A central issue for Casey Means is mitochondrial function/health. Here is a short, very important Peter Attia clip on how to measure/test mitochondrial function. These are the type of tests (along with the SapereX test for senescent cells) that will really move the science forward.
The part where Attia describes the test runs from the 5 minute mark til the 10 minute mark.
I agree and look forward to seeing them. Just did some searching and it looks like SuperSapiens is shutting down. Casey Means company Levels is a competitor that focuses on the health enthusiast rather than the athlete for glucose monitoring. Abbott just got FDA approval for over-the-counter sales of it’s Lingo CGM, however it still says:
“In the future, we could see biowearables with even more offerings. Glucose is just one of several important biomarkers that play a role in health and wellness. Don’t be surprised if you eventually see biowearables that can measure and interpret your body’s levels of ketones, lactate and more.”
So still no lactate sensors on the market (that I could find). I looked for updates on the IDRO device…nothing. Same for the PKvitality K’Watch Athlete.
I wonder if the Abbott Lingo will be capable of reporting both glucose and lactate? (in the future). This Forbes article seems to indicate that.
It says - “The approvals come as Abbott, which already has a top-selling continuous glucose monitor for diabetes management known as Libre that generates more than $5 billion in sales annually, is developing a new line of biowearables including Lingo and Rio that track glucose levels, ketones and lactate.”
Another very similar service is Zoe.com (also using CGMs) which offers both Membership/subscription to an App ($349/yr) and testing. The testing here:
“Testing: The total cost of the test kit is $294.00 or can be paid in six monthly installments of $49 each. This includes:
Gut microbiome test
Blood fat test
Standardised test meals - cookies!
Real-time blood sugar sensor (CGM) - if opted into our scientific study
Gut health report
Personalized insights report” https://zoe.com/
Both companies are of course collecting data and then using that insight to improve their recommendations to subscribers.
Another one with more extensive testing (and supplements!) is Zest.science (already subject of another thread.) https://www.rapamycin.news/t/functional-age-an-approach-to-measuring-this-new-app/8300?u=ng0rge
If you just want to hear Casey Means’ insight on CGMs (useful) go to the Huberman podcast above and listen to the segment from 2:19:30 - 2:33. (By the way, she says that the Abbott Lingo will be separate sensors for lactate and glucose and ketones.)
After watching this, and hearing Attia describe Metformin as a mitochondrial poison and that he wouldn’t prescribe it, I watched the Kaerberlein Podcast with Brandon Berry on mitochondria. At the 1:12:00 mark Brandon says yes, metformin inhibits mitochondria but the cell responds by making more, new mitochondria and the upshot is an improvement in mitochondrial function. So, first…metformin-bad! get off it…next, metformin-good! get back on it.
Coincidentally, I’m in the middle of a deep dive on mitochondria, including mitophagy/biogenesis and fission/fusion and their relationship to mitochondrial efficiency. So I just watched The Proof podcast with Dr Inigo San Millan, all 2 hours and 42 minutes. He’s also skeptical of any substitute for exercise to improve mitochondria (including rapamycin). I think it’s scientifically proven that fasting also works - at least short term. And now there’s lots of talk about Urolithin A (Dr Millan is skeptical…and like a lot of scientists, they drag out that old dead horse and say “Just look at the resveratrol scam”). My recent reading leads me to believe that PGC-1a is a critical substance to look at. But I’m also very interested in lactate monitoring as a measure of mitochondrial health. I wish the continuous lactate monitors would become available, they can measure either sweat or use the probe like the CGMs. Citrate @John_Hemming is also interesting…as is pyruvate…and the difference between OXPHOS and Glycolysis. I’m thinking that I need to get a stationary bike as a more measurable form of exercise…maybe like the CAROL bike when I win the lottery (Dave Pascoe recommends it …affiliate?). But I do agree with John that mitochondrial health is likely a major piece of the longevity puzzle. The Proof w/Dr Millan https://www.youtube.com/watch?v=ptZCObCiQn8
My search here for PGC-1a led to this interesting video, posted by @RapAdmin , from Nick Norwitz (of Keto/Lean Mass Hyper responder fame) on Small Extracellular Vesicles…turns out that microRNAs (of Nobel Prize fame) and their effect on PGC-1a might be the key mechanism, improving mitochondrial health. So it ties in with my other focus on epigenetics.
marketing, of course not…but there are studies on the science…not financed by the company.
It is actually produced in the gut microbiome (a postbiotic), but maybe in some people, not enough.
Targeting aging with urolithin A in humans: A systematic review Sept.2024
Concluding remarks
There is very limited evidence on the effect of UA in human aging. UA showed some improvement in mitochondrial activity and autophagy. It decreased inflammatory markers and increased muscle strength and endurance, however, it did not affect gut microbiota composition and physical function. Further research across a wider range of physiological systems, higher number of individuals and longer intervention periods is required.
So, not great, but “some improvements”.
Declaration of Competing Interest
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Andrea Britta Maier reports financial support was provided by Lien Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Nestlé Health Services: According to Reddit discussion, Nestlé Health Services, the owners of Mitopure, might have a patent on Urolithin A for its use in preventing muscle wastage.
Natreon: Natreon was granted a US patent in 2014 for a combination of Urolithin A (3,8-dihydroxydibenzo-α-pyrone) and CoQ10/Ubiquinol as mitochondria-targeted antioxidants for treatment of mitochondrial disorders.
Unknown Entity: A patent (BR-112014032809-A8) was found on PubChem, describing a composition for enhancing urolithin production in a human subject, but the patent owner is not specified.
Unknown Entity: Another patent (WO-2021185802-A1) was found on PubChem, describing a composition for enhancing urolithin production in a human subject, but the patent owner is not specified.
I don’t like or trust Nestle any more than anyone else here but Amazentis researched and tested Urolithin A before Nestle bought them. The study overview from Andrea Maier, I thought was very fair and unbiased - as opposed to this crappy Chinese overview:
Pharmacological Effects of Urolithin A and Its Role in Muscle Health and Performance: Current Knowledge and Prospects
Mitopure, on their website, is endorsed by Mark Hyman, Casey Means and Eric Verdin - not that that means anything, everybody’s gotta make a buck. And here are 2 interviews - the founder and the chief medical officer…not terribly convincing, but who knows?
“And so when we were doing these experiments, we started working actually at the Swiss Institute of Technology with a professor called Professor Johannes Ullrich, who’s a big name in the mitochondrial field. He was behind the discoveries of Resveratrol and a lot of NAD boosters. And so we gave him these compounds. We didn’t know which one was behind the beneficial effects. And he came running to our lab and he said, “What is this one compound?” Because it’s really boosting the longevity in worms, because worms is where all the aging research starts.”
OK, so there is that…he discovered another Resveratrol.
Two studies, one a single-center, randomized, placebo-control double-blind study in frail older adults over 65yrs are underway. I’ll reserve judgement but I’m not writing Urolithin A off yet. Hopefully, I won’t have to buy it from Nestle. This quote from the Andrea Maier paper, I found encouraging -
" While UA (500 mg/day for 28 days) did not have any significant effect on the mitochondrial biogenesis and dynamics markers, UA (1000 mg/day for 28 days) showed a trend towards improving the mRNA levels of Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-Alpha (PGC1A)."