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Drugs and supplements studied for slowing aging

Medicines first made for other uses, and supplements, that researchers are testing against aging itself.

What has been tested, and how far it has got

2RapamycinStage 2 · Small studies in people · Prescription, used off-label for agingRapamycin, also called sirolimus, is a prescription drug that suppresses the immune system and is used to prevent kidney transplant rejection.Main risk: The pages stress that it can make it harder to fight infections and raise the risk of serious infection.4MetforminStage 4 · Widely recommended · Prescription, approved for diabetesMetformin belongs to a class of drugs called biguanides.Main risk: Metformin may rarely cause a serious, life-threatening condition called lactic acidosis.2NAD+ boostersStage 2 · Small studies in people · Over-the-counter supplementsNAD+ boosters are supplements, such as NAD+ precursors like nicotinamide riboside and NMN, meant to raise levels of NAD+, a molecule in cells that declines with age.Main risk: A review of studies found all studies reported some side effects, most often muscle pain, nervous disorders, fatigue, sleep disturbance, and headaches.2NMN (nicotinamide mononucleotide)Stage 2 · Small studies in people · Over-the-counter supplementA molecule the body uses to make NAD+, which cells need to turn food into energy.Main risk: A review of studies found that oral NMN and NR (a related compound) were generally well tolerated over weeks to months in people.2NR (nicotinamide riboside)Stage 2 · Small studies in people · Over-the-counter supplementNR (nicotinamide riboside) is a compound that can raise levels of NAD+, a molecule in the body that declines with age.Main risk: A review of studies found oral NR was generally well tolerated over weeks to months.2Alpha-ketoglutarate (Ca-AKG)Stage 2 · Small studies in people · Over-the-counter supplementA molecule the body makes while turning food into energy. Supplements usually use a calcium form, Ca-AKG.2GlyNAC (glycine and NAC)Stage 2 · Small studies in people · Over-the-counter supplementsNAC is used as a drug for acetaminophen overdose and to help break up mucus.Main risk: The pages list stomach upset, diarrhea, nausea, vomiting and similar problems as the common side effects of NAC.2SpermidineStage 2 · Small studies in people · Over-the-counter supplementA natural compound in foods such as wheat germ, soybeans and aged cheese. It is studied for its role in how cells recycle their parts.2Urolithin AStage 2 · Small studies in people · Over-the-counter supplementUrolithin A is a gut metabolite, a substance made in the gut, derived from ellagic acid.Main risk: A review of studies found that adverse events not related to urolithin A were mild or moderate.

Recent research

New trial · ClinicalTrials.gov

Can metformin help prevent frailty in older adults?

This registered trial was set up to test whether the diabetes drug metformin can prevent frailty.

Original title: Metformin for Preventing Frailty in High-risk Older AdultsStudy in Human skin cells and skin samples in a lab, plus randomized studies in healthy people · iScience

Urolithin A cream may help skin in lab and small human tests

Researchers tested a skin cream with urolithin A on skin cells, skin samples, and people.

Original title: Topical application of urolithin A activates mitophagy and enhances mitochondrial function to promote skin longevity.New trial · ClinicalTrials.gov

A study will test an NMN supplement for exercise endurance in older adults

This is a planned trial that has not reported results yet.

Original title: Nicotinamide Mononucleotide Supplementation for Exercise Tolerance Improvement in Healthy Older AdultsNew trial · ClinicalTrials.gov

A planned trial of sirolimus in women with a higher Alzheimer's risk gene

This is a planned study that has not reported results yet.

Original title: Effects of Sirolimus on Asymptomatic ApoE4 CarriersNew trial · ClinicalTrials.gov

Can sirolimus slow functional decline in older adults? A new trial is recruiting

This is a plan for a trial that will test whether the drug sirolimus can slow aging-related decline.

Original title: The Role of Sirolimus in Preventing Functional Decline in Older AdultsNew trial · ClinicalTrials.gov

A trial testing nicotinamide mononucleotide, called NMN, in middle-aged and older adults

This trial is still recruiting people and has posted no results yet.

Original title: Intervention of Nicotinamide Mononucleotide in Middle-aged and Elderly PeopleTrial in Postmenopausal women aged 60-75 in a planned trial; no participant count stated · ClinicalTrials.gov

Testing a drug and exercise for bone and muscle health in older women

This trial will compare everolimus, weight-style exercise, both together, and dummy pills in women aged 60 to 75.

Original title: Resistance Training and Rapamycin to Enhance Bone Formation in Postmenopausal WomenNew trial · ClinicalTrials.gov

Testing a daily Urolithin A supplement on muscle strength in middle-aged adults

This study is a trial that has not reported results yet.

Original title: The Effect of Urolithin A (Mitopure®) Supplementation on Muscle Strength in Healthy Middle-Aged Adults

What experts say

“TAME is not a moonshot. It’s not even about scientific achievement really, it’s more about political achievement. Metformin is a tool to get aging as an indication.”

Nir Barzilai, Head of the Institute for Aging Research at Albert Einstein College of Medicine; scientific director for AFAR · STAT · Aug 9, 2022 · on Metformin · Source ↗

“But it’s premature to make any clinical recommendations based on the results from our study. NMN needs to be tested in more people and for longer periods of time to determine if it has anti-ageing effects in humans,”

Samuel Klein, doctor and nutritional specialist at Washington University School of Medicine in St Louis, United States · Nature · on NMN (nicotinamide mononucleotide) · Source ↗

“Finding an effect in muscle tissue is very interesting and does demonstrate that NMN is not inert,”

Samuel Klein, doctor and nutritional specialist at Washington University School of Medicine in St Louis, United States · Nature · on NMN (nicotinamide mononucleotide) · Source ↗

“It mightn’t be wise to increase cellular entry of NMN, as an increased intracellular NMN/NAD + ratio activates SARM1, an executor of axon degeneration.”

Evandro Fei Fang, molecular gerontologist leading an anti-ageing laboratory at the University of Oslo, Norway · Nature · on NMN (nicotinamide mononucleotide) · Source ↗

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This is general information gathered from the sources listed, not medical advice. Talk to your doctor before starting anything new.