your longevity genes are
not switched on.
So, you're falling apart, your
epigenome, your information that keeps
your cells functioning over time
degrades quickly. Your clock is ticking
faster
by always being fed.
Okay? Um the other thing that I think
might be happening
by always having food around
is that it's not allowing the cell to
have periods of rest and and reestablish
the epigenome.
And so, it also is accelerating in that
direction.
There's plenty of other reasons as well
that are not as profound such as
um having low levels of glucose in your
body will trigger your major muscles and
your brain to become more uh sensitive
to insulin and suck the glucose out of
your bloodstream, which is very good.
You don't want to have glucose flowing
around too much. And that will ward off
type 2 diabetes. What is the protocol
that people can extrapolate from that?
Well, if there's one thing I I could
say, if
I would say definitely try to skip a
meal a day.
That's the best thing. Does it matter
which meal or are they essentially
equivalent?
>> Well, as long as it's at the end or the
beginning of the day because then you
you add that to the sleep period where
you're hopefully not eating. Be aware
that the first two to three weeks when
you try that, you will feel hungry and
you also have a habit of wanting to chew
on something. There's a lot of physical
parts to it.
But try to make it through the first
three weeks and do without breakfast or
do without dinner.
Uh and I you'll get through it. Do you
ever do longer fasts like 48 hours or 72
hours or week-long fasts? Not very
often. I find it
quite difficult to go more than 24
hours.
Uh but when I do it, maybe it's once a
month I'll go for two days.
Um
after two and actually even better if
you go for three days without eating, it
kicks in even greater
uh longevity benefits. Um so, there's a
system called the autophagy system,
which digests old and misfolded proteins
in the body.
And there's a natural cleansing that
happens when you're hungry.
Um macroautophagy it's name is. But a
good friend of mine uh Ana Maria Cuervo
at Albert Einstein College of Medicine
discovered a a deep cleanse called the
chaperone-mediated autophagy, which
kicks in day two, day three,
uh which really gets rid of the the
the deep proteins. And what what excites
me is she just put out a a big paper
that said, if you trigger this process
in an in an old mouse, it lives 35%
longer. When you are fasting, regardless
of how long. I know you're ingesting
fluids like water and uh presumably some
caffeine. I heard you had several or
more espresso today. Are you also
ingesting electrolytes? Like I know some
people get light-headed, they start to
feel shaky when they fast um and that
the addition of sodium to their water or
potassium, magnesium,
something that's becoming a little more
in vogue now. Is that something that you
do or that you see a need for people to
do? Well, it makes sense um but I
haven't had a need to do it.
Um so, I don't. I just I drink tea
during the day and coffee when I'm first
awake.
And I don't get the shakes. So, you
know, I I don't fix what's not broken.
Okay. You've told us that there is ample
evidence that keeping your blood sugar
low for a period of time each 24 hours
can help trigger some of these pro-
longevity, anti-aging mechanisms. And
that extending them out two or three
days can trigger yet additional
mechanisms of of
eat gobbling up of of dead cells and
things of that sort.
How is it that blood glucose triggers
these mechanisms? Cuz we've said, okay,
remove glucose and things get better. Uh
you've uh talked before, maybe we could
talk more now about some of the
underlying cellular and genetic
mechanisms, things like the sirtuins.
But how are glucose and the sirtuins
actually tethered to one another
mechanistically?
Uh there's a really good question.
That proves you're a scientist. Uh
a world leading one. So, what we what
we've now know is that these longevity
pathways, we call them these longevity
genes, talk to each other.
And we used to say, "Oh, my longevity
gene is more important than yours." It
was ridiculous cuz they're all talking
to each other. You pull one lever and
the other one moves.
And the way to think of it is that there
are systems set up to detect what you're
eating. So, the sirtuins will mainly
respond to sugar and insulin.
And then there's this other system
called mTOR,
which is sensing how much protein or
amino acids are coming into your body.
And they talk to each other. We can pull
one and affect the other and vice versa.
But together, when you're fasting,
you'll get the sirtuin activation, which
is good for you, and you you'll also,
through lack of amino acids,
particularly three of them, leucine,
isoleucine, valine, the body will
downregulate mTOR. And it's that up
sirtuin, down mTOR
that is hugely beneficial and turns on
all of the body's defenses, the pro
chewing up the old proteins, improving
insulin sensitivity, giving us more
energy, repairing cells.
All of that. And and so, these two
pathways I think are the most important
for longevity. You mentioned leucine.
It's clear that because of leucine's
effects on the mTOR pathway, that there
are many people, not just people in
these particular fitness communities,
that are actively trying to ingest more
leucine on a regular basis in order to
maximize their wellness and fitness and
in some cases muscle growth, but also
just wellness. But what
I interpret your last statement to mean
is that leucine, because it triggers
cellular growth, is actually pro-aging
in some sense. Is that right? That's
what the evidence suggests. And again,
it goes back to the debate, should you
supplement with growth hormone or
testosterone?
All of these activities will give you
immediate benefits. You'll you'll bulk
up more, you'll feel better immediately.
But based on the research, it's at the
expense of long-term health.
So my
view of longevity, the way I treat my
body is
um I don't burn both candles. I have one
end of the candle lit. I I'm very
careful. I don't blow on it.
Um but I also do enough exercise that
I'm building up my muscle, but I'm I'm
not huge. Anyone who's seen me, you
know, knows that I'm not a a
professional bodybuilder.
But I tried to actually Here's the key,
and I haven't said this publicly that I
can remember.
I pulse things so that I get periods of
fasting, and then I eat.
Then I take a supplement.
Then I fast. Then I exercise. And I'm
I'm taking the supplements and eating
in the right timing to allow me to build
up muscle sometimes.
Because
you can't just expect to take something
constantly and do something constantly
for it to work. And that's that's why
it's taken me about 15 years to develop
my protocol. And there's a there's a lot
of subtlety to it. What you want to do
is to get the cells to be
perceiving adversity.
Okay? Cuz our modern life, we're sitting
around, we're eating too much.
Uh we're not exercising.
Our cells respond. They go, "Hey,
everything's cool. No problem."
And they become relaxed and they're
going to turn on their defenses, and we
age rapidly. We can see it in the clock.
People who exercise and eat less have a
slower ticking clock. It's It's a fact.
One of the questions I get asked all the
time is, "Does ingesting blank break the
fast? Does eating this or drinking this,
coffee, you know, if I walk in the room
and someone else is eating a cracker,
does it break my fast?" You know, people
get pretty extreme with this. My sense,
and please tell me if I'm wrong,
but my sense is that it depends on the
context of what you did the night
before, whether or not you're diabetic,
lots of things. So for instance, if I
eat an enormous meal at midnight,
go to sleep, wake up at 6:00 a.m.,
I could imagine that black coffee
or coffee with a little bit of cream
might, quote unquote, break my fast, but
the body doesn't have a breaking the
fast switch. The body only speaks in the
language of glucose, AMPK, mTOR, etc.
So,
do you worry that ingesting these
calories is going to, quote unquote,
break your fast? And more generally, how
do you think about the issue of whether
or not you're fasting enough to get
these positive effects? Because I Not
everybody
can manage on just water.
Or just tea. Or we should say not
everybody is willing to manage on just
water or just tea for certain part of
the day.
Well, the my first answer is not
scientific. It's philosophical. If you
don't enjoy life, what's the point? Um
and so I I'd like a cup of coffee in the
morning, little bit of milk.
Spoonful of yogurt's not going to kill
me.
Um olive oil doesn't have protein or
carbs in it, not many.
And so I'm probably not affecting those
longevity pathways negatively.
Um
but without that, uh first of all, I
wouldn't enjoy my life as much. Second,
well, the olive oil isn't is not as
great as the yogurt, but
uh I'm trying to optimize, and there's
no perfect solution to what we're doing,
and we're still learning. We don't know
what's optimal for me, let alone
everybody else.
But I I I'm with you. I don't believe
that taking a couple of spoonfuls of
something, unless it's high fructose
corn syrup, is going to hurt you. The
point about doing this is that you try
to do your best.
If If you go from regular living to
don't eat the whole day, you're going to
fail. Like quitting smoking cold turkey,
it's easier to chew gum and stick the
patch on.
Cuz your body has to get used to all
sorts of habits. And it's social, it's
physical, putting stuff in your mouth,
chewing, not just the low blood sugar
levels. And your brain will fight it.
Your limbic system is going to go, "Hey,
do it, do it, do it." And you're going
to have to fight it. Once you But once
you get through it,
you'll be better, but you do it in
stages. Don't go cold turkey, cuz
everyone knows it's a fact that if you
try to do a strict diet right out of the
gates, you'll almost always fail. That
captures the the essence of of fasting
rationally, an irrational approach to it
to supplementation very well. Along the
lines of supplementation, what about
NMN? How does one incorporate that into
a
supplementation protocol should they
choose to do that? All right.
Well, disclaimer is that I don't
recommend anything, but I talk about
what I do. So a bit of scientific
background, these sirtuin genes that we
discovered first in yeast cells when I
was at MIT,
and then in animals as I moved to
Harvard in the 2000s,
um and one of my one of my first
postdocs, actually literally my first
postdoc, Haim Cohen, published a great
paper and found that turning on the
sirtuin 6 gene, remember there's seven.
Number 6 gene is very potent. It
extended the lifespan dramatically of
mice that he engineered, both males and
females, which is great.
So what you want to do is naturally
boost the activity of these sirtuins.
They are genes, but they also make
proteins. That's what genes typically
make uh or encode. And then those
proteins take care of the body in many
different ways. NAD levels are really
important for keeping those sirtuin
defenses
at a youthful level. I take a precursor
to NAD called NMN,
and the body uses that to make
the NAD molecule in one step.
And so I know from measuring dozens of
human beings
that if you take NMN
for the time period that I do, I've been
taking it for years, but if you take it
for about 2 weeks, you'll double
on average double your NAD levels in the
blood. So I just want to be people to be
aware that
what I do may not perfectly or work at
all for others.
But I have studied, as I said, dozens of
people who take NMN
at a gram,
sometimes 2 g, and I know by looking at
all those people that without any
exceptions, that if you do what I do,
your NAD levels go up by about twofold
or more.
Anecdotally, cuz I've been taking this
for a long time, if I don't take it, I
start to feel 50 years old. It's
horrible. Um I can't think straight. I
It may may be placebo, but who knows?
But what we're doing now are very
careful clinical trials. I want to talk
about iron
and iron load. I don't think we can get
right down into how much iron somebody
needs, because it'll vary person to
person. But I was surprised to learn
that iron is actually going to
accelerate the aging process uh in
various contexts. This is new finding a
new finding out of Spain. Manuel
Serrano's lab has found that
uh excess iron will increase the number
of senescent cells in the body.
Uh and senescent cells are these zombie
cells that accumulate as you get older,
and they sit there, and they cause
inflammation mainly, and also can cause
cancer.
Uh and it's found that if you get rid of
these cells or never accumulate them, um
you stay younger.
Uh in in animals, and there's
some really interesting studies out of
Mayo Clinic in humans as well.
And what I find, for example, is people
who are really healthy and live the way
I do, and have a diet that's
um fairly vegetarian, but not strict,
uh still have slightly low hemoglobin
levels, slightly low iron, slightly low
ferritin.
But we have super amounts of energy.
We're not anemic.
And we're getting along with great in
life.
But a a doctor who just looks at that
might say, "Oh, we need to give you more
iron."
All right. So what I'm getting at is an
an example of we need to personalize
medicine and look at people over the
long run to know what works for them and
what's healthy for for them. And not
just work towards the average human, but
work towards what's optimal for human.
I love that answer. I You mentioned
tracking and tracking over time, and
this is a really interesting area that I
know you have been focused on for a long
time. I've been getting blood work done
about every 6 months since I frankly
since I was in college. I just got I
like data. Are there any things that you
pay attention to that you think are
particularly interesting for people to
just take note of? I mean, we're not
asking you to go against anybody's
physician, but what sorts of things
should people start to educate
themselves about in terms of what these
molecules are on their charts if they
choose to get them? And what do you what
do you look at? Yeah. Yeah. Um the first
is that you should be tracking things um
because one measurement isn't enough.
These things vary and over time, and you
If you can have a decade or more of
data, it's super informative, as you
know. But there are some main ones. I
would say uh your blood sugar levels.
You want to do your HbA1c, which is your
average glucose levels over the month.
There's uh CRP, which I mentioned for
inflammation. Yeah, let's talk about
C-reactive protein for a second, cuz I
think um it's been shown to be an early
marker of macular degeneration, of of uh
heart disease, a variety of different
things. Um CRP is something that we
don't hear enough about, I think. It is
a the best marker for cardiovascular
inflammation, and is also we use it as a
predictor of longevity.
And its levels go up at with
mortality.
Um and so there's an association, but
there's enough data that I would say if
you have high levels of CRP, you need to
get your levels down quickly. And the
levels usually go up with age
uh and with levels of inflammation. So
the ways to get it down would be to
switch the diet, eat less, uh try to eat
more vegetables, you'll find it will
come down. There are also drugs that can
do it.
Uh anti-inflammatories um can do it as
well.
But CRP is It's actually HCRP. There's a
high sensitive or HSCRP. Your doctor
will know. Get one of those readings,
cuz if if you've got normal blood sugar
levels, your doctor or fasting blood
sugar levels, um
your doctor might say you're fine.
But a lot of people have normal blood
sugar but have high CRP, which is just
as bad for you long-term and can predict
a future heart attack.
Zooming way out, what are the behavioral
tools that one can start to think about
in terms of ways to modulate these,
uh, you know, basically the way that DNA
is is being expressed and functioning.
In other words, what are the sorts of
things that people can do to improve the
sirtuin pathway? And I I realize that
there are caveats. We can't go directly
from a behavior to sirtuins, but in the
general theme, what what can people do?
What do you do? Well, we know that that
aerobic exercise in mice and rats raises
their NAD levels and and their levels of
sirt
one of the genes goes up, uh, two
actually, number one and number three. I
I base my exercise on the scientific
literature, which
has shown that
uh, maintaining muscle mass is very
important for a number of reasons. The
two main ones are
uh, you want to maintain your hormone
levels. I'm an older male, losing my
testosterone and muscle mass over time.
And by exercising, I will maintain that
and have uh, in fact, I've I've I
probably haven't had a body like this
since I was 20. So, that's
one of the the benefits of having this
lifestyle. What about estrogen? Because
women are different in the sense that
they do,
uh, the number of eggs that they in the
ovaries change over time, right?
Uh, do you think that they can maintain
estrogen levels at in uh, over longer
periods of time using some of these same
protocols? I I don't want to get too
much into the anecdotes, but I'll tell
you the science, which is
uh, that
if you take a a mouse and put it on
fasting or caloric restriction
for
up until the point where it should be
infertile. So, that's about it at a year
of age, a mouse gets infertile female
mouse due to due to fasting. Or due to
simply to aging. Due to aging. Due to
aging. The fasting, it's it's not a
extreme fast. It's just less calories.
>> Then you put them back on a regular food
and they become fertile again
for a many, many months afterwards. So,
the the effect on slowing down aging is
also on the reproductive system.
Interesting. And so, that I wouldn't say
to any woman, I wouldn't think that they
should become super skinny to try and
preserve fertility. That's not what I'm
saying. But these pathways that we work
on, these sirtuins, are known to delay
infertility in female animals.
Case in point, um, I'm one of the lead
authors on a paper where we used NMN.
Remember, this is the gas, the fuel, the
petrol for the sirtuins.
We gave old mice, uh, one group of mice
was 16 months old. Remember, they became
infertile at 12.
Gave them NMN
and I think it was only 6 weeks later,
they had
offspring.
They became fertile again, which
goes against biology, a textbook
biology, which is that female mammals
run out of eggs. Turns out that's not
true. You can rejuvenate the female
reproductive system and even get them to
come out of menopause, as we call it.
So, that's a whole new paradigm in
biology as well. What I think is really
interesting is that what we're learning
from work that you and your colleagues
have done and in my lab as well is that
the body has remarkable powers of
healing
and recovering from illness and injury.
And what we once thought was a one-way
street and you just can't repair, you
can't get over these diseases, you can
reset the system and the body can really
get rejuvenated in ways that in the
future we'll wonder why why didn't we
work on this earlier. And thank you for
talking to us today. I I realize I took
us
down deep into the guts of of mechanism
and and as well talking about global
protocols, everything from what one can
do and take if they choose that's right
for them,
um, to how to think about this whole
process that that we,
uh, talk about when we talk about
lifespan is, um, as always an in
incredibly illuminating. Thank you,
David. Thanks, Andrew.