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Comment by ttcbj | Hacker News Reader

My grandparents are now 95 and 96 (just shy of their 75th wedding anniversary). They are wonderful people, but it is clear that life is hard for them now. They have chronic pain and nothing can really be done about it. They have very limited opportunities for enjoyment or activity.

Watching them, and also my mother struggle with health issues at 73, has really changed my perspective on aging. I am very focused on enjoying my health now (at 47). Some people are spry and enjoying life up to their early 90s (my grandparents), but some experience health declines much earlier.

The stoic idea that "there will be a last time for everything" in your life (last time you go for a jog, last hike in the mountains, last time you can move without pain, last time you can travel, etc etc) is how I think about aging. I really try to enjoy the physical health I have now, and keep in mind that it will not last forever.

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My parents are like that in their 80s. They now respond to things like, "time is short, if there's anything you wanted to do, do it" with "that time has passed for us." It struck me as characteristic of their accidental lifelong stoicism.

It's sobering and makes it really hard to continue working in middle age.

I was surprised at the step down in quality at 59. Definitely worried about other lower qualities of life and thinking about how long it could last.

Yeah, I'd rather money be put into quality rather than quantity of life.

There's no reason you can't have both.

I have a gut feeling that as physical medicine has advanced faster than neuro or psychiatric medicine, people will live long enough to want to die, and euthanasia (self or pre arranged) will become acceptable, even normal.

I would choose to give my children financial benefits instead of years of late life medicine, even if I could afford to live over 100.

If you’re as good a parent as your comment suggests, I bet they’d trade the money for more time with you.

I would love for quality of life to improve so you could enjoy until, say 100, and then euthanize. The two problems i see are:

- Retirement age will likely be pushed until 80-85, to avoid long pensions.

- Young people will find it harder to get a job, even harder to get a well-paid one.

That would be waste to remain healthy enough to live to 100, then kill yourself. Mental health is a part of living that long in the first place. Anybody who has the mentality that they'll just kill themselves once they reach that age, probably won't live that long anyway.

Dr. Sinclair's book Lifespan (https://www.amazon.com/Lifespan-Why-Age_and-Dont-Have/dp/150...) talks about extending the health span of people. I've been personally taking 1g/day of NMN for almost 3 years now, and I feel like aging has paused or is going backwards slowly.

Where can you get NMN?

Don't bother. Sinclair is considered a quack by even some life-extension enthusiasts.

He owns part of the company that makes patented NMN which is just another form of NR which is a another form of very cheap Niacin.

He also owns part of the company that claims he is rolling back his biological clock.

That's not science, that's marketing and profiteering.

NAD production slows down with age and illness. All he is doing is supplementing what was produced more easily by a younger body.

There are a many other factors to aging, most of which cannot be changed (yet) by science.

Why disregard someone simply because they own a piece of a company that also supports the goal? I think any rational person would do the same - you believe in something so you start, invest in, or advise a company.

I think the comment also said that this person’s views aren’t taken seriously in the aging research community. So the combination of their ideas and a desire to profit from them raises flags.

I don't think Harvard would let Sinclair have a lab with some 35 people and publish articles under their name if he was a total fraud/quack.

My impression of Sinclair is that he likes public attention too much and often reports on work in progress with too much certainty, but results like this [1] seem to be fairly impressive.

[1] https://www.nature.com/articles/s41586-020-2975-4

Counterpoint from someone more educated (with a more precise conclusion that he is "not evidence based")

https://threadreaderapp.com/thread/1492902239312039938.html

I am doing some experiments with NR (no Sinclair in the business chain AFAIK) and pterostilbene and my ability to exercise has improved noticeably. I am 43 and I used to be fairly sore after a strenuous 60 minute exercise - especially my sinews were bad. This wasn't getting any better with more exercise, actually it was slowly getting worse with age, to the degree that I wasn't able to exercise in two consecutive days and sometimes I had to wait until the third day to go to the gym again. (To be clear, I am neither fat nor riddled with any serious disease.)

Nowadays the small pains and aches go away in a few hours, like when I was some 15 years younger. But if I stop the supplementation, the situation reverts to the old bad standard within a month or so.

I also noticed some effect on my visual acuity.

I know this is N == 1, hard to measure precisely and subject to a possible placebo effect.

Note I am not disputing NAD supplementation, only the limits of what it can do and who can benefit from it.

The key to NAD supplementation is the people who need it are older or ill.

There are a lot of other processes in such bodies that become deficient too.

None of the supplement methods for NAD, Niacin, NR, NMN will boost levels beyond what your body will use.

This is what the NAD cycle looks like, you can see NA (niacin) vs NR vs NMN are each closer to production but the end result is the same of what ends up in the blood vs organs like liver.

https://www.lifespan.io/wp-content/uploads/2019/06/NAD_schem...

There are wild arguments, even with scientific rigor, about NR vs NMN ability to get into cells. It is more likely that genetics matters and it varies from person to person and what else is in their diet.

I had a similar response doing a mostly vegan calorie restricted low protein diet. I was blown away because I had always been told protein = recovery, calories = recovery, but I have been able to rock climb pretty hard 6 days a week for the past 4 months now. Keto, general healthy eating, tons of supplements and all the other things I have tried have resulted in maybe 3-4 hard sessions a week and achy joints.

https://www.prohealthlongevity.com/collections/nmn-bulk-and-...?

There is no evidence it works taken orally. Save your money.

How old are you?

How are you gauging “aging has paused or is going backwards slowly”?

Mid 30s. Gauging by how my joints feel and how quickly I recover from physical exercise and injuries.

I’m 38. I’ve beaten the hell out of my poor aging frame. And then fixed a lot of those injuries to my poor aging frame by not playing rugby any more.

All of which to say: there is absolutely no way you are possibly controlling for all variables here. Things off the top of my head that could help with exercise recovery, all of which are more plausible than some poorly tested supplement:

- Changes in exercise type - Changes in exercise duration - Changes in exercise intensity - Changes in exercise form - Weight loss - Sleeping more for better recovery

I am willing to wager that Dr Sinclair is just peddling nonsense to make his million bucks and exit quickly.

considering he leads a research group at Harvard that publishes in high profile journals, you could actually look at the peer reviewed research, instead of relying on your "hunch"

It's old news but did you know, He did fuck GSK for 750 million? Basically no one could ever replicate his study. GSK should have done thier homework so boohoo for them but still all is not what it seems.

https://www.youtube.com/watch?v=JAFnD27ffqE

Well at least he isn't exiting quickly after having made his million bucks. I sometimes take NMN. I have no idea if it works or not.

He's also launched a podcast-- https://www.youtube.com/c/DavidSinclairPodcast/videos

I find the first 3 episodes to be absolutely stellar and was engrossed the whole hour. Pretty good takeaways.

The more recent ones are a little contentious and, as he himself admits, a little pseudosciency. He even says that these supplements are marginally helpful, and perhaps the most beneficial things is literally to just walk after a meal. Partially as a result, and partially because the recent episodes's concepts weren't explained well, I found myself distracted.

Random-- he makes a comment how the FDA often prematurely bans things e.g. peptides, which greatly hampers researchers' access to these materials.

I'm going to save you some money. What really works well and better than taking NMN orally(), eat a natural clean whole food diet (no pufa's or processed food), no alcohol or smoking and walk or do some sort of light exercise for about 30-60 minutes a day.
I am willing to bet it will do more for you than taking NMN.

Peter Attia has discussed this with folks who know a lot more than Sinclair and they have concluded there is no evidence it works. The number one thing you can do to extend lifespan is exercise.

but what if I do all of the above?

You would get healthy and waste money on NMN.

That's where my grandparents are right now. They retired in their early 60s, and they have a solid income between ss, pension, and 401k, but their healthcare takes up more-and-more of that money and they still struggle with their health. And just what have they done with their 30-odd years since they retired? They didn’t travel, pick up new hobbies, or finish their educations.

Retirement isn’t my goal. I want to work full-time until my late 70s, and die in my early-to-mid-80s at the latest. In the meantime, I’ll spend my money flying, traveling, and on my apartment and a fast car.

"I want to work full-time until my late 70s, and die in my early-to-mid-80s at the latest."

We'll check back in a few decades...

Lmao. So says the 20 something.

A lot of retired people I know have essentially taken on second careers as professional medical patients.

An old guy driving a car very fast would be a sight to behold. Most have slow reflexes and vision problems.

My 70 year old father-in-law driving his Tesla s plaid would like a word

Eventually we will fix all these issues. The only deaths will be freak accidents or killings/suicides. Youth forever. We're less than a hundred years away from that kind of tech, I believe.

That is essentially a religious belief with no scientific basis.

It may be excessively optimistic, but it’s hardly unscientific or without foundation. There are animals whose biology does not age in the sense ours does, and we have done some incredible work increasing the healthy lifespan of lab rats/mice.

No, it's not. We are machines, we can be fixed. Just a matter of when, not if.

The laws of physics don't owe you a solution to any problem you wish to solve, including eternal life.

And even if the problem can be solved, evolution doesn't owe you sufficient intelligence for our species to solve it.

Any within the bounds of physical laws and resources available.

I remember my grandpa in the hospital after it was deemed surgery was unlikely to succeed and he decided to try to sit up which seemed to be quite difficult/painful and he says “well that’s the last time I sit up”. And he was correct.

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