Supplement Secrets for a Longer Lifespan with Sandra Kaufman MD

Revealing how athletic pursuits fueled her quest for longevity . Dr Kaufman demystifies the complex relationships between post-reproductive evolution and cellular decline . Diving into the seven tenets of cellular aging , from DNA alterations to the critical shortening of telomeres and epigenetic changes , we're peeling back the layers of what it really means to grow old .

We get to step into the realm of longevity interventions , where the promise of NAD precursors meets the reality of FDA regulations . Dr Kaufman candidly discusses her own regimen involving senolytics , prescription drugs and the therapeutic use of infrared light .

She also examines the available methods for assessing biological age , sharing insights into how these tests often flatter us and the need for a holistic approach For those eager to embrace these anti-aging strategies . Dr Kaufman invites us all to connect and learn more about staying vibrant through the years .

This episode is brought to you by L Nutra , maker of the prolonged fasting-mimicking diet . If you'd like to try it . Use the link in the show notes for 20% off . You can support this podcast by checking out their website and taking a look at all their other innovative products . And now please enjoy this week's episode . Sandra , thanks for joining us today .

So as a consequence , many years later I turned out to be a pediatric anesthesiologist , and people always ask how longevity is related to anesthesia and it is , but it's not . So what I do now is I look at various agents through the lens of a physician as well as through the lens of a cell biologist . But to be more specific , how did I get into longevity ?

I'm a bit of an athlete , I'm a rock climber , I'm an adventurer , and it dawned on me in my mid 40s that unless I sort of figured out how not to age , my hobbies were not going to last very long .

So I went on this ridiculous quest at the age of 45 to unravel longevity and I decided that your cells age , because that's the basis of who you are , plus as a cell biologist . And then by manipulating cellular pathways via molecules , which is what we do in anesthesia , you can actually decelerate the process of aging .

And now this has sort of become my absolutely obsessed hobby and hopefully someday my real future . But for the moment it's just a crazy hobby .

How do you , how do you conceive of it ?

And if you look at the different categories of aging , which we will get into momentarily , there's different reasons for things . There's nutritional deficiencies , there's pathway failures , there's a myriad of issues that go on , and I think it's all driven by failure of evolution to need us after we raise our children .

Is it a combination of wear and tear , or what's happening beyond our reproductive years ? I guess that that results in our our dying .

So if you look at your proteins , over the course of time they become more and more disabled . Therefore your cell can't function the way it's supposed to . Therefore , if you take all of the proteins and sort of throw them in the same I'm falling apart category , your cell just can't function .

Over the course of time your DNA falls apart , everything sort of falls apart , and so there's just no impetus for it not to fall apart . You know , as an example , you've got for DNA repair mechanisms and when you're young they they're very , very active and as you get older they just aren't because of themselves are proteins , and proteins get destroyed over time .

So I mean it's a multifactorial problem just based on I guess you could all you could narrow it down to wear and tear , but I think it's more complex than that .

Well , we can skip to that if you want , I mean if I'll say let's take it in the order that you'd like I , before we get in the repair processes . You want to talk about the , the seven tenants of cellular aging . Is that a good launching off point or we can build up to that ?

You know someone has a list of 13 of them . I think seven is just an easier number to remember and it's all about sort of like putting them in different categories . So again seven , seven tenants of aging . I start with 10 at one , which is DNA alterations . So things go wrong in your DNA .

So we all know telomeres get shorter as cells reproduce , so that's a problem . And we've got epigenetic modification that happens over the course of time , which is problem . We also have DNA structural failure that occurs . So all of those things negatively affect your DNA and I would cluster them in in 10 at one . Tenant two is mitochondrial failure .

Every organism has to have energy . Energy comes from the mitochondria , as we know , and mitochondrial fail for very specific reasons . The big one , of course , after the age of 40 , usually as an NAD deficiency . So there's a whole market , of course , with that and that's a lot of things that's blowing up right now .

But there's all sorts of things in the mitochondria . For example , the mitochondrial transition poor fails over the course of time and that causes cell damage . Of course , free radical scavengers or that I can't speak today free radical scavengers are a big deal and your endogenous system to defeat those fail over the course of time .

So in your mitochondria alone there's probably six or seven different reasons that they fail . The first one is the three is pathways . There are innumerable pathways that affect aging in the body . I like to think about the big three as you start with the certuans . There's seven million sort to ends that control cellular homeostasis .

13 and six are specifically associated with longevity and we know that as you get older the genes don't make the proteins which then can't affect cellular change , and and and keeping them in the same way . Everyone knows about cert one right , that's why we're on Rosveratrol or Pterostilbine .

But cert three is actually a huge deal and because it runs your mitochondria and by the time you are 30 , cert three starts failing and by the time you're 60 it's abysmal . So these are the things that are very , very important to sort of control as you get older and the first or two ends . The second big pathway is the ampikinase pathway .

This of course measures how much energy you have and it switches your metabolism on and off to sort of control things . And then of course there's the notorious m tour pathway , and I know you're a big backer , so that that's a whole nother discussion

. But that that all falls into 10 at three , 10 at four is what I call quality control , and this is basically checking your widgets as if your cell is a factory . So , as I mentioned before , there are four DNA repair mechanisms .

There's two for single strand and two for double strand , and then there's mismatch repair and over the course of time your body is less able to repair DNA , unfortunately . And in every cell every day you have up to 10 to the fourth errors .

So if you don't fix them , you're more likely to have bad cells , either cancerous cells , senescent cells , all sorts of cellular problems , but unfortunately our ability to fix them fails every time . There's also protein repair issues , right ? This is leads to the conversation about chaperones and the ups system and how we recycle proteins that have gone awry .

And then of course , all topology falls into this category , because anytime your DNA or your proteins are not going so well , you recycle them so that you can make new ones . So that's category four . Category five is what I call the security or your inflammatory system .

So when you are young your immune system keeps you nice and healthy , keeps , you know , foreign bodies away and it keeps your bad cells sort of under control . But as you get older it fails .

So you have more SNES themselves , you have more cancer risk , you're unable to fight infection and you become horribly inflamed over time , which of course is inflamaging , which of course is why you guys are having this conference . Category six I call individual cell requirements . It's the recognition that all cells are not equal .

A red cell obviously has different needs in a liver cell or a brain cell . So it's the idea that we need to get rid of SNES and cells and we need to sort of keep track and care of our some cells . And then category seven is what I call waste management and this is basically glycation issues .

It's horribly bad for you and all the sugars are in general , and it destroys your tissues over the course of time and it's something we need to control .

And then there's the accumulation of lipophusion , which is garbage within your cell , and log of the cells that you really just can't get rid of in your brain , or brain cells because you basically don't know what to do with humiliates over time and causes brain issues , anyway , so in a very large nutshell , those are the seven tenants of aging .

On the other hand , if you have a huge family history of cancer or diabetes or some other concomitant medical issue , other other categories are going to be more important . So I think it's just very individualized and when you create your personal protocol , this is something that you have to identify .

So individual longevity programs are sort of built the identification of what is the worst category for you .

I mean , how is it like at the end of reproductive age or what ? When do people start aging ?

Right levels , as I said before , cert three starts dropping by the time you're 30 . That's huge .

But the real things that people seem to notice , symptomatically , of course , of women and menopause , that's a huge sign of aging right , and it generally happens roughly in the same period of time for people , and I think that's sort of like the big canary in the coal mine my mitochondria aren't good enough , my ovaries aren't good enough .

It's the first full system to fail . So people don't notice age until they have low energy levels or back pain or they're squinting in dark restaurants to read , you know , very small writing on menus . But I think aging gets noticed at different ages by different people . But I actually think that it really starts between pie 32 and 35 .

You know , in our bodies we're all familiar with the phenotypes of aging , yet the , the events that determine our longevity are specific . You know , number one causes heart attack and a stroke , and cancer and Alzheimer's disease . So it's it's almost like aging causes this gradual , generalized failure assistance throughout our body . Yet longevity is determined by these .

You know , three to five diseases that you know don't necessarily come as a result of of failure repair mechanisms , or maybe they do . What's your take on that ?

And the diseases that you mentioned are the end product of cellular failure . Right , we know that cardiovascular disease it's a combination of lipid accumulation , inflammatory issues , failure to clear it . I mean there's many , many contributions for cell failure that ultimately lead to these diseases , like all the neurologic diseases .

Of course , your brain has a , you know it uses more glucose than any other organs , so it has huge glycation issues . It uses more oxygen , right , so it has issues there and it has very little ability to actually repair itself . So if you have a family history of neurologic disease , you know we just need to address those specific tenants .

In addition , most of the neurologic diseases actually have failure of protein repair mechanisms and it , you know , theoretically , if you increase the ability to repair proteins , you know , you know relative risk goes down in terms of neurologic disease . So there's many things you can do , because I think it's not random . I think it's just all .

Development is the end stage of cell failure .

In general , having a fantastic outlook also forces you to do things like exercise , as an example , is hugely important to longevity . I'm actually engaging right now I'm writing a third book on exercise physiology with an ex Olympic athlete on the effect of exercise for longevity and health , because it's so absolutely crucial .

But if you've decided that you're old and decrepit , you're not going to go exercise and therefore it sort of begets itself , right , I mean . Additionally , it's just a positive attitude will absolutely be helpful . Can you positive attitude your way out of diabetes ?

Probably not , but you can certainly mitigate it , perhaps by being more functional and therefore , you know , delude , using up more glucose and blah , blah , blah , blah blah and helping your , your cells sort of functionally .

And as I was sort of waiting through millions of articles , it would talk about a specific molecular agent and how well it did in any one specific category . So it started out as just a big chart with like pluses and minuses and then it became a rating system .

So now what I do is any agent that we talk about in terms of longevity I put it through the rigors of every scientific article I can possibly find and does Agent X help in all of the different categories ? And if it does absolutely nothing for example , in Tenant 1 , for your DNA , it would get a zero .

If there was evidence that it did something in theory or in culture or in a test tube , it would get a one . If it was evidence to be beneficial in some sort of model that wasn't a human you know , a rodent , a dog , et cetera it would get a two , and if there was evidence for humans , it would get a three .

So now what I do is every agent and I think I'm up to 48 of them comes with a seven digit rating number that tells you exactly what it does in each tenant of aging and how efficacious it is . So you can build number grids to determine how well you're combating aging in each of the seven tenants .

And if someone is completely healthy , I would argue that all of the points at the bottom , when you add them up , should be roughly equivalent . And if you have a disease propensity where one category is going to be more significant , you put more points in that category . So that's how you sort of individualize your protocol .

Basically for the metrics of the individual , where they are in , their biological age or their disease states , in order to you know which supplements to apply ? How is that done ?

So if you have a high requirement in that category then we need to max out points in that particular category . Some of these categories have no specific measurements . It just becomes sort of family history and personal history . So , for example , in your mitochondria we don't have a whole lot of tests to tell us how great your mitochondria are .

I mean we could do cell biopsies but I don't think anyone really wants us to do that . But if you take someone's history and they have very low energy and that's basically a complaint that I get from any woman over the age of 40 , I can't keep up with my kids , I'm exhausted it's a mitochondrial failure . So we add points in the mitochondrial category .

So a lot of it's a lot of it's history and some of it's lab studies . So it's just it's multifactorial .

But , from a cellular perspective , sirtuins control your circadian rhythms and your sirtuins go down over the course of time and , of course , sirtuins are NAD dependent . So unless you augment your protocol with NADs and some sort of a sirtuin activator , you're not going to sleep Right .

The problem with not sleeping is that 30% of your proteins are actually made while you are sleeping . So if you don't sleep , you're not going to make the proteins and therefore we're going to sleep even less , and it's it's just this negative cycle .

But if you can get yourself to sleep , either naturally or via supplementation , then you can make the proteins and then it's a positive spiral . So sleep is absolutely crucial .

But I will tell you that I just bought a boatload of NMN just to have it on hand until the whole thing gets sorted out , and I also bought more stock in Chromadex just in case . I really don't know how the whole thing is going to play

out . It is so important for people not to be deficient in NAD that something will work out that we all have . It'll be available to us in some form . It's hard to hard to guess at this point .

I got a question here what is the evidence that NAD or NMN supplements support mitochondrial health ? Or what's the most compelling study we can quote for people ?

Number two it is a cofactor for sirtuin activation . So without it your sirtuins don't get activated and all of your cellular homeostasis is sort of in a disarray . Number three you actually use it in DNA repair mechanisms . It's part of the PARP nucleotide repair system .

So if you don't have NAD on hand , you're not going to repair your DNA and your risk of cancer or senescent cells escalates . And NAD is also used as a communication device in your cell between your nucleus and your mitochondria that tells your nucleus about how much energy levels you have .

So essentially , if you are NAD deficient , your entire cellular mechanisms are going to fail . I don't know if that's in one particular study , but you can look at individual studies and identify that .

But the challenge really is are we delivering it and is it helped ? I don't think there's any doubt that NAD is important in our bodies . It's sort of like phospholipids are important , but I can't take a phospholipid pill and I mean it won't get to . You know , it won't be delivered and be bioavailable .

But yeah , that's a whole conversation , I guess , with NAD and precursors , and the best we can do is just take the supplements because it's not necessarily going to hurt anything and hopefully more evidence will come in in the future .

I think the important thing to note here is that we're talking about cellular optimization with all of these agents and your body isn't smart enough to say , well , I'm going to optimize this good cell over here and not this cancerous cell over there .

So if you have a history of cancer or there's any chance you could have cancer , taking any of the agents that we talk about can't increase the risk of true cancer . So whenever I have a private client , we want to make absolutely sure that they've been screened for everything that we can screen for , so that we don't make things worse rather than better .

With rapamycin , it actually lowers the risk for cancer . But for any of these drugs , which ones I mean across the board if someone's cancer survivor and , let's face it , a large percentage of people today , whether it's skin cancer or other types of cancers , are cancer survivors which supplements should they be cautious about taking ?

So it is an absolute risk with any of the things that we take . I just think that the NAD precursors are so potent and I think they're one of the huge things that most people should be on Because it , because it's so potent , it's going to activate cancer cells as well . But I think any of the things that we talk about can theoretically make cancer worse .

But you're absolutely right . If you don't have cancer , we are optimizing all of the cells that can reduce cancer risk . A lot of these things increase the efficacy of natural killer cells , which , of course , decreases cancer risk , right ? So it's a double edged sword , depending on how many pre cancerous cells you may or may not have .

Hold another discussion there , yeah , but some of the supplements I think I've seen , like folate in particular , as the studies shown that you should really not take it in a recent post-cancer patients , and also it's basically a great thing to make people aware of and keep in mind . Let's talk about one last lifestyle factor , the elephant in the room .

What about nutrition ? I've heard you talk and say some provocative things about your views on diet and supplements . What about that ?

That being said , if you do follow in my footsteps , there are many ways to skin a cat . I take 72 different agents a day and a lot of them are aimed at glycation .

I think that you can block glycation in seven different ways and , as a consequence , I block each and every one of the possible pathways that I can block to make up for my bad dietary choices . So , yes , it's not a good idea for most people to do it this way , but it's possible .

And the reason I tell people this is because I think a lot of folks look at longevity people as if they're . You know these lifestyles are impossible to achieve . You know you're supposed to exercise every day , eat everything incredibly well , starve yourself for 18 hours a day , do everything right , and in reality , that's just not doable for most people .

So by publicly saying that I eat donuts every day , people think well , if she does it , then I don't have to be perfect either . And the answer is as much as you can do , that's great . That's fantastic Because doing a little bit is better than doing nothing at all .

And the future , maybe he can , maybe he can do more .

What are your guidelines when you choose a supplement that you know you're getting quality and it's worth the money ?

I tend to go to the smaller companies that specialize in the special formulations . I love the micro soma formulations because the bioavailability is higher and I think that to have the mechanisms to create that they get heavily tested , it's heavily certified and it's more trustworthy . So that that's one way .

I think it just depends on which supplement you're looking at as well . So , as an example , if you're just going to take an amino acid , it doesn't matter who makes that amino acid . It's really hard to screw up an amino acid . If you're going to take something specialized like spermamine or acid is an , then then the manufacturer is extremely important .

And then , as to the end thing comes from algae and I love the company , is that grow it outside , where it's natural . So I love the companies from Hawaii or Iceland . I mean , are there ? Are there companies in other places ? Absolutely , but I think it's just very dependent on which agent you're looking at .

It tastes terrible but it's more likely to get through the blood-brain barrier to combat neurologic disease and it's water soluble . So if you don't have neurologic disease , I go with Delfinidin , otherwise it's Andrographyloid .

I think there's a lot of big science out there that it's just phenomenal . It's not my space , but I'm very excited to sort of see what they develop and I've become a huge user of exosomes . I inject now once a month . I can tell you I feel like a million bucks when I do it . It's just outstanding .

I also I love red light , infrared therapy , so I actually sit in front of my light box every day , so that's kind of fun . And then I do things like less frequently , like once every month or every two months , which are exosomes . I take my senescent therapy every month or so . I guess that's funny . I'm sorry , Go ahead .

I take a ton of hydrolyzine , I take Pia Glitazone , which is one of my absolute new favorites . I take a statin for fun .

I take many , many things , but Pia Glitazone is , I think , insanely cool because , on top of being a diabetic drug , it actually redistributes your fat , so it takes it out of your viscera and it puts it in your subcut tissues , which is incredibly amazing . And it's also one of the strongest PCG1 alpha mitochondrial activators .

So it just has so many good things going for it . Like , how could you not ?

If you're going to increase nitric oxide in in one vessel or one organ , you might as well do it in all the organs . It makes sense .

But if we can get rid of our extra glucose , too , without significant harm , then why the heck not , right ? There's so many ways that we can use the present medications for longevity that I think they're just underutilized at this point .

We could talk for an hour on that . But how readily available are they ? I mean , can regular people get those , or what is their availability ?

I would assume that you would need to get to a longevity specialist and have them order them for you or have some sort of treatment protocol . You know , as a physician we sort of get away with a lot of things and I have them in my freezer at home next to my ice cube tray , which isn't exactly FDA regulated , but you know who's going to know ?

Right , that's how you make ATP . So for the same amount of energy going into a mitochondria , you're producing more ATP , so it revs up the cell . It's interesting Seven or eight minutes in front of a light panel can actually increase your metabolism by six to seven hours , depending on what it's sort of aimed at .

And because I've gotten a little bit nuts about this , I actually got a tiny little portable one and it's in my car and I aim infrared at myself while I'm driving , which you know , if I had the red one on . It looks a little spooky in the car , but the infrared .

You know it's going to see it , but the benefits are just amazing and it's such simple technology .

You can test your epigenetics , you can test your glycation score , you can test anything . Right , People always pick the one like my poop score with my bugs are the best , someone called me yesterday and said I am 19 years old , I'm like good for you , good but good .

But so in reality it's a balance of all of the tests and my theory is I max out on every possible therapy I can . So you know , is testing worthwhile ? Am I going to change my therapies ? I can't , because I've already sort of maxed out . So I don't really do it to myself anymore , but obviously my clients do and they seem to be doing quite well .

In addition , on Instagram it is Kauffman Anti-Aging and I don't put a ton of stuff on there , but if I'm speaking or at a conference or have something just I'm dying to tell someone about , then it's going to be on that platform .

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