Anti-aging supplements: what works

Do anti-aging supplements work? It’s a simple question with a complicated answer, but there’s increasing evidence that some of them do, and many do not. The problem is measuring the results, especially if you are a stickler about what anti-aging means. It certainly isn’t practical to use life span as an endpoint in clinical trials (that would take decades to do and by the time you get an answer there would almost certainly be better supplements). Things that make you feel younger without verifiable effects on the aging process have a dubious history, and some - such as growth hormone – actually accelerate aging by themselves. But now there are objective techniques to measure biological age and individual rate of aging by analyzing changes in your DNA. This means that we can track the effects of anti-aging therapies with remarkable accuracy; it’s like replacing an hourglass with an atomic clock. (Read more in my free ebook Biohacking Longevity.)

There’s a lot of marketing noise around supplements and anti-aging products, and a substantial amount of fraud. For non-prescription products, there’s very little regulation, so for the most part you’re on your own. Manufacturers and sellers can say almost anything they want without having to prove their claims or even that the product contains what it says. Independent testing has shown that some supplements have almost none of the active ingredient they’re supposed to.

Look for clinical trials with validated measures of results

So the first thing is to identify brands that have high standards of purity and consistency. The next question is do they work? What we’re looking for here are clinical trials in human subjects. Ideally, the trial is randomized (meaning that participants are allocated into placebo or the actual supplement by chance rather than choice), and blinded (they don’t know which group they’re in until the study is completed.) These strict criteria are designed to eliminate the possibility of influencing the results. Add a validated biological age test and you now have information that is potentially useful.

The vast majority published studies don’t meet these standards, but the ones that do reveal some truly exciting possibilities. It is now proven that biological aging can be reversed in humans! (References listed below.) A decade ago this type of claim would be rightfully dismissed as flimflam; most still are bogus, but a few specific exceptions have reported in recent years. An interesting commonality of these supplements is that they are all based on naturally existing compounds and are considered safe to use. Ingredients to look for include alpha-ketoglutarate, NMN (nicotinamide mononucleotide), NR (nicotinamide riboside), and pterostilbene (a bioavailable metabolite of resveratrol.) To be sure, there are hundreds of supplements and ingredients claiming beneficial effects, but for anti-aging the gold standard is reversal of biological age by validated tests on DNA in human trials. Brands to look for are Amelior (TruDiagnostic), Basis (Elysium), Niagen (Chromadex), and Rejuvant (Ponce de Leon).

These are the brands that I’ve vetted for their contribution to the science of anti-aging/longevity medicine, and high standards. It isn’t intended to be all inclusive, but there are a lot of imitators piggybacking onto their research.

Elhassan YS, Kluckova K, Fletcher RS et al. Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD+ Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Rep. 2019 Aug 13;28(7):1717-1728.e6.

Liao B, Zhao Y, Wang D et al. Nicotinamide mononucleotide supplementation enhances aerobic capacity in amateur runners: a randomized, double-blind study. J Int Soc Sports Nutr. 2021 Jul 8;18(1):54.