As the years go by, the single biggest indication of the passage of time in my body seems to be the gradual loss of energy.  This is not just a personal observation, but it is in fact the single biggest complaint given by patients to every doctor.  When asked what they want most in various medical surveys, the most common answer given was more energy.  Coffee only keeps you going for so long, and then even it no longer does the trick.  There is a fundamental reason for this built into the chemistry of aging, and it involves how we make energy in our cells and a chemical called NAD – nicotinamide adenine dinucleotide.  

Way back in high school biology we were taught about something called the Krebs cycle (sometimes called the citric acid cycle) that happens in the mitochondria inside all the cells of our body, except blood cells.  This cycle is about how we break down sugars and fats and turn them into energy.  There are two main energy products formed – ATP and NAD+.  ATP is the gasoline of the body that energizes almost every action we can make.  NAD and ATP interact to donate electrons to over 400 different enzyme reactions.  Literally, these guys are the chemical electricity of the body.  Enzymes are the little nanobots that build things and take things apart chemically in the body.  They break down what we eat into basic building blocks then reassemble those blocks into whatever the body needs.

So here is the problem, as we age our NAD levels drop.  That means our battery runs low.  We truly don't have as much electricity to run the body as we used to.  Without that electricity, we can't form new proteins to keep rebuilding replacement cells, we can't form the chemicals to keep our digestion working or build bones, and we can't even form the energy we need to think and form memories.  Aging is really a gradual loss of energy production.  

Why do our levels of NAD drop?  It seems that as cells get old, they get cranky and start releasing a compound called CD38 that knocks out our NAD.  Without our NAD, our mitochondria can't form ATP energy molecules and we lose power.  There is actually a good reason for old cells to do this.  Old cells usually have a lot of DNA damage and could potentially turn cancerous.  To prevent this they produce CD38 to shut down the cell processes and prevent cancer while waiting for the body to eat up the old cells and recycle the leftover building blocks.  This recycling process is called autophagy.  Unfortunately, modern humans don't go into autophagy much anymore because we have food abundance.  Autophagy turns on after we have eaten nothing for a few days.  This starvation mode is actually vital to our health as it turns on the removal of these cranky old  (senescent) cells.  Without their removal, this CD38 gets spread around and shuts down NAD in our healthy cells.  The net result is we feel old and tired because we can't make the chemical electricity we need to run our body.

I have been doing research lately on how to get around this dilemma.  I came across (I thought) a supplement that would allow me to produce more NAD directly called NMN.  It is very expensive.  To get enough to do any good you would need to spend $20 to $30 a day.  As I came across newer information, it was questioned whether NMN could even make it into the body cells in the first place before being broken down.  As I checked other pathways, I came across good old vitamin B3 – niacin.  In sufficient doses, it raises our NAD levels.  One study showed a 4 fold increase after several months of taking around 1 gram per day and an 8 fold increase after 10 months.  Niacin is cheap, but it creates flushing.  Unfortunately, the non-flushing type of niacin does not work.  The red flushing of the skin is not dangerous, but the itching is annoying.  For me, it lasts about an hour.  Slow-release niacin may work, but this form has been found to cause liver damage maybe – there is still some argument about this.

All this research dovetailed nicely with another benefit of high dose niacin – it reduces cholesterol and triglyceride levels and raises the levels of the HDL good cholesterol.  Ellen's doctor has given her a few months to lower her cholesterol levels naturally before he starts pushing the statin drugs.  In fact, when you look into niacin further, it sounds like a miracle drug.  It has been shown to reduce heart attacks, reduce atherosclerosis, open blood vessels,  treat depression and schizophrenia, help stop migraines, reduces inflammation and arthritis pain, reduces sun sensitivity, treats acne, the list goes on and on.  One recent study found that niacin reduced the dangerous fat around the organs by 25% and reduced fatty liver by 50%.  This is really good stuff!

Now before you all jump on the niacin bandwagon, I remind you that each of you is an individual.  As such your individual response to anything, be it foods, supplements, or drugs will vary.  Start out small and see how this works for you.  Niacin has been around for over a hundred years and has a very safe track record, but that does not mean that everyone can use it.  The flushing reaction is the first hurdle to overcome.  For most people, your body adjusts to the niacin in a few weeks and the flushing goes away.  Ellen and I started out with small doses of 100 mg once a day and have been building up as the reaction diminishes at each level.  I expect to level off at around 750mg to 1000mg a day in divided doses.  Niacin does raise cortisol for a couple of hours, so I expect to use niacin in the early morning and later morning as this is when my natural circadian rhythm raises my cortisol levels anyway.  Niacin also temporarily raises my blood sugar just as my body naturally does in the morning, but it does not raise the long-term blood sugar levels measured in the A1c tests.  The blood sugar seems to rebound in the opposite direction after a few hours.  In fact, for those of you trying to live a keto lifestyle, many folks have found that niacin seems to “burn” any sugar out of your liver and get you deeper into ketosis a few hours later – a big help if you have had a cheat day and want to get right back into ketosis.

Personally, I think that niacin will make a powerful addition to my keto lifestyle.  The one concern I have for older folks wanting to use niacin to reverse the low energy concerns has to do with the CD38 production from the senescent cells.  If you are not doing anything to promote autophagy on a regular basis to get rid of those cranky old cells, you could be revving up your DNA protein production in cells that have DNA damage.  Could this promote cancer?  I don't know.  No one has studied this yet.  The obvious answer is to do regular 4 to 5-day fasts every so often to clean these bad boys out of the system.  The research by Dr. Longo down at USC has shown that you do not even need to do full-on water fasts to promote autophagy and clean out the body.  He has created a fast mimicking diet protocol that lowers your calorie consumption to 600 calories a day for 5 days and completely eliminates any protein.  Protein in the diet is what keeps autophagy shut down.  It also eliminates any carbs as you have to be in ketosis for autophagy to turn on.  So that means eating fiber and a little fat for 5 days.  That means non-starchy vegetables, salads, and soups for 5 days.  It helps to already be in ketosis before you start one of these fast mimicking protocols as that turns off the hunger hormones.

With this new information I have learned about niacin, it will make getting into ketosis that much easier.  I am not saying that you need to be in ketosis as a lifestyle all the time.  That is something that depends on other factors.  But being in ketosis is necessary to help trigger your body's clean up and recycle mode, autophagy.  And autophagy is what is necessary to get rid of those cranky old cells that are shutting down your energy.  To get more energy for living my life, this is worth it.  I have my mom doing 5 days of keto followed by 5 days of just the veggies once a month as a treatment to help reverse memory loss.  The amyloid proteins that rob us of our memory are attacked and eaten up during autophagy as well.  Any unnecessary proteins, like unwanted excess skin, are gradually removed by autophagy.  It is a crucial part of our body's health process which we have side-stepped by eating every day.  Food abundance is not natural to our bodies.  Our modern diseases of excess are the result.

Take care,

David               

Ellen update:    

Hey, we finally got out of the house and did something!  As a celebration for my birthday, Ellen took me and Amber to Mystique Dining for a great prime rib dinner and a magic show.  Since it is close to Halloween, the dinner theater had an Edgar Allan Poe theme with the center of the table being one big casket and tombstones all around the table.  The magician did a mentalist/spiritualist act centered on the American spiritualist movement of the late 1800's.