AMA #35: "Anti-Aging" Drugs — NAD+, metformin, & rapamycin

**Peter Attia** (0:11)
Hey, everyone, welcome to a sneak peek, Ask Me Anything or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com forward slash subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything episode 35 This is a special AMA where, in addition to being joined by Nick Stenson, I'm also joined by a previous guest, Matt Kaeberlein.
Matt's been a previous guest on the podcast twice, actually, with the most recent one being, I believe, in September of last year.
He's a professor of laboratory medicine and pathology, an adjunct professor of genomic science, and an adjunct professor of oral health science at the University of Washington. His research interests are focused on the basic mechanisms of aging in order to facilitate translational interventions that promote healthspan and improve quality of life. I wanted Matt to join for this one because I knew we were going to go into a lot of different subjects where he would provide insight into the questions that many of you have asked. So in this episode, we focus on answering questions around the field of aging, but specifically looking at three geroprotective molecules. And these are the three molecules that I get asked about the most.
The first is all things that have to do with NAD, and that usually implies its precursors, NR and NMN, but also sometimes NAD itself. The second being rapamycin and the third being metformin. Now, if you were to do a search and find out which of those gets asked about the most, it's metformin ends down the most, and that's followed actually by rapamycin. And I think after that is NR, NAD, and NMN, but I might have that a little bit backwards. In this podcast, we focus on a number of questions in the field of aging. So it starts with a bit of a discussion around biomarkers of aging, what are they, how good are they, and what do they tell us about the field. We talk about how studying aging can be done in various animals, and we get into the specifics, meaning the benefits and disadvantages of studying these in yeast, worms, flies, mice, dogs, and ultimately, of course, humans, the species of interest. We talk about how to think about the various studies that are being done around the idea of lifespan and healthspan. We talk about epigenetic clocks, and then from there we really dive into the meat of this, getting into everything that has to do with NAD, and then ultimately its precursors, NR and NMN. It's a molecule, as I said, I get asked about this a lot, and so we had no shortage of questions and nuances to get into here. After speaking about NAD in detail, we then look at rapamycin and metformin, though probably not in as much detail because we've spent lots of time talking about those molecules on other podcasts. However, Matt felt, and I agreed when it was all said and done, that it was going to be beneficial to at least include these other molecules as a means to compare what we know and what we don't know about NAD to molecules for which we have much more data, at least in the case of rapamycin, as it pertains to longevity, but in humans, as it pertains to metformin.
The goal of this podcast was to help you not only understand these molecules and see how they stack up against each other, but also to help you think about the new information around these and what we might want to expect to see or look to see as we make decisions about the use of these things in the future. If you're a subscriber and you want to watch the full video of this podcast, you can find it on the show notes page where, of course, you also find the show notes. And if you're not a subscriber, you can watch a sneak peek of this video on our YouTube page. So without further delay, I hope you enjoy AMA number 35

**Nick Stenson** (4:03)
I'm doing good.

**Peter Attia** (4:04)
Very well. We're going to do things a little different today, huh?

**Nick Stenson** (4:06)
Yeah, we have a little different setup for this one. So what happened was back in February 2021, you and Bob did an AMA where you looked at one specific topic that was covered on multiple podcasts, in particular the Schulman episode, and kind of went back and tried to simplify that conversation around insulin resistance.