Longevity & Anti-Aging Compounds: The Complete Guide for 2026

What Is Longevity Medicine?

Longevity medicine targets the biological mechanisms of aging rather than treating age-related diseases after they manifest. The central thesis is that aging itself is the primary risk factor for cancer, cardiovascular disease, neurodegeneration, and metabolic dysfunction—and that interventions slowing the aging process will simultaneously reduce risk across all these domains. This approach has been validated in model organisms where single interventions (caloric restriction, rapamycin, genetic modifications) extend both healthspan and lifespan.

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme essential for mitochondrial energy production, DNA repair, sirtuin activation, and epigenetic maintenance. NAD+ levels decline 50% between ages 40 and 60. Precursors like NMN (nicotinamide mononucleotide) and NR (nicotinamide riboside) restore NAD+ levels, supporting cellular repair mechanisms. Senolytics like dasatinib combined with fisetin or quercetin selectively eliminate senescent “zombie cells” that accumulate with age and secrete inflammatory factors (the senescence-associated secretory phenotype, or SASP).

Mitochondrial peptides (MOTS-c, Humanin, SS-31) protect and restore mitochondrial function. Telomere-supporting compounds like Epitalon activate telomerase to maintain chromosomal integrity. Bioregulatory peptides from the Khavinson school (Thymalin, Pinealon, Vilon, and organ-specific peptides) aim to restore gene expression patterns associated with youthful tissue function. While human longevity data is still emerging for many of these compounds, the mechanistic evidence and animal model results are compelling.

Longevity Compound Library

NAD+ Pathway

Senolytics & Senomorphics

Mitochondrial Peptides & Antioxidants

Telomere & Epigenetic Support

Khavinson Bioregulatory Peptides

Common Protocols

NAD+ IV infusions are typically administered at 250–750 mg over 2–4 hours, once weekly for 4 weeks initially, then monthly for maintenance. Subcutaneous NAD+ at 100–200 mg daily offers a more accessible alternative. Oral NMN at 500–1,000 mg daily (sublingual preferred for absorption) or NR at 300–600 mg daily are the standard oral approaches. Benefits typically become noticeable after 2–4 weeks of consistent supplementation.

The dasatinib plus quercetin (D+Q) senolytic protocol uses dasatinib 100 mg plus quercetin 1,000 mg for 3 consecutive days, repeated monthly or quarterly. Fisetin-only protocols use 20 mg/kg body weight (approximately 1,500 mg for a 75 kg person) for 2 consecutive days, monthly. FOXO4-DRI is dosed at 5–10 mg/kg via subcutaneous injection for 3 consecutive days, cycled every 2–3 months. These hit-and-run protocols are designed to clear senescent cells without continuous exposure.

Epitalon is administered at 5–10 mg subcutaneously daily for 10–20 consecutive days, cycled 2–3 times per year. MOTS-c at 5–10 mg subcutaneously 3–5 times per week is emerging as a potent metabolic and exercise-mimetic intervention. SS-31 (elamipretide) is typically dosed at 40 mg subcutaneously daily in clinical settings.

Khavinson bioregulatory peptides follow a standard 10-day course: 10 mg intramuscularly daily for 10 days, repeated every 3–6 months. Multiple organ-specific peptides can be run sequentially or stacked depending on clinical goals. Oral forms (sublingual or capsule) are available for some bioregulators at 10–20 mg daily for 30 days. Comprehensive longevity protocols typically layer NAD+ support, senolytic cycling, mitochondrial peptides, and bioregulators across a 12-month calendar.

Who Should Consider Longevity Compounds?

Adults over 35 seeking to slow biological aging, optimize healthspan, and reduce chronic disease risk are the primary audience for longevity interventions. Those with elevated biological age (measured by DNA methylation clocks like GrimAge or DunedinPACE), a family history of neurodegenerative or cardiovascular disease, or biomarkers suggesting accelerated aging (elevated inflammatory markers, declining NAD+ levels, shortened telomeres) may benefit most.

Athletes and high-performers use mitochondrial support compounds (MOTS-c, CoQ10, NAD+) for recovery and energy optimization. Individuals experiencing cognitive decline, chronic fatigue, or metabolic dysfunction may find targeted interventions helpful. Longevity compounds are generally contraindicated in pregnant or breastfeeding women, those with active malignancy (particularly senolytics and growth-promoting peptides), and individuals on immunosuppressive therapy. Start with foundational lifestyle optimization (sleep, exercise, nutrition, stress management) before adding pharmacological interventions.

Monitoring & Safety

Longevity monitoring goes beyond standard bloodwork to include biological age testing. Baseline assessments should include: comprehensive metabolic panel, CBC with differential, high-sensitivity CRP, homocysteine, fasting insulin with HOMA-IR, lipid panel with ApoB and Lp(a), HbA1c, full thyroid panel, IGF-1, DHEA-S, and vitamin D. DNA methylation-based biological age testing (TruAge, GrimAge) provides the most validated measure of aging pace and can track intervention effectiveness.

NAD+ levels can be measured directly in whole blood (target: above 30 μmol/L). Telomere length testing via qPCR or FISH provides baseline and annual tracking. Senescent cell burden can be indirectly assessed through p16INK4a expression in blood or inflammatory markers (IL-6, TNF-alpha, GDF-15). Mitochondrial function markers include CoQ10 levels, organic acids (urine), and lactate-to-pyruvate ratio.

Senolytics can cause transient immune activation, fatigue, or mild flu-like symptoms for 24–48 hours post-dose as senescent cells are cleared. Dasatinib carries rare risks of pleural effusion and cytopenias—CBC monitoring before and after each cycle is recommended. NAD+ IV infusions may cause nausea, chest tightness, or flushing during infusion; slowing the drip rate typically resolves these symptoms. Report any persistent symptoms, unusual bleeding, or significant fatigue to your physician immediately.

Frequently Asked Questions

Can you actually measure biological age?

Yes. DNA methylation clocks (epigenetic clocks) are the most validated biomarkers of biological aging. The GrimAge and DunedinPACE clocks correlate strongly with all-cause mortality, disease onset, and functional decline. These tests analyze methylation patterns at specific CpG sites in your DNA to estimate your biological vs. chronological age. A comprehensive longevity program tests biological age at baseline and annually to track whether interventions are working. Companies like TruDiagnostic and Elysium offer commercial testing.

Is NMN or NR better for NAD+ restoration?

Both effectively raise NAD+ levels, but they differ in pharmacokinetics. NMN is one enzymatic step closer to NAD+ than NR, and recent studies (including the 2024 TIME trial) showed significant NAD+ elevation with oral NMN at 600–1,200 mg daily. NR (Niagen®) has more published human clinical data and FDA GRAS status. Sublingual NMN may have a bioavailability advantage over oral capsules. In practice, many longevity practitioners recommend NMN for its more direct conversion pathway, though individual response varies.

Are senolytics safe for long-term use?

Senolytics are designed for intermittent use (hit-and-run protocols), not continuous dosing. The 3-day monthly or quarterly cycling approach minimizes side effects while allowing the immune system to clear debris between rounds. Fisetin and quercetin have excellent safety profiles as natural flavonoids. Dasatinib is an FDA-approved leukemia drug with well-characterized side effects at chronic high doses, but the intermittent low-dose protocol used in senolytic therapy appears well-tolerated. Long-term human senolytic data beyond 5 years is still accumulating.

What is the most impactful single longevity intervention?

If restricted to one pharmacological intervention, most longevity researchers would cite NAD+ restoration (via NMN or NR) due to its impact on multiple hallmarks of aging simultaneously: DNA repair, mitochondrial function, sirtuin activation, and epigenetic maintenance. However, lifestyle factors remain the most impactful interventions overall: regular exercise (both resistance and cardiovascular), adequate sleep (7–9 hours), a nutrient-dense diet, and stress management collectively impact all nine hallmarks of aging and have the strongest human evidence base.