Longevity protocols: what the evidence actually supports.

What "biological age" actually measures

Biological age is the degree to which your body's systems have accumulated wear, independent of how many birthdays you've had. It's estimated by lab-based or epigenetic algorithms.

The most accessible and validated formula is Levine Phenotypic Age (PhenoAge), which uses 9 standard markers from a basic blood panel: albumin, creatinine, glucose, CRP, lymphocyte percentage, MCV, RDW, alkaline phosphatase, and white blood cell count. Phenotypic age higher than chronological age predicts increased all-cause mortality and disease risk.

Use the biological age calculator to compute yours from existing lab work.

NAD+: the coenzyme that drives cellular energy

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme required for cellular energy production, DNA repair, and sirtuin enzyme activity. Intracellular NAD+ levels decline roughly 50% by age 50, directly linked to mitochondrial decline, sirtuin dysfunction, and many of the cellular signatures of aging.

Restoring NAD+ via subcutaneous injection bypasses the gut metabolism that limits oral NMN/NR precursors. Subcutaneous NAD+ produces measurable elevations in cellular NAD+ levels and downstream improvements in mitochondrial respiration, energy, and recovery.

Sleep, autophagy, mTOR, and the metabolic levers

Sleep is the single most underrated longevity lever. 7-9 hours of quality sleep per night supports growth hormone secretion, glymphatic clearance, glucose tolerance, and cardiovascular health, every system relevant to aging benefits.

Time-restricted eating (16-hour overnight fasts, 8-hour eating window) supports autophagy, the cellular process that clears damaged organelles. mTOR pathway activation drives growth and synthesis but suppresses autophagy; AMPK pathway activation does the opposite. Pulsing between the two states (training-induced AMPK, post-meal mTOR) is the metabolic rhythm humans evolved with.

Hormones, weight, and longevity converge after 35

The longevity benefits of hormone optimization (TRT, enclomiphene where indicated) and of GLP-1-driven weight loss (where overweight/obese) are both substantial. The 2024 longevity case for losing 20% of body weight if obese: cardiovascular event reduction, diabetes remission, sleep apnea improvement, all-cause mortality reduction.

The longevity case for optimizing testosterone in symptomatic low-T men: muscle preservation, bone density, metabolic health, cognitive function. None of these are silver bullets, they're multipliers on top of the foundation (sleep, training, protein, hydration).

How to build your longevity protocol

Start by measuring. Use the biological age calculator with current lab data, the testosterone calculator for hormone status, and the BMI + body fat calculators for body composition. The Find My Protocol quiz synthesizes your inputs into a personalized plan.

The strongest single intervention with the broadest evidence: maintain healthy body weight + train (resistance and cardio) + sleep adequately. Layer NAD+, hormone optimization, and other protocols where labs indicate.