supplements

NAD, NMN, NR, and Injectable NAD: What Actually Makes Sense?

| johnas9000

If you spend any time around the longevity world today, you will quickly hear about Nicotinamide adenine dinucleotide (NAD) and the supplements that are supposed to raise it.

People talk about NAD like it is the master switch for aging, energy, brain function, and metabolism. Podcasts, clinics, and supplement companies all have their version of the story.

And like most things in health and longevity, there is some real science mixed with a lot of marketing.

Let’s break down what NAD actually is, what NMN and NR do, and where injectable NAD fits into the picture.

What NAD Actually Does

NAD is a molecule found in every cell in your body. It plays a central role in cellular metabolism and energy production.

Without NAD, your cells cannot efficiently convert food into usable energy.

NAD is also involved in:

• mitochondrial function
• DNA repair
• cellular stress responses
• activation of longevity pathways including Sirtuins

One of the reasons scientists became interested in NAD is that levels decline with age. Some research suggests that NAD levels may drop significantly between youth and older age.

That decline has led researchers to explore ways to restore NAD levels in the body.

Why People Don’t Just Take NAD Directly

You might think the simple answer would be to just take NAD itself.

The problem is that NAD is a large molecule, and when taken orally it does not easily enter cells intact. The body tends to break it down before it can be used.

That led researchers to focus on molecules the body can convert into NAD. These are called NAD precursors.

The two most widely discussed are Nicotinamide mononucleotide (NMN) and Nicotinamide riboside (NR).

Both of these compounds exist naturally in the body and are part of the pathway that produces NAD.

Very simply, the pathway looks like this:

Vitamin B3 → NR → NMN → NAD

Taking NMN or NR essentially provides the body with raw material to rebuild NAD through its normal metabolic pathways.

What the Research Shows So Far

The science around NAD and aging is fascinating, but it is still developing.

Animal studies have shown that raising NAD levels can improve mitochondrial function, metabolism, and certain markers associated with aging.

In humans, research has shown that NMN and NR do increase NAD levels in blood.

However, the big question remains unanswered.

Does raising NAD actually slow aging or meaningfully improve long-term health?

The answer today is: we don’t know yet.

The research is promising but still early.

The Rise of Injectable NAD

Because NAD itself is such a critical molecule, many wellness clinics now offer IV NAD infusions or injections.

The idea is that if NAD is delivered directly into the bloodstream, it could quickly boost cellular NAD levels.

These treatments can cost several hundred dollars per session, and patients often report feeling:

• increased energy
• improved mental clarity
• improved mood
• reduced fatigue

There is even some exploration of NAD infusions in addiction medicine during detox programs.

But scientifically, the picture is still unclear.

Even when NAD is injected into the bloodstream, it may still be broken down into smaller components before cells use it. In other words, the body may end up rebuilding NAD through the same pathways it would use with NMN or NR.

Another interesting detail is that NAD infusions often have to be administered very slowly. If the drip runs too fast, patients commonly experience flushing, chest pressure, nausea, or abdominal discomfort.

A Personal Perspective

I have been around the supplement and longevity world for a long time.

One of my close friends is Oz Garcia, who has spent decades advising actors, athletes, and people who are extremely serious about their health.

Oz has seen just about every supplement trend come and go.

When I asked him about NAD injections, his answer was simple and very practical.

He suggested that instead of paying $200–$250 per session for injectable NAD, it makes more sense to take NMN or NR powder and allow the body to build NAD naturally.

In his view, the metabolic pathway already exists. The body knows how to convert these precursors into NAD efficiently.

And from a cost perspective, it is dramatically cheaper.

The Bigger Picture

The NAD story highlights something interesting about the longevity field.

We are learning that aging is closely tied to cellular energy systems, mitochondrial health, and the body’s ability to repair itself.

NAD sits right in the middle of those systems.

But it is unlikely that one molecule alone will solve aging.

The strongest drivers of cellular health are still the basics:

• exercise
• metabolic health
• sleep
• nutrition
• stress management

Supplements like NMN or NR may support those systems, but they are not magic bullets.

My Approach

My personal approach is fairly simple.

I try to combine:

• the emerging science
• advice from people I trust who have spent decades studying nutrition
• and a little bit of common sense

When someone like Oz Garcia — someone who has been working at the highest level of nutrition for decades — suggests using NMN or NR powder instead of expensive NAD injections, that makes sense to me.

It respects the biology of how the body works, and it respects your wallet.

In the end, my philosophy has always been the same.

Blend good science, practical experience, and cost awareness.

That combination often leads to better decisions than hype alone.

Apparently I’m Right About Everything (And I Don’t Even Have a Team of Scientists)

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I just read this article on Apple News—backed by a team of researchers and MDs.
But weirdly… I’m already doing most of what he recommends, and I’d even suggest one simple, obvious upgrade.

[Link to the article]. Its Apple News You will not get it if you are not subscribed.

  • He avoids sugar.
  • He eats dark chocolate with minimal sugar.
  • He takes Metformin—not because he’s diabetic, but because it mimics the effects of fasting.

This is the same stuff I’ve been doing and talking about for a while now—just without the white coat.

Let me make one very obvious correction to his routine though:
Don’t use creamer in your coffee. That’s moronic.
Sorry, but come on—most creamers are filled with weird, nasty chemicals.
Use MCT oil instead. Even better? Add a scoop of chocolate protein powder like I do every morning. You’ll be full, alert, and not craving junk two hours later.

Now, in fairness, when I reread the article, he said cream, not creamer.
Still, most people don’t know the difference—and store-bought creamers are basically poison in a bottle.
I’d still bet MCT oil beats cream if we had the time, money, and long enough human lifespans to do a proper head-to-head study.
But we don’t. So sometimes we just have to use common sense and choose wisely.

And about that dark chocolate—I get it. It’s not dessert.
But let’s be real: you’ve probably acquired a taste for some gross stuff in your life.
Beer? Tasted like piss the first time.
Vodka? Scotch? Same deal.
So… why not dark chocolate?

I’ve got a few bags of Bouchard dark chocolate from Costco—minimal sugar.
I avoided them for months because I had “real” chocolate, cookies, and ice cream around.
But now that I’ve run out of the fun stuff? I’m eating the dark chocolate.
And guess what? It’s not bad. Actually—it’s good.
And it’s loaded with antioxidants.

I also take Metformin. I’ve known about it for over 10 years.
But last year, when I read that type 2 diabetics on Metformin were having better health outcomes than so-called “healthy” people, I nearly fell over. That was the last straw.

Now the FDA has approved the first-ever study of Metformin for anti-aging. That’s historic.
I take one tablet at night. It’s everywhere in the longevity space.
It mimics intermittent fasting—which I’d love to do… except I also love eating. So, Metformin it is.

The rest? Pretty simple:

  • Mediterranean-style eating
  • Less carbs
  • Fewer processed snacks
  • More movement

I’m working hard to take care of myself—not just for me, but because that’s what I do.
I use myself as a guinea pig for safe, tested, proven options.

No, I haven’t jumped on the rapamycin bandwagon (yet).
What I am doing is minimal and safe.
Metformin has been around for over 70 years.

So if you’re reading this, here’s your nudge:
Cut the sugar. Try MCT. Swap the creamer.
And maybe—just maybe—acquire a taste for dark chocolate.

P.S. I’ve been taking Methylene Blue for about a month. And while I’m not ready to recommend it without any caveats, I will say this:
I’ve had double the energy.
Not jittery caffeine energy—clean, focused energy. The kind that lets me sit for long periods and work 14-hour days instead of 8.
It’s been used in medicine for over 100 years, but I’m taking a higher-than-recommended dose—though still less than what’s used clinically.
I’ll wait for my next blood test before reporting back. Since I am taking it at around 80mg a day double the dose recommended for off label. For context it is used as high as 280 mg a day for medical conditions. Stay tuned.

Cancer Cures ? Alternative Medicine

| johnas9000

Are there alternative cures for cancer ? Natural Cures ?   Another question I answered on Quora that is worthy of repeating here. Is complementary/alternative medicine harmful?   

The uneducated practice of alternative or complementary medicine or even orthomolecular ( mega doses of vitamins) can absolutely be dangerous !!! I am the biggest health nut and pop dozens of supplements daily. But I studied first. We just watched an episode of strange deaths. Some nut job poisoned himself with vitamin A. Anyone taking supplements should know at least the fat soluble ones like A, E, K. You must have some level of understanding even to take a few vitamins. Most water soluble vitamins like vitamin C and most B vitamins will harmlessly wash out of your body every day.  Other vitamins, like vitamin A,  can literally kill you if you are stupid enough to take toxic amounts.  Herbs are also something to be extremely careful with.  Some herbs are extremely strong.  Remember ephedra ? A few people died from that. Its pretty much speed in herbal form. Most drugs were actually modeled on herbs. Where do you think the drug companies got the idea for ephedrine ? Plus you have to consider if its going to interact with any drugs or pre-exisiting conditions. Also they compete with each other, so by overdosing with one supplement you could create an imbalance or shortage of another one. I can think of countless issues where I have been helped as well as times I was surprised at a side effect. For example some make you more photo sensitive. I remember taking St John’s Wort and getting a really bad sunburn. I am olive skinned and rarely burned in my whole life. But the absolute worst thing you can do is to avoid getting proper, or conventional treatment because you are trying your alternative path first. I honestly dont know what I would do if I got cancer.  I have seen and listened to alternative cures both here and in Europe at the World Anti Aging Congress. But I also know that for certain types of cancer, if treated early there are many conventional therapies that are extremely effective and have very high cure rates if caught early. Also if you wait until it is spread throughout your body even the best conventional cures might be hopeless. If you are lucky and have a good complementary or integrative doctor that understands how to integrate alternative and conventional therapies for the best possible outcomes you would be in the best hands. But don’t do it yourself and dont take anything without telling your doctor no matter how much of a health nut you are. Certain supplements are terrific for your liver. But if you need a medication and the supplement or vitamin is clearing your liver out too quickly the medication will not be in your system long enough to be effective. So there is no blanket answer except for no, without proper education, yes with a good integrative doctor. That would be someone who is an MD and also a PHD in biochemistry and nutrition and or organic chemistry who also has clinical experience. Its a very new field of medicine and you should seek out the most experienced providers to assist you who work with conventional doctors that are open minded to complementary alternative treatments to integrate with your conventional treatment. But again I cant emphasize enough do not wait to get a conventional opinion on the speed and progression of whatever is ailing you. PS if you want a great education, the vitamin companies that sell exclusively to doctors have a tremendous amount of great research that together with guidance from a qualified practitioner can be carefully integrated into your treatment.  But dont do what my friend recently called me and did.  He got me on a three way call with his cousin and father in law who had cancer, for my opinion about a specific natural “cancer cure”  That is simply absurd.  There are dozens of different types of cancer that could be at various degrees of progression.  Unless you have a medical degree and are also a PHD in biochemistry and a ton of experience with different complementary medicines and the knowledge of how they can interact or effect a specific treatment you have no business messing with people’s lives.  That being said the time for alternative therapies is before anything bad happens.  Limit your exposure to the thousands of cancer causing chemicals.  There is nothing wrong with taking the brocolli sprouts and other wonderful natural substances that detox harmful cells before they get expressed as cancer.  There is a theory that we constantly have damaged cells.  Our body naturally eliminates them with our T cells and killer cells.  Its only when our system is overwhelmed that it becomes expressed as cancer.  Dont wait til things get that far gone. You can live very well without all of the cancer causing ingredients and chemicals. Paradoxically the wonderful natural supplements that eliminate “bad cells” or cancer cells or help your liver flush out all of the toxins will also flush out the drugs before they have a chance to help you.  This is a compelling reason to take all of those wonderful supplements now.  Because you literally cant, or will be betting your life if you wait until you have a serious disease before you pay attention to your health and embrace complementary or natural remedies.

 

Melatonin

| johnas9000

Melatonin deserves a blog unto itself.  It  is a hormone secreted by the pineal gland. It is believed to regulate other hormones and maintains the body’s sleep wake cycle or rhythm. You produces more melatonin at night, and it drops from light. Exposure to bright lights or shift work or travel can interrupt your circadium rhythm.

Some scientists believe melatonin levels may be related to aging since the these levels drop as we age. They believe that is why  older adults have sleep problems.  Melatonin also has strong antioxidant effects. Evidence suggests that it may help strengthen the immune system.

If you are considering using melatonin supplements you should talk to your doctor first. In fact you need to look no further then something as innocuous as vitamin E. Its among the list to avoid before surgery since it would slow the clotting time.

People use melatonin for jet lag and studies suggest that for short periods of time melatonin is more effective than a placebo in reducing the time it takes to fall asleep, increasing the number of sleeping hours, and boosting daytime alertness.Heart Disease

Several studies show melatonin has cardioprotective properties, including antioxidant and anti-inflammatory effects. Research also suggests that melatonin may help lower blood pressure levels and improve cholesterol profiles. More research is needed.

PS beauty sleep is a real thing. If you are not getting your sleep it will affect your appearance.  In fact another supplement based on magnolia flower is extremely popular and so helpful we call it beauty sleep.  Two of our patients told us it helped them get off Ambien ( another long story people have hurt themselves sleep walking on Ambien)

More on that and other beauty supplements here

Also in one of the most underappreciated but favorite book of mine Stopping the Clock by Klatz and Goldman it has a list of over one hundred of the top anti aging scientists in the world and what their vitamin regimens were.  I was astounded that the most common “Supplement:” was melatonin, because of their belief that of its anti aging properties.

Skin

| johnas9000

Let start with basics we should all be doing.  You cant make collagen without vitamin C.  We do lose collagen every day.  If Hollywood treatments like like Thermage or Exilis are not in your budget at the very least, get your daily intake of vitamin C supplemented.  I remember reading that even eating oranges is not going to cut it.  They tested oranges on a shelf and the amount of vitamin C varied all the way down to zero for those that had been on the shelf too long.  And while you are at it make sure you get your daily dose of vitamin D, especially if you are using sun block.  There have literally been thousands of studies that support the benefits of vitamin D for everything, and every disease and even depression.  Also my favorite supplement is fish oil.  If it tastes fishy return it. You want a formula with the most DHA and EPA, side effect, its brain food and will help with your moods and brain health.  There are also countless studies to support the use of fish oils.  If nothing else use sunblock, assuming you dont smoke, the no 1 thing that ages yours skin.  But the sun is no 2, so use sun block but take vitamin D, C and fish oil.  Almost forgot, water, no 2 right behind air to live.  We all have friends who drink lots of water.  I have noticed those that do have the best skin. If you are looking for vitamins for your skin try Genetiskin which I researched and developed with Dr Lisa Zdinak.  PS as I said I have only done 1 every 5 years, but we have patients who make very little money but who save all year to do their Thermage treatment because the one thing they really want to do is turn back the clock and they want the ultimate anti aging treatment for their face