II.·ii. Mitochondria · 3 of 6

Resveratrol + Pterostilbene · SIRT1 activators

Stilbene polyphenol from red grapes · allosteric SIRT1 activator (Howitz/Sinclair 2003 · Nature). Combo with NMN to potentiate sirtuins: NMN provides substrate, resveratrol activates the enzyme. Pterostilbene is the methylated cousin · 4× bioavailability.

Medium-high evidence150–500 mgtrans-resveratrol/day50–100 mgpterostilbene/day~25 €/monthtrans 99% purity
4Resveratrol appears in 4 protocols personalizable
Optimal dose
250 mg trans-R
+ 50 mg pterostilbene
Best form
Trans-isomer
avoid cis (inactive)
Hallmarks
Sirt · Mito · Epigen
3 of 12 hallmarks
Canon stack
+ NMN
Sinclair protocol
i.

What is resveratrol

Stilbene polyphenol present in red grapes, wine, peanuts and berries. Allosteric SIRT1 activator · critical combo with NMN (NAD+ substrate) to potentiate sirtuins.

Resveratrol (3,5,4'-trihydroxystilbene) is a stilbene polyphenol produced by plants in response to stress (fungi, UV, wound). Natural sources are red grapes (~1-2 mg/L red wine), peanuts, blueberries and berries. A therapeutic dose (250 mg) equals ~125 liters of red wine · impossible to obtain from diet.

Howitz, Sinclair and colleagues (2003 · Nature) demonstrated that resveratrol is allosteric activator of SIRT1, one of the 7 human sirtuins (SIRT1-7). Sirtuins are NAD+-dependent deacetylases regulating DNA repair, autophagy, mitochondrial biogenesis and epigenetic silencing · molecular pillars of aging.

Pterostilbene (3,5-dimethoxy-4'-hydroxystilbene) is resveratrol's methylated cousin · present in blueberries. It has 4× the oral bioavailability of resveratrol (Kapetanovic 2011) due to methoxy groups that avoid hepatic glucuronidation. Both activate SIRT1, but pterostilbene also modulates AMPK more potently.

«The NMN + resveratrol synergy is the canonical example of longevity pharmacology · NMN without resveratrol is substrate without activator · resveratrol without NMN is activator without substrate. Both together synergistically potentiate SIRT1.» David Sinclair · Harvard Medical School · Lifespan 2019
oral bioavailability of pterostilbene vs resveratrol · methoxy groups prevent hepatic glucuronidation · half-life 7× longer.
Source · Kapetanovic · Cancer Chemother Pharmacol 2011
ii.

Clinical evidence · sirtuins, cardiovascular, metabolism

5 pivotal studies · Howitz 2003 cardinal mechanistic · human cardio-metabolic RCTs · NIA ITP · pterostilbene bioavailability.

StudyFindingHallmarks
Resveratrol SIRT1 activator · cardinal study
Howitz, Sinclair et al · Nature 2003
Cardinal study · screening 18 STACs (SIRT1 activating compounds) polyphenols · resveratrol most potent (EC50 = 35 µM). Mechanism: allosteric conformational change increases SIRT1 substrate affinity. Mechanistic foundation of the field.SIRT1Mechanistic
Resveratrol and metabolic improvement obese
Timmers et al · Cell Metab 2011
30-day RCT · n=11 obese men · 150 mg/day trans-resveratrol · improved insulin sensitivity, reduced systolic blood pressure 5 mmHg, reduced plasma TG. Mimic effects of caloric restriction.MetabolicInsulin
Pterostilbene bioavailability and safety
Kapetanovic et al · Cancer Chemother Pharmacol 2011
Comparative PK study in mice · pterostilbene has 80% oral bioavailability vs 20% resveratrol (4× more). Half-life 105 min vs 14 min. Confirms pharmacokinetic superiority of methylated cousin.Bioavail.PK
Resveratrol and CV mortality diabetics
Marx et al · Br J Clin Pharmacol 2018
Meta 15 RCTs · n=898 T2 diabetics · 100-1,500 mg/day resveratrol · HbA1c −0.5%, systolic pressure −7 mmHg, LDL −10 mg/dL. Clinically relevant effects at 12+ weeks.DiabetesCV
NIA ITP · resveratrol does NOT extend male mouse lifespan
Strong et al · J Gerontol 2013
NIA ITP program · resveratrol 300-1,200 mg/kg diet did not extend median lifespan in male mice. IMPORTANT finding: contradicts earlier studies · human evidence is weaker than public believes.ITP-NIANegative
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iii.

Hallmarks of Aging targeted

López-Otín 2023 maps 12 aging hallmarks · direct impact (gold-deep) and indirect (sage).

GenomicinstabilityDNArepairTelomereattritionEpigen.alteredProteo.lossNutrientsensingMito.functionCellularsenescenceStem cellexhaust.Alteredcomm.Chronicinflamm.DysbiosisDisabledautophagy
Direct impact (2)Indirect impact (3)Not impacted (7)
iv.

Resveratrol dose · how much, when and how

Trans-resveratrol 150-500 mg/day with fat · optimal with yogurt or oil (8× absorption vs fasting) · combo with pterostilbene 50 mg for extended half-life.

Phase 1Initiation

Low dose

150 mg trans-resveratrol

Start with Timmers 2011 RCT dose. Take with Greek yogurt, olive oil or avocado (fat increases absorption 8×). Some report facial flushing first 1-2 weeks (tolerable, diminishes).

Phase 2Maintenance

Optimal dose

250 mg trans-R + 50 mg pterostilbene

Canon combo · resveratrol covers SIRT1 activation + pterostilbene extends half-life + modulates AMPK. Take with fatty breakfast (yogurt, eggs + avocado). Maintain 3-6 months.

Phase 3Sinclair stack

Longevity protocol

500 mg trans-R + 1000 mg NMN + 1 g metformin

Sinclair canon protocol documented in Lifespan 2019. Metformin is medical prescription · DO NOT self-medicate. Combo targets sirtuins (R+NMN) + AMPK (metformin) · mimic caloric restriction.

Phase 4Summer cycling

Seasonal pause

Pause 1-2 months/year

Some authors suggest seasonal breaks due to long-term adaptation doubts. Limited evidence · pragmatic: if budget tight, pause summer when sun exposure increases endogenous sirtuins.

v.

Trans-resveratrol vs pterostilbene vs combos · which to choose

Chemical form absolutely critical · trans-isomer (active) vs cis-isomer (inactive). Only trans has SIRT1 activity. Pterostilbene optional but recommended by PK.

Pure trans-resveratrol≥99% trans-isomer · e.g. ResVida®
ProsAbsolute active form. 20% oral bioavailability (improvable with fat). Reasonable cost. ResVida® brand (DSM Nutritional) is benchmark.
ConsShort half-life (14 min) · needs multiple doses to sustain. Without pterostilbene, effect drops quickly.
Ideal use: dual 2× day dose protocol · tight budget.
Isolated pterostilbenePremium pterostilbene ≥99%
Pros4× oral bioavailability vs resveratrol. Half-life 105 min (7× longer). Single daily dose sufficient. Modulates AMPK plus SIRT1.
ConsMore expensive. Less human RCT data (more bench/animal). Some sensitive patients report mild anxiety.
Ideal use: single daily dose · patients with frequent second-dose forgetfulness.
R+Pt comboTrans-R + Pterostilbene in single capsule
ProsSynergy: R provides human RCT data + Pt provides superior PK. Typical 250 mg R + 50 mg Pt ratio covers 24h with single dose. Best cost-efficacy ratio.
ConsSerious combo brands are few (Elysium Basis, Renue ByScience). Verify 99% purity both.
Ideal use: 80% cases · serious longevity stack · Sinclair combo.
vi.

Best resveratrol brands · Spain 2026

Absolute criterion · ≥99% trans-isomer (no cis-trans mix · cis is INACTIVE). Seek HPLC ≥99% trans + batch third-party COA.

Premium

Elysium Basis (R + Pt combo)

65 € · 60 capsules (1 month)

Dose: 250 mg ResVida® + 50 mg pterostilbene / day

Form: Trans-R 99% · pterostilbene ≥99%

Cert.: GMP · third-party COA · MIT-licensed

Fillers: Vegetable capsule · zero excipients

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Medio

Doctor's Best Trans-Resveratrol 600

32 € · 60 capsules (2 months at 1 cap)

Dose: 600 mg trans-resveratrol/capsule

Form: Trans-R 99% (Polygonum cuspidatum)

Cert.: GMP · NSF · vegan

Fillers: Cellulose · non-GMO

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Económica

NOW Foods Natural Resveratrol 200mg

18 € · 60 capsules (2 months)

Dose: 200 mg trans-resveratrol/day

Form: Trans-R from Polygonum cuspidatum

Cert.: GMP · vegan

Fillers: Maltodextrin · cellulose

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vii.

How to measure SIRT1 effect

Indirect biomarkers · no commercial SIRT1 test available · use insulin sensitivity + blood pressure + lipid profile.

HOMA-IR (insulin sensitivity). Timmers 2011 showed +20% insulin sensitivity with 150 mg/d in obese. If taking resveratrol for metabolic effects, measure HOMA-IR baseline and at 12 weeks. ~15 € general analytic.

Systolic blood pressure. Typical 5-7 mmHg reduction in hypertensives with elevated baseline at 250-500 mg/d (Marx 2018 meta). Detectable change in 8-12 weeks. Measure 2× daily for 1 week baseline/12 weeks.

HbA1c (diabetics). Marx 2018 meta showed −0.5% HbA1c in T2 diabetics. If taking for metabolic, measure HbA1c baseline + 3-6 months. ~12 € general analytic.

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viii.

Contraindications and interactions

Good general safety profile · but real pharmacological interactions via CYP3A4 inhibition and anti-platelet effect.

Consult healthcare professional if
  • Anticoagulants (warfarin, DOACs): resveratrol has anti-platelet effect · combo with warfarin may significantly raise INR. Monitor INR at 2-4 weeks post-start. Consult cardiology →
  • Inhibits CYP3A4: resveratrol inhibits hepatic CYP3A4 · can increase concentration of many drugs metabolized by this pathway (statins, cyclosporine, calcium-channel blockers). Consult interactions with pharmacist.
  • Estrogen-dependent cancer: resveratrol has mild phytoestrogenic activity · mixed evidence in estrogen-positive breast/uterine cancer. Consult oncology if hormone-dependent cancer history.
  • Scheduled surgery: discontinue 7-14 days before due to anti-platelet effect. Restart 48h post-operative without active bleeding.
  • Pregnancy and lactation: limited data · avoid as precaution. Dietary intake (wine, grapes) already covers what pregnant needs.
−0.5%
HbA1c in type 2 diabetics with 100-1,500 mg/day resveratrol · effect clinically comparable to low-dose metformin.
Source · Marx · Br J Clin Pharmacol 2018
x.

Frequently asked questions about resveratrol

8 real questions · scientific literature-based answers (including NIA negative trial).

Does it really extend lifespan?
Limited human evidence. NIA ITP (Strong 2013) showed resveratrol did NOT extend median lifespan in male mice · contradicts earlier studies. METABOLIC human effects (Timmers, Marx) are well established · human LONGEVITY effect remains extrapolation. Honest: take for cardio-metabolic, don't expect living to 120.
How much red wine equals?
A glass (150 mL) has 0.5-2 mg trans-resveratrol. To reach therapeutic 250 mg dose you'd need ~125 liters wine · impossible and hepatic damage. Supplementing is the only feasible way.
Why does trans- vs cis- matter?
Trans-isomer is the active SIRT1 form · cis-isomer is practically inactive. Cheap products may have 60% trans 40% cis mix. Verify HPLC 99% trans in COA. UV light converts trans → cis · brand must use opaque packaging.
Does it cause facial flushing?
Yes · resveratrol activates GPR109A receptors in skin similar to niacin · can cause facial flushing first 1-2 weeks. Tolerable · attenuates over time. Taking with fatty meal reduces intensity.
Better morning or evening?
Morning with fatty breakfast. SIRT1 has nocturnal activity peak · morning resveratrol maintains elevated activation all day. Taking before sleep may activate SIRT1 when already physiologically high.
Is pterostilbene alone sufficient?
Pt has better PK but less human RCT data than resveratrol. R+Pt combo is most pro: R provides data + Pt provides half-life. If budget tight, R alone with 2 daily doses is valid alternative.
Does it interfere with chemotherapy?
Yes · may interfere. Resveratrol modulates CYP3A4 + apoptosis · may attenuate effect of CYP3A4-dependent chemo or synergize (case-dependent). DO NOT supplement during active oncological treatment without consulting.
Is it safe long-term?
Up to 2 years human RCT evidence zero safety red flags. >2 years unknown. Most legitimate concern is CYP3A4 interaction if taking multiple drugs · review with pharmacist periodically.
xii.

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