Central Thesis

Why Sequence Determines Outcome

Aged cells operate under severe bioenergetic constraints. NAD+ levels decline approximately 50% between young adulthood and old age. This represents a fundamental limit on cellular capacity—an aged cell cannot simultaneously upregulate autophagy, maintain proteostasis, and clear senescent neighbors because it lacks the energetic reserves to fund these processes.

When multiple interventions are stacked simultaneously, they compete for limited resources. The result is partial activation of multiple pathways rather than complete execution of any single pathway—a condition worse than no intervention at all. The Bio-Energetic Sequencing Model addresses this by ordering interventions so each phase creates prerequisites for the next.

Framework Overview

Five Phases

Phase Details

NAD+ Restoration

Rebuild cellular energy capacity

The first priority in any rejuvenation protocol must be rebuilding cellular energy capacity. NAD+ serves as both an electron carrier in cellular respiration and a substrate for sirtuins and PARPs—enzymes critical to DNA repair and metabolic regulation.

Phase 1 focuses exclusively on NAD+ restoration through NMN or NR supplementation, supported by substrate availability optimization (B vitamins, methyl donors). No other interventions are introduced during this phase.

Duration4-8 weeks
Primary InterventionNMN / NR
Completion CriteriaEnergy biomarker improvement

Autophagy Induction

Clear accumulated cellular debris

With energy capacity restored, the cell can now fund housekeeping processes. Phase 2 introduces pulsed mTOR inhibition via rapamycin to stimulate autophagy—the clearance of misfolded proteins, damaged mitochondria, and accumulated debris.

The pulsing protocol is critical. Chronic mTOR inhibition suppresses protein synthesis and immune function. Pulsed dosing (weekly administration) provides autophagy stimulus while allowing recovery between doses.

Duration4-6 weeks
Primary InterventionRapamycin (pulsed)
Completion CriteriaAutophagy markers normalized

Senolytic Clearance

Eliminate dysfunctional cells

Only after energy restoration and autophagy-mediated cleanup can senolytic therapy succeed. Senolytics kill senescent cells—but killing is only half the problem. The debris from dying senescent cells must be cleared by neighboring tissue.

If neighbors lack energy reserves or have impaired autophagy, senolytic therapy generates inflammatory overload rather than rejuvenation. Phase 3 introduces senolytic compounds to energy-replete tissue with active autophagy.

Duration2-4 cycles
Primary InterventionD+Q / Fisetin
Completion CriteriaSenescence markers reduced

Stem Cell Support

Enable tissue regeneration

With senescent cells cleared and tissue prepared, Phase 4 introduces stem cell support interventions. The cleared terrain allows stem cells to function without interference from senescent cell signaling.

This phase may include exogenous stem cell therapy or interventions that activate endogenous stem cell populations. The specific approach depends on target tissues and individual response to earlier phases.

DurationVariable
Primary InterventionStem cell therapy
Completion CriteriaRegeneration markers

Epigenetic Maintenance

Stabilize rejuvenated state

The final phase focuses on maintaining the rejuvenated cellular state through epigenetic interventions. This may include partial cellular reprogramming through transient Yamanaka factor expression.

Phase 5 represents the frontier of longevity intervention. Current research explores methods to reset epigenetic age while maintaining cellular identity and function.

DurationOngoing
Primary InterventionEpigenetic modulators
Completion CriteriaEpigenetic age reduction

Biomarker Targets

Completion Criteria

NAD+ Levels

Whole blood NAD+ measurement indicates cellular energy capacity and Phase 1 completion.

Target: >40 nmol/mL

LC3-II / LC3-I Ratio

Autophagy flux marker indicating Phase 2 progress and cellular cleanup capacity.

Target: Elevated during pulsing

p16INK4a

Senescence marker indicating senescent cell burden and Phase 3 progress.

Target: Reduced expression

IL-6 / CRP

Inflammatory markers indicating SASP reduction and tissue preparation state.

Target: Within normal range

Epigenetic Age

DNA methylation clock indicating biological age and overall protocol effectiveness.

Target: Reduction vs chronological

Grip Strength

Functional marker correlating with overall biological age and healthspan.

Target: Maintained or improved

Guiding Principles

Sequence Over Selection

The order of interventions matters more than the specific compounds chosen. Proper sequencing transforms outcomes; poor sequencing negates benefits.

Energy First

No intervention succeeds in energy-depleted tissue. NAD+ restoration creates the prerequisite for all subsequent phases.

Pulsing Over Chronic

Brief, intense interventions followed by recovery periods outperform chronic low-dose approaches. Cells need cleanup phases followed by rebuilding phases.

Biomarker-Driven Transitions

Phase transitions occur when completion criteria are met, not after fixed time periods. Individual response determines pace.