Full title: #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 Sign up to receive Peter's email newsletter: https://bit.ly/4c602k2 Original release date: 3/25/19 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 it’s 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 an 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. Show notes page: https://peterattiamd.com/chrismasterjohn/ About: The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 10 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more. Peter is the founder of Attia Medical, PC, a medical practice with offices in San Diego and New York City, focusing on the applied science of longevity. The practice applies nutritional biochemistry, exercise physiology, sleep physiology, techniques to increase distress tolerance, lipidology, pharmacology, and four-system endocrinology to increase lifespan (delaying the onset of chronic disease), while simultaneously improving healthspan (quality of life). Learn more: https://peterattiamd.com/ Subscribe to receive exclusive subscriber-only content: https://peterattiamd.com/subscribe/ Sign up to receive Peter's email newsletter: https://peterattiamd.com/newsletter/ Connect with Peter on: Facebook: http://bit.ly/PeterAttiaMDFB Twitter: http://bit.ly/PeterAttiaMDTW Instagram: http://bit.ly/PeterAttiaMDIG Subscribe to The Drive: Apple Podcast: http://bit.ly/TheDriveApplePodcasts Overcast: http://bit.ly/TheDriveOvercast Spotify: http://bit.ly/TheDriveSpotify Google Play: http://bit.ly/TheDriveGooglePlay