>> Dr. Terry Simpson: Hey, welcome back to 4Q. Today we are launching a

new series about longevity and health span. Now,

longevity is easy to measure because there's a

date on every tombstone. But health span is

different. Healthspan we define as the time when

you're healthy, mobile, curious, and capable

before disease or aging slows you down. That's the

part we want to stretch out, because living longer

isn't the same as living well. Now, the moment you

step into the world of longevity, you meet a

parade of gurus, pouters, and podcasts. There's

some serious scientists in the field, like the

founder of the whole field, Leonard Hayflick, who

recently died at age 93. He was the one who

defined cellular aging in the first place. Or Dr.

Eric Topol, who actually advance his medicine. But

then there are those who have turned longevity

into a luxury brand. Take Peter Attia. In his many

iterations of himself, he finally settled on

building an empire where he can charge $150,000 or

more for a patient to become a patient of his. And

what do you get for that? You get a handful of

basic lab tests. You get a VO2 max run. You get to

hike with him with a rucksack, a weighted

backpack. You learn a few yoga poses, and you get

some lectures about how you should sleep better.

Some of this you can get from your local primary

care doctor and a local gym for about 30 bucks a

month and copay. So remember, this is a man who

never finished a surgical residency, but

billionaires pay him because they can. He

positioned himself exceedingly well. The man who

has gone from being all pro keto to let's do all

the exercise we can. By the way, he's also an

investor in something called AG1, that bright

green drink sold as nutrition in a scoop. And of

course, there's Andrew Huberman. He is another AG1

investor. He podcasts between studio lights that

are bright enough to give you a tan, and he seems

to always wear black. Now, both of these guys are

smart, they are accomplished, but let's be honest,

they live where marketing meets medicine. And

sometimes the marketing wins. There's the other

longevity star. You've probably heard of Dr. David

Sinclair. He's a Harvard professor, and he turns

something called nad, which is a supplement

almost, into a religion. And the precursor

molecules, these are initials you're going to

hear. Nmn, M and nr. They sound like secret

passwords to eternal health. You know David

Sinclair's early work on aging and sirtuins? It

was brilliant. But somewhere between Harvard and

Hollywood, the science and the sales pitch,

started to share a toothbrush. He even formed a

company. And he tried to patent NMN as a drug.

Now, when you try and patent a supplement as a

drug, the FDA does what they would always do. They

pulled it from the supplement market. Now this

sparked all of these rhettic panics and these

headlines that the government was hiding. The

fountain of youth. You can buy NMN now. But that

fiasco showed just how thin the line is between

research and retail and, and how desperate people

are for that fountain of youth. Now, no longevity

carnival would be complete without the shirtless

salesmen of supplements and scams, the ones who

promise eternal youth. Everything from protein

powder and ancestral vibes. Take Paul Saladino.

Hasn't seen a patient in years, discovered that

fruit is good for you, even after declaring steak

with salvation. Or the liver King, his erstwhile

partner, who discovered that, well, his secret

wasn't liver, but it was ever he was injecting.

Then, of course, no claim would be complete

without mentioning Gary Breca, the guy who says

he's a human biologist, whatever that is, and can

predict the date of your death. Of course, all you

have to do is buy some of his fancy amino acids,

his hydrogen water bottles, and all of his scams

in between. Those people aren't scientists.

They're basically services in human forms. Now

here at 4Q, we're not selling miracle molecules or

$150,000 wellness plans. We're bringing you the

real science. What we know, what we don't, and how

to tell the difference. Because understanding

longevity shouldn't require six figure copay or a

discount code. And as you will learn, you do not

have to be a billionaire to learn about it and to

implement it.

But today, we're going to start with nad, which

stands for nicotinamide adenine dinucleotide. This

is the so called molecule of life. Now, does it

actually work in humans? We're going to find out.

I'm Dr. Terry Simpson, your chief medical

explanationist, and this is Fork U Fork

University, where we bust myths, make sense of the

madness, and teach you a little bit about food and

medicine. NAD is something that every freshman

medical student learns in basic biochemistry about

how the body works. It responsible for fueling

energy production. It's in the Krebs cycle. It's

responsible for DNA repair. And as we age, NAD

levels drop, metabolism slows, inflammation rises,

cells get sloppy, and blood, like Leonard Hayflick

pointed out in the 1960s, senescent. So scientists

ask the most obvious of all, can we top it up?

Meaning can we Give external NAD or one of its

precursors and kind of turn these cells back into

powerhouses again, make those mitochondria shine.

Well, it turns out in mice, the answer is yes.

Boosting NAD in mice by using precursors such as

NR or NMN extends the lifespan of the mice by 5 to

15%. That translates to just a few months for a

mouse. But if you're thinking about a human mouse,

years in humans might work out to a couple of

years. But in mice, we found that the mice moved

better, they burned energy better, and as far as

we could tell, they aged a little slower. But, uh,

here's the catch. Human beings, we're not just

mice with mortgages. Here's the thing. You cannot

eat nad, but you can eat its precursors,

tryptophan and niacin, which is vitamin B3. These

are found in fish, poultry, beans, milk, and whole

grains. Does this sound familiar? Yeah, we call

that the Mediterranean diet. So before you drop 90

to 100 bucks on a bottle of NMN or NR, maybe stop

at the grocery store instead. The big supplement

players, NR and NMN, can raise NAD levels and are

generally safe up to about 2 grams a day. There's

no major side effects beyond the occasional flush,

but they don't reverse aging, and they don't

replace real medicine. Now, a meta analysis shows

that Some of these NAD precursors, especially

niacin, can lower LDL cholesterol by about 8 to

12%. That's a nice lab number, but let's compare

that to, let's say, Crestor, which is

rosuvastatin, which is the LDL lowering

cholesterol agent. I use 5 milligrams, lowers

cholesterol by about LDL cholesterol by 45%. 10

milligrams, 52%, 20 milligrams. What? I take 55%,

40 milligrams, same. So that's not a blip. That's

the miracle of modern medicine. And no NAD

supplement has ever been shown to prevent heart

attacks or strokes. Statins have again and again

shown that they can do that. Now, that's the

difference between some interesting biochemistry

and some actual medicine. But if we're looking at

this, who might actually benefit from taking some

form of nad? Well, maybe older adults with

metabolic syndrome or prediabetes. The. Those

small improvements in lipids or inflammation may

be helpful. But imagine this. My bottle of Crestor

cost me about 75 cents for a month. That bottle of

NAD is going to be out 100 bucks a month, and the

Crestor is going to do a little bit more for me.

Now, there has been a hint of potential in

patients with early Alzheimer's or Parkinson's

disease, but that data is tiny and for all intents

and purposes is statistically meaningless. Now, if

you're young and healthy, the only thing NAD will

reliably do is reduce your bank account. Safety

wise, there have been no major interactions that

have been found, although there are theoretical

issues with certain anti cancer or DNA repair

drugs. And even if your gut microbiome helps

process NAD precursors, another reason to feed it

well instead of flood it with pills, it may not

actually help you that much. So what actually

works NAD does drop. As we age, our cells enter

into their cellular retirement. Or as Hayflick

described it years ago, senescence. And whether

topping NAD keeps them working longer is still

really unknown. But what we do know is how to

support your body's own NAD production on a plate,

not in a capsule. The Mediterranean diet, which is

rich in fish, legumes, olive oil, whole grains,

naturally fuels the NAD pathway in your body and

protects your heart in a dozen other ways. You

don't need a subscription. You don't need a magic

powder. You don't need this bougie price tag. You

just need to eat better. Now, uh, here's the

thing. If you want to learn a lot more about

longevity the right way, we are going to actually

work on, we're working on it now. A longevity

cruise in the Mediterranean in the summer of 2026,

next summer, maybe the second week of August. Our

plan is to have world class physician, scientist,

a food network chef with real conversations about

living longer and better, all while sailing in the

Mediterranean with shore excursions that will drop

your socks off. You're not going to be fitted with

a weighted rucksack. You're not going to have to

pay a six figure fee. Um, unlike Peter Attia's

program, this one includes shore excursions, wine

and actual fun. And for the record, Yeah, I drink

AG1, but. But not because I have an affiliate

code. I don't get a kickback, I don't get stock on

it. I just like how gentle it is on my stomach,

which is why I take it. But I'm always looking for

a less pricey, less bougie way to get in my

vitamins. So come on. If you're interested, serve

that time and consider about thinking about

healthspan under the Tuscan sun, where we found 70

years ago, people lived longer and lived better by

eating simpler and developing immunity. This has

been fork you, fork University researched and

written by me, Dr. Terry Simpson, your chief

medical explanationist. All things audio and

editing were done by my friends at Simpler Media

and the pod God himself who spent X amounts of

time with me today and my new fancy equipment. For

references and show notes, visit4q.com or

YourDoctorsOrders.com or go to my

substack@drsimpson.com now remember, I'm a board

certified physician, but I am not your physician.

If you have medical concerns, please see a real

board certified doctor, not a chiropractor, not a

wellness influencer. And please, you don't need to

spend $150,000. This podcast is for education and

entertainment, not personal medical advice. And

until next time, stay curious, stay skeptical, and

keep your diet Mediterranean. Have a great week,

everyone.

All right, Evo, we're getting old enough that our

nad levels are dropping. I'm thinking that we

should replace them. I just don't know how. More

sunshine. An ocean. Happy? Uh, to hear your ideas.

>> Speaker B: Well, I may be getting older, but I'm still

perpetually 8 years old in my brain thinking about

how my nads are dropping as I get older.