TeleDocWell Insights

Prevention, Metabolic Health & Longevity

March 2026 • Laura Reis, DO

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The Future of Medicine Is Prevention

Most heart disease, stroke, dementia, kidney disease, and metabolic illness develop slowly over years before symptoms appear. The goal of modern longevity medicine is to identify risk early and intervene before disease develops.

At TeleDocWell, our focus is helping patients optimize the key drivers of long-term health: metabolic health, cardiovascular risk, hormone balance, inflammation, and muscle mass/fitness.

Practice Update

Thank you to everyone who continues to refer friends and family to TeleDocWell. We are grateful to be growing a community focused on prevention, longevity, and metabolic health.

A quick personal update — Jomelyn recently welcomed a healthy baby boy, and both mom and baby are doing wonderfully.

The 5 Labs Everyone Should Know

Many routine panels miss important risk markers. At TeleDocWell, we often evaluate the following labs to identify risk early and personalize a prevention plan.

Lab	Why it matters	Ideal goal
ApoB	Best marker of atherosclerotic particle burden and plaque-driving risk.	< 70 mg/dL
Fasting Insulin	Early signal of insulin resistance—often rises years before diabetes.	< 8
Hemoglobin A1c	Average glucose over ~3 months; helps assess long-term metabolic risk.	< 5.5%
Lipoprotein(a)	Genetic cardiovascular risk marker; many people have never had it checked.	< 30
Hormones (thyroid, estradiol/progesterone, testosterone, DHEA)	Hormone balance influences energy, metabolism, muscle, mood, and cardiovascular health.	Personalized targets

GLP-1 Medications and Metabolic Health

GLP-1 medications such as semaglutide and tirzepatide have become powerful tools in metabolic medicine. For many patients, they can improve insulin sensitivity, reduce inflammation, promote fat loss while preserving muscle, and reduce cardiovascular risk—when used as part of a broader plan.

Hormones and Longevity

Hormone balance plays a major role in metabolism, body composition, energy, and cardiovascular health. For some patients, optimizing hormones such as thyroid, estradiol/progesterone, testosterone, and DHEA can significantly improve quality of life—especially when paired with metabolic and lifestyle foundations.

The Longevity Foundation

• Resistance training 3–4x/week
• Cardiovascular activity most days
• Sleep optimization (7–9 hours)
• Stress management
• Metabolic monitoring with targeted labs

Thank You

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

— Dr. Laura Reis

TeleDocWell Insights

Longevity’s Newest Contenders: Niagen + LDN

May 2026 • Laura Reis, DO, DABOM

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.

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.

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.

Clinical References

• Martens CR et al. (2018). Chronic nicotinamide riboside supplementation increases NAD+ levels in humans and is well tolerated.
• Mehmel M et al. (2020). Nicotinamide riboside—the current state of research and therapeutic uses.
• Younger J et al. (2014). Low-dose naltrexone as a novel anti-inflammatory treatment for chronic pain.
• Toljan K & Vrooman B (2018). Low-dose naltrexone (LDN)—review of therapeutic utilization.
View Clinical References
• Martens CR et al. (2018). Nicotinamide riboside increases NAD+ in humans.
• Mehmel M et al. (2020). NR research and therapeutic applications.
• Younger J et al. (2014). LDN as anti-inflammatory therapy.
• Toljan K (2018). Review of low-dose naltrexone.

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