I’d love to tell you there is magic pill or combination of longevity drugs that will reverse your age.
We are nowhere near that elixir of life – at least yet.
What we have is a list of promising candidates. Drugs that stimulate cells to rejuvenate, compounds that optimise mitochondrial health, and others that prevent older cells becoming senescent zombies.
Optimising for health span has never been easier, and my hope is that breakthroughs in the 2030’s and beyond will see our healthy lifespans increase. In addition to promising anti-aging candidates, drugs specific to the diseases caused by aging have come a long way in recent years.
While the rapidly increasing pace of drug discovery and development is significant. We are not even close to understanding the beautifully mind-blowing complexity of cellular life, let alone the ways that our biological systems interact.
This is an introduction to longevity drugs. It covers the broad categories, important clinical trials, and exciting developments in personalised medicine.
Longevity Drug Discovery and Health Span Habits Interact
Drug discovery and development provides a great reason to stay healthy via sleep, exercise, good eating choices and avoiding toxins.
When it comes to your health span, hoping that a miracle drug will appear and undo all the damage is not a smart strategy. Accumulating cellular damage, chronic conditions and speeding up the aging process could see you miss out. Imagine there being a combination of approved drugs to keeping you fit, healthy and active to 100+ in the 2030’s, and missing the benefits because you made bad lifestyle choices now…
Broad Categories of Longevity / Anti-Aging Drugs
Longevity drugs fall into broad categories, albeit with overlaps.
This can be based on the genetic pathways affected, their end results, or which of the hallmarks of aging they deal with. Clinical trials are ongoing for promising candidates, and any exciting news coming from them will be covered here at the Age Well Times.
Here are the broad categories of longevity drugs (note multiple overlaps):
- Calorie / Energy Restriction Mimetics: Drugs which encourage apoptosis via pathways that are triggered by scarcity of food. Examples are Resveratrol, Rapamycin and Metformin.
- Senolytics: Drugs which clear ‘zombie’ (senescent) cells, reducing inflammation and the spread of zombie cell populations. Examples are Danstinib, Fisetin and Quercetin.
- SASP Inhibitors: These drugs inhibit the signalling of senescent cells, preventing damage through inflammation and spread of senescence. Examples are Rapamycin (and Rapalogs) and Metformin.
- Antioxidants: Drugs which reduce oxidative stress by mopping up ROS molecules. Examples are Sulforaphane and Vitamins A, C and E. Antioxidants have not shown that they can extend lifespan alone. Second order effects, via improved mitochondrial function, immune system boost and protection from oxidative stress events are all positives.
- NAD Precursors: NAD+ is the cellular energy cycle, it provides life’s energy. Precursors including NR, NMN and Niacin are popular supplements. Tryptophan is used in the cellular recycling of NAD+, boosting this is a potential therapeutic intervention.
Longevity Drugs: Which One Should I Start With?
I don’t recommend taking any longevity drug before you go through a process of understanding your own health and taking a long, sober look at the risk vs reward.
Drugs including Rapamycin have shown huge promise. Clinical trials are now underway in people, following animal studies and safety assessments. What we don’t (yet) know are the downstream effects.
What if a drug which extended life by one gene pathway increased your risk of a chronic condition like cancer or Alzheimer’s via another pathway?
Let’s also add that the right combination of drugs and supplements for you might be different from those that would benefit me.
Health histories, our DNA, age, and sex all play into this.
Supplement sales are big business. Choosing the right combination for you is at the end of a lengthy process. That process involves an honest longevity audit, assessment of your own health status and needs and broad understanding of the risks / rewards.
Follow my personal journey into the world of longevity drugs and supplements in my blog.
What Clinical Trials Involve Longevity Drugs?
Let’s separate clinical drug trials which measure the effect on aging, and those which measure effects of specific diseases.
The stalled TAME study is the biggest news for proponents of treating aging as a disease. This study is the first NIH approved clinical trial which will directly measure the effects on aging (among other things). It will use the diabetes drug Metformin.
While the effect of Metformin on aging is anticipated to be modest, the TAME trial is significant for a different reason. By legitimising clinical trials of drugs that target aging, a precedent for funding of future trials will be set.
Trials Involving Rapamycin:
Rapamycin is approved for use as an immunosuppressant following organ transplant. Following positive animal studies there are now human trials underway. While small scale, these studies are expected to show significant benefits:
PEARL Study: This clinical trial was crowdfunded though Lifespan.io. 150 participants aged 50 to 85 are followed – in a randomized, double-blind setup. Results compare 5mg and 10mg doses of Rapamycin to the placebo using functional measures. Liver function, renal measures and glucose / insulin response comparisons are key to the results. This trial ends in December 2023.
I’ll keep this page updated with the latest and most exciting trials – so don’t forget to bookmark the Age Well Times today.
Longevity Drugs and Supplements Listing:
- NMN / NR / Niacin
This list will grow as new deep-dive explainers are published here at the Age Well Times.
NAD+ and Precursors
NAD+ is essential to all life.
Among its core roles is an essential coenzyme in mitochondria, NAD+ allows energy to be produced and moved (via the electron transport chain) to where it is needed. NAD+ also facilitates DNA repair, works with the sirtuins in healthy cellular function and enables metabolic processes including the citric acid cycle and glycolysis.
NAD declines with age and clinical data shows that increasing its levels have positive effects on cell health measures.
Digestion breaks down NAD, preventing it from passing into the blood.
For this reason, longevity drugs are the building blocks of NAD+ production. Creation of NAD+ via three cellular pathways is boosted when these building blocks are abundant. Precursors are Niacin (vitamin B3), NR and NMN.
I dive deeper into these, and the NAD+ / NADH cycle, in my separate post on all things NAD.
A New Era of Personalised Medicine
We are on the cusp of a revolution in medicine.
Treatments matched to your DNA, brand new compounds discovered by AI, pooled patient data revealing root causes of common complaints and drugs which work by boosting our natural immune response are only the starting point.
While I cover the most exciting developments here at the Age Well Times, the topic is broad enough for ten websites to cover.
These advances are a key reason to stop aging now (by making longevity habits part of your routine). In parallel with drugs that delay aging, new treatments for those conditions which used to kill millions of people are in the pipeline.
It is an amazing time to be alive – and an amazing time not to damage your body before you get to take full advantage.