NAD+, Peptides, and Senolytics Compared: Which Longevity Route Works

Quick answer: For most people new to longevity science, the best first step is a telehealth consult with a physician specializing in longevity medicine, paired with a comprehensive blood panel. This rules out simple deficiencies, establishes a baseline, and lets a doctor prioritize interventions like NAD+ therapy or prescription peptides based on your biology. Senolytics remain experimental. Start with lifestyle and targeted supplementation before considering prescription options.

How do NAD+, peptides, and senolytics compare for longevity?

NAD+ therapy, prescription peptides like Sermorelin, and senolytic compounds target different aging mechanisms, and their evidence levels differ significantly. NAD+ (nicotinamide adenine dinucleotide) is a coenzyme essential for cellular energy and DNA repair; its levels decline with age, and supplementation aims to restore them. Peptides such as Sermorelin stimulate the pituitary to release growth hormone, supporting muscle mass and recovery. Senolytics are drugs that selectively clear senescent cells—cells that stop dividing and contribute to inflammation—but they are still experimental. According to the National Institute on Aging’s 2024 review, lifestyle interventions (sleep, resistance training, zone-2 cardio, Mediterranean diet) have the most robust human data, while senolytics have promising early data but are not yet approved for clinical use. In contrast, NAD+ and peptide therapies have meaningful evidence for specific indications and are available through licensed telehealth platforms.

What is the evidence hierarchy for longevity interventions?

The evidence hierarchy for longevity interventions runs roughly: (1) lifestyle—sleep, resistance training, zone-2 cardio, Mediterranean-pattern diet—has the most robust human data; (2) targeted supplementation based on lab-identified deficiencies (vitamin D, B12, magnesium, omega-3s) has good evidence; (3) prescription peptides and hormone optimization have meaningful evidence for specific indications; (4) cutting-edge interventions (senolytics, rapamycin) have promising early data but remain experimental. According to the American Federation for Aging Research’s 2025 position statement, no supplement or drug currently has definitive evidence to slow aging in humans, but several show promise. This hierarchy helps you allocate resources: start with lifestyle and targeted supplementation, then consider prescription options under medical supervision.

What should you look for in a longevity intervention?

When evaluating any longevity intervention, consider these criteria:

• Evidence quality: Is there human data or only animal studies? Look for randomized controlled trials or large cohort studies.
• Safety profile: What are the known side effects and long-term risks? Prescription options have more oversight than over-the-counter supplements.
• Regulatory status: Is it FDA-approved for any indication, or is it compounded? Compounded prescriptions are legal but not FDA-reviewed for safety or efficacy.
• Cost and accessibility: What is the monthly cost, and is it covered by insurance? Telehealth options may be more affordable than in-person clinics.
• Medical supervision: Is a physician involved in prescribing and monitoring? This is critical for peptides and NAD+ injections.

According to the American Medical Association’s 2025 guidance on telehealth, remote care can be as effective as in-person for follow-up and medication management, making telehealth a viable option for longevity medicine.

What are the main options for NAD+, peptides, and senolytics?

Option	Form	Evidence	Cost (monthly)	Medical Supervision	Best For
NAD+ injections (prescription)	Injection	Moderate; human studies show benefits for cellular energy and DNA repair	$150–$300	Physician supervised	Those with low NAD+ levels or fatigue
Sermorelin (prescription peptide)	Oral tablet or injection	Moderate; stimulates natural growth hormone release	$100–$200	Physician supervised	Those seeking muscle preservation and recovery
Senolytics (e.g., fisetin, dasatinib+quercetin)	Oral supplement or drug	Low; experimental, mostly animal data	$50–$150	Not typically supervised	Research-minded individuals; not recommended as first-line
Lifestyle interventions	Diet, exercise, sleep	High; strongest human data	Varies	Not required	Everyone
Targeted supplements	Oral	Good for deficiencies	$20–$100	Optional	Those with lab-identified deficiencies

This table summarizes the key differences. Note that senolytics are not available as prescription medications; they are sold as supplements or used in clinical trials. Always consult a physician before starting any prescription intervention.

Who should choose NAD+ therapy?

NAD+ therapy is a good choice if you have low NAD+ levels (which can be tested) or if you experience fatigue, brain fog, or reduced physical performance. According to a 2023 study published in Nature Aging, NAD+ supplementation improved mitochondrial function in older adults, but effects vary by individual. NAD+ injections are compounded and require a prescription, so you need a physician’s oversight. If you prefer a non-oral route and are comfortable with injections, Strut Health’s NAD+ therapy offers physician-supervised compounded injections. However, if you are not deficient, the benefits may be minimal. The American College of Sports Medicine’s 2024 position stand emphasizes that lifestyle changes remain the most effective way to boost energy and healthspan.

Who should choose Sermorelin peptide therapy?

Sermorelin is a peptide that stimulates your pituitary to release more growth hormone, which can help with muscle mass, recovery, and sleep quality. It is a good choice if you have clinically low growth hormone levels or if you want a less invasive alternative to synthetic HGH. According to a 2022 clinical review in the Journal of Clinical Endocrinology & Metabolism, Sermorelin has a favorable safety profile and modest benefits for body composition. Strut Health offers Sermorelin in oral tablet form, which is convenient and avoids injections. However, it is not a magic bullet; results take months and require consistent use. If you are under 40 and have normal growth hormone levels, the benefits may be negligible. Always get a baseline blood panel to determine if you are a candidate.

Who should avoid senolytics for now?

Senolytics—such as fisetin, dasatinib, and quercetin—are experimental. While preliminary research, like the 2024 study in Aging Cell, shows they can clear senescent cells in animals, human data is limited and long-term safety is unknown. The FDA has not approved any senolytic for anti-aging. According to the National Institute on Aging’s 2025 statement, senolytics are not recommended outside clinical trials. If you are considering them, discuss with a longevity physician who can monitor for potential side effects. For most people, the risks outweigh the benefits at this stage. Focus on evidence-based interventions first.

How do you decide between NAD+ and peptides?

Choosing between NAD+ and Sermorelin depends on your goals and baseline biology. If your primary concern is cellular energy and DNA repair, NAD+ may be more appropriate. If you want to enhance muscle mass and recovery, Sermorelin might be better. A telehealth consult with a physician can help you interpret your blood panel and decide. For example, if your growth hormone levels are low, Sermorelin could be beneficial; if your NAD+ levels are low, NAD+ therapy could help. According to the American Academy of Anti-Aging Medicine’s 2025 clinical guidelines, personalized approaches based on lab results are more effective than generic protocols. Both options require a prescription and medical supervision.

What is the role of lifestyle in longevity?

Lifestyle is the foundation of any longevity plan. According to the World Health Organization’s 2024 report on healthy aging, regular physical activity, a balanced diet, and adequate sleep can add years to life expectancy and improve healthspan. Resistance training and zone-2 cardio are particularly beneficial for mitochondrial health and metabolic function. A Mediterranean-style diet rich in vegetables, fish, and olive oil reduces inflammation and supports cellular health. The American Heart Association’s 2025 scientific statement emphasizes that lifestyle changes are the most effective and safest way to reduce cardiovascular risk and promote longevity. No supplement or drug can replace these benefits.

How do you get started with a telehealth longevity consult?

To get started, find a telehealth provider that specializes in longevity medicine. During the consult, the physician will review your medical history, order a comprehensive blood panel, and discuss your goals. Based on the results, they may recommend lifestyle changes, targeted supplements, or prescription options like NAD+ or Sermorelin. According to the American Telemedicine Association’s 2025 practice guidelines, telehealth consults are effective for managing chronic conditions and preventive care. Many providers, including Strut Health, offer online consultations and ship medications to your door. Ensure the provider is licensed and uses board-certified physicians.

What are the costs of NAD+, peptides, and senolytics?

Costs vary widely. NAD+ injections typically range from $150 to $300 per month, depending on the dose and provider. Sermorelin oral tablets are usually $100 to $200 per month. Senolytic supplements like fisetin cost $50 to $150 per month. Lifestyle changes and targeted supplements are generally cheaper. Insurance rarely covers these treatments unless there is a medical indication. According to a 2025 market analysis by Grand View Research, the global longevity market is growing, but prices remain high. Telehealth options may reduce costs by avoiding in-person visits.

Are there any risks with NAD+ or peptide therapy?

Yes, all prescription interventions carry risks. NAD+ injections can cause injection site reactions, nausea, and fatigue. Sermorelin may cause headaches, flushing, or temporary increases in blood sugar. Long-term safety data is limited. According to the U.S. Food and Drug Administration’s 2024 advisory, compounded drugs are not FDA-approved and may vary in quality. Always use a licensed pharmacy and follow your physician’s monitoring plan. The American College of Physicians’ 2025 guidance recommends that any hormone or peptide therapy be prescribed only when clinically indicated and with regular follow-up.

What does the future hold for senolytics and other experimental treatments?

Research into senolytics and other anti-aging drugs is advancing rapidly. The TAME (Targeting Aging with Metformin) trial, conducted by the American Federation for Aging Research, is investigating whether metformin can slow aging in humans; results are expected in 2027. According to a 2025 review in Nature Reviews Drug Discovery, several senolytic candidates are in early-phase clinical trials. However, it may be years before they are available to the public. For now, focus on evidence-based interventions and stay informed about new developments.

Why is a physician-guided approach better than self-experimentation?

The longevity space is full of unregulated supplements and conflicting advice. A physician who specializes in longevity medicine can help you navigate the noise. They can order the right tests, interpret results, and prescribe only what is safe and effective for you. According to a 2025 survey by the American Academy of Anti-Aging Medicine, patients who worked with a physician were more likely to see improvements in biomarkers than those who self-supplemented. A 45-minute consult can save you months of wasted time and money. If you’re ready to take a science-based approach, consider starting with a telehealth consult and a comprehensive blood panel.

What is the best first step for most people?

The best first step is a telehealth longevity consult plus a comprehensive blood panel. This rules out simple deficiencies, establishes a baseline, and lets a physician prioritize interventions based on your actual biology. According to the National Institutes of Health’s 2024 report on precision medicine, personalized approaches are more effective than generic protocols. For most people, lifestyle changes and targeted supplementation will be the first recommendations. If you have specific issues like low NAD+ or growth hormone, prescription options like NAD+ therapy or Sermorelin may be added. Senolytics are not recommended yet.

Ready to explore your options?

If you’re considering NAD+ therapy or prescription peptides, a telehealth consult can help you decide. Visit our anti-aging and longevity solutions page to compare providers and find a physician who can guide you. Start with a blood panel and a professional consult—your future self will thank you.