NMN (Nicotinamide Mononucleotide) vs Saw Palmetto (Serenoa repens)

Mechanism

NMN is a direct biosynthetic precursor to NAD+ via the salvage pathway enzyme nicotinamide phosphoribosyltransferase (NAMPT). Elevated NAD+ activates sirtuins (SIRT1-7), PARP DNA repair enzymes, and CD38/CD157 signaling. SIRT1 activation deacetylates PGC-1alpha (mitochondrial biogenesis), FOXO transcription factors (stress resistance), and NF-kB (anti-inflammatory). NMN also enters cells via the Slc12a8 transporter, recently identified in the gut.

Standard Dosing

500-1000mg daily

Timing

Morning on empty stomach. Sublingual absorption bypasses first-pass metabolism.

Cycle Duration

ongoing

Side Effects

• Mild GI discomfort
• Flushing (rare, unlike niacin)
• Mild headache during initial use

Contraindications

• Active cancer (theoretical concern: NAD+ may fuel rapidly dividing cells)
• Pregnancy/lactation (insufficient data)
• Theoretical concern in active cancer (NAD+ fuels all rapidly dividing cells)

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Mechanism

Saw palmetto berry extract contains fatty acids (lauric acid, oleic acid, myristic acid) and phytosterols (beta-sitosterol) that inhibit both isoforms of 5-alpha-reductase (types I and II), reducing conversion of testosterone to dihydrotestosterone (DHT). It also exhibits anti-androgenic activity by competing with DHT at androgen receptor binding sites. Additional mechanisms include: inhibition of cyclooxygenase and 5-lipoxygenase (anti-inflammatory in prostate tissue), induction of apoptosis in prostate epithelial cells, and relaxation of bladder smooth muscle via alpha-1 adrenergic receptor antagonism.

Standard Dosing

320mg daily (standardized to 85-95% fatty acids and sterols)

Timing

With food (fat-soluble lipophilic extract). Morning or evening.

Cycle Duration

Minimum 3 months to assess response; ongoing for maintenance

Side Effects

• Mild GI discomfort
• Headache
• Dizziness
• Rare: erectile dysfunction (DHT reduction)
• Rare: liver injury (case reports)

Contraindications

• Pregnancy (anti-androgenic — teratogenic potential for male fetus)
• Hormone-sensitive conditions (complex hormone modulation)
• Children

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