Plastic Surgery has a focus on cellular health. We need it for healing; we need it for aging better. It is part of what led me to doing fat transfer (and the stem cells and skin quality improvement I see), and it has led me to biohacking- not in the snake oil way, but in a let’s-look-at-the-science way. It is part of why I became an advisor at Biohackr Health (longevity + healthspan) and Midi (menopause), and it is why I am a fan of NAD.
What is NAD?
NAD, short for nicotinamide adenine dinucleotide, is a coenzyme found in all living cells. It plays a crucial role in cellular metabolism and energy production by helping convert food into energy and supporting DNA repair, immune function, and other vital processes. As we age, NAD levels naturally decline, which has led to NAD supplements, which use precursors like nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN), which the body can use to produce more NAD.
What is regenerative medicine?
Regenerative medicine is a cutting-edge field focused on repairing, replacing, or regenerating damaged tissues and organs to restore normal function. This can be done with stem cells, tissue engineering, or gene therapy. We are trying to slow or stop cell senescence.
This was an article in Plastic and Reconstructive Surgery published in 2021, “The role of NAD in regenerative medicine.”
The article is full of great information, but the author believes as I do, that addressing aging is something best done on a global, cellular level. So what we see as skin aging, is reduced collagen and elastin, thinner skin, reduced cell turnover, harder wound healing, and pigmentation. But what is the ROOT cause?
- Poor DNA repair
- Telomere shortening
- Epigenetic alterations (see my page on epigenetics)
- Mitochondrial dysfunction (mitochondria are the powerhouse in every cell in your body)
- Cell senescence
- Stem cell exhaustion
NAD is thought to help in many of these processes. It promotes telomeres, it helps mitochondrial function, it helps against cell senescence, reduces age related inflammation, helps stem cell rejuvenation, and helps cells adapt to stress. NAD+ is a cellular coenzyme that plays an essential role in both metabolic and signaling reactions. In metabolism, NAD+ helps redox reactions which form ATP, the energy in each cell.
In skin, we see this damage in many forms and taking NAD supplement (available in my office as the NMN precursor) may help reverse or slow the aging.
- UV damage needs DNA repair mechanisms. NAD helps this DNA repair, with PARP and SIRTs. With out DNA repair, this leads to cell senescence, which we see as aging
- Senescent cells do not produce collagen and elastin, they cannot repair damage, they release inflammatory factors
- Senescent fibroblasts degrade the extracellular matrix and are pro inflammatory, which leads to skin thinning. NAD restoration has been shown to reduce senescent cells in dermal fibroblasts
- DNA methylation clocks predict biologic age of cells- NAD SIRTs cause expression of beneficial genes in the epigenome, which are linked to activation for wound healing and skin regeneration.
- Mitochondrial dysfunction leads to increased oxidative stress and dermal atrophy. NAD is critical for normal mitochondrial function.
My thoughts?
Speaking to the choir. I am on NAD, through the stable powder supplement form NMN. I carry it at my office and it is available at Biohackr Health. Ours is high quality, and it includes the NAD precursor NMN, D-Ribose and Nicotinamide. You can test your NAD levels to see how deficient you are- levels go down with age, but as with everything, everyone is different in how deficient they are.
I believe in trying to improve healthspan. Not only will your skin look better, but every body system will improve. I think the next frontier of medicine is to try to address root causes of aging at the cellular level. We may not be able to reverse aging, but we can try to slow it.
MEDICAL REFERENCE:
PRS NAD article
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