The Dorian Gray Dilemma: Can We Reverse Aging—or Just Age Better? NAD and Aging

06-12-2025

By Dr. Howard Friedman MD | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC

Two faces, one story: aging is more than skin deep. While time leaves its mark, how we live—how we sleep, eat, move, and manage inflammation—can shape the journey. At HHOM LLC, we explore science-backed strategies like NAD+ to support aging with dignity, not denial.

The Dorian Gray Dilemma: Can We Reverse Aging—or Just Age Better?

They say youth fades with every year,

But age is more than lines we fear.

Its pathways dim and engines slow,

Signals missed that once would flow.

Yet in our cells, a thread runs deep—

A spark we lose but still might keep.

---Dr. Howard Friedman MD

Introduction:

At HHOM LLC, we’ve walked the long road of inflammation—chronic stress, poor sleep, toxic exposures, and how gratitude, food, and rest can push back against this tide. Today, we step into a related frontier: aging. Specifically, how inflammation and aging intertwine in the cellular process—and where NAD+ fits into the picture. This is a look at how complicated our bodies are, this is the quest though out time, the search for the fountain of Youth, the fable of Dorian Gray, the billion dollar supplement and beauty industry, how do we age better? The Dorian Gray Dilemma, can we reverse aging, or just age better?

NAD+ has become a buzzword in longevity research, touted by some as a potential key to aging gracefully. While there's no Dorian Gray mirror to freeze time, we do believe lowering inflammation gives us the best chance to age with strength and dignity. Let’s explore what the science says—and what it doesn’t. This does not need to be a dilemma, we will go through the state of research, and find markers of the process, but is stll will come down to us, our choices through out our lives, diet, exercise, sleep and stress reduction.

What is NAD+ and Why Does It Matter?

NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme found in every living cell. It plays a central role in:

• Energy metabolism

• DNA repair

• Cellular stress resistance

• Activation of sirtuins (proteins linked to longevity and cellular regulation)

  
  

As we age, NAD+ levels decline. This drop is linked with mitochondrial dysfunction, higher DNA damage, increased inflammation, cognitive decline, and a weakened immune system. But here’s the open question: is the loss of NAD+ the driver of aging—or merely a marker?

Aging skin loses elasticity. Wounds take longer to heal. Muscles tire more easily, metabolism shifts, and the brain grows more vulnerable to injury. These symptoms align with declining NAD+, but correlation is not causation. We’re still unraveling what this molecule truly means for aging.

Is There Research Trying to Restore NAD+?

Yes—and it's rapidly evolving. Animal studies have shown promising results. By boosting NAD+ levels, researchers observed:

• Improved mitochondrial function

• Greater muscle endurance

• Better insulin sensitivity

• Enhanced cognitive performance

• Delays in age-related disease onset

  
  

Much of this research has come from leaders like the Salk Institute and Harvard’s David Sinclair. In human trials, precursors to NAD+—like NMN (Nicotinamide Mononucleotide) and NR (Nicotinamide Riboside)—are used, as they can be taken orally and raise NAD+ levels in cells.

So far, some human studies show:

• Modest improvements in blood sugar and lipid profiles

• Slight gains in aerobic capacity and reduced fatigue

• Evidence of improved mitochondrial function

  
  

But let’s be clear: no study has shown that restoring NAD+ definitively slows or reverses aging in humans. Not yet.

Should You Supplement with NMN or NR?

At this time, supplementation is a personal choice. The science is intriguing, but inconclusive. NAD+ precursors remain under active investigation. NR (sold as Niagen) is available, but long-term safety is not fully understood. NMN is currently in regulatory limbo; the FDA has moved to classify it as a drug candidate rather than a supplement.

In short: this is not yet a proven path to longevity—it’s a developing story.

A Forward-Thinking View: Not Just One Thread in the Tapestry

The quest for youth is as old as mythology. NAD+ is one chapter in a much larger book. Other areas gaining traction include:

• Senolytics: removing aged, malfunctioning cells

• mTOR inhibitors: mimicking the effects of fasting and caloric restriction

• Stem cell therapies

• Lifestyle medicine: diet, sleep, exercise, stress control

  
  

NAD+ may prove to be a powerful lever, but it’s not a solo act. It’s part of a complex network involving mitochondrial integrity, inflammatory signaling, and genetic repair.

Even resveratrol—a once-promising compound found in red wine—has faced a bumpy road from theory to evidence. NAD+ may follow a similar path: full of potential, but difficult to harness cleanly.

The Bottom Line: A Spark, Not a Solution

NAD+ isn’t a miracle drug. It’s not a pill that grants immortality. But it may help extend the years we live with energy, clarity, and vitality.

The real goal isn't to defeat aging. It’s to transform it—from a slow unraveling to a deliberate, empowered journey. Inflammation, sleep, food, connection, and perhaps NAD+ all play a role in that.

Closing Thoughts from HHOM LLC

If aging is a quiet undoing, then restoring NAD+ is one thread we might tug back into place. It's not the whole tapestry, but it may help us stitch a few extra years of resilience—and that’s worth paying attention to.

At HHOM LLC, we don’t chase fairy tales. We pursue clarity, grounded in evidence and experience. Whether you’re here for help with a VA claim, a Nexus Letter, or simply to stay well—we welcome you.Browse our other blogs on inflammation, lifestyle, and healing at HHOMLLC.com.

Thank you for reading.

—Dr. Howard Friedman MD

Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps

Founder of Howard’s House of Medicine (HHOM LLC)

https://www.hhomllc.com

Frequently Asked Questions:

Q: What is NAD+, and why is it important in aging?

A; NAD+ (Nicotinamide Adenine Dinucleotide) is a vital coenzyme found in every living cell. It plays a key role in energy production, DNA repair, and regulating cellular stress responses. As we age, NAD+ levels naturally decline—this is linked with fatigue, reduced resilience, and age-related diseases. While it's unclear if declining NAD+ causes aging or is simply a byproduct of it, restoring its levels is a promising focus in longevity science.

Q: Can supplements like NMN or NR actually slow the aging process?

A: The short answer: we don’t know yet. NMN (Nicotinamide Mononucleotide) and NR (Nicotinamide Riboside) are NAD+ precursors being studied for their potential to improve energy, brain function, and metabolic health. Some early human studies show modest benefits, but there is no conclusive evidence that these supplements slow or reverse aging. The science is still evolving—and long-term safety data is limited.

Q: What’s the best way to age well while we wait for more research?

A; Aging well doesn’t require magic—just consistency. The strongest evidence still supports lifestyle medicine: anti-inflammatory nutrition, regular physical activity, restorative sleep, stress reduction, and meaningful connection. NAD+ might enhance this picture, but it’s not the foundation. At HHOM LLC, we focus on what works now, while keeping a watchful eye on what may work next