We Are Energy: Martin Picard on Mitochondria, and Where NMN and Urolithin A Actually Fit

If you found this page, you have probably just spent two and a half hours with Dr. Martin Picard on The Diary of a CEO, sitting with the strangest ideas: that our cells live in symbiosis, bound by a kind of social contract; that energy is not something you have, it is what you are; that in some sense you are living in service of your mitochondria. If you missed it, this is not a summary of that episode, so go watch it here first.

Asked directly, he says so plainly, and he explains why: he worries that reaching for a pill trains you to stop paying attention to what your body is actually telling you. His instinct is to trust the organism, the "beautiful dynamic equilibrium" of a system that already knows how to heal, over a compound sold by a company with something to gain.

For Youth makes NMN and urolithin A supplements, and Picard, a leading mitochondrial scientist, does not personally take them. That is worth sitting with rather than glossing over. But it is also worth reading closely, because his reasoning is more specific than "supplements don't work."

Here is the distinction that matters. Picard's skepticism is really a skepticism of the magic-pill mindset, the idea that a capsule substitutes for sleep, movement, food discipline, and meaning. On that we completely agree, and nothing below changes it.

But "I don't take supplements" and "these specific compounds do nothing" are different statements, and Picard is careful never to make the second. On NAD+ and urolithin A he actually grants that the mechanisms are real and the human data is, in his words, fairly compelling. He simply lands on caution for himself. That is a reasonable place to land.

It is also compatible with a different, equally reasonable choice: using a well-formulated supplement as one targeted input on top of the lifestyle work, not instead of it. With that settled, here is what the science says about the two compounds his audience kept asking about.

Picard's framework rests on three moves, and all three point to the same lever.

1. Fixed energy budget: You cannot simply eat more to have more energy. Overload the system and it strains, the way a circuit overheats when you push too much voltage through it.
2. Hierarchy of energy needs, a bioenergetic Maslow's pyramid. Under stress the body pulls energy away from low-priority maintenance, the jobs that keep you young, and spends it on immediate survival. Grey hair, in his telling, is one of the first things to get defunded.
3. Energy resistance governs everything: it is how much energy your body is demanding set against how much your mitochondria can actually deliver. When demand outruns supply, resistance builds, and resistance is where damage, inflammation, and ageing accumulate.

That lever is mitochondrial flow capacity. You do not get ahead by adding fuel; you get ahead by helping the system move energy more efficiently and keeping its machinery in good repair. That is precisely the territory NMN and urolithin A operate in.

When the supplement question finally arrives, Picard's most substantive answer is about NAD+. He calls it probably the best-supported intervention for reducing inflammation, and he explains why it matters mechanically: NAD+ is an electron carrier. It picks up electrons from the food you eat and hands them to the electron transport chain so your mitochondria can flow those electrons with low resistance. Run low on NAD+ and that whole circuit gets more resistive. In Picard's own language, that is energy friction.

His framework and the NMN research line up cleanly here. NAD+ is not something you can usefully swallow directly, and Picard says as much: eaten straight, its bioavailability is poor. You raise it through precursors. NMN (nicotinamide mononucleotide) is one of the most studied, and oral NMN has been shown to raise blood NAD+ in healthy adults¹. The Uthever® form of NMN used in The Repair was tested in its own multicentre, randomised, double-blind, placebo-controlled trial and found to be safe and effective at raising NAD+².

There is also a specific reason NAD+ needs topping up with age, and it is more precise than general decline. NAD+ falls measurably across the human lifespan³. Part of that fall is a consumption problem: an enzyme called CD38 rises with age and actively burns through NAD+, driving both the decline and the mitochondrial dysfunction that follows⁴. So there are two ways to defend your NAD+, and the complete approach does both at once: supply more raw material, and slow the drain.

That two-sided logic is the entire design rationale for The Repair, and it is where it separates from a plain NMN capsule. Each capsule contains 450mg of NMN (as Uthever®), 50mg of apigenin (as ApiAge®), and 50mg of pterostilbene, and the formulation addresses the NAD+ system at three points rather than one:

• Supply the precursor. Uthever NMN feeds the salvage pathway the substrate it needs to rebuild NAD+².
• Slow the drain. ApiAge apigenin inhibits CD38, the enzyme that consumes NAD+ as you age⁵. Adding NMN while ignoring CD38 is like filling a tank without checking whether the outflow valve is stuck open, and the older the tissue, the more that valve matters.
• Support the downstream machinery. Pterostilbene, a close cousin of resveratrol with better bioavailability, keeps the sirtuins that NAD+ fuels switched on.

That last point deserves a line, because it connects Picard's "energy flows more smoothly" language to something concrete. NAD+ is the fuel that powers a family of enzymes called sirtuins, SIRT1 chief among them, which act as the cell's maintenance and repair managers. They cannot work without NAD+. As NAD+ declines with age, sirtuin activity falls with it, which is a large part of why low NAD+ shows up as reduced repair capacity^{6 7}. Raising NAD+ is not the goal in itself; it is the key that unlocks the machinery which does the anti-ageing work. If you want that mechanism in full, we wrote it up separately in Sirtuins, SIRT1, and Why NAD+ Is the Key That Unlocks Them.

None of this contradicts Picard. He said NAD+ is the best-supported anti-inflammatory intervention, that most people are not clinically deficient, and that for reasons he does not fully claim to understand, it makes some people feel noticeably more energetic. The Repair is, in effect, built to make that "some people" outcome more likely and more durable, by attacking the NAD+ problem from the supply side and the drain side together rather than hoping precursor alone is enough.

Urolithin A is the other compound the audience pushed hardest on, and Picard's explanation is genuinely useful. Your cells constantly run quality control on their mitochondria: worn-out ones get tagged and recycled through a process called mitophagy (self-eating of mitochondria), which frees the cell to build better replacements. This housekeeping slows with age, so damaged mitochondria accumulate. What urolithin A appears to do, Picard says, is accelerate that clean-out.

The mechanism is well described. The human data is where the episode gets loose, since Steven reads an on-screen summary that slightly overstates it, so here is the accurate picture across three trials:

• Older adults (65 to 90). Four months of urolithin A significantly improved muscle endurance in both hand and leg muscles and lowered biomarkers of mitochondrial inefficiency and inflammation⁸. The caveat the episode skipped: the six-minute walk distance improved more than placebo, but that difference was not statistically significant⁸.
• Middle-aged adults. A separate four-month trial found significant gains in muscle strength of around 12 percent, alongside better aerobic endurance⁹.
• Safety. An earlier study established that urolithin A is safe and produces a molecular signature of improved mitochondrial health in humans¹⁰.

The honest summary: clean mechanism, solid safety, and human evidence pointing consistently toward better mitochondrial function and muscle performance, with some endpoints landing as clinically meaningful rather than statistically significant. That is a stronger evidence base than many longevity ingredients can claim.

This is the compound at the centre of The V-Max, and there is a practical reason a supplement makes sense here. Your body can make urolithin A on its own, but only if two things line up:

• The diet. The raw material is the polyphenols in pomegranate, walnuts, and berries.
• The microbiome. You need the right gut bacteria to convert them, which only around a third to a half of people carry.

Miss either gate and you produce almost none. Supplementing the finished compound skips that lottery entirely.

One last thing, worth passing on straight. When Steven jokes that everyone should be on urolithin A, Picard plays along for a beat, then pulls back: he is skeptical, and it "feels like the next fad," even while granting the science is fairly compelling. That skepticism is a healthy prior, though on the evidence it is more cautious than the trial data strictly requires, a difference of temperament as much as of fact. Where NMN rebuilds the NAD+ supply, The V-Max works through a separate pathway, which is why it is the logical next lever for someone already fit and already on an NAD+ booster.

Picard spends a good stretch on red light therapy, and since we do not sell red light devices, we can be purely educational here.

The logic is elegant and slots straight into his energy-resistance model. Light is energy, and for light to do anything in biology, something has to absorb it. The antenna for red and near-infrared light turns out to be inside the mitochondria: an enzyme in the electron transport chain called cytochrome c oxidase, the very place electrons meet oxygen to become water. Shine the right wavelength on tissue and you appear to nudge that machinery to flow energy a little more readily.

The study Picard references is real and recent. Shining 670nm red light on people's backs before a glucose drink reduced the resulting blood glucose spike, cutting the elevation by roughly 28 percent over two hours, with a corresponding rise in mitochondrial metabolism measured through the breath¹¹. The interpretation is that the light let cells take up and flow the incoming glucose more efficiently, the "reduce resistance" story in optical form.

But note the caveat Picard raises, because it is the same one that governs everything in his framework: dose. Red light appears to follow a bell curve. A modest dose stimulates mitochondria; too much drives excess reactive oxygen species and can tip from repair into damage. There is such a thing as too much, which is why "shine it on yourself for two hours while you read" is not the move. More is not better; the right amount is better. That principle, the sweet spot rather than the maximum, is the through-line of the entire episode, and it applies to supplements every bit as much as to light.

If you take Picard seriously, and you should, supplements are one input among several, and not the first. The episode keeps returning to a small set of levers that move energy resistance more powerfully than any capsule:

• Exercise is controlled resistance. The uncomfortable part is the point: pushing your mitochondria past their comfort zone signals the body to build more of them during recovery. A sedentary person training up can roughly double the mitochondria in their muscle.
• Not overeating keeps the system out of the chronic overload that drives resistance and inflammation. Picard's own view is that most of us eat when we are not hungry, and that a shorter eating window helps the body enter its efficient, repair-oriented state.
• Ketones reach the mitochondria by a much shorter metabolic path than glucose, part of why many people report feeling more mentally energetic on them, not because there is more energy, but because it flows more cleanly.
• Managing the stress response, because as Picard puts it, it is not the stress that burns you down, it is your reaction to it. The cortisol cascade has a real metabolic cost, and awareness is the intervention that interrupts it.
• Purpose, which is not a soft add-on in his model. In a postmortem study his group contributed to, older adults who had reported greater well-being showed a greater abundance of mitochondrial energy machinery in the brain¹². Meaning, it turns out, is metabolically visible.

Supplements sit alongside these, not above them. That is the honest hierarchy, and it happens to be Picard's.

Here is the synthesis, and it is the one the science supports rather than the one that sells the most product.

A supplement is a targeted tool. Where the compound is well-studied and the mechanism understood, and NAD+ precursors and urolithin A are two of the better cases in the whole longevity field, a good formulation is a reasonable way to support a specific part of your mitochondrial biology. NMN feeds the NAD+ system while apigenin protects it from the CD38 drain, which is the logic behind The Repair. Urolithin A helps your cells clear the mitochondria dragging down the average, which is the logic behind The V-Max. For most people building an NAD+ foundation, The Repair is the natural starting point; for the already-fit who have that base covered and want to work on mitochondrial quality directly, The V-Max is the separate lever.

But a supplement is not a substitute, and this is the part worth carrying from Picard's conversation. It will not out-run poor sleep, chronic stress, constant overeating, or a life without movement or meaning. Picard chooses to rely on those levers alone, and that is a defensible, even admirable, position. Choosing to add a well-formulated supplement on top of that same foundation is also defensible. What is not defensible, by his lights or ours, is treating the pill as the point.

If you take one thing from the episode, let it be his: you are the energy flowing through this body. Everything that helps it flow more smoothly, and keeps its machinery in good repair, is working in the same direction. We follow the evidence. When it changes, so will we.