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Supplements for Longevity & Their Efficacy | Dr. Peter Attia

In this episode, my guest is Dr. Peter Attia, M.D., a Stanford and Johns Hopkins School of Medicine-trained physician expert in improving human healthspan and lifespan. Dr. Attia is also the host of The Drive podcast and author of the best-selling book Outlive. We discuss the NAD pathway in human cells and its possible links to aging and health. We evaluate how supplementation can augment molecules in the NAD pathway; we compare NAD, NMN, and NR, different routes of administration, their safety, and bioavailability. Then, we discuss the broader research and clinical literature on longevity to decide if supplementation with NAD, NR, NMN, rapamycin, or resveratrol can indeed extend lifespan. Finally, we each describe our supplement regimens and compare the role of supplementation to behaviors such as sleep, nutrition, and exercise for longevity. We also discuss whether tests of biological age are true indicators of aging and whether normal radiation levels increase cancer risk. Listeners of this episode will learn if supplements purported to improve lifespan show any efficacy and the behaviors and other factors that can prevent disease and extend lifespan. Access the full show notes for this episode: https://www.hubermanlab.com/episode/dr-peter-attia-supplements-for-longevity-their-efficacy *Thank you to our sponsors* AG1: https://drinkag1.com/huberman LMNT: https://drinklmnt.com/huberman Levels: https://levels.link/huberman Eight Sleep: https://eightsleep.com/huberman *Huberman Lab Social & Website* Instagram: https://www.instagram.com/hubermanlab Threads: https://www.threads.net/@hubermanlab Twitter: https://twitter.com/hubermanlab Facebook: https://www.facebook.com/hubermanlab TikTok: https://www.tiktok.com/@hubermanlab LinkedIn: https://www.linkedin.com/in/andrew-huberman Website: https://www.hubermanlab.com Newsletter: https://www.hubermanlab.com/newsletter *Dr. Peter Attia* Website: https://peterattiamd.com The Drive Podcast: https://peterattiamd.com/podcast Newsletter: https://peterattiamd.com/newsletter X: https://x.com/PeterAttiaMD Instagram: https://www.instagram.com/peterattiamd YouTube: https://www.youtube.com/c/PeterAttiaMD Facebook: https://www.facebook.com/peterattiamd *Timestamps* 00:00:00 Dr. Peter Attia, NAD Pathway 00:02:31 Sponsors: LMNT, Levels & Eight Sleep 00:06:38 Categories of Longevity Approaches 00:17:22 Peter’s Supplements; Rapamycin & Research Data 00:25:01 NAD Pathway: Energy & DNA Repair; Knock-Out & Knock-In, Klotho 00:30:35 Sponsor: AG1 00:32:25 Yeast, Sirtuins, Caloric Restriction & Lifespan 00:38:56 Sirtuins, Transgenic Mice, Gender & Lifespan 00:43:42 DNA Repair, Sirtuins, Cancer; Resveratrol 00:53:31 Perform with Dr. Andy Galpin Podcast 00:54:18 NAD & NADH, Reactive Oxygen Species (ROS), Mitochondrial Health 01:02:17 NAD vs NR vs NMN Supplementation; IV & Oral Routes 01:11:33 NR vs. NMN, Doses, Side Effects; Interventions Testing Program 01:17:43 Fatty Liver Disease & NR; NMN & Glucose; Clinical Significance 01:25:17 Safety & FDA, NMN & NR Supplementation; Skin Cancer Benefits 01:30:38 Longevity, NR & NMN Supplementation, Inflammation 01:41:00 Rapamycin & Immune Function 01:44:37 Biological Aging Tests, Chronologic & Biologic Age; Vigor 01:55:24 Radiation & Cancer Risk 01:58:12 Tool: Self-Care in 50s-70s & Aging; Energy Decline 02:07:12 Tool: Exercise Timing & Energy Levels 02:11:22 Peter’s Supplements 02:18:46 Andrew’s Supplements 02:24:34 Tool: Supplement Use vs. Critical Behaviors; Titanic Analogy 02:26:52 NAD Pathway Supplementation for Longevity? 02:28:52 Zero-Cost Support, YouTube, Spotify & Apple Follow & Reviews, YouTube Feedback, Social Media, Neural Network Newsletter Title Card Photo Credit: Mike Blabac - https://www.blabacphoto.com Disclaimer: https://www.hubermanlab.com/disclaimer

Andrew HubermanhostPeter Attiaguest
Jul 28, 20242h 30mWatch on YouTube ↗

At a glance

WHAT IT’S REALLY ABOUT

Huberman, Attia Dismantle NAD Longevity Hype, Prioritize Real Lifespan Levers

  1. Andrew Huberman and Peter Attia examine the scientific basis for using NAD, NR, and NMN supplements to extend lifespan or improve healthspan, and conclude that current evidence is extremely weak. They walk through the full backstory: sirtuins, caloric restriction, NAD biology, and the key mouse and human studies, showing where popular narratives diverge sharply from actual data.
  2. Attia emphasizes that rapamycin and caloric restriction are the only interventions with consistent, cross-species lifespan extension data, whereas NR/NMN have failed in rigorous lifespan testing (ITP) and show, at best, small, clinically trivial effects in humans. The one possible bright spot is a preliminary signal for reduced non-melanoma skin cancers.
  3. Both underscore that behavior—sleep, exercise, nutrition, emotional health—dwarfs any supplement or infusion (including NAD drips) in impact on longevity and vitality. They close by transparently sharing their own supplement regimens and reiterating that almost all of the NAD-related hype is unsupported by robust science.

IDEAS WORTH REMEMBERING

5 ideas

The NAD–NR–NMN longevity narrative rests on multiple unproven leaps of faith.

Attia spells out the chain of assumptions: (1) sirtuins modestly extend lifespan in yeast and one transgenic mouse model; (2) this is assumed to generalize to humans; (3) NAD decline with age is assumed to be causally important; (4) raising NAD (via NR/NMN or NAD infusions) is assumed to restore sirtuin-mediated benefits; and (5) all of this is assumed to translate into human lifespan extension. None of these links has strong experimental support in humans.

Rigorous lifespan testing in mice shows NR/NMN do not extend life, while rapamycin and glucose-control drugs do.

The NIH-funded Interventions Testing Program (ITP), run in triplicate at three independent labs in genetically heterogeneous mice, is the gold standard for lifespan interventions. NR failed to extend lifespan at high doses; rapamycin, canagliflozin (SGLT2 inhibitor), and acarbose did extend lifespan, often without changes in body weight, highlighting blood glucose regulation and mTOR modulation as genuinely promising levers.

Human NR/NMN trials show, at best, small, often clinically trivial effects.

One NR+pterostilbene trial in people with fatty liver found no overall change in liver fat, weight, glycemia, or inflammation; only a post‑hoc subset with moderate steatosis showed a modest drop in liver fat that remained well above disease thresholds. An NMN trial showed a minor increase in insulin-stimulated glucose disposal, comparable in magnitude to red-light-on-the-back before a glucose challenge. These effects are statistically significant but not meaningfully life-changing.

A single potentially meaningful NR/NMN signal is reduction in non-melanoma skin cancers, but needs replication.

Attia highlights one study suggesting a 60–80% reduction in basal cell and squamous cell carcinoma incidence with NAD-precursor supplementation, with no effect on melanoma. Because skin shows the steepest age-related NAD decline, this could be a real, tissue-specific benefit, especially for high–sun exposure or high-risk individuals—but the result is preliminary and requires confirmation before being used as a primary rationale.

Raising blood NAD does not automatically mean meaningful cellular or clinical benefit.

NR clearly raises blood (and likely liver) NAD; NMN likely does as well after dephosphorylation. But NAD is tightly regulated, and total NAD+NADH may not change materially—what declines with age may be redox potential and mitochondrial function, not simply NAD concentration. Current evidence does not show that pushing NAD above physiologic levels improves lifespan, healthspan, or performance in a substantial way.

WORDS WORTH SAVING

5 quotes

Everything we have talked about on this podcast today, whether it be NR, NAD, NMN… all of that stuff… I would put in the category of: was the Titanic serving lobster or steak? Exercise, sleep, nutrition, emotional health is the question of what was the heading of the Titanic.

Peter Attia

There are only two interventions, full stop, that have ever extended life across those four categories of eukaryotes: caloric restriction and rapamycin.

Peter Attia

The single thing I can say with the greatest confidence is there is no evidence whatsoever that sirtuins have anything to do with caloric restriction and vice versa.

Peter Attia

I passionately do not believe [NR/NMN] do anything for me, and why would I waste time, money, anything, on something that I really don't believe makes a difference?

Peter Attia

If you had an extra two hours a week to choose between paying $1,000 for an NAD infusion or lift weights for an hour, go for a half-hour walk, and then eat a meal… I can just think of so many better ways to spend time and money.

Peter Attia

Frameworks for thinking about longevity interventions (behavior vs drugs vs geroprotectors)Sirtuins, caloric restriction, and the origins of the NAD longevity storyNAD biology, redox potential, and age-related changes in NAD/NADHEvidence on NR, NMN, and NAD infusions for lifespan and healthspanRapamycin, caloric restriction, and the Interventions Testing Program (ITP)Biological age tests and their limitationsPractical longevity: exercise, sleep, nutrition, emotional health, and real-world supplement use

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