Longevity and healthy aging: bioregulators, NAD+ and sermorelin, with the evidence and prices

What "healthy aging" means on this page

We use it in the ordinary sense: keeping energy, sleep, strength and normal body functions as the years add up. We do not use it to mean slowing or reversing aging. No product on this page has been shown to extend human lifespan.

The order of evidence matters. Exercise, sleep, blood pressure and blood sugar control, not smoking and a sensible diet have decades of outcome data. The options below are add-ons with far thinner evidence, so treat them as optional.

Peptide bioregulators: the supplement route

Peptide bioregulators are short peptides or tissue-derived peptide complexes from Vladimir Khavinson's research program in St. Petersburg. The two best-known aging compounds are Epitalon (a synthetic pineal tetrapeptide, Ala-Glu-Asp-Gly) and Epithalamin (the injectable pineal extract it was modeled on).

Most of the evidence is laboratory work. A 2003 study reported that Epitalon switched on telomerase and lengthened telomeres in human cells in culture, and a 2025 study in human cell lines reported longer telomeres through telomerase or the ALT pathway. Neither is a human trial. The human studies of Epithalamin were run largely by the same research group, used an injectable extract and measured markers such as melatonin rhythm rather than lifespan.

Oral capsules sold today (GARMONIA Cytomax, Cytogen, and Vita-Stream's own Vita Peptides line) have not been tested in human trials under their own names. They are sold as dietary supplements with structure/function wording. If you try them, see them as a low-cost experiment, not a treatment.

• Khavinson et al. 2003, Bull Exp Biol Med: Epitalon and telomerase in human somatic cells (cell culture)
• Al-Dulaimi et al. 2025, Biogerontology: Epitalon and telomere length in human cell lines (cell culture)
• Araj et al. 2025, Int J Mol Sci: review of Epitalon research
• Korkushko et al. 2004, Bull Exp Biol Med: Epithalamin and melatonin rhythm in elderly people (injectable extract)

NAD+: the prescription route for "cellular energy"

NAD+ is a coenzyme every cell uses in energy metabolism, and levels fall with age in many tissues. That biology is well established; what is not established is that taking NAD+ improves how people feel or age.

The best-known human study used an oral precursor, not NAD+ itself: nicotinamide riboside (1,000 mg a day for six weeks) was well tolerated and raised blood NAD+ in healthy middle-aged and older adults, without clear changes in the main physiological outcomes. Injectable and nasal NAD+ have even less human data. HealthRX, one of the providers below, says plainly that NAD+ injection is not FDA-approved for any use and that the main human data is a small eight-week safety pilot.

NAD+ injections and nasal sprays are compounded medicines prescribed by licensed providers after an online intake. Common side effects listed by providers include flushing, nausea, injection-site soreness and headache.

• Martens et al. 2018, Nat Commun: nicotinamide riboside raised NAD+ in healthy middle-aged and older adults
• HealthRX NAD+ injection page: evidence and FDA status statement (read Oct 7, 2026)

Sermorelin: context before you buy

Sermorelin is a short synthetic peptide, the first 29 amino acids of growth-hormone-releasing hormone (GHRH). It signals the pituitary to release the body's own growth hormone, which is different from taking growth hormone itself.

It was once an FDA-approved brand drug, Geref, approved for growth hormone deficiency in children with growth failure and as a diagnostic test of pituitary function. The maker discontinued it, and in 2013 the FDA determined that Geref was not withdrawn for reasons of safety or effectiveness. Today's sermorelin is compounded, which means it is not FDA-approved, and adult use for energy or body composition is off-label with limited trial data.

Providers list active or recent cancer as a reason not to use it. Ask about it before starting if you have diabetes, thyroid disease or a pituitary condition.

• Federal Register, Mar 4, 2013: FDA determination that GEREF (sermorelin acetate) was not withdrawn for safety or effectiveness
• Walker 2006, Clin Interv Aging: sermorelin in adult-onset growth hormone insufficiency (review)

How to choose

If you want the lowest cost and no prescription: a one-month bioregulator course, following the label, and an honest look at whether anything changed.

If you are considering NAD+ or sermorelin: compare the all-in monthly price, the plan length you are committing to, whether a licensed provider reviews you before you pay, and the refund terms if you are not prescribed. Check that the provider names its pharmacy and is LegitScript-certified (all three below display a LegitScript seal).

Bring your medication list. Anything that affects hormones, blood sugar or blood pressure is worth a conversation with your own clinician first.

NAD+ and sermorelin through licensed telehealth providers

Sorted by lowest published starting price. These are prescription products: a licensed provider decides after an online intake whether they are appropriate. The compounded versions are prepared by licensed pharmacies and are not FDA-approved.

Prescription products are prescribed only if a licensed provider finds them appropriate. Individual results vary. Availability differs by state. See our editorial approach.

FAQ

Related on the Atlas

• Epitalon: compound profile
• Epithalamin: the pineal extract
• Epitalon alternatives you can buy as capsules
• Best bioregulator stack for longevity
• How to cycle bioregulators
• Longevity protocol
• Bioregulator Evidence Index (PubMed counts)

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