Anti-Ageing Treatments Compared: What Actually Works?

The anti-ageing industry is vast, and the claims made by providers range from the scientifically grounded to the frankly implausible. For patients genuinely interested in slowing biological ageing and optimising their health, the challenge is separating evidence-based treatments from marketing hype. This article compares the most widely discussed anti-ageing interventions, examining the evidence for each with honest assessment of what works, what shows promise, and what remains unproven.

The Biology of Ageing: A Brief Overview

Before comparing treatments, it is helpful to understand the key biological mechanisms that drive ageing. The major hallmarks of ageing include:

• Cellular senescence: Accumulation of damaged cells that no longer divide but release inflammatory signals
• Mitochondrial dysfunction: Declining energy production within cells
• Telomere shortening: Progressive erosion of chromosomal end-caps with each cell division
• Chronic inflammation: Low-grade, systemic inflammation (sometimes termed “inflammaging”)
• Epigenetic changes: Alterations in gene expression patterns that accumulate over time
• Declining NAD+ levels: Reduction in a key coenzyme essential for cellular energy and DNA repair

Effective anti-ageing treatments should address one or more of these mechanisms. Treatments that do not target these biological processes are unlikely to produce meaningful results beyond placebo.

NAD+ Therapy

What It Is

Nicotinamide adenine dinucleotide (NAD+) is a coenzyme found in every cell of the body, essential for energy metabolism, DNA repair, and cellular signalling. NAD+ levels decline significantly with age, and restoring these levels is a key target in longevity medicine.

NAD+ therapy typically involves intravenous infusion of NAD+ or its precursors (NMN, NR), though oral supplementation is also available.

Evidence

The scientific rationale for NAD+ therapy is strong. Animal studies have consistently demonstrated that boosting NAD+ levels improves mitochondrial function, extends healthspan, and delays markers of ageing. Human clinical data is more limited but encouraging, studies have shown improvements in cellular NAD+ levels, inflammation markers, and subjective measures of energy and cognitive function.

Realistic Expectations

NAD+ therapy is among the more evidence-supported anti-ageing interventions currently available. Most patients report improved energy, mental clarity, and recovery within weeks of treatment. However, it is not a stand-alone solution, its benefits are optimised when combined with other lifestyle and medical interventions.

Peptide Therapy

What It Is

Peptide therapy uses short chains of amino acids, bioactive peptides, to target specific biological processes. In anti-ageing medicine, commonly used peptides include BPC-157 (tissue repair), Epitalon (telomere regulation), thymosin alpha-1 (immune modulation), and growth hormone secretagogues (cellular regeneration and metabolic support).

Evidence

The evidence base for peptide therapy varies by peptide. Some, such as BPC-157, have extensive preclinical data but limited human clinical trials. Others, such as thymosin alpha-1, have established clinical applications (particularly in immunology). Growth hormone secretagogues have been studied more extensively in humans, with evidence supporting their role in improving body composition, sleep quality, and metabolic markers.

Realistic Expectations

Peptide therapy is a promising and rapidly evolving field. Patients may experience improvements in tissue healing, immune function, sleep, and overall vitality. However, the evidence is still developing for many peptide applications, and responsible providers should be transparent about what is established versus what is emerging.

Stem Cell Therapy for Anti-Ageing

What It Is

Stem cell therapy for anti-ageing typically involves the administration of mesenchymal stem cells (MSCs), either intravenously for systemic effects or targeted to specific tissues. The goal is to replenish the body’s regenerative capacity, reduce inflammation, and support tissue repair across multiple organ systems.

Evidence

Animal studies have shown that MSC administration can extend lifespan, reduce frailty, and improve organ function in aged subjects. Human evidence is more preliminary, with clinical trials demonstrating improvements in frailty markers, inflammatory biomarkers, and functional measures in older adults. The field is promising but not yet definitive.

Realistic Expectations

Stem cell therapy may offer meaningful anti-ageing benefits, particularly for patients experiencing age-related decline in multiple body systems. However, it should not be presented as a guaranteed rejuvenation treatment. The most responsible approach is to view stem cells as one component of a comprehensive longevity strategy.

Exosome Therapy for Anti-Ageing

What It Is

Exosome therapy delivers cell-free signalling vesicles, derived from stem cells, that carry regenerative, anti-inflammatory, and immunomodulatory messages to target cells. Exosomes can be administered intravenously or locally, and they are increasingly used in anti-ageing protocols.

Evidence

The exosome field is newer than stem cell therapy, and the human clinical evidence is still in early stages. Preclinical data is encouraging, showing effects on inflammation, tissue repair, and cellular rejuvenation. As the field matures, stronger clinical data is expected.

Realistic Expectations

Exosome therapy is a promising addition to the anti-ageing toolkit, but patients should understand that the evidence base is still developing. It is best viewed as a complementary therapy rather than a primary anti-ageing intervention at this stage.

Lifestyle Interventions: The Foundation

No discussion of anti-ageing treatments is complete without acknowledging that lifestyle factors remain the single most evidence-supported approach to healthy ageing. These include:

• Regular exercise: Both aerobic and resistance training have robust evidence for extending healthspan and reducing biological age markers
• Nutritional optimisation: Caloric moderation, adequate protein intake, and anti-inflammatory dietary patterns
• Sleep quality: Consistent, restorative sleep is fundamental to cellular repair and hormonal balance
• Stress management: Chronic stress accelerates biological ageing through multiple pathways

Medical anti-ageing treatments are most effective when built upon a foundation of healthy lifestyle habits. No therapy, however advanced, can fully compensate for poor sleep, sedentary behaviour, or chronic stress.

Comparing the Approaches

Treatment	Evidence Strength	Primary Mechanism	Typical Response Time
NAD+ Therapy	Moderate–Strong	Cellular energy, DNA repair	1–4 weeks
Peptide Therapy	Varies by peptide	Tissue repair, immune, hormonal	2–8 weeks
Stem Cell Therapy	Emerging–Moderate	Cellular regeneration	4–12 weeks
Exosome Therapy	Emerging	Cell signalling, anti-inflammatory	4–8 weeks
Lifestyle	Strong	Multiple systemic pathways	Weeks–months

What Actually Works?

The honest answer is that no single anti-ageing treatment is a proven solution in isolation. The most evidence-supported approach combines:

1. A strong lifestyle foundation: exercise, nutrition, sleep, and stress management
2. NAD+ optimisation: one of the better-supported medical interventions
3. Targeted peptide therapy: selected based on individual needs
4. Regenerative therapies (stem cells, exosomes), as part of a personalised programme for patients with specific indications

The key principle is personalisation. Effective anti-ageing medicine starts with comprehensive biomarker assessment and designs a protocol based on what your body actually needs, rather than applying a standardised programme to every patient.

Anti-Ageing Treatment in Thailand

Thailand has emerged as a significant destination for anti-ageing and longevity medicine, offering access to a comprehensive range of regenerative therapies under medical supervision. At Longevity Thailand, anti-ageing protocols are designed around individual biomarker data, with treatment plans built by physicians experienced in regenerative and longevity medicine.

International patients benefit from the combination of clinical expertise, treatment accessibility, and cost-effectiveness that Thailand offers, making comprehensive longevity programmes accessible to patients from across Asia and the Middle East.

The responsible message is this: anti-ageing medicine has genuine potential to improve health and vitality, but patients should approach the field with informed scepticism, seek evidence-based providers, and maintain realistic expectations about outcomes.