Peer Perspective on How to Live for 300 Years: Searching for the Best Way Forward

Let’s discuss Sirtuin activation (SIRT1 through SIRT7). Sirtuins regulate DNA repair and mitochondrial homeostasis, but they are strictly NAD+-dependent. As we age, CD38 enzyme expression skyrockets in macrophages, consuming NAD+ before sirtuins can use it. Taking oral NMN or NR alone is inefficient because gut CD38 degrades 80% of it. The optimal protocol is dual-action: combining an oral CD38 inhibitor (like Apigenin or Quercetin) with subcutaneous liposomal NMN or direct IV NAD+ infusions.