LIFTS Episode 120 – The Molecule Matters: How NAD Actually Works in the Body | with Rachele Pojednic

26:58They're not calling him out on sponsoring an AG1 or InsideTrack. And I just feel like there's there's got to be some very clear lines that are set because they have such a big platform and consumers run towards something that could be harmful or not effective or something else. And even, you know, Atiyah has been in the news recently and all of a sudden people are now digging into him and kind of calling him out. And in a lot of cases, those that are in the know, like us here, we knew the real story behind Atiyah, not in terms of what he was involved in, But, you know, in terms of his background and research, is he really best, is he an actual doctor?

27:38Is he actually best positioned to be giving advice on health and longevity? The answer is no. Like the answer is really no. He's just got a great following. He's got a great podcast voice and that's how he grew. But nevertheless, a lot of these folks, the good thing that they did is that they brought awareness, I think, into the idea that while environment certainly plays an impact, genetics play an impact, but depending on who you speak to, anywhere from 50 to 80 % of your life outcome, in most cases, is in your control. and you could control a lot of the things that are going to dictate starting at a young age, but can dictate how well you live into your 40s, 50s, 60s, and well beyond that.

28:22From your perspective, Rachel, and just seeing this hyper-influencer market that we're in, most of our audience is operators and studio owners of people that are working in the industry and they are here to serve their members and achieve better outcomes. how do they kind of stay ahead of the noise or know what is rail versus what is fiction is the real challenge in this space right um and just to call out you know sort of incidents around some of the the podcasters in the world like it's that whole incident is vile um and also it sheds a light on this idea that like should we have been trusting this person in the first place like were they the right person to be delivering this information?

29:11And so this is, frankly, it's why I have a job. I love what I do. I am a classically trained scientist, right? Came up through the ladder, the very traditional ladder. I was down on the tenure track, you know, like I was doing the whole thing, had just been promoted to associate professor with tenure. And I was listening to a podcast actually by a woman and they were railing, I believe it was Jen Gunter talking about how the wellness industry needs to start funding their research and they need to put some data behind the stuff that they're promoting in their marketing. And I was out for my walk and I was like, yeah, Jen, absolutely.

29:56And then two or three days later, I got a call from the then chief medical officer at restore and he was like very randomly would you be interested in spinning up a lab and doing what you do in industry and i was kind of like universe like what because if you had known me three years ago when i before i got this job i would have been like absolutely not why would i blow up my career to go and work in industry and study things that the biohackers are using like what do i care And then I got really curious and I was like, well, actually, there's some decent preliminary data in these therapies and people are using them.

30:37And for whatever reason, they're saying that they feel better. Matthew, like you're like, hey, my sleep was better. I felt like I had more energy. Libido is up. Like what's going on there? Because what's happening in the traditional academic space is this is not being investigated because kind of to your point, Mo, it's often cases it's a nice to have, right? People can pull those big levers and the big lever, if you wanted to increase NAD without spending$1 ,500 on an IV would be eat some tryptophan and some niacin. Those are also precursors to NAD. And you can get that from eating some lean, yeah, exactly.

31:19Eat some turkey, eat some, you know, take a multivitamin with some, you know, some niacin, some B3 in it. And so you don't have to have these very high doses. And so two points to be made here is number one, there actually are ways that the average human that doesn't have$1 ,500 and doesn't want to go to a longevity clinic can improve their NAD concentrations, utilizing big levers. And we do have a real credibility issue within this space because there are not a lot of people like me, scientists that are being employed by industry to actually figure out what this stuff is doing and what it isn't doing.

32:04And that's what I loved about this project that we just did with the NAD and the NRIV is, you know, NAD was kind of like science 1.0. It was a pretty like logical minus the fact that we We all knew that there was no transporter if they asked a scientist, but it was kind of logical to say, if I take this molecule, I'm going to increase this molecule in my body. That's intuitive. But now that we have some good data and some good science behind it, we can move to science 2.0 and say, actually, that molecule probably wasn't the right one, but here's a better one. And now what we can do is we can start figuring out what it does, because there's a lot of hype out there, as you describe, listening to these podcasters saying, oh, increases longevity.

32:48It increases, you know, all these outcomes like my skin's beautiful. My, you know, hair looks wonderful. My libido, my sleep is great. That's all what I would call anic data right now. It's self-report. We don't have hard numbers to put behind that right now. And this was a frustration that I had that actually drew me into this space is me standing back and being like, where are you getting this information from? Because it doesn't exist. Like, it doesn't exist. So you saying that is based on what Andrew here is. And often it's an N of one, right? And it's not like they've done the research. But again, one, I'm excited to see you at Stanford in a couple of weeks.

33:34That's going to be a really fun event coming up. Yeah. Yeah, I'm looking forward to that. So I guess as you're thinking about these therapies, you know, just not to go off topic from NAD, but if you were to list some that you've heard that are just completely outlandish, a complete waste of money, any that come top of mind? And we've talked a lot on this podcast about things like contrast therapy, red light therapy. But I'm just curious, you know, from your perspective in your role at Restore, are there some that you're like, you know what, guys, like this is just a complete waste of money or you're just going to pee it out?

34:13Or are there some that you think people should really pay more attention to? Yeah, it's a really good question. And I'm going to answer it in sort of two steps. So the first would be, I took this job because I am a very curious scientist. And right now what we have is what I would call an absence of evidence of a lot of these products, meaning we just don't have the data. And so it's actually fairly challenging for me to answer that question based upon what data, what little data we have. It would be sort of a little bit of supposition and maybe even a bit of opinion. That being said, I am partnering with a lot of really incredible scientists that are looking at things like temperature therapies, contrast therapies.

35:01They're looking at red light therapy. So we have two grants at Restore with Harvard. One, we're looking at sauna, infrared sauna for mental health. There's some really good early signals to show that sauna, specifically infrared sauna, which is interesting, can be helpful for people that have mental health disorders like depression and anxiety. There's another group that we're partnering with looking at cryotherapy cold for long COVID because long COVID is an autonomic disorder. And so they think the cold could be helpful for their symptoms. There is a group that I'm partnering with at UCSF that's really interested in looking at firefighters and sauna to understand if it's detoxifying.

35:47We say that a lot in our marketing. Mo, there's not a single study that shows that using a sauna actually brings enough of these toxins out of your body to have a measurable physiologic effect. But this is really important is we just don't have the data, right? So I'm not saying it doesn't work. And in fact, this really like grinds my gears is when scientists and a lot of doctors get out there and they say, there's no data, it's snake oil, don't do it. Because I find that to be intellectually lazy, to be completely honest. Like, why can't we just say, we don't know if that works and we don't have the data to show that there is some kind of dramatic effect size.

36:33But I would be generous and say, if going into the infrared sauna makes you feel better, do it. Like it's not hurting you. The problem and their secondary argument is, is that a lot of these therapies are reserved for people with money and access. And so that also becomes an issue with a lot of these is that if it actually does work, then a lot of people that suffer from depression and anxiety should and we would want them to get access to these therapies. It's a different conversation for a different podcast. But as far as like what works and what doesn't, I think the things that I would be really careful about are super, super, super high doses of a lot of these IV nutrients.

37:18We know this from the oral literature is that if you're taking these massive doses, in some cases, you're going to reach a tolerable upper limit, in some cases, toxicity. So a really good example is I would not infuse super high doses of fat soluble vitamins. Like particularly we're down this rabbit hole right now. Like, should you be taking super high doses of vitamin A to prevent things like measles? Don't. It's going to be problematic long-term because most of these nutrients have a U-shaped curve. Not enough is bad. Too much is also bad. Or in some cases, you might just be wasting your money, like 50 ,000 milligrams of vitamin C is probably not going to do anything for you.

38:04Because once those, once those, you know, enzymes, transporters are saturated, you're just going to pee the rest of it out. So I would say, right now, it's kind of like a buyer beware situation. And also, figure out what feels good for you, what you feel like is actually working and do a little bit of N of one experimentation. I was going to move on to something coming back to NAD really in terms of safety.

38:38Matthew Januszek:I wasn't ever introduced to any of the negative or concerns that I needed to be aware of regarding NAD until recently. And I met a friend over dinner who's in the industry and he said, well, just be careful about nad because one of the things it it does do or it has been known to do is to grow things and to and and and one of the things that you probably don't want to be growing is is if you've got any type of cancer or if you're aware of any type of cancer one of the things i've had um is i've had some slight some um sun what is it called not sun cancer but i've had some cancerous things which i've had to have removed on the top of my head because i don't have any hair and um I, well, yeah.

39:22Matthew Januszek:And a hat I've been told I should have won a long time ago, but, but anyway, I was, I was, when I heard that I was concerned that could, could I be taking something to help me feel better and live longer, but at the same time, stimulating cancer growth or, or accelerating early stage cancer growth that I also don't want to do. And I wasn't really sure where to go next because, like I say, I've tried it, experimented it, but also worried about what could happen, similar to the previous example you gave. So what advice would you give to people, particularly as they're getting into their 40s and 50s and 60s, where some of these things start to accelerate more than when you were younger?

40:05Matthew Januszek:And how can you stay on top? Like, do you just go and have a blood panel with someone that looks to see if you've got cancers, and if it says no, then you're fine? should you be speaking to the people that you're getting your NAD off to do your checks like where do you go because it it definitely is a little bit confusing and and and quite concerning if you make a wrong decision you point out something that's so important in the wellness industry right now that is really not being talked about enough is that we're pushing a lot of these products at doses that we don't understand and so this is a real issue where you know this manuscript that we just published, we really just wanted to understand, is this safe from the perspective of your liver, your kidneys, and some biomarkers that we were looking at?

40:52As far as these doses and cancer growth, we don't know the answer to that question. The data that you are talking about was animal data. They gave very, very high doses of a couple of the different precursors. So this study has been repeated a couple of times. they used nr for one they used niacin for another i believe there's another one that they were specifically giving nad as well and here's the issue in some of these cases the mice that they were using are actually bred to develop cancer that's the whole idea and so in some cases and this happens a lot in the research is they basically look at these animals and say did the group that we gave this high very high dose to develop cancer more rapidly than the other group So they don't wait around in these studies to figure out whether or not these animals are naturally going to develop cancer.

41:42They have these models to figure out if it happens more rapidly. And that's a clue to the scientists that there might be some kind of carcinogenesis risk with these molecules. That being said, there is also hypotheses out there that this high dose of NAD precursors could be preventive from the case of cancers because you're actually fine tuning your molecules in your body to chase after that damage that could potentially then become a tumor. And so this is where I get really sort of fussy with my group is we don't know what these high doses do. And so we do need to be very careful. So right now at Restore, we have a contraindication, an absolute contraindication with NAD and NR that if you have a history of cancer or you have an active cancer, you are not allowed to get our product because we want you to be safe.

42:41And also from an industry perspective, we don't want any issues with liability around these sort of experimental molecules. And so you point out something that's critically important. And I would point as well as we kind of like turn this corner into the world of peptides, for example. This is coming at us fast and furious. GLP-1s are kind of like the tip of the spear here with the peptides. And we know that there is a whole gray market out there, regulatory changes that are coming our way. Peptides are coming. And for the vast majority of them, we don't have dosage data. We don't have safety data.

43:19We have a lot of growth hormone secretagogues that are in these peptide stacks that we don't know if that is going to cause a tumor to grow or if it's only going to cause your muscle to grow. So I would say this is a real issue in our industry right now is that we are rolling with a lot of products that have not had the safety and the dosage testing that we really should have had before we got them out the door. That being said, it allows me as a scientist to come in and thankfully with the support of Restore who basically said to me, follow the data, like, please let us know what's working, what's not, what's safe, what isn't to come in and do a little bit of this work.

44:06And I'm excited to keep doing this, but we are really behind on the claims that are being made compared to the safety and the scientific evidence that has been generated. Yeah, I think peptide is also a really good point. Matthew and I have been, I don't know if you spoke about it on the podcast, Matthew, but I know offline we're always talking about it. And one that comes to mind is, I think it's BPC157 is a real popular one. In fact, I injured my knee from running a couple of weeks ago. And you'll be surprised, Rachel, how many people said go on this peptide for recovery. And I was thinking about ordering one, but there's so many options, and I feel like I need to talk to someone smarter than Matthew.

44:49So this is why maybe it's good to have people like you in my circle to maybe speak about this. But that's really an issue, right? Because yes, in some ways, there's an inherent distrust of our healthcare system, and even the FDA and even HHS and all of that, because you don't know with some of the decisions they're making, you're like, okay, that makes sense. Like the food pyramid kind of reclassification, you could kind of look and say, okay, that makes sense. But some of the other ones related to vaccines and all, you kind of squint a little bit. You're like, okay, I don't know if I truly buy into that.

45:28So even at the government level, it's hard to get that. And you talked about doctors just simply and scientists immediately dismissing anything related to something like peptides or NAD at the same time. And I like that term you called lazy scientists, because I think that's right. So I think that's how it created this lane of consumers and influencers that are just here to try it. And I agree with you. I think as long as something isn't at a high dose, But then the issue is, though, you don't really know what's the high dose either. No. Right? That's not really clear to you. I mean, I'll give you an example.

46:06We talked about this. And I've been a user of this. But when I take long flights, I overdose on creatine. So I do 25 grams a day. And I hope it doesn't. I mean, it's been researched. It's probably one of the most researched supplements out there, maybe the most. And I think that that's okay. But, you know, now that you're hearing you talk, I'm like, I'm a little bit concerned. Should I not be doing that? the good thing is the good thing i'll stop you with creatine those high doses seem to be perfectly fine darren kando and his team and abby smith ryan have done a ton of really good work on creatine so keep doing that it does seem to be that that high dose is what actually does affect your brain

46:41Matthew Januszek:so you're good you're good on that one although although just on that one mode like we were a common industry friend introduced us to a to something that helps you sleep and i was gonna i was gonna actually send you and him a message um but it's uh there's a there's an ingredient that's in some of these sleeping tablets that apparently is very effective and you don't get the hangover. But I was looking at an article the other day where apparently it could give you risks of dementia and other kind of mental issues. So I was like, okay, I was really excited about my new sleep hack and yet it could lead to other things.

47:17Matthew Januszek:So just something as simple as a very inexpensive sleeping thing that you get in whole foods could have long-term negative effects to potentially give you a high risk of dementia yeah i think that's what infuriates a lot of the sort of like traditional clinical care teams is they're like we don't know to your point mo like what is a high dose like where is the threshold of safety and these beneficial outcomes and crossing over into this upper limit or toxicity space. And so this is something that I believe industry really needs to start doing their due diligence about. And frankly, this was the guise with which the FDA was able to say, we're putting all of these peptides on this category two compounding list.

48:08We don't have the safety data. And I kind of have to say, we deserved that, right? We didn't do our due diligence. And as a result, we're just slinging all these peptides out. People are injecting them all over the place. And we don't have a range to say, this is where it's dangerous and this is where it's safe. And frankly, that's the FDA's job is to put their foot down when that kind of a problem kind of pops up. And so I think about my job in addition to figuring out whether or not this stuff works and it's really fun and I get to do research in the longevity space. But I also think about it as a responsibility to our industry to say, if we want to actually offer these products, then we should do the due diligence to make sure that what we are saying these products do, they actually do in your body.

49:07Well, we are almost at time, and Matthew, I remember it's almost a year ago in the UK, you and I tried methylene blue for the first time. and I don't think we've tried it.

49:16Matthew Januszek:Let's see what Rachel thinks of that one then. So Methamble is used in the hospital. It is, I have to think of, there's a very specific disorder. It's like a blood oxygenation disorder. I can never pronounce it. It's like, it begins with an M. It's like methamoglobinemia or something like that. And I don't feel bad butchering it because every doctor I've ever talked to can't pronounce it either. So it has been used. It does have, interestingly enough, because it's been used clinically, it has better safety profiles than others. As far as whether or not the claims that are being made from the longevity sector are true, that again, no data to show whether or not these outcomes are happening with methylene blue.

50:08But again, curious scientists over here, I would say there's biological plausibility that shows that it could potentially be helpful. Combine that with some decent safety parameters and like we could probably start doing some cool studies to figure out exactly what it's helping and what it's doing.

50:25Matthew Januszek:It is interesting because even with methylene blue again I sort of get these articles sent to me but there was something that it could affect eyesight. There was some early research to say that they'd notice that when you go out and I don't know whether it gets into your eyes and it affects and it interacts with the sun or something, but there were there was possible concerns. And it just makes me think about really, although a lot of times, even myself, you want to be cutting edge and be interested in some of these things. And when it comes to government, government are extremely slow and regulation is slow and having any kind of really genuine and meaningful studies are really, really slow.

51:10Matthew Januszek:But in a lot of cases, when you can see some of the unintended consequences for some of these things that you're injecting into your body, they're the opposite of helping you live a long and healthy life. In fact, you could be taking something that you think is helping you live longer, and it actually is doing quite the opposite in many cases. And so just I know we have got to wrap up and we are short of time, but for many people who listen to this are in the health, fitness and wellness industry, and they're considering introducing some of these things into their businesses. nowadays there's everything from peptides to NEDs where you can go to your gym and they'll mail it to you and the gyms have almost become this hub of where you would get information or product.

51:52Matthew Januszek:What would be some very simple advice that you would give to people to ensure that from a business perspective that they're certainly not putting anyone into any unnecessary danger? Yeah, I think I would say two things. Number one, consult with people that know what they're talking about. So that I think is really important. Get an advisor that understands what the limitation and the safety parameters are, at least to the best of our knowledge. Don't go off of what you're hearing on podcasts or whatever the revenue is that you think that you can get from this, because you are injecting people with something that could potentially be harmful.

52:30And you want to make sure that they're well, number one, but you also want to make sure that your business stays well. The other piece that I would say that we didn't touch on, but is really important and critical is know your supply chain. The supply chains in these products are gnarly. That is an official term that I will use. And there is a lot of consequences to carrying these nutrients across state lines. Where are they coming from? Where are they being shipped in from? Are they being tested? Are they research grade? Are they actually FDA approved? So if you want to bring these into your business, I would say consult with somebody that can help you set some parameters and then also make sure that your supply chain is really buttoned up because you can have some really serious consequences if either of those things are not tight.

53:15Matthew Januszek:Very good. Mo, is it takeaway time, I guess? Sorry, I've extended it longer than planned. It's okay. And I'm going to give you my final takeaway and then I might have to hop off. First, Rachel, thank you so much for joining us the podcast. This has just been incredible. I'm probably going to text you after just to see. I'm here for it. I need to schedule my NAD therapy now. I'm curious. It sounds like I'm not too young to start some NAD therapy. Can I put a fine point on that really quickly? I actually think right now with NAD, people are starting too late. So I think the consequence of starting in your 50s, 60s, and 70s, which is where a lot of people are starting, I think that the neurodegeneration and the issues are starting much earlier.

54:01And I would actually encourage people to start earlier, you might not feel it the way that you would feel it in your 40s, 50s and 60s. But that's kind of the point, right? What we want to do is prevent degradation. So I would say, start in your 30s, honestly, and we have some pretty good data to show sleep and other improvements occur during the NAD and NR infusion. So I would say actually start a little earlier. Well, Rachel, thank you so much for joining us in this episode of Lyft. I look forward to seeing you in a couple of weeks. For those of you who are listening, if you found this episode helpful, please do like, comment, and share.

54:37We look forward to hearing from you. And if there are topics or guests that you'd like us to have on, please send us an email. We're actually going to be launching a new website, a new newsletter. So we will be sharing more about that in the coming week.

54:55Thank you.