Regenerative medicine is expanding rapidly, but the language used to describe many interventions increasingly exceeds the strength of the evidence. This lecture introduces Biological Honesty as a framework for separating established regenerative science from biological plausibility, commercial extrapolation and inadequately regulated clinical practice.

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Particular attention is given to the growth of intravenous regenerative and longevity therapies, including IV NAD⁺, IV exosomes, stem-cell-derived products, secretome preparations and peptide infusions. These interventions are frequently promoted as enhancing cellular repair, mitochondrial function, ageing biology or systemic regeneration, despite major differences in the quality of supporting human evidence.

NAD⁺ is a useful example.

 

Its importance in cellular redox biology, mitochondrial function and sirtuin-related pathways is well established, and age-associated changes in NAD metabolism are biologically credible. However, this does not automatically establish that intravenous NAD⁺ produces clinically meaningful anti-ageing, regenerative or longevity outcomes in humans. Pharmacological plausibility, transient biochemical change and therapeutic efficacy must be treated as separate questions.

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The same principle applies to IV exosomes and secretome-derived products, where questions remain regarding product characterisation, manufacturing consistency, biodistribution, dosing, safety and clinically relevant human endpoints.

The lecture also examines the rapid expansion of unregulated or loosely regulated peptide therapies, many promoted for tissue repair, inflammation, cognition, metabolism, muscle preservation and longevity. Some peptides have legitimate mechanistic interest, but biological plausibility should not be confused with established clinical efficacy, particularly when products are compounded, non-approved or marketed outside robust regulatory frameworks.

A central theme is the distinction between biostimulation, molecular signalling and true regeneration. Changes in cytokines, extracellular vesicles, gene expression, inflammatory biomarkers or metabolic pathways do not by themselves demonstrate restoration of tissue architecture, function or durable clinical benefit.