The guest
Dr. Peter Attia: Stanford- and Johns Hopkins-trained physician and one of the most trusted voices on healthspan and lifespan, author of the bestseller 'Outlive.' He runs an active clinical practice and is known for rigorously reviewing the research literature.
What this episode covers
Attia lays out a framework for longevity (behaviors, disease-targeting drugs, geroprotective molecules, and the kitchen-sink approach) before he and Huberman take a deep, skeptical dive into the NAD pathway. They trace the science from sirtuin overexpression in yeast through resveratrol's collapse, the failure of NR in the rigorous Interventions Testing Program, and weak human studies on NMN. Both conclude there is no evidence NAD-boosting supplements extend lifespan, with the only possibly genuine signal being reduced basal/squamous skin cancer risk. They contrast this with rapamycin, which Attia takes and considers the most promising geroprotective drug, and close by sharing their full personal supplement regimens while stressing that sleep, exercise, nutrition, and emotional health dwarf any supplement.
Recommended on this episode
ProductRecommended
Magnesium L-threonate
various
“I take”
“I take um magnesium L3 and8 and ashwagandha for Sleep”— Peter Attia
ProductRecommended
Creatine monohydrate
various
“I take”
“I take creatine monohydrate five grams a day”— Peter Attia
ProductRecommended
Pendulum (probiotics: Glucose Control, Polyphenol, Akkermansia)
Pendulum
“there's no other probiotic that has any meaningful effect on the body outside of pendulum”
“as far as I know there's no other probiotic that has any meaningful effect on the body outside of pendulum”— Peter Attia
The guest's own work
BookBy the guestISBN verified
Outlive: The Science and Art of Longevity
Peter Attia
“your book outlive beautifully covered these and I tend to regurgitate some of what you say on this podcast”— Andrew Huberman
Also referenced (named, not recommended)
ProductReferenced
Rapamycin (sirolimus)
generic / Rapamune (Pfizer)
“I take at least one that is purely just based on the belief of its capacity and Juro protection which is rrap ayin”— Peter Attia
ProductReferenced
Nicotinamide riboside (NR)
various
“the notable failure is NR NR was tested ... there was no extension of life there was no improvement in health span”— Peter Attia
ProductReferenced
Nicotinamide mononucleotide (NMN)
various
“I like the effects of taking sublingual nmn ... it makes my hair grow really fast ... I do feel an increase in energy”— Andrew Huberman
ProductReferenced
Basis (NR + pterostilbene supplement)
Elysium Health
“so commercially available product called basis and it was tested there was a three arm study in humans”— Peter Attia
ProductReferenced
Metformin
generic
“it it's a high bar met foran failed by the way”— Peter Attia
ProductReferenced
Acarbose
generic
“acarbose a drug that inhibits glucose absorption worked and interestingly didn't require weight loss”— Peter Attia
ProductReferenced
Canagliflozin (SGLT2 inhibitor)
Janssen
“The same was true with the sglt2 inhibitor canaga floen ... and yet they both lived longer”— Peter Attia
ProductReferenced
N-acetylcysteine (NAC)
various
“it's a mucolytic it's actually a great decongestant ... and it increases glutathione that's my understanding”— Andrew Huberman
ProductReferenced
Everolimus
Novartis
“Joan manik and Lloyd klickstein when they published that paper in 2014 using everolimus ... found an enhanced immunity”— Peter Attia
ProductReferenced
Fish oil (EPA/DHA)
various
“I do take EPA and DHA in the form of liquid or capsule fish oil capsules”— Peter Attia
ProductReferenced
Carlson's liquid fish oil
Carlson Labs
“I take a quality fish oil either the one that AG makes or Carlson's in liquid form ... that has that lemon flavoring”— Andrew Huberman
ProductReferenced
Vitamin D3 (5,000 IU)
various
“I do take vitamin D because interestingly despite the fact that I'm outside every day ... my levels are surprisingly low”— Peter Attia
ProductReferenced
Methylfolate and methyl B12
various
“I do take methyl folate and methyl B12 ... the rationale there is I do think there's some evidence that elevated levels of homosysteine are bad”— Peter Attia
ProductReferenced
Slow-Mag (magnesium chloride)
Slow-Mag
“i' take slow mag which is just a magnesium chloride slow relasing version of magnesium”— Peter Attia
ProductReferenced
Theanine (in Apigenin/L-theanine sleep stack)
various
“before sleep I take magnesium 3 and8 ... appenine 50 milligrams which is essentially chamomile extract and theanine”— Andrew Huberman
ProductReferenced
Whey protein
various
“I use a quality way protein as a protein replacement that kind of thing”— Andrew Huberman
ProductReferenced
Alpha-GPC
various
“600 million Mig of alpha GPC or 900 milligrams of alpha GPC in a Double Espresso prior to a workout you feel different”— Andrew Huberman
ProductReferenced
Theanine (Suntheanine cognitive)
various
“I take thumin and there's some reasonable evidence in MCI patients that thumin improves cognitive function”— Peter Attia
ProductReferenced
Your Life in Weeks wall chart
Tim Urban / Wait But Why
“I bought that chart my life in weeks yes in fact I bought two of them ... I've watched that chart Phil”— Andrew Huberman
Big reveals from this episode
- Attia and a few patients personally raised ~$2.5M to keep Matt Kaeberlein's dog aging rapamycin study going after NIH funding fell short.
- Attia states flatly there is zero evidence sirtuins and caloric restriction work through the same pathway, despite 20 years of belief they do.
- Attia describes IV NAD as feeling like 'somebody stepping on your chest with a boot' for the first 10 minutes.
- NR was a notable failure in the Interventions Testing Program: no lifespan extension, no healthspan improvement.
- Both agree NAD supplements do not extend lifespan: 'the answer appears to be unambiguously no.'
- Attia pinpoints the 2014 everolimus immunity study as his personal turning point toward taking rapamycin.
- Attia: 'I don't take these supplements full stop ... I passionately do not believe they do anything for me.'
Worth remembering
- Attia takes 8 mg of rapamycin once a week, cycling on and off because it gives him canker sores in about 10% of users.
- Only two interventions have ever extended lifespan across yeast, worms, flies, and mammals: caloric restriction and rapamycin.
- Skin loses about 60% of its NAD over a lifetime, versus roughly 15-20% in the brain and ~20% in blood.
- A 2015 study found NAD drops with age but NADH rises by the same amount, so what really declines is redox potential, not total NAD.
- Mouse efficacy doses run 500-1,000 mg/kg; at human equivalents that would cost roughly $300/day, making them infeasible.
- The one genuine NMN/NR signal Attia found: a 60-80% reduction in basal and squamous cell carcinomas, but no effect on melanoma.
- Generic rapamycin costs about $5/mg, so Attia's 8 mg weekly dose runs ~$40/week.
- Living at sea level gives ~1 millisievert of radiation a year; a DEXA scan delivers less than a cross-country flight.
- Pendulum is, per Attia, the only company that can make anaerobic Akkermansia probiotics, requiring Pharma-grade nitrogen-infused vats.
- Attia's analogy: supplements are like whether the Titanic served lobster or steak; sleep, exercise, nutrition and mental health are the ship's heading.
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