TeleDocWell Longevity Score

Answer these quick questions to see where you may benefit from longevity optimization.

Do you struggle to lose weight despite consistent effort?

Do you often feel fatigued or low energy?

Do you sleep fewer than 7 hours most nights?

Has your blood pressure ever been elevated?

Do you have a family history of heart disease or stroke?

Have you had elevated cholesterol, insulin, or A1c?

Do you strength train less than twice per week?

Do you suspect a hormone imbalance involving thyroid, testosterone, progesterone, or another hormone?

Please answer all eight questions before calculating your score.

This quiz is for general education only and is not a diagnosis, medical assessment, or substitute for individualized medical care.

TeleDocWell Insights

Longevity’s Newest Contenders: Niagen + LDN

May 2026 • Laura Reis, DO, DABOM

Summer Schedule Announcement

TeleDocWell will be closed on Fridays over the summer. Patient messages, refill requests, lab questions, and scheduling needs should be sent earlier in the week whenever possible so we can respond before the weekend.

This month we are highlighting two therapies that are getting increasing attention in longevity and functional medicine: Niagen injectable nicotinamide riboside and low-dose naltrexone. Both are used as part of a broader strategy to support cellular energy, inflammation balance, metabolic health, and resilience with aging.

Longevity’s Newest Contender: Niagen Injectable NR

Niagen is a form of nicotinamide riboside chloride, a vitamin B3 derivative that serves as a precursor to NAD+. NAD+ is a critical coenzyme involved in mitochondrial energy production, DNA repair, cellular stress response, metabolic signaling, and healthy aging pathways.

NAD+ levels naturally decline with age, metabolic stress, inflammation, poor sleep, alcohol use, and chronic illness. Lower NAD+ availability is thought to contribute to impaired cellular repair, reduced mitochondrial efficiency, fatigue, slower recovery, and age-related metabolic dysfunction.

Why Patients Are Interested in Niagen

  • Supports NAD+ production and cellular energy pathways
  • May support mitochondrial function and healthy aging
  • May support recovery, resilience, and metabolic health
  • May be useful for patients who feel depleted, inflamed, or slow to recover
  • Can be paired with hormone optimization, GLP-1 therapy, peptide protocols, and lifestyle medicine

Human studies on oral nicotinamide riboside show that it can increase NAD+ levels and appears generally well tolerated. Research is still evolving, and the injectable form is newer, so it should be viewed as a supportive longevity tool rather than a guaranteed treatment for disease.

At TeleDocWell, Niagen is considered in the context of the whole patient: metabolic labs, sleep, hormone status, inflammation, nutrition, training, recovery, and long-term goals.

Important note Injectable NR does not yet have the same depth of published human outcome data as oral NR. It is used based on mechanism, NAD+ biology, clinical judgment, and individualized patient goals.

Low-Dose Naltrexone: A Quiet Longevity Tool

Low-dose naltrexone, often called LDN, is one of the most interesting low-cost tools in functional medicine. At standard doses, naltrexone is used for opioid and alcohol dependence. At much lower doses, commonly around 1.5–4.5 mg nightly, it appears to have different effects related to immune modulation, inflammation signaling, endorphin activity, and glial cell regulation.

LDN is not a stimulant and it is not a hormone. Instead, it may help reduce the inflammatory “background noise” that can contribute to pain, fatigue, autoimmune flares, poor recovery, and neurologic sensitivity.

Why LDN Fits Longevity Medicine

  • May help regulate immune overactivation
  • May reduce neuroinflammation through microglial modulation
  • May support chronic pain, fibromyalgia-type symptoms, and inflammatory sensitivity
  • May pair well with hormone therapy, GLP-1 therapy, peptides, and mitochondrial support
  • Generally well tolerated for many patients when introduced gradually

In longevity medicine, inflammation is often the missing piece. Patients may be doing the “right” things—nutrition, exercise, hormone optimization, GLP-1 therapy, peptides—but still struggle with fatigue, pain, poor sleep, autoimmune symptoms, or slow recovery. LDN may help create a calmer internal environment so other therapies work better.

LDN is still considered off-label, and not everyone is a candidate. It should not be combined with opioid pain medications, and dosing should be individualized.

How These Tools Work Together

Niagen and LDN approach longevity from different angles. Niagen supports the cellular energy and NAD+ side of aging, while LDN supports the immune and inflammation-regulation side. For some patients, combining mitochondrial support, inflammation modulation, hormone balance, metabolic health, and strength training creates a much more complete longevity strategy.

Pharmacy Spotlight

MedSync Pharmacy

We are proud to work with MedSync Pharmacy, a small business that delivers excellent service and a patient-centered approach. Reliable partners are essential, especially for those using customized compounding as part of a personalized care plan.

Expert Compounding

They specialize in tailored medications, ensuring precise dosages and formulations unique to each patient.

Transparency & Affordability

They provide clear, upfront pricing and honest communication, making specialized care more accessible.

Clinical Expertise

Their team offers professional-grade support with a neighborhood feel, prioritizing long-term health over volume.

By focusing on the individual, MedSync makes navigating complex, personalized healthcare simpler and more human.

TeleDocWell Is More Than Metabolic Health

Many patients first come to TeleDocWell for GLP-1 therapy, weight loss, or hormone optimization, but our work is broader than that. TeleDocWell provides functional family medicine with a focus on prevention, longevity, root-cause evaluation, cardiometabolic risk, hormones, inflammation, and quality of life.

Interested in Optimizing Your Health?

TeleDocWell offers care for metabolic health, hormone optimization, GLP-1 therapy support, longevity planning, peptide therapy, inflammation, fatigue, and root-cause functional medicine.

View Clinical References

Thank You

Our mission is simple: help patients feel better, function better, and stay healthy, active, and independent for as long as possible. Prevention is the most powerful medicine.

— Dr. Laura Reis

Educational information only; not medical advice. Individual needs vary. Niagen injectable NR and LDN may not be appropriate for every patient. Please schedule a visit for personalized guidance.
August 2026 Longevity Edition | TeleDocWell
T E L E D O C W E L L
August 2026 • Longevity Edition

The Science of
Healthy Aging

Epitalon, rapamycin, and the pursuit of a longer healthspan

A note from Dr. Reis

Longevity medicine is one of the most exciting areas of modern healthcare—but it can also be one of the most confusing. New peptides, medications, and claims appear constantly. My goal is to help you understand what is promising, what is proven, and where thoughtful medical guidance matters.

This month, we are exploring Epitalon, an experimental peptide associated with telomere and circadian research, and rapamycin, an established prescription medication now being studied for its potential role in healthy aging.

The goal is not simply to live longer. It is to preserve strength, cognition, energy, metabolic health, independence, and quality of life.

Inside This Issue

  • What Epitalon is—and why telomere biology has attracted attention.
  • Why rapamycin and the mTOR pathway are central to modern longevity research.
  • What the human evidence does and does not show.
  • Potential risks, monitoring considerations, and the TeleDocWell approach.

Epitalon & Rapamycin

Epitalon remains highly experimental. Rapamycin has substantially stronger preclinical evidence, but human longevity benefits are not established.

Epitalon: The Telomere Peptide

Epitalon, also called Epithalon, is a synthetic four-amino-acid peptide: Ala-Glu-Asp-Gly. It emerged from research involving pineal peptide preparations.

What Is Being Studied

  • Telomerase and telomeres: laboratory studies report increased telomerase activity and telomere elongation in cultured cells.
  • Circadian biology: early research has explored melatonin rhythms and pineal signaling.
  • Cellular stress: antioxidant, gene-regulatory, and tissue-protective effects remain under investigation.

The Limitation

There are no large, independently replicated randomized trials showing that Epitalon slows aging, prevents disease, or extends human life.

Rapamycin: Targeting mTOR

Rapamycin, also known as sirolimus, inhibits the mechanistic target of rapamycin pathway—a central regulator of growth, nutrient sensing, protein synthesis, and autophagy.

Why Researchers Care

  • Animal lifespan: rapamycin extends lifespan in multiple mouse studies, including when started later in life.
  • Autophagy: intermittent mTOR inhibition may encourage cellular recycling and stress resilience.
  • Immune aging: selected mTOR-inhibitor studies have reported improved immune outcomes in older adults.

Human Evidence Today

Selected low-dose or intermittent regimens appear feasible in early studies, but long-term effects on lifespan and major age-related disease remain unknown.

Potential Areas of Interest

Epitalon

  • Sleep and circadian support
  • Telomere biology
  • Cellular stress responses
  • Healthy-aging biomarkers

Rapamycin

  • mTOR modulation
  • Autophagy and cellular recycling
  • Immune aging
  • Metabolic and functional healthspan

Safety Considerations

Epitalon

  • Long-term human safety is not established.
  • Peptide quality, sterility, identity, and potency can vary.
  • Telomerase stimulation raises theoretical questions because many cancers use telomerase; clinical relevance is unknown.

Rapamycin / Sirolimus

  • Possible mouth ulcers, rash, gastrointestinal symptoms, edema, headache, or fatigue.
  • Possible changes in lipids, glucose, blood counts, liver tests, or kidney-related markers.
  • May impair wound healing and increase infection risk, particularly at immunosuppressive exposure.
  • Important medication interactions must be reviewed.

Clinical Screening and Follow-Up

  • Before treatment: review goals, evidence limitations, medications, supplements, infection history, cancer history, metabolic risk, upcoming surgery, and pregnancy potential.
  • When rapamycin is prescribed: individualized monitoring may include CBC, CMP, fasting glucose or A1c, fasting lipids, urinalysis or urine protein assessment, blood pressure, symptoms, and medication interactions.
  • Pause and reassess: significant infection, poor wound healing, planned surgery, persistent oral ulcers, unexplained cytopenias, or substantial laboratory abnormalities.
Longevity prescribing should be individualized, conservative, transparent about uncertainty, and paired with evidence-based fundamentals.

The TeleDocWell Perspective

No peptide or medication replaces the interventions with the strongest evidence for healthy aging. At TeleDocWell, emerging therapies are considered only within a comprehensive, personalized plan centered on:

Resistance Training

Preserve muscle, bone, strength, insulin sensitivity, and function.

Cardiorespiratory Fitness

Support vascular health, cognition, energy, and longevity.

Sleep and Circadian Health

Address duration, quality, sleep apnea risk, and consistent timing.

Metabolic Risk Reduction

Optimize blood pressure, lipids, glucose, body composition, and visceral fat.

Nutrition and Protein Adequacy

Prioritize minimally processed foods and sufficient protein to preserve lean mass.

Preventive Medicine

Keep vaccinations, cancer screening, bone health, and cardiovascular risk assessment current.

Epitalon is best described as experimental. Rapamycin is scientifically compelling but still investigational for longevity. Neither should be presented as age reversal or guaranteed life extension.

Selected Literature

  1. Khavinson VK, et al. Epithalon peptide induces telomerase activity and telomere elongation in human somatic cells. Bull Exp Biol Med. 2003.
  2. Harrison DE, et al. Rapamycin fed late in life extends lifespan in genetically heterogeneous mice. Nature. 2009.
  3. Kraig E, et al. A randomized control trial to establish the feasibility and safety of rapamycin treatment in an older human cohort. Exp Gerontol. 2018.
  4. Chung CL, et al. Topical rapamycin reduces markers of senescence and aging in human skin. Geroscience. 2019.
  5. Mannick JB, et al. mTOR inhibition improves immune function in the elderly. Sci Transl Med. 2014.
  6. Mannick JB, et al. Targeting the biology of ageing with mTOR inhibitors to improve immune function in older adults. Lancet Healthy Longev. 2021.
Health Watch

The Gut Microbiome

A new frontier in healthy aging

The gut microbiome is emerging as one of the most exciting areas of longevity research. These microbes influence immune function, metabolism, inflammation, nutrient absorption, and brain health through the gut-brain axis.

Support Your Gut

  • Eat 25–35 g fiber daily
  • Prioritize sleep
  • Eat a variety of colorful plant foods
  • Avoid unnecessary antibiotics
  • Include fermented foods
  • Limit ultra-processed foods
  • Exercise regularly

Research Spotlight

A recent review of sixteen clinical trials found that regular exercise increased gut microbial diversity in older adults and promoted beneficial bacteria that produce anti-inflammatory short-chain fatty acids. Exercise may improve healthspan in part by improving gut health.

Biomarker of the Month: hs-CRP

Measures low-grade inflammation. Lower levels generally indicate lower cardiovascular risk.

Support lower hs-CRP with exercise, quality sleep, healthy body composition, and nutrition.

Myth vs. Reality

Myth: The probiotic with the most strains is always the best choice.

Reality: A diverse, fiber-rich diet has stronger evidence for supporting a healthy microbiome than simply taking more probiotic strains.

Dr. Reis’ Longevity Pearl

“If I could recommend only one longevity intervention after not smoking, it would be resistance training. Muscle is one of the strongest predictors of healthspan, independence, and resilience.”

Coming Next Month

The Science of Creatine

Brain Health • Strength • Recovery • Longevity

Medical disclaimer: This material is for general education only and does not constitute medical advice, diagnosis, or treatment. Epitalon is not FDA-approved for anti-aging treatment. Rapamycin use for longevity is off-label and investigational. Individualized evaluation, informed consent, and appropriate monitoring are essential.

TELEDOCWELL.COM • LAURA REIS, DO, DABOM