Is There Really a Compound For Every Biohack? With Dr. Sandra Kaufmann

SELBX is FDA-approved in Japan for drug-induced gastritis, which Kaufmann finds ironic because it protects the stomach from the very drugs she is recommending. The same heat-shock mechanism operates in different tissues: in the stomach it prevents drug-induced inflammation; in the brain it refolds misfolded proteins and may slow or reverse dementia-related cell dysfunction. She says it also makes sense to take SELBX alongside sauna because more heat shock proteins are unambiguously beneficial.

Hydralazine is an emergency blood-pressure drug, but Kaufmann uses it for the hydrazine molecule's scavenging properties. When glucose is eaten, it attaches to amino acids and nucleic acids through six non-enzymatic steps; the first three are reversible and the last three are not. Hydralazine is more attractive to glucose, so the glucose jumps ship and the conjugate is excreted in urine. That makes it a practical tool for anyone eating a high-glucose diet: you can effectively sponge up some glucose before it becomes an advanced glycation end product.

Kaufmann describes pentoxifylline as a phosphodiesterase-class-adjacent agent that increases microvascular blood flow by lowering blood viscosity and making red blood cells more deformable. That is why it helps distal tissues that lose capillary density with age. She also values it because it inhibits glycation and activates PGC-1alpha and NRF2, giving mitochondrial and antioxidant benefits.

Kaufmann came to lithium through studying telomeres: bipolar patients have shorter telomeres, but bipolar patients on lithium for more than two years have longer telomeres than average. Normal people have not been studied on significant doses, so she used pharmacodynamics to settle on 75–150 mg. She describes lithium as controlling the mitochondrial permeability transition pore, which prevents cytochrome C release and cell death; it is also pro-autophagy, pro-stem-cell, pro-osteoblast, and neurogenic. Her daughters told her 75 mg/day turned their stress down by about 25%, and she herself felt it helped her manage a difficult year.

Kaufmann's circadian-rhythm research found that NAD+ and sirtuin one govern the two sleep-inducing proteins, the two wake-inducing proteins, and the two proteins that amplify those oscillations. NAD+ is itself produced in a circadian rhythm and has a short half-life, making timing critical. If you take NAD+ at the wrong time, you can reduce the efficacy of sirtuin one supplements. Her practical recommendation is mid-afternoon dosing, halfway between light and dark, and IM over IV for injectable use.

Kaufmann points out that lithium and magnesium compete even though their molecular structures look dissimilar. This is why high lithium doses cause problems: they create magnesium deficiency. Since most people are already magnesium deficient, supplementing with magnesium L-threonate is a good safeguard while using lithium. She also notes magnesium 3&8 increases hippocampal plasticity, so theoretically it improves memory and learning.

Kaufmann was looking for ways to activate sirtuin three specifically and concluded the two decent options are hinokitiol and dihydromyricetin. DHM upregulates mitochondrial activities, which is why it is sold as a hangover remedy: if your liver mitochondria are healthier before alcohol, you recover better. She adds the caveat that sirtuin activators are ineffective without sufficient NAD+, tying it back to her NAD+ timing guidance.

Kaufmann calls exosomes part of her longevity pyramid: daily actions, weekly actions, and monthly exosome injections. She injects locally into injuries such as her arthritic fingers, puts extra in her face, and otherwise does a “big dump into my vein.” Ben reports that an exosome IV at the conference made him feel amazing, and that intranasal exosomes gave him the clearest head of his life for two weeks.

After Ben described needing megadoses of many substances and processing coffee quickly, Kaufmann told him he has probably upregulated his metabolic enzymes. Her remedy is a reset week: come off everything, let the enzyme feedback loops readjust, then see if normal doses work again. Ben responded that for him that basically means going camping or hunting.

Her core claim is that popular biohacks work through cellular mechanisms — heat-shock proteins, AMPK/mTOR, sirtuins, NAD+, and similar pathways — and drugs can engage those same mechanisms more efficiently. She is not anti-sauna or anti-exercise; she calls herself an exercise junkie who runs, lifts, swims, and rock climbs, but she travels too much to always get the behavioral stimulus. So she uses pharmaceuticals as an adjunct when the behavior is impractical.

Kaufmann came to lithium while studying telomerase and the enzymes around telomeres. Because there are no studies of normal people on significant lithium doses, she extrapolated from pharmacodynamics: 600–900 mg causes pathology, roughly 300 mg is generally safe, and 75–150 mg is a practical dose for emotional stability with no side-effect profile. She gave 75 mg/day to her 18- and 20-year-old daughters during stressful college transitions; both said stress dropped by about 25% with no cognitive dulling. She also takes it herself and says she managed a year of difficult personal events better while on lithium.

Two proteins put you to sleep, two wake you up, and two increase the oscillation of those cycles; NAD+ and sirtuin one sit on top of all of them. Because NAD+ is created in a circadian rhythm and has a short half-life, a large IV bolus is disruptive. She also says taking NAD+ at the wrong time can reduce the efficacy of sirtuin-one supplements. Her optimization: mid-afternoon dosing for NAD+, separate from or coordinated carefully with sirtuin activators, and use IM rather than IV because IV doses are too large.

Peptides send messages to DNA to turn on production of certain molecules — like requesting a specific shoe from a factory. If the factory is old or depleted, the order cannot be filled. If you are young and have a good factory, peptides are amazing. If you are older and not on a cellular optimization program, they are less effective. Pharmaceuticals, by contrast, work “come hell or high water,” which is why Kaufmann sees them as more reliable in aging patients, with peptides as add-ons after the cell is already optimized.

Kaufmann says she deliberately shied away from pharmaceuticals in her books because she worries readers will not understand how powerful they are. Her new seminars are intended for physicians and serious self-experimenters. She is also building protocol supplements based on the seven tenants of aging so people do not need 25–30 separate pills. Club Exosome, co-founded with Steve McCain, is a quarterly Las Vegas event where people get exosome therapy, framed as a club rather than a medical intervention because exosome therapy is not FDA approved.