"Anti-aging" and "longevity" treatments get a lot of attention, but they vary enormously in how well they're supported by evidence. This overview explains the most talked-about options, what each one actually is, its regulatory status, and how strong the human research is—so you can tell hype from substance. None of the systemic therapies below is FDA-approved to slow aging or extend lifespan, and this article is general education, not medical advice.
NAD+ and Its Precursors (NMN, NR)
NAD+ is a coenzyme involved in energy metabolism and DNA repair, and its levels appear to fall with age in lab studies. It's offered as IV infusions, injections, or oral precursors such as NMN and NR (sold as dietary supplements, not approved drugs).
Evidence: small, short human trials show precursors can raise NAD+ markers and are generally well tolerated, but they have not shown that NAD+ therapy slows aging or extends lifespan. Researchers consistently call for larger studies.1,2
Metformin (Off-Label)
A long-established diabetes medication that some clinicians prescribe off-label for longevity, based on observational data and animal studies.
Evidence: FDA-approved only for type 2 diabetes. The dedicated TAME trial is designed to test whether metformin delays age-related diseases in older adults, but it has not yet reported results, so longevity benefits in healthy people remain unproven.3
Low-Dose Naltrexone (Off-Label)
Naltrexone is FDA-approved at 50 mg for alcohol and opioid use disorders. At low doses (commonly about 4.5 mg), it's compounded and used off-label for various chronic conditions.
Evidence: generally safe and inexpensive, but recent reviews conclude current evidence does not support routine clinical use, with most data coming from small or uncontrolled studies.4
Rapamycin and Peptides
Rapamycin is FDA-approved as an immunosuppressant; its use for aging is off-label and experimental. Many "research" peptides (such as BPC-157) are not FDA-approved for human use.
Evidence: rapamycin reliably extends lifespan in animals, but human data have not established anti-aging benefit, and it carries real risks including immune suppression and metabolic effects.5 Peptides marketed online often sit outside the legal compounding framework and lack human safety data.
Cosmetic and Skin Treatments
Separately from systemic "longevity" approaches, cosmetic options—topical retinoids and serums, injectables for wrinkles, and energy-based procedures like lasers, microneedling, and radiofrequency—target the appearance of skin. These address surface changes and should not be confused with claims about slowing biological aging.
How to Compare These Options
When weighing any of these treatments, it helps to ask:
- Is it FDA-approved for this use, off-label, or unregulated?
- What does the human evidence actually show—and how large were the studies?
- What are the risks and possible drug interactions?
- Will a licensed clinician review my history and monitor me?
- How do the cost and commitment compare to lifestyle changes with stronger evidence?
If you're comparing providers and treatment types, CompareTreatments.com offers resources to help you weigh these options with realistic expectations—and to bring informed questions to a qualified clinician.
Compare TreatmentsSources used for medical context
- Review of NMN human clinical trials (PMC/NCBI) for the early-stage state of NAD+/NMN evidence.
- American Federation for Aging Research (TAME trial) for metformin's approved use and the in-progress aging trial.
- Low-Dose Naltrexone narrative review (PubMed) for LDN's off-label status and limited evidence.
- Aging journal review of off-label rapamycin for rapamycin's unproven, experimental status in healthy adults.
