Longevity: proven vs. promised
Rapamycin, metformin, NAD+, epitalon — the same shelf, completely different weights of evidence. A series for those who like to tell them apart.
Editorial introduction
Longevity is the only field where promises are often sold as data. Three tests help: does it extend lifespan in more than one model organism? Are there human trials, or only biomarkers? Who wrote the study?
Rapamycin passes the first two (mice + the TENS trial in humans). Metformin passes the first and half of the second (epidemiology + pilots; the TAME trial is still running). NAD+ precursors pass only the biomarker test (NAD+ levels rise; clinical outcomes do not follow). Epitalon passes none — which is why it has the prettiest story.
Read this series as discrimination training: same shelf, same marketing, completely different science.
Reading list
- 01Rapamycin (Sirolimus)small-molecule
Macrolide from Streptomyces hygroscopicus, discovered on Rapa Nui island; mTOR pathway inhibitor.
Approved drugStrong evidence - 02Metforminsmall-molecule
Biguanide derivative, type 2 diabetes drug since the 1950s; mitochondrial complex I inhibitor.
Approved drugStrong evidence - 03NAD+ (IV)small-molecule
Nicotinamide adenine dinucleotide — universal cofactor of redox reactions and sirtuin substrate.
Research chemicalLimited evidence - 04NMNmali molekul
An NAD+ precursor — one of the most popular "longevity" molecules.
Research chemicalModerate evidence - 05Urolithin Amali molekul
A pomegranate postbiotic (the microbiome makes it from ellagitannins) — activates mitophagy, mitochondrial "recycling".
Approved drugModerate evidence - 06Epitalonanalog
Tetrapeptide 'epitalon', the putative peptide factor of the pineal gland; developed in the Khavinson program.
Research chemicalLimited evidence