Researching supplements claiming to be the next anti-aging miracle makes me feel like I’m in the movie Groundhog Day- different day, same story. The products might be different, but the lack of sufficient scientific evidence stays the same. I recently wrote about LifeVantage’s Protandim, a product sold using a multi-level marketing strategy and lacking sufficient evidence for its claims. Then I came across Elysium and its product Basis™, which supposedly increases levels of the coenzyme nicotinamide adenine dinucleotide (NAD+) to support cellular health and well being. Unlike LifeVantage, Elysium was founded by a scientist, has a robust Scientific Advisory Board and a commitment to only marketing products after completing clinical trials in humans. For a moment, I reached my own state of scientific bliss here on Earth, and I thought my groundhog days were over.
Thanks to improved hygiene and medical advancements global life expectancy has increased from 48 years in the 1950’s to 71 years today. Unfortunately the human lifespan- the maximum number of years a human can live- remains unchanged at about 120 years. Modern science has been attempting to unravel the mystery of aging to increase maximum lifespan, but it hasn’t been successful in humans yet. Initially thought to have a single cause, the scientific community now accepts that aging is a multi-factorial process most likely explained by a combination of theories and mechanisms. Despite this, supplement manufacturers continue to focus on one proposed mechanism of aging, create a product based on that mechanism, and market it. NAD+ and cellular metabolism is one of these mechanisms.
Billions of chemical reactions occur in our bodies every second, most of which would not be possible without the help of coenzymes, which are small non-protein organic molecules usually derived from vitamins. Think of them like gasoline for a car. A car may have all the parts it needs, but without gasoline it’s not going very far. One of the most important coenzymes is NAD+. Derived from niacin (Vitamin B3), it has a pivotal role in cellular metabolism in mitochondria, the power plants of the cell. NAD+ alternates between its oxidized (NAD+) and reduced forms (NADH), transferring electrons in the metabolic reactions required to sustain life. It is also involved in DNA repair, gluconeogenesis, cell signaling and fatty acid metabolism. NAD+ levels and mitochondrial function decline as we age, both of which are thought to contribute to aging. The good news is research in animals has shown that increasing NAD+ levels could potentially treat chronic disease and reverse aging. Feeding elderly mice nicotinamide mononucleotide (NMN), a naturally occurring precursor for NAD+, restored mitochondrial function to that of a “youthful mouse.” Mice given the supplement nicotinamide ribonucleotide (NR), which is similar to NMN, have shown improved mitochondrial function and even protection from diabetes.
Elysium co-founder Dr. Leonard Guarente has extensively researched another area of particular interest: a class of enzymes called sirtuins. These unique enzymes are dependent on NAD+ for their function, and research in yeast, worms, and flies has shown that when they are overexpressed they can extend lifespan. These results are conflicting and therefore controversial, but results in mice appear more promising. In a study published in Nature in 2012, male mice genetically modified to overexpress the sirtuin SIRT6 had a significantly increased median lifespan. Mice overexpressing other sirtuins have been found to have protection against neurodegenerative diseases like Alzheimer’s Disease. Resveratrol, the antioxidant compound in red wine, has been found to increase the activity of sirtuins and extend lifespan in animal models as well. All of this research on NAD+ and resveratrol forms the foundation for Basis™.
Basis™ has two active ingredients: nicotinamide riboside (NR) 250 mg and pterostilbene 50 mg. Remember that NR is the precursor to NAD+ that increases NAD+ levels. Pterostilbene is a naturally occurring compound related to resveratrol, and is thought to be one of the primary antioxidants in blueberries. Its chemical structure makes it more bioavailable and potentially more potent than resveratrol, but research supporting this is limited. Basis™ can only be purchased from the Elysium website for $60 per bottle, or via a subscription plan for $40 to $50 per month. According to Elysium, it’s the only product on the market to increase NAD+ levels in humans in a clinical trial. Lucky for us, the results of this trial were published just a few weeks ago.
In a randomized, placebo-controlled, double-blind Phase 1 trial, 120 healthy adults either received placebo, a single or a double dose of Basis™ daily. After 4 weeks, NAD+ levels of the single dose group increased significantly by 40% and were maintained up to 8 weeks. In the group receiving two doses daily, NAD+ levels increased 90% at 4 weeks, and was also maintained for 8 weeks. The placebo group had no significant NAD+ increase. These freshly published results in Nature Partner Journals are promising, but as with Protandim, we have to remember they only tell us Basis™ can increase NAD+ levels in healthy adults for up to 8 weeks. More research over a longer study period is needed to know whether this increase translates to actual health benefits in the long-term. I also want to take this opportunity to use this study as an example of a bigger point.
Often times what’s not published can tell us just as much, if not more, than what is. We live in a world where failure is frowned upon. Positive results are shouted from the rooftops while negative ones are quietly swept under the rug, leading to pervasive publication bias. I am of the opinion that much can be learned from what isn’t talked about and a quick visit to the Clinicaltrials.gov registry reveals a few interesting things about the Basis™ study (NCT02678611). Reading the published data, one would think NAD+ levels were the only outcome studied, but this isn’t the case. In fact, Elysium intended to measure other primary and secondary outcomes at 8 weeks such as blood pressure, blood parameters (CBC, electrolytes, ALT, AST), heart rate, physiological performance, body weight, lipids, blood glucose, and quality of life. I could play the devil’s advocate and say maybe Elysium will publish these results in the future, but considering their recent publication in November mentioned none of these outcomes, it’s more likely the results were not favorable. If this is the case, one interpretation of this data (or lack thereof) is that there is already some evidence Basis™ may not turn out to be as beneficial for aging and chronic disease as previously hoped.
Regardless, to an unsuspecting consumer it may seem as though Elysium is at the forefront of research on NAD+ with their novel product. What Elysium doesn’t advertise is that the patents for the ingredients are owned by ChromaDex, a dietary supplement company founded in 1999, and that ChromaDex has its own nicotinamide riboside (Niagen) and pterostilbene (pTeroPure) products on the market already. Not only that, it has licensing agreements allowing other companies to market the same products under different names. So if these ingredients sound familiar, that’s because they are. Elysium and Chromadex signed an agreement stating Elysium did not have to disclose where their ingredients came from, which wasn’t public knowledge until a recent lawsuit between the two companies. To add insult to injury, ChromaDex recently announced it has evidence from its latest clinical trial that Niagen can also increase NAD+ levels in humans. Another trip to clinicaltrials.gov reveals that ChromaDex has been studying the benefits of NR and pterostilbene in humans for years, but little data has been published. Elysium will argue that because Basis™ is a combination pill it would be expected to have a synergistic effect compared to other products. I would argue that so far the scientific evidence says otherwise.
Aging is a complex process that can’t be solved by any one supplement on the market, but consumers are still enchanted by the idea that it might be. If you want to take Basis™ because you think you could use a boost in your NAD+ levels, remember the evidence doesn’t indicate it can do any more for you than that. And if you do try it, purchase the ingredients separately from other companies to save money. In the mythology of my people, the Greeks, Elysium was a place in the afterlife reserved for those who became immortal after being blessed by the Gods, and for the righteous. I could be wrong, but they probably never imagined a future where supplements would be marketed as an alternative for entry through the gates of immortality.