#46 - Chris Masterjohn, Ph.D.: Navigating the many pathways to health and disease - NAD and sirtuins, methylation, MTHFR and COMT, choline deficiency and NAFLD, TMAO, creatine, and more

The Peter Attia Drive - A podcast by Peter Attia, MD - Mondays

In this episode, Chris Masterjohn, entrepreneur, independent researcher, and doctorate in nutrition, elucidates the latest research on the risk and benefits of NAD supplements, and shares his personal intuition on the topic. We also dive deep into choline deficiency and its role in the rising prevalence of nonalcoholic fatty liver disease. From there, Chris enlightens us on the importance of methylation, a simple yet profoundly important biochemical process affecting our physical and mental health. He also describes the variations of the genes MTHFR and COMT, enzymes which play important roles in methylation and which have profound impacts on our well-being.   We discuss: Chris’s background, falling in love with biochemistry, and decision to pursue research over medicine [7:45]; Choline: what it is, why it is important, and how a deficiency can cause non-alcoholic fatty liver disease [11:45]; NAFLD: increasing prevalence and potential causes [25:00]; TMAO: Should we be worried about the TMAO content in choline and our foods? [39:15]; Types of fatty acids: How they may predispose us to different types of illnesses [53:30]; Why don’t we see low VLDL in patients with NAFLD? [59:45]; Understanding flux, and how machine learning may affect medicine in the near future [1:03:15]; NAD: How it works, supplements, sirtuins, and the central role of the liver [1:09:30]; Intravenous NAD [1:33:00]; Oral NR: Is it the optimal way to get more NAD? [1:38:30]; What is the possible harm of taking an NAD precursor? [1:47:15]; The MTHFR gene [1:49:45]; The methylation pathway [1:58:15]; The COMT gene [2:04:30]; Creatine: The uses and benefits and its important role in methylation [2:10:15]; Dietary strategies for MTHFR: choline, creatine, folate, and glycine [2:16:45]; How to mitigate the negative effects of NAD supplements [2:23:45]; A case study of a person with high homocysteine [2:28:00]; What is the level of evidence that you need to take action? [2:32:15]; Does Chris supplement with NAD precursors? And can it improve symptoms of rosacea? [2:35:45]; Decision making in the face of inconclusive data, and trying to disentangle the placebo effect [2:39:00]; What does Chris believe to be true that very few people would agree with him about? [2:43:15]; How to follow Chris’s work [2:48:45]; and More. Learn more at www.PeterAttiaMD.com Connect with Peter on Facebook | Twitter | Instagram.