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The RE-Movement Science Series
RE-COMP

UNDERSTANDING BODY COMPOSITION, CELLULAR ENERGY, HEALTHY AGING & HORMONE RESEARCH

RE-COMP is an educational resource about body composition, cellular energy metabolism, healthy aging, growth-hormone physiology, and current research involving NAD and Sermorelin. NAD and Sermorelin are associated with very different biological pathways and should not be interpreted as an established combination for changing body composition, preventing aging, or increasing lifespan.

METABOLISM

INFORMS

BODY

COMPOSITION

EVIDENCE

GUIDES

HEALTHY

AGING

KNOW THE EVIDENCE. RESPECT THE LIMITS.

NAD⁺ METABOLIC & ENERGY PATHWAY

3-Stage Cascade

NAD⁺ is synthesized intracellularly, drives mitochondrial redox and ATP production, and serves as a substrate for sirtuins, PARPs, and CD38 in cellular signaling and DNA repair.

1STAGE 1

NAD⁺ BIOSYNTHESIS

NAD⁺ is synthesized intracellularly from tryptophan, nicotinic acid, or NAD precursors such as NR and NMN via salvage and de-novo pathways.

Nicotinamide riboside (NR) & nicotinamide mononucleotide (NMN)
Salvage pathway salvage of nicotinamide (NAM)
Tissue-specific NAD⁺ pool maintenance
2STAGE 2

REDOX & ENERGY TRANSFER

NAD⁺/NADH serves as a principal electron carrier in mitochondrial oxidation–reduction reactions driving ATP production.

Glycolysis & TCA cycle electron transfer
Oxidative phosphorylation & ATP synthesis
Mitochondrial respiratory chain function
3STAGE 3

SIGNALING & REPAIR

NAD⁺ acts as a substrate for sirtuins, PARPs, and CD38, influencing DNA repair, cellular signaling, and metabolic regulation.

Sirtuin deacetylase activity & metabolic sensing
PARP-mediated DNA damage repair
Cellular signaling & metabolic regulation

FACTORS THAT INFLUENCE COMPOSITION

Multi-Factorial

Body composition is influenced by multiple interacting biological and lifestyle factors.

Genetics & age
Physical activity & exercise
Nutrition & energy balance
Hormonal status (GH, IGF-1, sex)
Sleep & recovery
Medications
Metabolic & chronic health
Muscle mass & energy expenditure

DIMENSIONS OF BODY COMPOSITION & AGING

Weight change does not necessarily reflect equivalent change in body composition.

Biopsychosocial Overview
Genetics & Age

Heritable traits and life stage shape baseline composition and metabolism.

Nutrition & Energy Balance

Protein intake and caloric balance drive muscle retention and fat changes.

Physical Activity

Resistance and cardiovascular exercise maintain lean tissue and function.

Hormonal Status

GH, IGF-1, sex hormones and thyroid influence body-composition physiology.

Sleep & Recovery

Restorative sleep supports hormonal pulses and metabolic regulation.

Metabolic Health

Underlying conditions and medications affect composition and energy use.

NAD⁺

DINUCLEOTIDE COENZYME
NAD⁺Dinucleotide Coenzyme
  • NAD⁺ is found throughout the body's cells with essential roles in energy metabolism, redox reactions, mitochondrial function, and DNA-related processes.
  • A 2026 systematic review of 33 studies found oral NR and NMN generally increased NAD biomarkers, but effects on healthspan outcomes were heterogeneous and often absent.
  • A 2026 study of seven human cohorts found whole-blood NAD⁺ remained remarkably stable with age — challenging its use as a simple aging biomarker.
  • As of FDA's April 2026 update, NAD appears in 503A Category 1 under evaluation — not FDA approval. FDA has warned about adverse events with injectable NAD⁺.
Status: Under Evaluation (503A)PubMed Review

Sermorelin

GHRH ANALOG (29-AA FRAGMENT)
SermorelinGHRH Analog (29 AA fragment)
  • Synthetic peptide corresponding to a portion of growth hormone-releasing hormone (GHRH); signals the pituitary to release growth hormone.
  • GH secretion is pulsatile and influenced by age, sleep, exercise, nutrition, metabolic status, and stress; GH influences IGF-1 production.
  • A change in GH or IGF-1 is not equivalent to a clinically meaningful improvement in strength, performance, healthspan, or lifespan.
  • Inclusion alongside NAD does not imply the two have been clinically demonstrated to work together for body composition or longevity.
Status: GH/IGF-1 PathwayPubMed Review

WHAT THE EVIDENCE SHOWS

NAD and Sermorelin represent very different areas of biomedical science and evidence bases.

NAD precursors can raise NAD biomarkers, but effects on healthspan outcomes are heterogeneous and often absent.

GH/IGF-1 physiology participates in body composition, but pathway involvement ≠ proven clinical benefit.

There is insufficient evidence to present NAD + Sermorelin as an established combination for body composition or longevity.

REGULATORY & SAFETY CONSIDERATIONS

NAD appears in FDA 503A Category 1 (under evaluation) as of April 2026 — not FDA approval as a drug.

FDA has reported adverse events with injectable NAD⁺: severe chills, shaking, vomiting, fatigue — some requiring treatment.

Being studied, used in compounding, or on a category list is not the same as being FDA-approved.

Compounded drugs are not FDA-approved and are not reviewed for safety, effectiveness, or quality before marketing.

QUESTIONS TO DISCUSS

1

What factors are influencing my current body composition?

2

Are underlying medical or hormonal conditions contributing?

3

Was the research performed using NAD itself or an NAD precursor?

4

Does the evidence apply to the proposed route of administration?

5

Is the product FDA-approved for my intended use, or is it compounded?

IMPORTANT: This information is for general educational purposes only and is not medical advice, diagnosis, or treatment.
EDUCATIONAL MONOGRAPHCLINICAL & PRECLINICAL EVIDENCE REVIEW

RE-COMP: Understanding Body Composition, Cellular Energy, Healthy Aging & Hormone Research

RE-COMP is an educational resource about body composition, cellular energy metabolism, healthy aging, growth-hormone physiology, and current research involving NAD and Sermorelin.

Body composition describes the relative amounts of fat, lean tissue, bone, and other components of the body. Body composition changes throughout life and can be influenced by nutrition, physical activity, age, genetics, sleep, hormones, medications, health conditions, and energy balance.

Researchers also study cellular metabolism and hormonal signaling to better understand how these systems change with age.

NAD and Sermorelin are associated with very different biological pathways and should not be interpreted as an established combination for changing body composition, preventing aging, or increasing lifespan.

1

Understanding Body Composition

Body composition is influenced by multiple interacting biological and lifestyle factors.

These can include:

Genetics
Age
Nutrition
Physical activity
Muscle mass
Energy expenditure
Sleep
Hormonal status
Medications
Metabolic health
Chronic health conditions

Weight change ≠ composition change:

Changes in body weight do not necessarily reflect equivalent changes in body composition. For example, changes in weight can involve fat mass, lean tissue, body water, or combinations of these components. Maintaining muscle through appropriate nutrition and resistance exercise can be particularly important as people age.

2

Understanding NAD

Nicotinamide adenine dinucleotide (NAD⁺) is a molecule found throughout the body's cells. It plays essential roles in:

Cellular energy metabolism
Oxidation–reduction reactions
Mitochondrial function
DNA-related processes
Cellular signaling
Metabolic regulation

Because NAD biology is connected to cellular metabolism, researchers have investigated changes in NAD metabolism during aging and disease. However, the relationship between NAD and human aging is more complicated than is sometimes suggested in wellness marketing.

A 2025 review concluded that evidence demonstrating an age-related decline in NAD⁺ in humans has been consistent in only a limited number of studies, and human clinical trials involving NAD precursors have demonstrated limited efficacy. PubMed

A 2026 study examining seven independent human cohorts found that whole-blood NAD⁺ remained remarkably stable with age, challenging its use as a straightforward biomarker of aging. PubMed

3

NAD & Healthy Aging Research

NAD-related research has attracted significant interest because of NAD's fundamental roles in metabolism and cellular biology. Much of the early evidence supporting NAD-targeted approaches came from laboratory and animal research.

Human studies have more commonly investigated NAD precursors, such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), rather than administration of NAD⁺ itself.

A 2026 systematic review identified 33 human intervention studies and found that oral NR and NMN generally increased NAD-related biomarkers. However, effects on metabolic, vascular, functional, and other healthspan-related outcomes were heterogeneous and frequently absent or limited to particular endpoints. PubMed

The review found no eligible clinical outcomes trials evaluating intravenous or intramuscular NAD⁺ itself for anti-aging or wellness indications. PubMed

Biomarker ≠ clinical benefit:

Increasing an NAD-related biomarker should not automatically be interpreted as demonstrating improved longevity or clinically meaningful anti-aging effects.

4

NAD & Body Composition

Researchers have also investigated whether interventions affecting NAD metabolism influence metabolic health and physical function. Preclinical studies have generated considerable interest, but translation into humans remains uncertain.

For example, a randomized controlled trial of the NAD precursor NMN in older men found increased blood NAD-related concentrations and exploratory changes in some measures of physical function, but no significant effect on body composition. PubMed

Research involving NAD precursors should not automatically be used to make conclusions about administering NAD itself.

The specific compound, formulation, dose, route of administration, population, and clinical outcome all matter when interpreting the evidence.

5

Understanding Sermorelin

Sermorelin is a synthetic peptide corresponding to a portion of naturally occurring growth hormone-releasing hormone (GHRH). GHRH is produced in the hypothalamus and signals the pituitary gland to release growth hormone.

Growth hormone secretion occurs naturally in pulses and is influenced by:

Age
Sleep
Exercise
Nutrition
Metabolic status
Stress
Other hormonal signals

Growth hormone also influences production of insulin-like growth factor 1 (IGF-1). The GH/IGF-1 pathway participates in normal growth, metabolism, tissue maintenance, and body-composition physiology.

However, involvement of a biological pathway in body composition does not establish that increasing activity within that pathway will safely produce beneficial body-composition or longevity outcomes.

6

Sermorelin & Body Composition Research

Sermorelin has historically been studied for its ability to stimulate endogenous growth-hormone secretion. This makes its biology different from directly administering growth hormone.

Research into the GH/IGF-1 system has examined relationships involving:
Growth hormone secretion
Lean body mass
Fat mass
Protein metabolism
Bone metabolism
Aging
Exercise physiology

These physiological relationships should not be interpreted as proof that Sermorelin improves body composition or extends longevity in otherwise healthy adults.

Evidence demonstrating a change in GH or IGF-1 is also not equivalent to demonstrating a clinically meaningful improvement in strength, physical performance, healthspan, or lifespan.

7

Understanding Healthy Aging & Longevity

Healthy aging and longevity are not interchangeable concepts. Longevity refers to length of life. Healthspan generally refers to the period of life spent in relatively good health.

Scientists study many biological processes associated with aging, including:
Cellular senescence
Mitochondrial function
DNA damage and repair
Epigenetic changes
Inflammation
Metabolic regulation
Hormonal changes
Muscle loss
Cardiovascular health
Neurological health

No single biomarker or biological pathway fully determines how a person ages.

Research involving NAD metabolism or growth-hormone signaling should therefore not be interpreted as demonstrating that NAD or Sermorelin slows, stops, or reverses human aging. Current reviews of NAD-targeted interventions continue to emphasize substantial uncertainty about their therapeutic value for human aging. PubMed

8

Understanding the Evidence

Research involving NAD and Sermorelin represents different areas of biomedical science.

NAD research includes:

  • Cellular studies
  • Animal studies
  • Human metabolic studies
  • NAD-precursor clinical trials
  • Biomarker research
  • Aging research

Sermorelin research relates primarily to:

  • Growth-hormone physiology
  • GHRH signaling
  • Pituitary function
  • GH/IGF-1 biology

Research demonstrating a biological mechanism does not necessarily establish a clinically meaningful health benefit.

Likewise, increases in NAD-related metabolites, growth hormone, or IGF-1 should not automatically be interpreted as evidence of improved body composition, slower aging, or increased lifespan. Large, appropriately controlled human studies using clinically meaningful outcomes are needed to establish those conclusions.

9

Supporting Healthy Body Composition & Aging

Established approaches supporting body composition and healthy aging can include:

Regular physical activity
Resistance exercise
Appropriate cardiovascular exercise
Adequate protein and balanced nutrition
Maintaining an appropriate energy balance
Adequate sleep
Avoiding tobacco
Managing cardiovascular risk factors
Maintaining metabolic health
Preventive healthcare
Treatment of underlying medical conditions

Individual needs vary according to age, health, medications, physical ability, and medical history.

10

Regulatory & Safety Considerations

The regulatory status of NAD deserves particular attention.

As of FDA's April 22, 2026 update, Nicotinamide Adenine Dinucleotide (NAD) appears in 503A Category 1 — Bulk Drug Substances Under Evaluation. That classification should not be confused with FDA approval of NAD as a drug for body composition, anti-aging, or longevity. U.S. Food and Drug Administration

FDA has also warned specifically about injectable NAD⁺ products. The agency reports receiving adverse-event reports following injectable NAD⁺, including severe chills, shaking, vomiting, and fatigue, with some patients requiring medical treatment. FDA stated that these reactions were consistent with excessive endotoxin levels and reminded compounders to use ingredients suitable for sterile compounding. U.S. Food and Drug Administration

FDA also issued a January 2026 warning letter involving an outsourcing facility that compounded NAD⁺ products under circumstances FDA said did not meet conditions for the applicable 503B exemptions. U.S. Food and Drug Administration

These distinctions matter because being studied, being used in compounding, appearing on an FDA compounding-category list, and being FDA-approved are not the same thing.

The regulatory status, formulation, route of administration, source, sterility, and quality of a compounded product can all be important considerations.

11

Questions to Discuss With a Healthcare Professional

Patients learning about body composition, NAD, Sermorelin, and healthy-aging research may wish to ask:

What factors are influencing my current body composition?
Are underlying medical or hormonal conditions contributing?
What established approaches could address my goals?
What human clinical evidence exists for the proposed treatment?
Was the research performed using NAD itself or an NAD precursor?
Does the evidence apply to the proposed route of administration?
What evidence exists specifically for Sermorelin in people like me?
Is the proposed use FDA-approved?
Is the proposed product compounded?
What short- and long-term risks are known?
What important safety questions remain unanswered?
How would treatment outcomes and potential adverse effects be monitored?
12

Continuing Research

NAD metabolism and growth-hormone physiology remain active areas of biomedical research.

NAD: Research has established that NAD plays fundamental roles in cellular metabolism and that certain NAD precursors can increase NAD-related biomarkers in humans. However, a comprehensive 2026 systematic review concluded that clinical effectiveness for anti-aging and wellness outcomes remains inconclusive. PubMed
Sermorelin / GH-IGF-1: Research into growth-hormone physiology similarly demonstrates that GH and IGF-1 participate in body composition and metabolism, but manipulation of those pathways should not automatically be interpreted as improving healthspan or longevity.

Future research may clarify which populations, if any, benefit from specific NAD-targeted or growth-hormone-related interventions. Patients should distinguish among normal physiology, biological mechanisms, biomarkers, experimental research, compounded preparations, and established FDA-approved medical treatments when evaluating claims about body composition and longevity.

Educational Resources & Citations

Educational Disclaimer

This page is provided for general educational purposes only. It is not intended to provide medical advice, diagnosis, or treatment.

References to NAD, Sermorelin, growth hormone, IGF-1, body composition, longevity, cellular metabolism, biological mechanisms, laboratory research, animal studies, or areas of clinical investigation are provided for educational purposes and should not be interpreted as a recommendation or endorsement of a particular substance or treatment.

Discussion of NAD or Sermorelin does not establish that either substance, individually or in combination, has been demonstrated to improve body composition, extend lifespan, slow aging, reverse aging, or improve longevity.

Changes in biomarkers such as NAD-related metabolites, growth hormone, or IGF-1 should not automatically be interpreted as clinically meaningful improvements in health or longevity.

Treatment decisions should be individualized and made with an appropriately licensed healthcare professional based on medical history, current health, medications, potential risks, available clinical evidence, and professional clinical judgment.

FDA approval status, compounding policies, clinical evidence, and regulatory requirements may change. Current information should be verified through the U.S. Food & Drug Administration and other recognized medical resources.