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Supplements for Longevity & Their Efficacy | Dr. Peter Attia

Episode 187 Jul 29, 2024 2h 30m 21 insights
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 at hubermanlab.com.
Actionable Insights

1. Prioritize Foundational Health Behaviors

Engage in essential behavioral practices correctly, including moving appropriately and often (zone two cardio, resistance training, maintaining nerve-to-muscle connection), eating right, and understanding your genetics. These foundational behaviors are vastly more impactful for healthspan and lifespan than any supplement.

2. Prioritize Emotional Health & Well-being

Focus on emotional health, happiness, and overall well-being, as this directly impacts longevity and makes it significantly easier to adhere to other foundational health behaviors like diet and exercise.

3. Delay Chronic Disease Onset

To extend lifespan, concentrate on delaying the onset of major chronic diseases such as cardiovascular disease, cerebrovascular disease, cancer, neurodegenerative diseases, and metabolic diseases.

4. Build Physiologic Reserve in Midlife

Actively build and maintain as much physiologic reserve as possible, especially muscle mass and strength, during your 50s and 60s, as it becomes substantially more challenging to gain these later in life.

5. Avoid Injury and Prolonged Inactivity

Prevent injuries and extended periods of inactivity, particularly in midlife and beyond, because recovery from such setbacks becomes significantly more difficult and time-consuming with age.

6. Manage Blood Glucose Levels

Strive to keep blood glucose levels steady to maintain optimal energy and focus, avoiding significant spikes or crashes. Tight glycemic control, independent of body weight, is associated with longevity benefits.

7. Use a Continuous Glucose Monitor (CGM)

Utilize a CGM (like Levels) to gain real-time feedback on how different foods affect your blood glucose levels. This information can help optimize food choices, timing of meals around workouts, and improve sleep quality by stabilizing blood sugar throughout the night.

8. Control Sleep Environment Temperature

Regulate the temperature of your sleeping environment (e.g., using a smart mattress cover) to facilitate the natural body temperature drop required for deep sleep and the subsequent increase needed for refreshed waking.

9. Ensure Proper Electrolyte Hydration

To maintain optimal cognitive and physical performance, ensure proper hydration and electrolyte balance. Andrew Huberman’s protocol involves dissolving one packet of Element in 16-32 ounces of water first thing in the morning, and another packet later in the day, potentially a third if exercising or sweating heavily.

10. Optimize Exercise Timing for Energy

Experiment with the timing of your workouts; completing exercise before 9 AM may lead to increased energy throughout the day compared to mid-to-late morning workouts, potentially due to body temperature regulation.

11. Incorporate Sauna and Cold Exposure

Integrate practices like sauna and cold exposure into your weekly routine (e.g., once a week) as part of a comprehensive health and wellness strategy.

12. Consider Geroprotective Molecules (Rapamycin)

Explore exogenous molecules that target hallmarks of aging, such as rapamycin, which is the only molecule besides caloric restriction that has shown uniform life extension across various eukaryotes in experimental data.

13. Rapamycin Dosing (Peter Attia’s Protocol)

If prescribed rapamycin for geroprotection, Peter Attia’s personal protocol involves taking 8mg once a week for two months, followed by a one-month break, to manage potential side effects like canker sores.

14. Consider Disease-Targeting Molecules (Prescription)

Consult with a medical professional about taking prescription exogenous molecules like metformin, SGLT2 inhibitors, GLP-1 agonists, PCSK9 inhibitors, statins, or bempedoic acid to directly impact and delay the onset of specific chronic diseases.

15. Avoid Resveratrol for Longevity

Do not take resveratrol with the expectation of extending lifespan, as rigorous testing in the Interventions Testing Program (ITP) found no such effect in relevant animal models.

16. Avoid NAD/NMN/NR for Longevity

Do not take NAD, NMN, or NR supplements with the primary expectation of lifespan extension, as there is currently insufficient scientific basis to support their efficacy for this purpose.

17. Consider NR/NMN for Skin Cancer Risk

If you are an individual at high risk for basal cell and squamous cell carcinomas (non-melanoma skin cancers), consider NR or NMN supplementation, as one study showed a 60-80% reduction in risk for these specific cancers.

18. Peter Attia’s Supplement Regimen

Peter Attia’s personal supplement regimen includes EPA/DHA, Theracumin (for cognitive function), Vitamin D (5000 IU daily if levels are low), Methylfolate and Methyl B12 (to lower homocysteine), Magnesium (L-Threonate, Slow Mag, Oxide for sleep, bowel function, cramp prevention), Element electrolytes, Creatine Monohydrate (5g daily), AG1, and Pendulum probiotics (Glucose Control, Polyphenol, Akkermansia).

19. Andrew Huberman’s Supplement Regimen

Andrew Huberman’s personal supplement regimen includes AG1 (1-2 servings daily for vitamins, minerals, adaptogens, polyphenols, gut health), quality fish oil (above 1g EPA daily), Vitamin D3 (3000-7000 IU daily, adjusted by blood levels), Methyl B12, Tongkat Ali (one capsule early day to lower SHBG), green tea capsules, Element electrolytes, Creatine Monohydrate (10g daily), Magnesium Threonate, Apigenin (50mg), Theanine, Inositol (900mg occasionally) for sleep, and whey protein.

20. Alpha-GPC as Pre-Workout

Consider taking 600-900mg of Alpha-GPC with a double espresso prior to a workout for a stimulatory effect. Peter Attia notes he does not believe TMAO, which Alpha-GPC can increase, is a significant health concern.

21. Supplements as Augments, Not Necessities

View supplements as an insurance policy or an augmentation to mental and physical health, rather than necessary components. Prioritize foundational behavioral practices over supplement use, as they have a far greater impact.