Hey Doc,

In this issue 104, I mapped the systems a physician founder needs to build, launch, and scale a longevity clinic. It became the Longevity Clinic Readiness Checklist - the practical guide I wish I had when I started.

As always, Happy Sunday.

Dr. David Luu, Founder, longevitydocs.™

One story a week for physicians moving into longevity medicine (part 3).

Longevity Clinic Readiness Checklist

Why we created this

Longevity medicine should be more than a menu of tests and therapies. It should be physician-led, grounded in evidence, transparent about uncertainty, measured by outcomes, and supported by systems that protect patients and clinical judgment. We created this checklist to help physicians and practice leaders identify what must be documented, implemented, and reviewed before launching or scaling a longevity medicine practice.

How to use it

Review the checklist with your leadership team. Tick an item only when it is documented, assigned to an owner, implemented in practice, and reviewed on a defined cadence. Keep evidence for each completed item, prioritize safety-critical gaps first, and turn the remainder into a dated action plan. Revisit it at launch, before adding services, after major changes, and at least annually.

Download the Longevity Clinic Readiness Checklist

Longevitydocs Clinic Readiness Checklist

1.04MB ∙ PDF file

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Download

Introducing the Longevity Medicine Lexicon

Longevity medicine is moving faster than anyone can build standards for it.

That is mostly good. More people care about their health. More physicians are moving into prevention. More researchers are studying aging. More companies are shipping products.

But the vocabulary has not kept up. The same term means three things depending on who is using it, and patients arrive with definitions they got from a social media post.

We need words everyone agrees on.

The Lexicon is our answer. A standardized definition for each concept, with the publications behind it, so you can check the evidence without a PhD and without fact-checking an influencer.

How the Lexicon works

1. Pick a concept and learn it with references.

Take DEXA Scan. Definition, how it works, how it is measured, what the levels mean, with a T-score table and a citation on every claim. Key takeaways at the bottom if you need it in thirty seconds.

2. Explore connected concepts.

Every concept sits in a map. DEXA connects to bone density, muscle mass, sarcopenia, visceral fat, osteoporosis. Follow the links or open the graph and see the whole field at once.

3. See what the LongevityDocs community says about it.

This is the part no textbook has. Under Community knowledge, you get what physicians in our network actually do with the concept in practice.

A Mastermind faculty debate on whether an AI read of a plain spine image can substitute for DEXA, and why FDA approval says no. A Hormones Mastermind participant asking why we wait until 65 to scan bone, by which point the damage is done.

Members can jump straight to the timestamp and watch it.

Open to everyone

The definitions and references are free. Anyone can read them. The community layer, the sessions, the timestamps, the full recordings, is for physicians members of longevitydocs.

Some concepts are already written. Others are referenced constantly and not yet covered. Those are on the frontier list, and they get written next.

If you are building a clinic, explore the Lexicon to standardize how your team uses clinical language.

Explore the Lexicon

ROOMS

The Heart-Gut-Brain Connection

September 2, 2026, 12.00pm ET• longevitydocs.ai

Dr. Sarah Cammarata, board-certified psychiatrist, will discuss The Heart-Gut-Brain Connection: Preventing Comorbidities and Boosting Mental Health.

Women’s Longevity Protocols

September 9, 2026, 12.00pm ET• longevitydocs.ai

Dr. Elizabeth Poynor, gynecologic oncologist and Chair of Women’s Health & Gynecology at Atria, will discuss the latest women’s longevity protocols.

MASTERMIND

Skin, Bone & Muscle

October 24, 2026 • New York City

Faculty:

Saranya Wyles, MD, PhD
Amanda Hill, MD
Naana Boakye, MD
Doris Day, MD
James Peyer, PhD
Dan Belkin, MD
Neely Kahn, MD
Catherine Johnson, MD
Kay Durairaj, MD
Elizabeth Yurth, MD

Secure your ticket

SUMMIT & AWARDS

CANNES 2027

June 9-11, 2027 • Cannes, France

Buy Digital Replay - Summit 2026

DIGITAL

MEDICAL EDUCATION

Browse Programs

Keto Outperforms Mediterranean and Low-Fat on Liver Fat: RCT

WashU randomized 42 patients with obesity, prediabetes, and fatty liver to keto, Mediterranean, or low-fat, fed them everything, and matched all three arms to roughly 10% weight loss. Keto cut liver fat 67% versus 45%, with no rise in lipids despite 73% of calories from fat. Prediabetes resolved in half the keto group, 29% Mediterranean, 7% low-fat. Cell Metabolism

For longevitydocs: same weight loss, different metabolic outcome. In a patient with steatosis and prediabetes, the carbohydrate restriction is doing work independent of the pounds. Worth holding onto as GLP-1s make the pounds the easy part.

Silent Atherosclerosis across Adult Life

Atherosclerosis may begin in early adulthood and remain clinically silent for decades before cardiovascular disease manifests. Although silent atherosclerosis is associated with cardiovascular events and death independent of traditional cardiovascular disease risk factors, its age- and sex-specific prevalence, vascular territory distribution, and plaque volume across adult life remain incompletely defined. NEJM

For longevitydocs: this is the evidence gap underneath every imaging decision you make in a 40-year-old. Risk calculators are built on events, not on the twenty silent years before them. Until the prevalence data exists, you are making a judgment call each time, and the honest version of that conversation says so.

Longevity Medicine Certification for Dermatologists

Our CLD learners told us they wanted to study alongside their own specialty. So we built one, starting with dermatology.

Dermatologists see skin aging every day. Patients come in for the surface and want the inside treated too. They ask about biomarkers, hormones, GLP-1s. This cohort teaches how to apply longevity medicine in a dermatology clinic, on the patients already in front of you.

Limited to physicians in dermatology, plastic surgery, and aesthetic medicine.. Applications close September 25.

Do You Qualify?

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

PHARMA

Mounjaro Approved for Cardiovascular Diseases

FDA approved tirzepatide on August 28 to reduce MACE in adults with type 2 diabetes at high risk. SURPASS-CVOT ran 13,299 patients across 30 countries for a median 210 weeks, head to head against dulaglutide rather than placebo. Result: non-inferior, 8% lower rate of CV death, heart attack or stroke, superiority not established.

POLICIES

“Intrinsic Capacity” in the NYT

The WHO's composite of what a person can actually do, scored across locomotion, cognition, sensory, psychological, and vitality. Grip strength and gait speed. It landed in ICD-11 in 2022, and ARPA-H is now funding work to test whether it tracks function and whether exercise or GLP-1s can move it.

WEARABLE

Abbott Adds Ketones to the Sensor

FDA authorized Libre Duo 10 Day on August 25, the first sensor tracking glucose and ketones together. Built for insulin users and patients on SGLT2s, where DKA develops with normal glucose and admissions are up 55% in a decade. The biowearable just picked up a second analyte, and it will not be the last.

MANUFACTURING

Celularity Manufactures Muse Cells

Robert Hariri built Celularity on placental-derived cell therapy. This week it started manufacturing someone else's platform: Dezawa MuseCells, MuseExosomes, and MuseSecretome, at its Florham Park site. The science is not the bottleneck anymore, cGMP capacity is. If you use exosome or secretome products, ask which facility made the vial and from what starting material.

Every doctor should be a longevity doctor

longevitydocs.™ is the research and education network for longevity medicine - 1,000+ physicians, 68 countries

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Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of longevitydocs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

longevitydocs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

Ten mistakes in the report below. I made most of them.

New tech and new protocols get the attention. There are a thousand posts a week on them. The hard work happening on the ground is less clickable. The sweat, the tears, the wins nobody sees. Foundations, reputation, team.

Part of why it stays quiet is that the conversation is hard. It takes humility, self-awareness, and a willingness to say what you got wrong with your name attached.

So I asked. Twenty-six doctors answered, in the open. I compiled it into a field report below. It is a work in progress, and that is the point. If we want a standard for longevity medicine, we have to put this out and let others build on it.

Our certification learners also told us they wanted to study alongside their own specialty. So we are opening the first CLD cohort for dermatologists. Just reply to this email if that is you.

As always, Happy Sunday.

Dr. David Luu, Founder, longevitydocs.™

PS. Built the technology. Built a complex product. Built a multi-offering. Built a place. Maybe I should not have. I learned from all of them. We were building something that did not exist yet. Happy to give back now. These are the photos from that time.

One story a week for physicians moving into longevity medicine (part 2).

Mistakes to Avoid When Building a Longevity Practice

A field report from 26 physicians.

What 26 physicians would do differently

Longevity medicine has a growing clinical literature and no operational one. Physicians opening practices have no published standards, no pricing benchmarks, no model comparisons, no software evaluations, and no account of what the first eighteen months actually cost.

So we collected one. Over the course of a week we put a series of questions to physicians in the member chat on longevitydocs.ai and let them answer each other in the open. Twenty-six responded on the record, from two months in practice to twenty-three years.

Ten mistakes came back often enough to treat as the operating reality of the field rather than one person’s bad luck. Insurance does not pay for this work. Most physicians underprice at launch. The payment model decides how you practice, not just how you get paid. Capital gets spent before demand exists. Service lines get added before any of them are good. Paid marketing loses to the physician’s own voice. Income tied to time caps the practice. Access given without terms is the most common boundary failure. No software does the job, so everyone runs workarounds. And systems get built only after something breaks.

One condition sits under all ten. Longevity medicine is an emerging field. Cardiology has had since 1949, when the American College of Cardiology was founded, to build its benchmarks and its guidelines. We are starting to build it for longevity medicine.

We know the medicine. We are still learning the business.

Published work in longevity medicine covers what to measure and what to prescribe. It says nothing about the conditions the medicine gets delivered in.

So every physician entering the field solves the same problems from scratch. What to charge. Whether to take insurance. Membership or fee for service. Which software. When to hire. Each one solves it alone, pays for the errors alone, and never finds out what anyone else learned.

Nobody has asked the people who know.

Community-sourced field report

Questions were posted in the member chat on longevitydocs.ai over the course of a week. Physicians answered in an open thread, visible to each other, and were told their answers would be quoted by name, with the option to stay unnamed.

Questions covered early mistakes, what they would build differently from zero, technology, and operations.

Twenty-six physicians contributed. Experience ranged from two months to twenty-three years. Settings included solo boutique, concierge, membership, hybrid fee for service, and pre-launch. Quotes are verbatim, trimmed only for length.

Ten mistakes, in the order they cost you money

Ten mistakes recurred across respondents.

1. Expecting insurance to pay for longevity testing

2. Underpricing at launch

3. Letting your payment model decide your medicine

4. Spending on space and equipment too early

5. Building every service line at once

6. Spending on paid marketing instead of your own voice

7. Tying your income to your time

8. Giving away your access without boundaries

9. Waiting for the perfect EMR

10. Waiting to build systems until you need them

1. Expecting insurance to pay for longevity testing

Steven Murphy named it as his first error in exactly those words. Every respondent who addressed insurance had made the same one.

Murphy rebuilt his around three moves: explain why the patient should pay for it, identify where insurance legitimately covers something based on a medical diagnosis, and make clear you will be a good steward of their spend. “That built a trusting Sherpa relationship where I could then navigate the ship for best labs at best prices.”

His constraint: “Don’t expect to be able to spend this much time with a patient and have insurance pay for your time.”

Jijoe Joseph found the more dangerous version, which is partial coverage.

“I got insurance wrong by assuming that ‘usually covered’ was good enough. About 1 in 8 patients could still get a surprise $4,000 to $5,000 bill.”

He negotiated pricing at roughly 80% off retail, then built his own panel and folded the cost into his plans so pricing was predictable upfront. Partial coverage is worse than none. It moves unpredictable risk onto the patient, and the surprise lands on your relationship.

Melissa Loseke has been cash pay since 2012 and is the only respondent looking the other way. She sees parts of this work drifting toward coverage and says the open question is “determining when to start utilizing insurance again.” She already uses insurance for prescriptions where she can.

2. Underpricing at launch

Near-universal. The regret is not the number. It is that the number is hard to change later.

Melissa Loseke: “I should have started pricing higher. Most of my colleagues would chastise me for how little I charge. And that’s harder to walk back now.”

Shah Ahmed, one year in, correcting it now: “I know I will lose people but I undervalued myself for a year.”

Jijoe Joseph, past it: “You’ll be surprised how many stay after the price increase.”

Steven Murphy offers the bridge for anyone who cannot wait on revenue. Price the practice where you intend to sustain it and fund the ramp elsewhere. He points to Medicare work in short term rehabs and SNFs, “where there is zero overhead.”

3. Letting your payment model decide your medicine

The most consequential finding came from a physician who changed her model to fix her medicine.

KeriLyn Bollmann spent twenty-three years with the underserved and underinsured before moving into longevity practice. On fee for service she says

“I was nervous to ask people to come back (and pay money), so instead I would see them, do some testing, give them some supplements, and then they would feel lost for next steps.” She moved to concierge to ensure “consistent follow up, so people felt like we were moving the needle.”

Fee for service made her reluctant to ask patients to return. That reluctance removed follow-up. Without follow-up, testing produces confusion instead of care. She changed the payment structure to restore the clinical loop.

Julie Doyle reports the same from the other side. Unlimited portal messaging, same-day replies.

“I would not have been able to offer this outside a membership structure... I’m never feeling like answering messages or responding to patient questions is uncompensated time.”

Jijoe Joseph gives the timeline. He ran both.

“Membership was slow for almost two years. Fee for service kept the lights on.” New patients are now membership only.

His planning note: “Whatever overhead you estimate, double it.”

4. Spending on space and equipment too early

Shah Ahmed lists renting space and buying equipment “thinking I would do so many things” among his first-year errors.

Steven Murphy on sequencing: “Make money first, assess patient needs and then buy one thing at a time.” He also names the pressure that produces bad capital decisions. A patient told him she loved him but got more at another practice. “That stung, but good business is not reacting to every sting with bad economic decisions.”

Shoma Datta-Thomas bought devices she did not need and says she should have hired admin help earlier. The equipment was the wrong purchase. The person was the right one.

Ahmed’s counterfactual is the cleanest alternative on record:

“If I could go back I would literally just open a PLLC, rent a desk somewhere, and do some light organic marketing and social content.”

5. Building every service line at once

Jijoe Joseph named this as his number one:

“Every vertical adds equipment, staff, training, marketing, and management complexities before demand is proven.”

Mark Dukshtein gives the number:

“Trying to add too many services at once instead of being really good at 2-3.”

Shoma Datta-Thomas found demand somewhere she had not planned for. She expected more GYN minor procedures. “Patients were begging for good hormone therapy.” Her rule is to iterate the menu on observed demand, fast.

Daniel Kessler applies the same logic to case selection:

“Start with something solvable that gets the patient results quickly. Do not start with the complex cases.”

Jonathan Stegall puts the boundary around who rather than what:

“Don’t try to be everything to everybody. Define your ideal patient avatar and go after them.”

6. Spending on paid marketing instead of your own voice

Melissa Loseke would cut all of it:

“Word of mouth and just doing a great job with patients is all you need.”

Shah Ahmed ran the comparison inside his own practice without intending to. He spent $20,000 on local ads. His social account reached 17,000 followers “despite zero formal strategy and completely erratic posts.” His conclusion:

“Now imagine if I took the 20k in local ads and put that into a real social team instead.”

Twenty thousand dollars of advertising underperformed inconsistent posting by the physician himself.

Jonathan Stegall states the principle:

“You don’t need perfect videos or perfect social media posts. The public wants your authenticity, not your perfection.”

7. Tying your income to your time

Jonathan Stegall: “Don’t tie your income to your time. Put systems in place early so that other people in your practice are doing the heavy lifting.”

Jijoe Joseph states the target:

“a business that can keep working even when the founder takes a step back.”

Shah Ahmed is inside the problem and says so. Compensation directly tied to time with patients. He is announcing memberships and building workflows an APP or nurse can run.

What he wishes he had: “a ‘business’ partner... someone to look over my shoulder and help me avoid silly mistakes.”

Ladi Ilkhani reduces it to three instructions: “Ask for help and take it. Delegate instead of trying to do it all myself. Billing consistently.”

Katie Rybak on the spending decision underneath:

“I wouldn’t be so afraid to spend the money on quality staff. They are everything to a successful practice.”

Haleem Mohammed:

“I wouldn’t do it alone. Easy way to burn out. I’d find a group of like minded killers with no ego who live and breathe medicine.”

8. Giving away your access without boundaries

Shah Ahmed identifies the asset: “People are paying to sit down and talk to me. The value is the physician.” Which makes the rest harder to explain. Ladi Ilkhani:

“I also would protect my ‘time,’ something I never thought we could put more value on. Shouldn’t have given out my cell so easily.”

Melissa Loseke changed her number over it.

“I changed numbers because of this. Most had little respect for my time or awareness.”

Sarah Lacarrubba would define roles, ownership, and accountability from day one:

“Set clearer boundaries and trust more slowly. In the beginning, I blurred the lines between being a boss, mentor, friend, and business partner, and I was too generous with trust, titles, and credit.”

9. Waiting for the perfect EMR

Lisa Menuet, opening a practice soon, asked the simplest question in the thread: does anyone have an EMR they love?

The answers describe a category that has not been built.

Haleem Mohammed says his most used app is not his EMR.

“Doximity Ask is probably the most used app in my entire phone... helps me organize my thoughts, create notes, my social post captions are fact checked on there and I use the dialer to do telehealth video visits.”

Tatiana Zeballos gave the most complete account. Solo boutique practice on SimplePractice, valued for one thing: app-based messaging that feels like texting, with “no emails directing patients to a portal, repeated logins, password resets, or other EPIC-like friction.” As she adds services she needs lab integrations, e-prescribing, wearables and high-risk merchant processing without losing that.

“Essentially, I’m looking for the unicorn: SimplePractice ease plus a more robust longevity-medicine EMR.”

She has tried Charm, Practice Better, OptiMantra and Elation. She is evaluating Ultralight Health and SigmaMD, with Ultralight the current front-runner.

Bismarck Cadet on Ultralight: “awesome and continues to improve.” Mohan Muvvala runs Hint Health core and clinical, and rates the marketplace integrations and the responsiveness of the team.

Steven Murphy names the system hardest to change later. “It’s really hard to switch EMRs.” Choose for patient communication and documentation from day one. Retention runs through it.

Salomé Masghati answered the question the way the market should find most interesting. Does she have an EMR she loves? “Yes, the one we created ourselves.”

Maloes Zadeh diagnoses why none of it resolves. What is missing is “a truly integrated longevity platform that brings together labs, imaging, wearables, lifestyle data and longitudinal trends and translates them into clinically meaningful, evidence based actions.” Measurement is solved.

“The real challenge is turning all that data into better clinical decisions rather than simply generating more dashboards.”

10. Waiting to build systems until you need them

Jijoe Joseph put it first on his list.

“Businesses last when they have repeatable processes, and revenue that doesn’t depend on the founder doing everything. The goal is building a business that can keep working even when the founder takes a step back.”

Jonathan Stegall on timing: put systems in place early

“so that other people in your practice are doing the heavy lifting.”

Shah Ahmed is building his now, retroactively: firmer systems for simple workflows “that an APP or nurse can follow for me.” What he wishes he had had is a business partner. “Someone to look over my shoulder and help me avoid silly mistakes.”

Shoma Datta-Thomas disagrees, and specifically. Her first lesson from running a boutique practice:

“NO consultants! They could never value every hard earned dollar I brought in myself the same way.”

Both are right about different people. A partner with skin in the game is not a consultant billing hours.

Janaan Arfeen, new to the field, asked the room the question this section exists to answer:

“I would appreciate if the leaders and pioneers in this field can share their wisdom and guide newbies in establishing systems.”

Ten mistakes, one cause

Most of the conversation in this field is about protocols. Which peptide, which panel, which AI tool, which automation. Useful, but small. None of it decides whether a practice survives.

The decisions that do are the ones in this report. What you charge. Whether you take insurance. Membership or fee for service. What you buy and when. Who you hire. What you delegate. A physician can have every protocol right and still close, because the strategic decisions were made blind.

And they are made blind. There are no benchmarks, so most price low and learn years later. There are no guidelines, so each physician invents the scope, the panel, the follow-up cadence. There is no infrastructure, so one wrote her own software and the rest run workarounds.

Some of that is writable and should be written. Fee ranges by model and market. What an EMR has to do. How long membership actually takes to gain traction.

The rest is not. Judgment, taste, and strategy do not compress into a benchmark. Knowing when to raise your price, when to say no to a patient, when to hire, when to stop adding services. That comes from experience, and from watching other physicians make the same calls and say out loud how they went.

Which is why a thread beat a study here. Shah Ahmed is correcting his pricing in public while Jijoe Joseph, who has already done it, tells him more patients stay than he expects. That exchange is not data. It is judgment being transferred, and it is the only way this kind of knowledge moves.

“Money is the least of it. I just want to be BETTER. More efficient. More high value for my patients.” Shah Ahmed

Limitations

Respondents were self-selected members of a single professional community and are not a random sample of physicians practicing longevity medicine. The sample skews toward United States practice mainly and toward solo and small-group settings. Responses were given in an open thread where participants could read each other, introducing possible convergence. All figures are self-reported and unverified.

This is not survey data and should not be cited as such. It is the collected operational experience of practicing physicians, which is a different thing and, for a physician about to open, a more useful one.

What this field still has to build

This field is early. Nobody in this report had a map when they opened, and it shows in what they got wrong.

What closes the gap is not more protocol content. It is benchmarks, so a physician knows what to charge without guessing for two years. It is systems, so the first eighteen months are inherited instead of reconstructed. It is technology built for this work rather than borrowed from another specialty. And it is continuous learning between physicians, because judgment and strategy do not come from a document. They come from watching a colleague make the call and say how it went.

That last part is the one we can do immediately, and it is what this report is. Twenty-six physicians answered a question in the open so the next physician does not pay for the same lesson alone.

Next week: The Ecosystem Checklist

Thank you to the longevitydocs members who answered in the app

Shah Ahmed, Janaan Arfeen, Katy Bernstein, KeriLyn Bollmann, Bismarck Cadet, Shoma Datta-Thomas, Brenda Dintiman, Julie Doyle, Mark Dukshtein, Ladi Ilkhani, Jijoe Joseph, Daniel Kessler, Sarah Lacarrubba, Melissa Loseke, Salomé Masghati, Lisa Menuet, Haleem Mohammed, Steven Murphy, Mohan Muvvala, Jontel Pierce, Laura Preece, Katie Rybak, Jonathan Stegall, Christine Watson, Maloes Zadeh, Tatiana Zeballos.

This conversation happened inside the network. The next one will too. Physicians only, applications reviewed.

Join the Network

This report describes the experience of individual physicians. It is not legal, financial, or medical advice, and nothing here should be taken as guidance on billing, coding, or corporate structure in your jurisdiction.

Go deeper on one concept every week from the LongevityDocs Lexicon. Longevitydocs Lexicon

Red Light Therapy

Definition

Red light therapy, more formally photobiomodulation (PBM) and previously known as low-level laser therapy, is a noninvasive form of phototherapy that uses wavelengths in the red light (620-700 nm) portion of the visible spectrum and the near-infrared (700-1440 nm) spectrum. ^[1] It is often administered through low-level lasers or light-emitting diodes and is applied to a range of dermatologic and nondermatologic conditions. ^[1] The field, sometimes known as photobiomodulation, has broadened over time to include light-emitting diodes and other light sources beyond lasers, spanning many wavelengths in the red and near infrared. ^[2]

How it works

Photons from red and near-infrared light are absorbed by endogenous photoreceptors including mitochondrial cytochrome c oxidase, whose activation modulates ATP production, generates reactive oxygen species, and alters intracellular calcium levels. ^[1] Red to near-infrared light can stimulate complex IV of the mitochondrial respiratory chain (cytochrome c oxidase) and increase ATP synthesis, with light absorption by ion channels releasing calcium and activating transcription factors and gene expression. ^[3] It is hypothesized that inhibitory nitric oxide can be dissociated from cytochrome c oxidase, thereby restoring electron transport and increasing mitochondrial membrane potential. ^[4] The modulation of ATP, reactive oxygen species, and calcium promotes activation of signaling pathways that contribute to downstream effects on cellular proliferation, migration, and differentiation. ^[1]

Evidence & status

An evidence-based consensus of an international multidisciplinary panel concluded that photobiomodulation is a safe treatment modality for adult patients and that red light PBM does not induce DNA damage. ^[5] The same consensus judged PBM an effective treatment option for peripheral neuropathy, androgenic alopecia, wound ulcers of multiple etiologies, decubitus ulcers, pain from diabetic foot ulcers, and acute radiation dermatitis. ^[5] A systematic review and meta-analysis of 22 randomized placebo-controlled trials with 1063 participants found that low-level laser therapy significantly reduced pain and disability in knee osteoarthritis, with no adverse events reported. ^[6] A separate systematic review and meta-analysis of randomized controlled trials found that low-level laser therapy significantly reduces pain and disability in lower-extremity tendinopathy and plantar fasciitis in the short and medium term, though long-term data were not available. ^[7] There is a considerable body of evidence supporting the efficacy of PBM for preventing oral mucositis in patients undergoing radiation therapy for head and neck cancer, chemotherapy, or hematopoietic stem cell transplantation. ^[8] In a meta-meta-analysis of myopia control strategies, repeated low-level red-light therapy demonstrated clinically significant effects on slowing both axial length elongation and spherical equivalent refraction progression. ^[9]

Why it matters

PBM is generally well-tolerated and safe, with erythema being the most common and self-limiting adverse cutaneous effect. ^[1] More than 50 years after its discovery there is still no agreement on the parameters and protocols for clinical application, and the wide range of applicable parameters has in some cases led to contradictory results. ^[10] Effective therapy depends on treatment parameters such as fluence, treatment duration, and output power, and cells or tissues with higher numbers of mitochondria tend to respond to lower doses of light than those with fewer mitochondria. ^{[1] [10]}

Community knowledge

Brain Applications

Dr. Neil Paulvin includes red light in his brain-optimization stacks, favoring red light helmets while noting that the more effective devices are costly and typically require at least a three-day-a-week commitment, whether used at home or in-office, and pairing them with more portable options such as mini red lights for travel ^A.

Skin And Hair Applications

Dr. Amanda Hill has found red light caps such as Revian to be a helpful adjunct in androgenic alopecia, explaining that they increase nitric oxide, which locally reduces the conversion of testosterone to DHT through reduced 5-alpha reductase activity without side effects, and likely also help via their anti-inflammatory effect ^B.

Dr. Saranya Wyles acknowledged some utility for at-home red light, microcurrent, and RF devices but stressed that consistency of use, daily versus twice weekly, drives the difference in results, and that sunscreen remains the single strongest skin-longevity intervention on the market ^C. At the Cannes Summit 2025, the Skin, the Next Longevity Frontier talk introduced Cell Bioprint, a five-minute proteomic diagnostic that estimates skin biological age and predicts future skin concerns, offering a complementary way to track outcomes from interventions such as red light therapy ^H.

Mechanism

Dr. Giovanni Campanile described photobiomodulation, that is, red light therapy, as affecting mitochondria throughout the body even when applied peripherally, and recommends pairing a red light panel with regular sauna use ^D.

References

Rooms

A. My Brain Longevity Stack to Type A Patients: Dr. Neil Paulvin

B. ROOMS: Dr. Amanda Hill : The hair loss protocol, how to prevent and reserve hair loss

Summit

E. Peptides from Research to Practice — Dr. Craig Koniver

F. Gene Therapy Demystified — Dr. Patrick Sewell

G. Cellular Optimization: Is It the Future of Medicine? — Dr Elizabeth Yurth

H. Skin, the Next Longevity Frontier — Vania LaCascade

Mastermind

C. The SkinSpan Stack — Dr. Saranya Wyles

Faculty Lectures

D. Unlocking Secrets of Heart Health — Dr. Giovanni Campanile

1. 1.Maghfour J, Ozog DM, Mineroff J, Jagdeo J, Kohli I, Lim HW. Photobiomodulation CME part I: Overview and mechanism of action. J Am Acad Dermatol · 2024

2. 2.Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR. The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng · 2012

3. 3.Salehpour F, Mahmoudi J, Kamari F, Sadigh-Eteghad S, Rasta SH, Hamblin MR. Brain Photobiomodulation Therapy: a Narrative Review. Mol Neurobiol · 2018

4. 4.Hamblin MR. Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation. Photochem Photobiol · 2018

5. 5.Maghfour J, Mineroff J, Ozog DM, Jagdeo J, Lim HW, Kohli I, Anderson R, Kelly KM. Evidence-based consensus on the clinical application of photobiomodulation. J Am Acad Dermatol · 2025

6. 6.Stausholm MB, Naterstad IF, Joensen J, Lopes-Martins RÁB, Sæbø H, Lund H, Fersum KV, Bjordal JM. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open · 2019

7. 7.Naterstad IF, Joensen J, Bjordal JM, Couppé C, Lopes-Martins RAB, Stausholm MB. Efficacy of low-level laser therapy in patients with lower extremity tendinopathy or plantar fasciitis: systematic review and meta-analysis of randomised controlled trials. BMJ Open · 2022

8. 8.Robijns J, Nair RG, Lodewijckx J, Arany P, Barasch A, Bjordal JM, Bossi P, Chilles A. Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022. Front Oncol · 2022

9. 9.Zaabaar E, Asiamah R, Kyei S, Ankamah S. Myopia control strategies: A systematic review and meta-meta-analysis. Ophthalmic Physiol Opt · 2025

10. 10.Zein R, Selting W, Hamblin MR. Review of light parameters and photobiomodulation efficacy: dive into complexity. J Biomed Opt · 2018

Longevity Medicine Certification for Dermatologists

Our CLD learners told us they wanted to study alongside their own specialty. So we built one, starting with dermatology.

Dermatologists see skin aging every day. Patients come in for the surface and want the inside treated too. They ask about biomarkers, hormones, GLP-1s. This cohort teaches how to apply longevity medicine in a dermatology clinic, on the patients already in front of you.

Board-certified dermatologists only. Applications close September 15.

Do You Qualify?

Mastermind: Skin, Bone & Muscle

October 24, 2026 • New York City

Faculty: Amanda Hill, MD - James Peyer, PhD - Saranya Wyles, MD, PhD, - Elizabeth Yurth, MD and more.

Secure your ticket

Biological clocks validated as trial endpoints, reshaping longevity drug development

A Nature Medicine study shows epigenetic aging clocks are sensitive enough to detect biological responses to longevity interventions in living humans within trial-feasible timeframes, not just stratify risk in observational cohorts. That distinction matters for regulators and trial designers who’ve debated whether biological age metrics can substitute for hard endpoints like mortality or disease incidence, this closes the evidence gap needed for accelerated approval pathways in aging medicine. Nature Medicine

Semaglutide’s cardiovascular benefit may run partly through inflammation, SELECT sub-study finds

A pre-specified secondary analysis of the SELECT trial found semaglutide cut hsCRP by 37.8% over 104 weeks versus placebo in patients with cardiovascular disease and obesity but not diabetes. Patients with baseline hsCRP ≥10 mg/L had 2 to 4 times the risk of major cardiovascular events, cardiovascular death and all-cause death versus those under 2 mg/L. The hsCRP drop showed up within 4 to 8 weeks, before major weight loss and even in patients who lost none, and modeling suggests reduced inflammation accounts for roughly a third of semaglutide’s cardiovascular event reduction. Circulation

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

PHARMA

A Cancer Vaccine Worked For Melanoma

Merck and Moderna’s mRNA vaccine hit in Phase 3. Intismeran plus Keytruda kept melanoma from returning and delayed spread to other sites. No numbers yet, it came out as a press release. The magnitude we do have is from June: a smaller five-year study where the combination cut recurrence or metastasis by 49% against Keytruda alone.

The vaccine encodes up to 34 mutations from the patient’s own tumor. Melanoma is the easy case, loaded with mutations, so the immune system finds it. Lung, bladder and kidney trials are running. That is where we learn whether this is a melanoma result or a cancer result.

TECH

Whoop Expands Labs to Non-Members

Whoop announced it is making Advanced Labs available without a membership for the first time, and adding Grail’s Galleri multi-cancer early detection test to the offering. Whoop will hold your daily biometrics and your bloodwork under one app. They already do video visits and pull your records. Prescriptions come next?

WEARABLE

Happy Sleep Raises $75m for Sleep Apnea

Happy Sleep raised a $75 million Series A led by ARCH Venture Partners and OpenLoop to build out its AI-powered home care platform. The company’s FDA-cleared Happy Ring is the first smart ring approved for multi-night sleep testing, diagnosing obstructive sleep apnea and insomnia in as few as three nights at 98% accuracy. Nearly 80% of Americans with sleep apnea remain undiagnosed.

HEALTHCARE

Bone Health Is The Next Big Category

Cardiovascular had its decade. Then metabolic. Then hormones and sleep. Bone is next, and prevalence has nothing to do with it. More than 60 million US adults over 50 have osteoporosis or osteopenia. Most are never diagnosed. What changed is that patients are starting to ask. Medcity

AI

Network Bio is Building a General Medical Intelligence

Network Bio is training AI models on biological data broad enough to work across diseases rather than one at a time. The pitch is a single model that can answer quantitative questions about any condition: detect it earlier, find the biomarkers, point at a more personalized therapy.

Every doctor should be a longevity doctor

longevitydocs.™ is the vetted network of longevity doctors - 1,000+ doctors. 68 countries.

Apply to Join

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of longevitydocs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

longevitydocs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

Issue 102. I started watching Best Medicine on Netflix yesterday - don’t judge please. A heart surgeon leaves Boston for a village practice. He was used to treating the organ, fixing the patient, next. Now he sees his impact on the community he just moved into, good and bad.

What I like about Dr. Best is the relentlessness. The pursuit of the diagnosis, the appetite for investigation, the complete indifference to what anyone thinks of him, and the coldness with which he educates - he could be a bit warmer though. Watch his personality shift across the episodes. I recognized something. I did the same thing for years. Fix the heart, not the health.

That is what this week’s cover story is about. Why more doctors are moving into longevity medicine.

And no, this is not an invitation to binge Netflix!

As always, Happy Sunday.

Dr. David Luu, Founder, longevitydocs.™

Go deeper on one concept every week from the LongevityDocs Lexicon.

Lipoprotein(a)

Also known as Lp(a), Lpa, apo(a)

Definition

Lipoprotein(a) [Lp(a)] is an apoB100-containing lipoprotein whose two major protein components are apoB100 and apolipoprotein(a), and high levels are an independent and causal risk factor for atherosclerotic cardiovascular disease. ^[1] Lp(a) is predominantly a monogenic (genetically determined) cardiovascular risk determinant, with roughly 70% to 90% of the interindividual variation in levels being genetically determined. ^[1] High Lp(a) concentrations are present in about 10% to 20% of the population and, on a genetic basis, affect an estimated more than one billion individuals worldwide. ^[2]

How it works

High Lp(a) drives atherosclerotic cardiovascular disease through mechanisms associated with increased atherogenesis, inflammation, and thrombosis. ^[1] Epidemiologic and genetic studies involving hundreds of thousands of individuals strongly support a causal and continuous association between Lp(a) concentration and cardiovascular outcomes across different ethnicities, and elevated Lp(a) remains a risk factor even at very low levels of LDL cholesterol. ^[3] Lp(a) has pro-inflammatory and pro-atherosclerotic properties that may partly relate to the oxidized phospholipids it carries, and high Lp(a) is associated with both microcalcification and macrocalcification of the aortic valve. ^[3] Effect sizes are most pronounced for myocardial infarction, peripheral arterial disease, and aortic valve stenosis, where high Lp(a) concentrations predict roughly 2- to 3-fold increases in risk. ^[2]

Connected concepts

How it’s measured

Lp(a) measurement should be performed using well-validated assays with traceability to a recognized calibrator so that common cut-offs for high concentrations and risk assessment can be applied. ^[2] A recognized limitation is that the field still lacks full standardization and harmonization of assays and universal guidelines for diagnosis and risk assessment. ^[1] Multiple cardiovascular societies now recommend measuring Lp(a) concentration at least once in all adults, with cascade testing having potential value in familial hypercholesterolaemia or with a family or personal history of very high Lp(a) or premature ASCVD. ^{[3] [4]} European consensus recommendations note that Lipoprotein(a) cholesterol is contained within the LDL cholesterol reported on the standard Lipid Panel, and advise estimating it in all patients at risk of atherosclerotic cardiovascular disease ^[5]

What levels mean / management

In a participant-level meta-analysis of statin-treated individuals, those with an Lp(a) level above 50 mg/dL (about 125 nmol/L) had increased ASCVD risk across all quartiles of achieved LDL-C, confirming Lp(a) as a risk driver independent of LDL-C control. ^[6] Because no Lp(a)-specific lowering therapy is yet approved for outcome reduction, current guidance is early, intensive management of all other modifiable cardiovascular risk factors in people with elevated Lp(a). ^[3] Statins do not reduce Lipoprotein(a) and instead tend to increase its levels, an effect proposed to contribute to the residual cardiovascular risk observed in statin outcome trials and clinical practice ^[7] In primary prevention, elevated Lipoprotein(a) acts as a risk-enhancing factor that refines calculator-based cardiovascular risk estimates, complemented by subclinical atherosclerosis testing with Coronary Artery Calcium scoring to guide preventive therapy decisions ^[8]

Community knowledge

Lipoprotein(a), or Lp(a), is a genetically determined, LDL-like particle with pro-inflammatory and prothrombotic properties that carries substantial atherosclerotic, thrombotic, and aortic-stenosis risk.

Dr. Giovanni Campanile has described Lp(a) as a silent, largely genetically fixed risk factor for which no direct therapy is yet approved, recommending once-in-a-lifetime measurement and cascade testing of first-degree relatives, and noting that high-dose statins can paradoxically raise Lp(a) while PCSK9 inhibitors and apheresis lower it ^a; he has also emphasized the ApoB/ApoA1 ratio as a highly predictive treatment target ^d

Dr. Jessica Shepherd, Dr. Saranya Wyles, Dr. Giovanni Campanile, and Dr. Elizabeth Poynor jointly noted that Lp(a) is not perfectly constant and can rise with inflammatory states, remaining a several-fold stronger risk factor than LDL when elevated at any point in life ^c.

Dr. Simar Randhawa has echoed the guidance to consider trending Lp(a) over time and to lower ApoB and the ApoB/ApoA1 ratio when direct Lp(a) reduction is not yet available ^b.

The Longevitydocs community have noted that dedicated Lp(a)-lowering agents are anticipated and may become options for high-risk patients.

References

Rooms

a. How should we treat high Lp(a)? with Dr. Giovanni Campanile

b. Dr. Simar Randhawa

Summit

c. Women’s Longevity 360, Dr. Jessica Shepherd, Dr. Saranya Wyles, Dr. Giovanni Campanile, and Dr. Elizabeth Poynor

Faculty Lectures

d. Unlocking Secrets of Heart Health, Dr. Giovanni Campanile

Peer-Reviewed Publications

1.Reyes-Soffer G, Ginsberg HN, Berglund L, Duell PB, Heffron SP, Kamstrup PR, Lloyd-Jones DM, Marcovina SM. Lipoprotein(a): A Genetically Determined, Causal, and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease: A Scientific Statement From the American Heart Association. Arterioscler Thromb Vasc Biol · 2022

2.Kamstrup PR. Lipoprotein(a) and Cardiovascular Disease. Clin Chem · 2021

3.Kronenberg F, Mora S, Stroes ESG, Ference BA, Arsenault BJ, Berglund L, Dweck MR, Koschinsky M. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J · 2022

4.Anchouche K, Baass A, Thanassoulis G. Lp(a): A Clinical Review. Clin Biochem · 2025

5.Nordestgaard BG, Langlois MR, Langsted A, Chapman MJ, Aakre KM, Baum H, Borén J, Bruckert E, Catapano A, Cobbaert C, Collinson P, Descamps OS, Duff CJ, von Eckardstein A, Hammerer-Lercher A, Kamstrup PR, Kolovou G, Kronenberg F, Mora S, Pulkki K, Remaley AT, Rifai N, Ros E, Stankovic S, Stavljenic-Rukavina A, Sypniewska G, Watts GF, Wiklund O, Laitinen P. Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM. Atherosclerosis · 2020

6.Bhatia HS, Wandel S, Willeit P, Lesogor A, Bailey K, Ridker PM, Nestel P, Simes J. Independence of Lipoprotein(a) and Low-Density Lipoprotein Cholesterol-Mediated Cardiovascular Risk: A Participant-Level Meta-Analysis. Circulation · 2025

7.Tsimikas S. A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies. J Am Coll Cardiol · 2017

8.Goldsborough E, Osuji N, Blaha MJ. Assessment of Cardiovascular Disease Risk: A 2022 Update. Endocrinol Metab Clin North Am · 2022

9.Boffa MB, Koschinsky ML. Lipoprotein(a) and cardiovascular disease. Biochem J · 2024

10.Xu R, Wang Z, Dong J, Yu M, Zhou Y. Lipoprotein(a) and panvascular disease. Lipids Health Dis · 2025

New feature: Audio courses are live in the CLD

You asked. We built it. Every unit now has an audio version.

Courses used to need a free weekend, or a cold conference room in a suburban hotel. Now all you need is headphones. Hit play and the lecture runs while you drive, train, cook, or pretend to listen to family reunion. Adjust the speed and get through it faster.

Open School in the app, try the audio, and tell us what you think of the voice we picked.

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

Why More Doctors Are Moving Into Longevity Medicine. Part 1/4

Over the next four weeks I am writing one story a week for the physicians thinking about this move. Why doctors are making it. How to actually start a practice. The ecosystem you have to build around it. And what the work looks like in practice. Then on September 13, something opens.

Imagine thirteen minutes to work out what is wrong with your patient, order the tests, interpret them, prescribe, educate, and feel like you practiced medicine. You cannot.

So the visit ends, the patient leaves with the prescription he came in for, and goes looking for the real answer somewhere else. Another doctor, a med spa, a chatbot.

Probably not what you signed up for after ten years of training. You know exactly what I am talking about.

Nearly half our Certified Longevitydocs, across 29 countries, come from primary care, emergency medicine and internal medicine. That surprises people who assume this is a boutique subspecialty for concierge doctors. It is not. The doctors building this field came from the frontline, and they left it wanting better care for their patients.

Ten reasons they give

1. Prevent disease instead of managing its complications
Treat the atherosclerosis, not the heart attack.

2. Spend time on medicine
Ninety minutes with a patient instead of ninety minutes on prior authorization.

3. Get paid for outcomes, not volume
Right now, seeing thirty patients badly pays more than seeing ten well.

4. Write protocols for the patient in front of you
Not wait for a committee, not inherit a pathway built for a population that is not yours.

5. Follow patients long enough to know the protocol worked
Watch the biomarkers improve instead of referring the patient and never finding out.

6. Answer what patients are already asking
When they ask about peptides, be the one who answers instead of the influencer.

7. Own the reputation
Patients come to you, not to the logo on the building.

8. Own the business
A panel of 150 at $5,000 instead of 2,000 patients you never really see.

9. Live what you prescribe
Stop advising people on sleep while running on five hours yourself.

10. Freedom.
Which is what the other nine add up to.

What nobody tells you

The first year is hard. You are building a business you were never trained to build. Pricing used to be done by the insurer. Now it is yours. So are the protocols, finding your first patients, choosing the technology, hiring the team. Nobody does this alone. That is what opens on September 13.

Next Sunday: Part 2/4 - How to actually start a longevity practice, including what the first year costs and earns.

Each week, I give you a sneak peek on topics discussed in our community.

The Retatrutide risks

Lilly sued six companies for selling unapproved retatrutide. Med spas, compounding pharmacies and online sellers, most shipping “research use only” product for human use. More than 200 additional entities were referred to FDA, DOJ, state attorneys general, law enforcement and professional licensing boards. Read that last one twice. Retatrutide is still Phase 3 with no approval anywhere, filing now expected in Q1 2027, and FDA said in June that it cannot lawfully be compounded. Lilly also asked payment processors and credit card companies to cut sellers off, so check your merchant terms this week. If retatrutide is in your practice, you are at risk.

Build your own lab panel

Cash-pay lab access came up hard this week, mostly out of New York where client billing is not permitted. Some physicians route patients through indigent pricing at Quest or Labcorp, up to 80 percent off. Know what that program is. It is reserved for patients with genuine financial hardship, the requisition has to say so, and it is not a pricing strategy for a cash-pay practice. The better answer came from members who stopped working around the big labs and built their own. A custom panel designed with a lab partner, roughly $400 all in, scheduled pickups, and the exact markers you actually need.

Join the Network

Sneak peek: the Skin, Bone and Muscle Mastermind

October 24, 2026 • New York City

Secure your ticket

Why skin, bone and muscle

It is the front door of longevity care. It is what the patient sees first, what brings them in, and what they use to judge whether any of this is working.

And it is a triad, not three separate problems. Bone and muscle fail together. Skin reports on what is happening in both. Manage them in isolation and you get exactly the results the field has been getting.

The medical community still underrates it. Cardiometabolic gets the seriousness, skin and musculoskeletal get filed under aesthetics, and the patient goes looking for answers somewhere other than a physician’s office.

That is the gap we are closing in one day.

Physician-led sessions. Every one sends you home with a protocol or a framework. Full program drops next week. Here is a sneak peek:

• Skin, Bone and Muscle. The clinical triad of healthy longevity.

• The Evidence. Where the science stands today, and where it is going.

• New Diagnostics. The biomarkers, AI and devices you can use in practice now.

• The GLP-1 Tax. Protecting skin, bone and muscle in patients already on the drug.

• The Regenerative Menu. Stem cells, peptides and photons, with a risk-tiered framework for each.

• Advanced Protocols. What to implement, and in whom.

• The Debate. Where the money is versus where the data is. Choosing a service line you can defend in five years.

Front-row access to the physicians pioneering skin, bone and muscle longevity. One day in New York City. Breakfast, lunch and a VIP dinner. Clinical protocols and scientific breakthroughs you can put to work Monday.

For physicians only. Limited to 150.

CLD Zoom in: one section of the Certified Longevitydocs program(CLD)

Beyond Statins

For patients requiring greater LDL reduction than statin monotherapy achieves — or in patients with statin intolerance — combination therapy with non-statin agents provides additive benefit:

Ezetimibe:

• Mechanism: Inhibits intestinal NPC1L1 cholesterol transporter; reduces dietary and biliary cholesterol absorption

• LDL-C reduction: Additional 15–20% when added to statin

• Cardiovascular outcome evidence: IMPROVE-IT trial demonstrated significant incremental MACE reduction when ezetimibe was added to statin in post-ACS patients — establishing the principle that LDL lowering beyond statin monotherapy provides additional cardiovascular benefit

PCSK9 Inhibitors (evolocumab, alirocumab):

• Mechanism: Monoclonal antibodies inhibiting PCSK9-mediated LDL receptor degradation; increase hepatic LDL receptor recycling

• LDL-C reduction: 50–60% reduction when added to maximally tolerated statin

• Cardiovascular outcome evidence: FOURIER (evolocumab) and ODYSSEY OUTCOMES (alirocumab) trials demonstrated significant MACE reduction; FOURIER notably showed progressive benefit with greater LDL lowering, supporting the “lower is better” principle down to very low LDL-C levels

• Vascular biology benefit: PCSK9 inhibitors may have direct anti-inflammatory and plaque-stabilizing effects beyond LDL reduction, currently an area of active investigation.

Unit 16 - Cardiovascular Longevity Medicine. Sections are reviewed and updated continuously as the evidence moves.

Become Longevity Fluent

The only longevity medicine curriculum built for physicians, by physicians.

Join the Certification Next Cohort

Histological aging signatures for monitoring tissue-specific aging and disease

Aging is the primary risk factor for chronic disease and is characterized by profound structural and architectural remodeling of human tissues. Here, we present a comprehensive assessment of these changes using 25,712 whole-slide histopathological images from 40 tissue types across 983 individuals in the Genotype-Tissue Expression cohort. By leveraging deep learning, we quantified nuanced morphological alterations to develop ‘tissue clocks’, predictors of biological age that reflect tissue structural integrity and physiological fitness. These clocks correlate with established aging markers, such as telomere attrition, subclinical pathologies and comorbidities. Nature

Exercise intensity modulates interorgan communication and is associated with cardiometabolic health outcomes in humans

We found that exercise intensity distinctly influenced the plasma proteome and metabolome in untrained and trained participants. By integrating multi-organ gene and protein expression datasets with in vitro and in vivo tissue sampling, we mapped regulated proteins to their predicted tissues of origin and destination. Muscle fibers and adipocytes were particularly sensitive to exercise intensity and observed to undergo broad secretory and transcriptomic changes. Cell Reports Medicine

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

CARE

Hims & Hers planning to sell compounded peptides

Hims & Hers Health is planning to sell compounded peptides, the company said in a Monday earnings call. The company’s CEO, Andrew Dudum, said in the earnings call that it was “currently developing a best-in-class peptides experience, including U.S. manufactured products, clinical-led guidance, and ongoing blood testing.” A public company announcing a compounded peptide line in the same week Lilly sued six peptide sellers is worth watching. The Hill

AI

Want concierge medicine? AI can deliver it

About 1 in 3 American adults have turned to a chatbot for health advice in the past year. Bots can sound like a concierge doctor. What AI does best is the underlying work: reading a patient’s health history, weighing symptoms and suggesting a treatment plan. AI is already in almost every pocket. It can transform healthcare with the record, the proof and the payment. Build them, and the forward-looking concierge care some have today could become available to anyone with a phone. WSJ

TECH

Google puts insulin resistance on the wrist

Google announced Health Guardian for Pixel Watch and Fitbit Air on Aug 12. Four features: insulin resistance trends (trained over a trillion minutes of data from 5 million opted-in users), estimated from multi-week physiological data with no blood draw. Blood pressure trends come from pulse and motion patterns with no cuff and no calibration. Sleep breathing quality tracks overnight, and breathing emergency detection can call emergency services on a critical oxygen drop. Google

PHARMA

The brain may be about to have its Ozempic moment

The Economist makes the case that orexins are the next GLP-1. FDA approved oveporexton on Aug 5, the first orexin agonist for narcolepsy, after a trial where patients stayed awake 12.5 to 25 minutes longer on the Maintenance of Wakefulness test and had roughly a third as many cataplexy attacks. Lilly bought Centessa in June for up to $7.8bn to get into the class. Morgan Stanley projects $16bn a year by 2035 from sleep disorders alone. The Economist

RESEARCH

XPRIZE Healthspan names 20 finalists

XPRIZE Healthspan named 20 finalists for the clinical phase of its $101 million competition, with ten teams taking $1 million each. Between 2026 and 2029 they run trials of up to one year in adults aged 50 to 90, aiming to restore muscle, cognitive and immune function lost to at least ten years of age-related decline, with 20 years as the stretch target. LongevityTechnology

The ten $1 million awardees:

• AgelessRx (US)

• Goda Lab, NanoTitan with University of Tokyo and Tokyo RELIFE Clinic (Japan)

• Johns Hopkins-Suninflam, Suninflam Inc with Johns Hopkins University (US)

• Longeveron, Inc (US)

• Minicircle Inc (US)

• Mitochondrial All Stars, Mighty Therapeutics with University of Washington (US)

• NYC-Vita, Mount Sinai Health System (US)

• RETRO-EPIGERNA, Macau University of Science and Technology (Macao SAR, China)

• RPRGAON-Progeria, PRG S&Tech (South Korea)

• TIME TRAVELER Plant-EVs (Japan)

SOCIETY

The $250,000 blood concierge

A non-physician concierge charging up to $250,000 a year to arrange unapproved therapies for wealthy clients. Peptides, stem cells, exosomes, infusions, delivered by private nurse with no baseline screening, no regulatory oversight and nobody accountable for outcomes. This is what fills the space when the field has no standard. Longevity medicine needs standardization and it needs to be judged on health outcomes, not on what a client can be sold. Vanity Fair

Every doctor should be a longevity doctor

longevitydocs.™ is the vetted network of longevity doctors - 1,200+ doctors. 68 countries.

Apply to Join

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of longevitydocs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

longevitydocs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

Issue 101. I am starting the next hundred with what we get wrong about longevity medicine.

Not exactly a summer newsletter… no 120 tips.

What I heard. This year I met physicians, scientists, entrepreneurs and patients across the world. Everyone is talking about longevity. The enthusiasts and the skeptics, in the same room, using the same word to mean different things.

What I saw. An explosion of products, services and clinics, from Italy to Shanghai. Almost no way to tell which ones actually work. And a growing number of people who no longer trust the science at all.

What I feel. Longevity medicine is being led by platforms, influencers, and physicians are being left behind. We have the knowledge. We are losing the authority.

And I am optimistic because this is the beginning of a new era, driven by people who decided that they will be in charge of their longevity.

As always, Happy Sunday.

Dr. David Luu, Founder, longevitydocs.™

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

What People Get Wrong About Longevity Medicine

Written for your patients. Feel free to forward it to them.

I have spent this year in a lot of different countries, different cities, different rooms. Same questions every time.

What does longevity actually mean? Where do I find a good doctor? What do you think about GLP-1s, Brian Johnson, Huberman, Sinclair, BPC-157, peptides, NAD? Who is the best doctor, the best clinic, the best test?

Longevity has gone mainstream. It does not matter where you are in the world or what you earn. Everyone is interested. Everyone is talking about it. It is the new status, and it is here to stay.

People come in through whatever door is closest to them. Beauty. Sleep. Wearables. Weight loss. Diet. A full-body MRI they saw on a podcast.

Then they get lost.

Ten things people get wrong, from the believers to the skeptics

1. Longevity means living forever. It does not. It means more years where your body still works, and you are enjoying your life.

2. Longevity is a panel of tests. Bloodwork, genomics, microbiome, full-body scan. Testing is not care. A result you cannot act on is a number, not a plan.

3. Longevity is diet, sleep and exercise. These matter enormously. They are the floor, not the ceiling.

4. Longevity is biohacking. Biohacking is n-of-1 with no control group and nobody accountable for the outcome.

5. Longevity is intervention. Peptides, hyperbaric chambers, sauna. Interventions are tools. Tools are not a strategy.

6. Longevity drugs already exist. They do not, not in the way people mean.

7. Longevity is genetics. Your genome loads the gun. It is not the only thing pulling the trigger.

8. The right stack will do it. No supplement combination has ever been shown to extend human lifespan.

9. AI knows better than my doctor. So I will order my own labs and find my own drugs online.

10. We are all going to die anyway, so let me enjoy my life. My grandfather smoked until 95 and he was fine. Maybe. You are not your grandfather, and survivorship bias is not a health plan.

The problem is not the evidence. It is the interpretation.

There is more longevity research published now than any physician can read. That is not the bottleneck. The bottleneck is who translates it.

Right now that job falls to media articles, influencer content, and scientific papers most people cannot parse. Self-appointed gurus. Brands explaining the thing they are selling. A few excellent physicians, drowned out.

One diet study in mice becomes a viral claim that protein is bad for you. Nobody reads the paper. Everybody shares the reel.

Meanwhile the people who actually know are in clinic or in the lab. Physicians and scientists are not trained to communicate at the speed the internet demands. So the loudest voice wins, and the loudest voice is usually selling something.

Longevity medicine is network intelligence

There is a deeper problem than bad information. Longevity medicine does not work as a list of facts.

ApoB does not sit by itself. It connects to the lipid panel, to PCSK9 inhibitors, to oxidized LDL, to cardiovascular risk, to atherosclerosis, and out from there to inflammation, to hs-CRP, to IL-6.

Search any one of those terms and you get an article about that term. That is not how the biology works, and it is not how a good physician thinks. Your doctor is not looking up a definition. She is holding a map.

That map is what patients have never had access to. We believe longevity should be a human right. Which means the education has to reach everyone.

Introducing the Lexicon

Lexicon is a living map of longevity medicine, built on published research and the experience of physicians who see patients.

Two ways in. Search a term and read the entry. Or open the graph and see how that term connects to everything around it, which is the part that actually teaches you something.

Every entry gives you the science, the publications, the clinical experience, the strength of the evidence, and where consensus exists versus where it honestly does not.

Every entry carries a community note from a verified physician. Not an influencer. Not a brand. A doctor with a license and patients.

The Lexicon is open to everyone.

Anyone can join the waitlist

Hundreds of topics are live, and we are building toward the most comprehensive map of longevity medicine there is.

We are opening the beta to a limited number of non-physicians before the Lexicon goes public. This group gets first access, and gets to tell us which topics we write next.

Reply to this newsletter, or email us at contact@longevitydocs.org, and tell us why you want in. What brought you to longevity. What you are trying to figure out.

We read every one. Numbers are capped, small enough that we can answer every one of you.

Each week, I summarize conversations from our community.

Mitochondrial Testing: Measure vs. Interpret

Two tests came up this week, and the thread ended up somewhere more useful than where it started.

A Doc raised GDF-15 as the marker he builds mitochondrial protocols around. The practical answers came fast. There is only one clinical lab running it, it costs around $250. The same lab is currently declining pTau-217 under age 50 because of how their LDT indication is written.

“GDF-15 is like a red alert if you use traditional levels. I adjust them down based on health and age. But that’s an art, not a study of 100,000 people with a statin.”

Another Doc raised the concern regarding organic acid testing

“I also do OAT testing, however, a colleague at another institution told me that commercial OAT testing are not ACMG approved for mitochondrial function, only for inborn errors of metabolism.”

Why it matters

If you order GDF-15, know the reference ranges were not built for the patient in front of you. Document why you moved the threshold. If you order OAT, check the lab’s certification before it changes a protocol.

Right now we can measure more than we can interpret.

A $450M round, and what it taught us about pricing

A large growth financing in consumer diagnostics set off a debate.

First question in the room: what is actually proprietary here beyond a brand and a subscriber list. The answer from members with visibility was recurring revenue and growth, heavy customer acquisition spend, and churn nobody (outside the cap table) can see. One member called it a CAC financing rather than a normal equity round, closer to venture debt during the zero-rate years.

The useful part came from three physicians who had changed their own pricing in the last month.

One raised membership 50% across the board and gave existing patients a discounted rate for the first year.

“No one freaked out. Of course there will be some churn but one needs to trim old branches for fresh growth.”

A second raised fees for legacy patients and was surprised by how little happened.

A third took a different route. He closed his panel, built a waitlist, hired a PA, and placed 42 of 50 waitlisted patients within two months.

Pricing, branding and positioning matter in longevity medicine

That company raised $450M on pricing, branding and positioning. Not on outcomes, not on a molecule, not on a proprietary assay. What got valued was their positioning, their growth, their ecosystem of services and their subscriber list. And they did it very well.

The same logic runs in your practice at a smaller scale. Three physicians raised prices this month and none of them lost the patients they feared losing, because what they sell is not a visit. It is judgment, access, and a relationship that took years to build. Price follows position, and most of us are positioned better than we are priced.

The one who closed his panel understood this best. Scarcity is a positioning decision. A waitlist is a brand asset.

If you have not touched your fees in two years, they are probably outdated. The market moves fast. Testing gets cheaper, more doctors enter, more services launch, and your own experience deepens. So how do you brand, position and price your services differently?

Sneak peek: the Skin, Bone and Muscle Mastermind

October 24, 2026 • New York City

Secure your ticket

Why skin, bone and muscle

It is the front door of longevity care. It is what the patient sees first, what brings them in, and what they use to judge whether any of this is working.

And it is a triad, not three separate problems. Bone and muscle fail together. Skin reports on what is happening in both. Manage them in isolation and you get exactly the results the field has been getting.

The medical community still underrates it. Cardiometabolic gets the seriousness, skin and musculoskeletal get filed under aesthetics, and the patient goes looking for answers somewhere other than a physician’s office.

That is the gap we are closing in one day.

Physician-led sessions. Every one sends you home with a protocol or a framework. Full program drops next week. Here is a sneak peek:

• Skin, Bone and Muscle. The clinical triad of healthy longevity.

• The Evidence. Where the science stands today, and where it is going.

• New Diagnostics. The biomarkers, AI and devices you can use in practice now.

• The GLP-1 Tax. Protecting skin, bone and muscle in patients already on the drug.

• The Regenerative Menu. Stem cells, peptides and photons, with a risk-tiered framework for each.

• Advanced Protocols. What to implement, and in whom.

• The Debate. Where the money is versus where the data is. Choosing a service line you can defend in five years.

Front-row access to the physicians pioneering skin, bone and muscle longevity. One day in New York City. Breakfast, lunch and a VIP dinner. Clinical protocols and scientific breakthroughs you can put to work Monday.

For physicians only. Limited to 150.

Tickets are open. Pricing increases next week.

Apply for Membership

From Colorectal Surgery to Women’s Metabolic Health: Dr. Mayoni Gooneratne’s Journey to Medicine

Dr. Mayoni Gooneratne spent years as a pelvic floor and colorectal surgeon in the UK before an inflection point sent her into what she calls her “wilderness years.” Today she’s Functional Medicine Doctor & Executive Medical Director at PHC (Personalized Health Clinics) in London, building a metabolic health practice for women, and a Certified longevitydocs.^™ CLD graduate.

Q: Take us back to the beginning. What first pulled you into medicine?

My mom gives this fantastic story of being 8 or 9 years old, and she just said I always wanted to be a studier and to help people. I think medicine is that incredible opportunity to do both. Both my parents are doctors, and they always strongly supported my journey into medicine without forcing the issue, but also very clearly identified when I was beginning to struggle within the structures I was working with in the UK.

As I entered medical school, all I wanted to do was to be a surgeon, and I completed my surgical training. I did a period of research as a fellowship towards a PhD during my surgical training, and that was when I first encountered the huge gap that women faced in healthcare, because I was looking specifically at control of the large bowel. That really meant, in clinical terms, helping women who had suffered with fecal incontinence for many years. That was when I discovered there was a huge underserving of these women. I was a young surgeon, I didn’t really think much more of it, but I remember clocking that. And then I completed my surgical training.

When I entered the end of that time, looking at my colleagues and my mentors who were also coming to the end of theris, I felt a very difficult moment, I realized it was a do or die point, a real inflection point in my training, and with a lot of support and a lot of counseling, I decided to leave.

My parents supported me in that decision, because they could see how difficult it was for me. It was not easy. I had my wilderness years, as I describe it. I had my children while I was recalibrating, and all women who’ve had children, and I think even women who have not had children, have these points in their career where they really have to reformat. I describe them as iOS updates.

I had my first update then, and just had to look around me and pivot, and I set up my first esthetics clinic as an opportunity to really financially grow at that point. But I very quickly discovered a group of women who were like me, who were tired, a bit broken, perimenopausal, balancing all the things, and needed support with lots of things. I put together this process of Skin Fit, Mind Fit, Body Fit, which then evolved over time as I added to my training. I’m a portfolio doctor, really, with multiple services I’ve collated to be of the highest service to the women who come to me, so that we’re offering this wraparound service. They’re not having to shop around, they’re not having to go to different providers either; it was me delivering that service, or a trusted group of clinicians and practitioners who would do that for them under my umbrella. Covid happened, and Human Health evolved out of that. And essentially now I’ve stepped out of that role to be the Functional Medicine Doctor and Executive Medical Director for PHC, where I’ve taken a lot of my learnings to help this incredible space.

Q: When did longevity medicine first land on your radar?

Like many people, both in the general public space and in the medical space, I’d been hearing this word for a while, and I think that was probably first about four years ago. I met David Luu and joined longevitydocs.^™ and at that point I was very much on the outside just looking in, curious, watching this space and looking up to these incredible peers and mentors who have gone before us for the last 20 odd years.

I think, much like functional medicine, you’ve got this incredible group of pioneers who are carving out a space, but what is the actual point of difference? I think about people like Dr. Yurth, who talks about sitting at the level of the cell, and my own passion for the mitochondria has grown over many years, because women fail to understand that connection between their cellular health and why they’re exhausted at 4pm. They’ve been on the go, they’ve woken up, they’ve not eaten; that is not fasting, by the way. They’re not fueling their bodies in the best possible way, and then they hit lunchtime, they grab a sandwich, they’re eating at their desk, and suddenly they’re crashing and burning.

But it’s also, I think, thriving medicine. One of my programs is called Thrive, because women have, somewhere along the way, forgotten that life is not just for existing. Having been that woman who’s worn all the hats, I think it’s important for women to know there is life after the perimenopause, but there’s also life at all the metabolic inflection points: PCOS, endometriosis, pregnancy. These are all critical points where the mitochondria are under attack, but we can support it. That, to me, is what longevity is about, how to thrive.

Q: For physicians watching who feel that pull but haven’t taken the leap, what would you tell them?

Do it. It’s the best possible medicine you will ever have practiced. It’s a question we’ve all been talking about at this Congress: what is medicine actually for? It was not to operate more. It was not to prescribe more. It was not to navigate systems and bureaucracy better. It was to truly connect with that human, and to really help them, and to go back to what my mum always reminds me of: it was to take the best of our academic and scientific excellence and bring it to the clinical room.

Q: What’s one thing you loved about the Certified longevitydocs. CLD certification?

Definitely, just number one, knowing that there’s this huge, vast capacity of knowledge, with the capacity to learn more, but also just collating it. I was going through it, going, oh yeah, I know that, I know that, but then actually I don’t know that. And suddenly pulling it together and having a really coherent model to deliver things. A lot of my programs already ticked some of those boxes, but there was a whole load of more information and scope to improve what I’m doing.

Q: Is there one thing that would help you practice most fully?

Number one, for us to be fully present as clinicians with our patients is what’s going to drive our practice and enhance it. So anything that helps with that, whether it’s administrative tasks or knowledge and access to community, and knowing that morally and ethically we are doing the right thing. I think we find that within the longevitydocs.^™ group. But also, for me leading a clinic, it’s actually having other clinicians that I can pull into our system. We’re looking to recruit; we need more people who are trained up, because I can’t do this alone, and we can’t change global health alone. It is definitely a we program, not an AI program.

This is exactly why we are building The Certified Longevitydocs.™ (CLD) the certification and training for the longevity physician of the future. Every doctor should be a longevity doctor.

Join the Certification Next Cohort

Cellular Senescence Repositioned as an Upstream Driver of Coronary Disease

A new review in Ageing Research Reviews argues that senescent vascular smooth muscle cells and endothelial cells generate a SASP that directly propagates plaque instability, positioning senescence as an upstream accelerant of coronary disease rather than a downstream consequence of atherosclerosis Ageing Research Reviews, Li et al., 2026.

Associations of testosterone, sex hormone-binding globulin, and related hormones with risks of cancer

Lower total testosterone or dihydrotestosterone concentrations in men were associated with a higher risk of cancer death, and mid-range SHBG or luteinising hormone concentrations were associated with a lower risk. Men with lower SHBG or luteinising hormone concentrations had an associated higher risk of incident prostate cancer. Sex hormones could serve as biomarkers for cancer risk, warranting further investigation of these observed associations. Lancet Healthy Longevity

Biological mechanisms of different exercise modalities in improving sleep disorders: A review

This narrative review aims to consolidate and examine the contemporary body of scientific evidence elucidating how distinct forms of exercise, primarily categorized as aerobic endurance training, resistance or strength training, and mindful mind-body practices, act to alleviate various sleep disturbances. The underlying biological pathways through which these exercise modalities exert their positive effects are complex and interconnected, encompassing thermoregulatory processes, neurochemical adaptations, endocrine signaling, and shifts in autonomic nervous system balance. IBRO

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

DIAGNOSTICS

Full-Body AI Skin Imaging

Founded by Deezer co-founder Jonathan Benassaya after his own melanoma was nearly missed, SkinBit closed a $6M pre-seed from Boost VC, Cleo Capital, Manna Ventures, and Profluent Capital, with participation from board-certified dermatologists and angel investors. The proprietary scanner completes a 20-minute automated full-body scan, maps and categorizes marks, and builds a longitudinal skin baseline physicians can track over time. First scanners are landing in medspas, longevity clinics, and dermatology offices, with three locations live in 2026 and 15 planned by the end of 2027.

TECH

Hers App Offers Doctor-Led Care

Hims & Hers, the leading health and wellness platform, today announced a first-of-its-kind intelligent care experience that puts AI directly inside customers’ care, not on the sidelines of it. Rolling out first to Hers weight loss members, this proactive care experience delivers personalized guidance, real-time attention to her progress, and keeps her motivated so she can hit her goals.

Whoop Helps You Track Fertility

WHOOP partners with Natural Cycles°, a FDA-cleared medical device, that uses biomarker data, including temperature and heart rate data, to identify fertile and non-fertile days, helping users prevent pregnancy without hormones while also providing fertility insights. Beyond birth control, the app also supports users through pregnancy planning, pregnancy, postpartum, and perimenopause with dedicated modes tailored to each stage of their reproductive journey.

RESEARCH

Gene Therapy Center for Rare Diseases

The New York Times profiled ARPA-H’s THRIVE initiative, Treating Hereditary Rare Diseases with In Vivo Precision Genetic Medicines, which is building infrastructure to make single-intervention precision genetic medicines faster and cheaper to develop, aiming to move rare disease treatment past the one-drug, one-disease model most pharmaceutical companies avoid on cost. An estimated 95% of rare conditions still have no approved treatment.

AI

AI-designed Unknown Functional Virus

Stanford researchers used generative AI models Evo1 and Evo2, trained on genetic sequences from viruses, bacteria, plants, and humans, to design 302 candidate bacteriophage genomes from scratch. Sixteen proved fully functional in the lab, replicating and killing E. coli. It’s the first time a complete viral genome has been AI-designed rather than edited, a milestone researchers are calling a turning point for computer-designed biology, with near-term potential in phage therapy for antibiotic-resistant infections. BBC

CONSUMER

Thorne sold to P&G for $3.8B

Procter & Gamble has agreed a $3.8bn deal to acquire supplements maker Thorne, delivering an outsized return for LVMH-backed private equity group L Catterton less than three years after it bought the company. FT

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Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of longevitydocs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

longevitydocs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

Today is issue 100. It started the newsletter as a way for me to share the latest science, the technology, the market insights with a small group of physicians. The ecosystem got bigger as longevity became mainstream. Longevitydocs’ mission remains the same: democratize longevity medicine.

And we are getting there! Testing is cheaper. Care is more accessible. More physicians are moving into the space. More research is funded. More regulation and policy on the books. More health systems offering longevity services.

Longevity is becoming an industry beyond medicine. That is evolution, and it is also the reason the patient in front of you Monday arrives with more claims, more products, and fewer people qualified to sort them. Physicians will still play a role. Knowledge first, then care.

This is what I learned writing them (don’t expect copywriting tips)

1. Fringe becomes standard faster than you think. Plenty of what this newsletter covered as cutting-edge in 2024 is now used by millions of people, reimbursed, approved. Stay open.

2. Innovation impacts everything. Science, pricing, patient behavior, policy, regulation, and what gets taught in medical school. Keep building.

3. Longevity is a long-term game. Real science takes time. So does a real product. The companies that tried to skip that step are gone, and they took a lot of patient trust with them on the way out. Be patient.

4. Community creates impact. I do not agree with everyone in ours. That is the point. Same mission, same patients. Stay united.

5. It is about the patient. Every so often it is worth zooming out and asking why any of us are doing this. The answer has not changed in a hundred issues. Remember why.

The newsletter was always meant to be shared freely with our community. For 100, I am opening it up to trusted physicians from that community, in their own words, on the questions they actually get asked in clinic, the protocols they use, the work they do in the field.

Dr. Josh Starbuck goes first: peptides and the FDA.

Thank you for reading every Sunday. All hundred of them.

Dr. David Luu, Founder, longevitydocs.™

PS: I visited Milan, Shanghai and Venice. 3 things that struck me:

• In Milan I stood in front of the Duomo that took six hundred years. The people who laid the first stone knew they would never see it finished. They laid it anyway.

• In Venice, millions of wooden trunks driven into the mud, on the bet that wood underwater would not rot. The city is still standing on them.

• In Shanghai I watched a city that went from bicycles to electric everything inside of twenty years.

Three cities. Six hundred years, a thousand years, twenty years. I have been thinking about it since.

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life. This week, Dr. Joshua Starbuck shares his perspective from the FDA's PCAC hearing on peptide compounding.

The FDA’s Pharmacy Compounding Advisory Committee recommended six peptides for inclusion on the FDA’s compounding list.

Dr. Joshua Starbuck, MD, IFMCP - Makena Health

The question at hand was never whether these compounds should be FDA approved. It was whether a licensed 503A compounding pharmacy should be legally permitted to prepare them for an individual patient holding a valid prescription from a licensed clinician.

That distinction collapses fast in translation. The 503A Bulks List is the mechanism that allows this kind of compounding, and a substance only lands on it after a full sequence: nomination, a PCAC recommendation like this one, a comment period, then formal rulemaking through the Federal Register. Even in the fastest scenario, that takes roughly 90 days from here. The last time the list actually gained anything new was 2019, six substances, five of them topical, and those six remain the only ones ever added across fourteen meetings of this committee. Fourteen meetings, six substances. That’s a fair question to sit with on its own: whether the list was ever built to move at the pace patients actually need.

Separate from the Bulks List, and important not to confuse with it, sits FDA’s category system, an interim enforcement policy built because the rulemaking path is so slow. Category 1 means FDA doesn’t currently intend to act against compounding while it works through evaluation. Category 2 means the agency identified safety concerns. Category 3 means the nomination lacked sufficient data. A substance in Category 1 is not on the Bulks List, and can sit there for years without the rulemaking that would make it official ever finishing.

Patients have been asking about these compounds for years, evidence gaps and all, because the alternative was never no access, it was unregulated access.

The votes were close, not unanimous, and each went against FDA’s own scientific staff, who had recommended against inclusion. The evaluation framework runs on four factors regardless: characterization, safety, efficacy if known but not required, and history of use.

None of this is FDA approval. The 505 pathway demands an IND, full clinical trials, and often hundreds of millions to billions of dollars before a single indication is granted. This vote doesn’t touch that pathway, and these peptides remain unapproved drugs regardless of what the rulemaking eventually does. That gap between a recommendation and an actual legal listing is where the real work now sits.

That work took shape during the public hearing, the most human part of two otherwise procedural days. Dr. Elizabeth Yurth’s testimony on BPC-157 nearly brought me to tears, she named patients describing lives improved dramatically after years searching for a provider willing to try it. Reading the public docket alongside testimony like hers made the process feel less abstract, a decision with real suffering and real relief on the other side of it.

The hearing is also where the practical path forward took shape, as speakers spent less time arguing the science and more time proposing a safer bridge while rulemaking grinds forward. Dr. Jeffrey Egler and others laid out pieces of it: a verified-sourcing registry for API suppliers, something like a greens list; expanded state-level regulatory pathways; and a structured adverse-event reporting system, the same instinct behind VAERS. None of that needs a final rule, and none builds itself either. The next challenge isn’t waiting for these six to clear rulemaking, it’s building those guardrails now, so access arrives the right way instead of just faster.

Underneath all of it, the foundation this community already knows doesn’t change. Sleep, nutrition, hydration, movement, community, stress management, and recovery carry the weight. Peptides, if they arrive on the list at all, are the icing, not the cake. Physicians carry a real responsibility to model that hierarchy rather than let it invert, appropriate use, not overuse. A reason for use rooted in the patient in front of you, informed consent that’s honest, and monitoring that catches problems early.

Get that part right, and the rest follows. When patients win, we all win.

Dr. Joshua Starbuck, MD

Sneak peek: the Skin, Bone and Muscle Mastermind

October 24, 2026 • New York City

Why skin, bone and muscle

It is the front door of longevity care. It is what the patient sees first, what brings them in, and what they use to judge whether any of this is working.

And it is a triad, not three separate problems. Bone and muscle fail together. Skin reports on what is happening in both. Manage them in isolation and you get exactly the results the field has been getting.

The medical community still underrates it. Cardiometabolic gets the seriousness, skin and musculoskeletal get filed under aesthetics, and the patient goes looking for answers somewhere other than a physician’s office.

That is the gap we are closing in one day.

Physician-led sessions. Every one sends you home with a protocol or a framework. Full program drops next week. Here is a sneak peek:

• Skin, Bone and Muscle. The clinical triad of healthy longevity.

• The Evidence. Where the science stands today, and where it is going.

• New Diagnostics. The biomarkers, AI and devices you can use in practice now.

• The GLP-1 Tax. Protecting skin, bone and muscle in patients already on the drug.

• The Regenerative Menu. Stem cells, peptides and photons, with a risk-tiered framework for each.

• Advanced Protocols. What to implement, and in whom.

• The Debate. Where the money is versus where the data is. Choosing a service line you can defend in five years.

Front-row access to the physicians pioneering skin, bone and muscle longevity. One day in New York City. Breakfast, lunch and a VIP dinner. Clinical protocols and scientific breakthroughs you can put to work Monday.

For physicians only. Limited to 150.

Early access tickets are open now. Pricing goes up next week.

SECURE YOUR TICKET

Navigating Risk in Telemedicine - Dr. Suneer Chander

Dr. Suneer Chander, an ER physician and co-founder of Air Physician Academy, argued that malpractice fear is overblown in telemedicine and that the real exposure is regulatory. He built a four-bucket compliance framework, licensure, modality, standard of care, and treatment-specific rules, and walked through why state-by-state nuance around peptides and compounding pharmacies is shifting faster than most practices can track.

5 KEY TAKEAWAYS

• Malpractice risk in telemedicine is low and priced accordingly by underwriters (roughly $5,000-$12,000/year nationally, versus ~$30,000 for emergency medicine and $40,000-$200,000 for OB-GYN), because most telemedicine is low-acuity care with no procedures attached. When claims do arise, roughly two-thirds involve misdiagnosis, making the real discipline knowing when telemedicine is the wrong tool and referring to in-person care.

• Chander frames the actual risk in four buckets: licensure, modality, standard of care, and treatment-specific rules. Physicians must be licensed in the state where the patient is physically located, not where the physician sits, which is why he holds licenses in all 50 states plus DC to see patients nationally.

• Modality rules vary meaningfully by state. Synchronous video, audio-only, and asynchronous store-and-forward or questionnaire-based care are each permitted differently, so a state like Texas may restrict an asynchronous chat workflow that a state like Mississippi allows, and a compliant setup in one state can be a violation in the next.

• Treatment-specific rules for controlled substances, GLP-1s, TRT, and peptides are set at both the federal and state level and shift roughly every three to six months. A single compliance mistake in one state gets reported to every state medical board where a physician holds a license, forcing them to defend the same incident everywhere at once, even in states where the rule in question doesn’t exist.

• Chander’s practical fix is a tracking system, as simple as a spreadsheet or a service like Mockingbird, to monitor licensure renewals and rule changes before expanding into a new state. Best read as an operational discipline rather than a one-time compliance setup: the regulatory landscape here is a moving target, not a fixed checklist.

longevitydocs. ROOMS™ are 20-minute, live-audio, unscripted peer conversations available exclusively for our members in the longevitydocs.ai platform. Sessions are designed to answer your questions in real-time.

Apply for Membership

Meet the Longevity Doctor of the Year Redefining Women’s Health

We sit down to interview Dr. Jessica Shepherd, a board-certified OB-GYN and Chief Medical Officer of Hers, named this year’s Longevity Doctor of the Year at Longevitydocs.™ Cannes 2026.

When did longevity medicine first end up on your radar?

Longevity Medicine actually was on my radar very early. I actually had an undergrad degree in exercise physiology and kinesiology, and that’s really where I saw what the body is able to do and the mechanics of the body, really looking at it from a nutritional and an exercise perspective. Going through medicine is when I started to hear women in their struggles, and I realized we were really looking at health from a disease perspective. I knew there was a way I could teach my patients to practice better, in a way they could understand their body and work from that aspect. About 7 or 8 years ago is when I saw that I needed to shift my practice and move more into education and lifestyle, and hence longevity, where we are now.

What does it mean to you to be Longevity Doctor of the Year?

I was completely shocked, in a way, because a lot of what you do, you’re just so passionate about it, and if you really love it, you just keep doing it because you love it. So to put a title to it, or an award-winner aspect to it, is really shocking, but so inspirational, because deep down you’re like, I’m doing what I’m supposed to be doing. I think a lot of times in longevity you feel it’s siloed, or you feel that you’re alone, because that’s not the structure of medicine, and that’s not how we’re trained. So to be a longevity doctor really means you have to fundamentally, wholeheartedly believe what you do.

What’s one piece of advice you’d leave a young physician watching this?

Always think big and stay curious. I never would have imagined where I started, and even when I finished training, that I would be where I am today. There’s so much that is kind of untraditional when we think of medicine, and that can be, I wrote a book on menopause, I never thought that would be something I would do, or being chief medical officer of a company who really understands that what we deliver in healthcare is not always what people need. So I would say think big, stay curious, because being curious breeds growth.

How a CLD Grad Discovered Longevity Medicine Through Her Current Patients

Dr. Angela Contreras, an anesthesiologist and interventional pain physician in Chicago and founder of Integer Health, didn’t set out to become a longevity doctor. The shift happened almost by accident, in Hawaii, right as a wave of newly separated veterans started asking her for something her training hadn’t prepared her to give.

When did longevity medicine first come on your radar?

Longevity medicine is something that I really came into touch with kind of right before I moved to Hawaii. I moved to Hawaii back in 2024 to open an interventional pain clinic for the federal government, for the VA health system. Right before that, I started noticing my interest in longevity and wanting to shift toward an approach to medicine that wasn’t as reactive, and wasn’t just treating diseases as they were surfacing for patients, but rather getting to the root of the problem. I was really fortunate to have a wonderful patient population of new veterans, individuals right out of active duty, at the pinnacle of their physiological health. They were asking me for things patients hadn’t really ever verbalized before, ways to heal their bodies in a nontraditional way, not just with interventional pain injections, but with a more holistic approach. It was the perfect timing. These patients were asking for it at the same time I was seeking something different. Longevity became something I couldn’t just ignore.

You graduated from CLD. What was one of your key takeaways from the certification?

Because the field is so novel, there’s a lot of unknowns. The certification allowed me to at least recognize what I don’t know, and gave me the framework to build some of these foundational concepts of longevity that aren’t necessarily something you can find at one conference, or in one journal, because it spans all the different specialties and then some, and it spans the basic sciences. The course allowed me to build a framework for what I need to delve into further. I would have been very lost without it. It’s navigating unknown territory.

What’s one piece of advice you’d give a physician looking to get into longevity medicine?

I would encourage them to do it. I think now is the time, the field is evolving quickly. It’s exciting, it’s novel. For a lot of physicians, this fills a void that seemed to have been there, taking the more traditional approach. So I would say just do it.

This is exactly why we are building The Certified Longevitydocs.™ (CLD) the certification and training for the longevity physician of the future. Every doctor should be a longevity doctor.

Prognostic Value of Blood-Based P-Tau217 Levels for Progression to Cognitive Impairment

In a pooled sample of multiple selected cohorts of cognitively unimpaired older adults, higher plasma p-tau217 levels were consistently associated with increased risk of clinical progression and accelerated cognitive decline. By providing time-specific absolute risk estimates, these findings support the potential of p-tau217 for prognostic model development, with direct implications for future trial design. JAMA

Metformin added to lifestyle intervention for physical function

The RCT published in Lancet suggest that in older adults with obesity undergoing intensive lifestyle intervention, metformin does not provide additional improvement in physical function. These results support prioritising lifestyle-based strategies to improve functional outcomes in this population. Lancet Healthy Longevity

Functional, molecular, and digital measurements of biological age

In this state-of-the-art Review, we explore historical and modern approaches to estimating biological age and highlight key conceptual, technical, and translational challenges that remain unresolved. As geroscience-guided interventions are incorporated into clinical evaluations, robust and accurate interpretable measures of biological aging are crucial to ascertain treatment effects in clinical trials. JCI

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

AI

OpenAI Health is Live

Health launched July 23 to US users 18+, all plans, web and iOS. Patients can connect Apple Health, One Medical, Function Health, and supported hospital system records. ChatGPT then reads labs, medications, conditions, visit notes, sleep, and activity, and carries that context into any conversation, not a separate health tab. OpenAI says connected records are not used for training or ads, and that permission is requested per response unless the patient switches it to always-allow.

Caristo Diagnostics' CaRi-Heart® Coronary Inflammation Technology Authorized by U.S. FDA

Developed from research at the University of Oxford, CaRi-Heart's flagship technology uses advanced AI to detect inflammation-related changes in the fat surrounding the coronary arteries and quantify them as a fat attenuation index score (FAI-Score™), Caristo's validated proprietary biomarker of coronary inflammation. The analysis also generates the CaRi-Heart® Risk score, a personalized estimate of a patient's risk of cardiovascular mortality over 10 years.

PHARMA

Eli Lilly Pays $2.8B for a Psychedelic-Medicine Bet

Forbes reports Eli Lilly is acquiring AtaiBeckley, the psychedelic-medicine biotech Christian Angermayer built after a personal mushroom trip convinced him FDA-approved drugs could come from psychedelics, in a $2.8 billion deal. Forbes

TECH

Why Eli Lilly is collaborating with Oura

Eli Lilly’s digital healthcare platform announced a marketing collaboration with Oura. Get a free Oura ring sizing kit. Marketing deal only, no data sharing between the two.

The partnership announcement also comes just weeks after Oura announced a new in-app tool called GLP-1 Insights, which helps GLP-1 users track their doses, side effects, and weight.

POLICY

Montana’s plan to become an experimental medical hub just pushed forward

As of this week in Montana, any biotech company with an experimental drug has a clear path to selling it to consumers. Companies whose drugs have been through preliminary testing—sometimes in as few as 10 healthy people—can pay $12,500 to apply to a newly established review board for approval. Once its treatment is rubber-stamped, the company can set the price of the drug and sell it via experimental treatment clinics, the first of which is likely to be up and running around the end of this year. MIT

CULTURE

How the Longevity Movement Is Transforming Luxury Real Estate

The findings suggest a fundamental shift in how luxury real estate is viewed. The modern trophy home isn’t necessarily the largest or most extravagant property on the block, but rather something of a tool to help owners live better, longer, and more independently for decades to come. Robb Report

The Home of Longevity Medicine

longevitydocs.™ is the largest vetted community of longevity physicians in the world, and the home of the credential that defines the field. 1,200+ doctors. 68 countries. Building the new standard of care. Every doctor should be a longevity doctor.™

Apply to Join

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of longevitydocs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

longevitydocs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

I just got back from Shanghai and Seoul, and I am fired up. I visited clinics, hospitals, met dozens of physicians and owners, all building longevity care on opposite sides of the planet. The infrastructure is here, and it is going up fast.

Look at this week. Neko raised $700 million to put prevention within reach of everyone, not just the wealthy. Lilly became the first trillion-dollar drug company by betting on preventive medicine. A $13,500 robot performed live surgery with the physician in the loop the whole time.

Prevention is being democratized. The tools are getting cheaper, the reach is getting wider, and for the first time we can bring this to millions of patients, on every continent, not a lucky few.

That is our mission. The infrastructure is being built right now. Super grateful to be meeting the physicians building it around the world!

Dr. David Luu, Founder, longevitydocs.™

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

Field Notes from Shanghai and Seoul

What I Learned Visiting Clinics and Hospitals in China and South Korea

I just spent two weeks in Shanghai and Seoul, meeting physicians and leaders and walking through their clinics and hospitals. Here is my honest summary, the opportunities and the challenges:

Opportunities

• Experience. Some of these clinics and hospitals are designed like five-star hotels. Impeccable amenities, real architecture, the finish of a luxury property. The space itself tells the patient this is serious.

  

• Equipment and technology. Rooms full of the latest imaging, CT, MRI, DEXA, functional diagnostics, at a level most Western clinics would think twice before buying. Some cosmetic-focused clinics run twenty-plus devices worth several million dollars, the newest of everything, all under one roof.

  

• Price. They can be strikingly competitive, a full workup for a few thousand dollars. And even when they reach Western prices, they deliver it in a few hours instead of spreading it across days.

• Scale and speed. Care moves fast, sometimes finished in hours, and they handle large numbers of patients at once without the experience falling apart.

  

• Longevity tourism. Put the price, the equipment, the experience, and the speed together and you have a destination, not just a clinic. Patients will travel for a week of diagnostics and a level of care they cannot get, or cannot afford, where they live. Asia is quietly positioning itself to be where they land.

Challenges

• Regulation. Every country has its own rules, and in most of them nobody has defined what longevity medicine even is yet. That is freedom and risk in the same breath, because what is allowed today can close tomorrow and no one is building on ground they trust.

  

• Language. It is a wall that works in two directions. A patient will not fly toward a place they cannot talk to, and the best training and literature still move in English, so both the patients and the knowledge travel slower than they should.

  

• Communicating the care. Nobody has figured out how to explain this medicine simply, to patients or to referring physicians, what it does and why it is worth paying for. The value is real. The language for it is not built yet.

• Patient acquisition and competition. Beautiful buildings, serious equipment, strong teams, and the hardest question in every room is still how to fill the schedule. The category is getting crowded fast, so differentiation stopped being optional, and nobody has actually solved acquisition.

• No institutional framework. There is no shared standard, no common credential, no agreed definition of what a longevity clinic actually is. Everyone is building their own version.

• Access to education. The hunger to learn was everywhere I went, and it genuinely moved me. But the training pipeline is narrow and expensive, demand far outruns supply, and it still needs to be adapted to local culture and regulation.

• Recruiting doctors. You can buy the machines. You cannot buy the physician who knows how to read them, and everyone is chasing the same short list of people who can. The talent is the bottleneck, not the capital.

  

I came back genuinely impressed. What they are building in preventive, cosmetic, and dental care is real and moving fast, and longevity is firmly on the map. They will deliver.

And what I saw in Shanghai and Seoul is the same everywhere. This is not an Asia story, it is the shape of the field worldwide. Longevity care is becoming an economic asset, the way a country’s hospitals and universities already are. The investment will build the infrastructure, the buildings, the machines, the scale, with or without us.

Capital builds the infrastructure. Trained physicians deliver the care, and that is what makes them the most valuable asset in the building. So if you run a clinic or a hospital, the highest-return investment you can make is not another scanner. It is training your doctors.

That is exactly what we are building at longevitydocs.™: the certification and the training program for the longevity physician of the future. Every doctor should be a longevity doctor.

Certify Your Doctor

Therapeutic Plasma Exchange - Dr. Dobri Kiprov

Dr. Dobri Kiprov, a 40-year veteran of therapeutic apheresis, explained how therapeutic plasma exchange (TPE) removes pro-inflammatory factors and may reverse aspects of immune aging. He reviewed clinical experience in autoimmune disease (myasthenia gravis, lupus), the AMBAR Alzheimer’s trial, and a placebo-controlled longevity study, plus emerging adsorption-column filtration technology.

5 KEY TAKEAWAYS

• TPE is performed via centrifugal or membrane apheresis to separate plasma from cells. It is used across more than 90 diseases, the majority autoimmune, with indications graded by the American Society for Apheresis (ASFA) every three years.

• The concept is “subtractive medicine”: removing offending factors (autoantibodies, cytokines, chemokines, circulating immune complexes) rather than adding drugs that can trigger new pathways and side effects.

• Kiprov targets three aging hallmarks: inflammation, immunosenescence, and cell senescence/SASP. He reports that TPE removes SASP factors effectively and can restore proliferation of naive CD4 and CD8 T cells, shown by flow cytometry.

• The AMBAR Alzheimer’s trial (sponsored by Grifols) tested amyloid removal by albumin-bound plasma exchange. Amyloid was found not to be the sole driver of disease, and outpatient TPE proved safe and well tolerated. Kiprov framed it as evidence the modality is viable in neurodegeneration, not as a head-to-head comparison against approved anti-amyloid therapies.

• In a single double-blind, placebo-controlled study in adults 50 and older, TPE was associated with a lower biological age and an immune profile roughly 7 to 9 years younger, alongside reduced SASP and inflammatory markers, measured by DNA methylation clocks including organ-specific aging. Best read as preliminary, single-study results resting on epigenetic-clock surrogates still under validation.

Estrogen, Statins, and Lipids - Dr. Amy Killen

Dr. Amy Killen discussed how estrogen loss at menopause and statin therapy exert overlapping negative effects (particularly on mitochondria and insulin sensitivity) in women, yet the interaction between hormone therapy and statins has not been studied since the 1990s. She argued for prioritizing hormone therapy and lifestyle before statins in appropriate patients and challenged long-held assumptions about lower-dose estrogen being safer.

5 KEY TAKEAWAYS

• A June 2026 observational study of about 1,200 postmenopausal women across 9 countries found statin users reported more severe menopause symptoms (47% vs 31%), more severe muscle and joint pain (53% vs 34%), and roughly twice the rate of sarcopenia.

• No study since the late 1990s has examined how menopausal status or estrogen therapy affects statin efficacy or side effects. JUPITER is the only major lipid trial that even addresses menopause status, and it does so by excluding premenopausal women.

• Estrogen acts protectively at multiple levels of lipid metabolism (production, absorption, and clearance). Its loss at menopause drives up LDL, ApoB, and triglycerides.

• Statins and estrogen loss produce a “double hit” on mitochondria: statins block CoQ10 synthesis, and estrogen loss reduces mitochondrial resilience. Both also worsen insulin resistance, likely explaining why statins cause more muscle side effects and diabetes risk in women.

• Killen questions the “lowest dose, shortest duration” estrogen dogma, noting it was never actually studied. A 2019 Lancet analysis found the lowest Premarin dose (0.3 mg) carried the highest associated breast cancer risk, with all other doses carrying roughly equal risk.

Every week, the longevitydocs.™ App feels like a front-row seat to the future of medicine. Here’s what had doctors buzzing:

Should everyone with elevated Lp(a) be on aspirin?

One doc asked the cardiologists directly:

“Where are we on aspirin for everyone with Lp(a), or not?”

Those are some of the answers:

“I give it if they have plaque on CT or ultrasound carotids, clopidogrel as opposed to aspirin. If no plaque, I don’t.”

“You need evidence of significant cardiovascular disease to increase the odds that the CV benefit outweighs the bleeding risk.”

Aspirin is not a free intervention, and elevated Lp(a) alone does not settle the risk-benefit math.

“There is a guideline answer and a practical answer. Give aspirin if there is any evidence of atherosclerosis, especially if accelerated. The monogenic and polygenic information matters: there is real benefit for Lp(a) carriers and the high polygenic-risk group, the top 20 percent. And isoforms matter, shorter ones drive higher levels, and the damage is proportional to the plasma level.”

Another doc pushed on the genetic angle, raising a commercial LPA-genotype panel that “apparently suggests aspirin benefit.”

The case for aspirin specifically in high-Lp(a) patients rests on genotype-subgroup data, not a prospective trial built for the question. A Women’s Health Study analysis found that carriers of an Lp(a)-raising variant got a cardiovascular benefit from low-dose aspirin, and a 2022 ASPREE genotype analysis in JACC pointed the same direction, reduced events in carriers of the Lp(a)-raising genotype, bought at the cost of bleeding.

Meanwhile the broad primary-prevention aspirin trials, ASPREE, ARRIVE, and ASCEND, landed on net neutral or net harm in unselected patients, which is exactly why universal aspirin fell out of favor in the first place. Current guidelines treat elevated Lp(a) as a risk-enhancing factor, a thumb on the scale, not a standalone indication to treat.

So the practical synthesis matches where the group landed. Aspirin for elevated Lp(a) is a targeted decision, not a blanket one. Reach for it when there is evidence of subclinical atherosclerosis, plaque on CT or carotid imaging, or a genuinely high genetic burden, and weigh it explicitly against bleeding risk in each patient. In an asymptomatic person whose only finding is a high number, the honest position is that the trial you would want does not exist, and a risk-enhancer is not a mandate.

One structural point worth saying out loud. We are debating aspirin partly because there is still no approved therapy that lowers Lp(a) itself, with several agents in phase 3. Until those read out, aspirin and aggressive management of every other modifiable risk factor around the Lp(a) are the levers we actually have. That is the real reason this question keeps coming up, and the real reason it stays unsettled.

Stay up to date with the latest news & conversation inside the longevitydocs.™ app

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Prognostic Value of Blood-Based P-Tau217 Levels for Progression to Cognitive Impairment

A single blood marker, plasma p-tau217, predicted 5-year risk of cognitive decline in healthy older adults, from 12% in the lowest group to 38% in the highest, and it held up even after adjusting for amyloid PET. New JAMA pooled analysis of 2,684 cognitively unimpaired adults, the clearest case yet for a scalable, blood-based Alzheimer's risk test in prevention. JAMA

Addressing benchmarking gaps in large language models for health and medicine

The models that ace medical benchmarks fall apart under pressure: 94% of initially correct answers failed dynamic robustness testing, 86% of privacy scenarios leaked protected health information, and hallucination hit 74% across widely used LLMs. New Nature Health study red-teaming 15 state-of-the-art models, and it should temper how much any of us lean on these tools unsupervised in the clinic. Nature

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

CARE

Neko Raises $700M to Scale Longevity Care

Neko Health, Daniel Ek’s preventive full-body-scan company, raised $700 million at a near $7 billion valuation. Their proprietary 60-minute scan includes non-invasive full-body imaging with skin photos, blood work, ECG, and arterial and body-composition analysis, screening for skin cancer, cardiovascular disease, and diabetes. It has run 100,000 scans across eight UK and Sweden clinics with 350,000 more waitlisted, and now opens its first US clinic in New York.

TECH

A $13,500 Robot Performs Live Surgery

Two off-the-shelf Chinese humanoids, Unitree G1s at around $13,500 each, performed the first live-animal surgery by general-purpose robots: two porcine gallbladder removals at UC San Diego, published in Nature. The detail that matters is that these were not purpose-built surgical devices. Surgeons teleoperated standard humanoids holding the same laparoscopic instruments already in every OR, one run pairing a robot with a human surgeon, another pairing two robots.

BIOTECH

World’s First CAR-T Cell Therapy For Solid Cancer Approved in China

China’s NMPA just approved CARsgen’s satri-cel, the first CAR-T cell therapy to clear regulators for a solid tumor: claudin18.2-positive, HER2-negative advanced gastric and GEJ adenocarcinoma after at least two prior lines. In the phase II trial Peking University’s Lin Shen led, published in The Lancet, median overall survival was 7.9 months versus 5.5 on physician’s choice in the ITT population, and 12-month survival was 39% versus 27%. The catch: 99% of treated patients had grade 3 or higher adverse events, and 95% developed cytokine release syndrome.

PHARMA

Lipfendra: The First PCSK9 You Swallow

The FDA just approved enlicitide (Lipfendra), Merck’s once-daily oral PCSK9 inhibitor, for adults with hypercholesterolemia and heterozygous familial hypercholesterolemia. In CORALreef Lipids it dropped LDL by 57.1% versus a slight rise on placebo at 24 weeks, and CORALreef HeFH showed a 59.4% between-group reduction, both with placebo-level tolerability. It joins the injectables (inclisiran, evolocumab, alirocumab, lerodalcibep) as the first one you swallow.

POLICIES

Annual Testosterone Testing for US Soldiers

Defense Secretary Pete Hegseth will require every male service member 30 and older to be screened for low testosterone, with the option of testosterone replacement therapy (TRT) if levels come back low, framed around "lethality" and optimizing performance. That is a large population: more than 300,000 active-duty men over 30.

BUSINESS

Lilly Bets On Longevity Medicine

Eli Lilly became the first drugmaker worth more than a trillion dollars, and CEO Dave Ricks told The Economist the obesity franchise is only the on-ramp. The real bet is reinventing pharma around prevention: GLP-1s expanding into cardiovascular, sleep apnea, and kidney disease, donanemab tested in asymptomatic Alzheimer’s, and $7.8 billion spent on a sleep biotech. More than half of new GLP-1 starts now begin online through LillyDirect.

WELLNESS

IM8 Secured $1B to Support Growth

David Beckham’s supplement brand IM8, built under Danny Yeung’s Prenetics (public co), secured $1 billion from General Catalyst. It reports over $200 million in revenue since its December 2024 launch, roughly $17 million a month, projecting a $300 million run-rate by year-end. The flagship is a 90-ingredient “Daily Ultimate Essentials” powder.

Cannes Summit Replay Now Available

The longevitydocs. Summit™ now lives on demand. Three days of stage time from forty-plus speakers, ready for you to watch from anywhere in the world.

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The Home of Longevity Medicine

longevitydocs.™ is the largest vetted community of longevity physicians in the world, and the home of the credential that defines the field. 1,000+ doctors. 68 countries. Building the new standard of care. Every doctor should be a longevity doctor.™

Apply to Join

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of longevitydocs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

longevitydocs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

Thank you for your patience. I took some time off after Cannes to recharge with my family, catch up with friends, eat Mediterranean food, discover new places and enjoy life. I am writing this week newsletter just coming back from Florence, the capital of the Renaissance. A city built by the Medici, who were essentially the original venture capitalists, backing artists, architects, and scientists the way we fund startups today. And one of those bets was Leonardo da Vinci.

Dav dissected the body of an elderly man in Florence to understand why his vessels had changed. He described thickened arterial walls, narrowed lumens, and reduced blood flow. He drew it. He documented it. Four hundred years before we had the word atherosclerosis. A painter, sitting in a morgue, doing vascular biology because he was curious.

This newsletter is my reflection on what is happening with longevity hospitality globally, and specifically the longevity tourism boom that is reshaping how people access (or think they are accessing) medicine around the world.

Dr. David Luu, Founder, longevitydocs.™

PS: few memories and longevity tourism

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

The Longevity Tourism Boom

Longevity spa, longevity retreats, or longevity checkup. Longevity is everywhere. A hotel in the Swiss Alps is selling a “longevity suite” with cryotherapy and IV drips. A resort in Bali is packaging breathwork and cold plunges as longevity medicine. A clinic in Bangkok is offering full-body MRI screenings to tourists between temple visits. A facility in the Cayman Islands is offering stem cells at $25,000 per session.

The word longevity is now a travel category.

This is not new.

People have always traveled for health. Romans soaked in the hot springs at Bath. European physicians in the 1800s prescribed entire seasons at Baden-Baden, Vichy, and Karlovy Vary. Baños de Agua Santa in Ecuador built an economy around volcanic thermal springs centuries before anyone used the word longevity. The Swiss sanatoriums treated tuberculosis with mountain air and structured rest. The Dead Sea has been a medical destination for skin disease for over two thousand years.

The instinct to travel toward health is ancient. What is new is the scale, the marketing, and the clinical distance between what is being sold and what is being supervised.

The four levels of longevity tourism

Not all longevity tourism is the same. The category now spans four distinct tiers, each carrying a different risk profile.

Level 1: Hotel and spa programs. This is the entry point. A luxury hotel adds a “longevity menu” to its spa: cryotherapy, infrared saunas, IV vitamin drips, red light therapy, metabolic smoothies. The interventions are mostly low-risk. The medical supervision is mostly nonexistent.

Level 2: Retreats. A step up in duration and intention. Five to fourteen days. Structured programs with breathwork, meditation, cold exposure, movement, nutrition, and sometimes basic lab work. The best ones have medical directors and structured intake. The worst ones package the same activities under a longevity label with no clinical oversight and no follow-up after checkout.

Level 3: Diagnostic tourism. This is growing fast. Patients flying to South Korea, Thailand, or Dubai for comprehensive health screenings: full-body MRI, coronary calcium scoring, cancer biomarkers, genetic panels, gut microbiome analysis. The value proposition is real. In some of these countries, the same imaging that costs $5,000 in the United States is available for $800 with shorter wait times and newer equipment. Seoul alone has built an entire medical tourism corridor around Gangnam with clinics that process hundreds of international patients per week. The risk is not the diagnostics themselves. The risk is what happens after. A finding on a scan means nothing without a physician who can interpret it, contextualize it, and manage the follow-up. A tourist who flies home with a USB drive full of imaging and no relationship with the radiologist who read it is not a patient. They are a consumer holding data they may not understand.

Level 4: Procedural tourism. The highest-risk tier. Stem cell injections or gene therapy in the Cayman Islands or Mexico. Exosome therapies in Dubai. Gene therapy in Costa Rica. Hyperbaric oxygen courses in Turkey. These are medical interventions being delivered outside the regulatory frameworks of the patient’s home country, often by providers who could not offer the same treatments at home because of local regualtions.

What the boom is getting right:

Awareness. More people are willing to travel for their health. They are thinking about preventive care or health optimization because a hotel or a clinic in another country introduced the concept. That pipeline into medicine is real.

Access. A full-body MRI in Seoul for few hundred dollars is reaching patients who would never get one at home. Diagnostic access is expanding because of tourism, not in spite of it.

Experience. Hospitality knows how to design an experience around health. Medicine historically does not. The best longevity retreats are teaching physician-led practices something about how patients want to be treated.

Competition. When a resort in Thailand offers better imaging at a third of the price, it forces domestic health systems to ask hard questions about their own pricing and access. That pressure is productive.

What the boom is getting wrong:

No continuity. A retreat lasts a week. A diagnostic trip lasts three days. A stem cell injection is a single visit. Longevity medicine is continuous. Without follow-up, without a physician who knows the patient’s history, without a plan that extends beyond checkout, these are isolated events, not medicine.

Poor regulation. Many procedural tourism destinations exist precisely because the regulations are looser. That is not always sinister, but it means the patient is bearing risk that a regulatory body would normally absorb. When something goes wrong in a stem cell clinic in an offshore jurisdiction, the recourse options are limited.

Lack of science-backed protocoles. Some of what is being sold at Level 3 and Level 4 has strong emerging evidence. Some of it has none. The patient often cannot tell the difference because the marketing is identical in both cases.

Inconsistent medical supervision. The spa with no medical director. The retreat with no physician on staff. The diagnostic clinic that hands you results with no consultation. The procedural facility where the “doctor” is a general practitioner who completed a weekend training in regenerative medicine. Medical supervision exists on a spectrum, and the lower end of that spectrum is lower than most patients realize.

What to check before you go.

Whether you are a physician advising a patient or a patient evaluating a program, these are the questions that separate serious from speculative.

Is a licensed physician supervising the program? Not advising. Not consulting. Supervising. Present. Accountable. What are their credentials, their specialty training, and their experience with the specific interventions being offered?

What are the local regulations? A stem cell therapy that is illegal in the United States is not necessarily unsafe, but the patient should understand why it is not approved at home and what evidence the destination facility is relying on instead. Ask for the published data. If there is none, that is your answer.

What does the follow-up look like? Who reads your results after you leave? Who manages an incidental finding on your MRI six months later? If the answer is “your doctor at home,” then the facility has built a product, not a care model.

What is the pricing telling you? A full-body MRI in Seoul for $800 reflects genuine cost efficiencies in the Korean healthcare system. A stem cell injection in the Caribbean for $25,000 reflects demand-based pricing for an unproven therapy with no insurance coverage. Price is information. Read it.

Is the facility transparent about outcomes? How many patients have they treated? What are the complication rates? What is the published evidence for the specific intervention you are considering? If the clinic cannot answer these questions with data, they are selling confidence, not medicine.

Is there a complaints or malpractice pathway? In your home country, a bad outcome has legal and regulatory recourse. In a medical tourism destination, that pathway may not exist. Understand what protections you have before you need them.

The Future of Longevity Tourism

The longevity tourism boom is real, it is growing, and it is not going away. The instinct behind it is good. People want to live longer and better, and they are willing to travel to do it. That same instinct sent Europeans to thermal springs for three centuries.

But the distance between a spa menu and a stem cell injection is the distance between a mineral bath and surgery. The category called “longevity tourism” now contains both, and the patient browsing options on their phone cannot always tell which is which.

Physicians belong in this conversation. Not to shut it down, but to help patients navigate the spectrum with the same rigor they would bring to any clinical decision. Ask for the evidence. Ask for the credentials. Ask for the follow-up plan. Ask who is accountable when something goes wrong.

The boom is here, let’s make is as impactful as possible for the patients.

Every week, the Longevity Docs App feels like a front-row seat to the future of medicine. Here’s what had doctors buzzing:

Midjourney’s Medical Scanner: Hype or Hardware?

Midjourney launched an ultrasound body scanner in a spa setting with cold plunges and saunas, not through radiology partnerships. The community split. “If the tech was legit and worked, why would they not want all of medicine to use it?”

A radiologist flagged the physics problem: bowel gas and bones limit what ultrasound can see. The business explanation: “They have enough capital to run it through the wellness route without needing SaMD.” The regulatory read: by not interpreting images for cancer screening, they sidestep FDA approval.

The clinical worry: “A wealthy gateway for multiple further paid investigations of benign anomalies, with a high rate of false positive, provoking anxiety and cost.” One physician reframed the whole thing: maybe the device is better suited as a therapeutic than a diagnostic.

CAC 149 in the LAD: What Would You Do Next?

Real case: 49-year-old male, ApoB treated to 75, Lp(a) under 10, clean inflammatory markers, CAC 149 with 97% in the LAD. The community said CCTA next, citing SCAPIS (n=24,791) and SCOT-HEART (low-attenuation plaque burden over 4% linked to 5-fold increase in MI). The room also broke down Cleerly (best for plaque morphology), HeartFlow (actual virtual FFR measurement), and Caristo (best perivascular inflammation analysis, not yet FDA-approved in the US). Photon-counting CT is coming but currently limited to Mayo, MGH, and NIH.

Your NAD+ Infusions Are Not Safe

A physician with 20 years of longevity practice experience posted: “Sorry guys, your NAD infusions are not safe.” Why do patients report feeling better? “The temporary release of inflammatory cytokines can feel a little like an energy rush.” The clinical reality: “For everyone who feels better for a short time, I have about 20 people who have chest pain or nausea.” A professional athlete case was shared: consistent NAD+ use during the season, surprise UCL tear, mitochondrial testing revealed fatty acid oxidation and electron transport chain dysfunction. After addressing root cause, recovery held. The takeaway: fix the mitochondria first, not force them with IV push. Some early data on oral NR for ovarian aging may tell a different story.

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NAD+ Supplementation Blocks Ferroptosis and Lipid Overload in Aging Cells

A new preclinical study identifies a two-pronged mechanism by which NAD+ precursor supplementation combats cellular aging: suppressing CD36-driven lipid accumulation and halting ferroptotic cell death, both of which accelerate tissue dysfunction with age. The findings are notable because ferroptosis has emerged as an underappreciated driver of organ aging, and CD36 overexpression is linked to metabolic disease and cardiovascular risk. NIH

Why it matters: Clinicians managing older patients with metabolic syndrome or cardiometabolic comorbidities should watch this pathway closely as translational work accelerates. The study adds mechanistic depth to the already crowded NAD+ supplementation field, potentially sharpening patient selection criteria for trials.

Weekend Exercise Confers Mortality Protection Rivaling Daily Physical Activity

New accelerometer-derived data show that concentrating physical activity into one or two days per week, the so-called Weekend Warrior pattern, yields substantial reductions in all-cause and cardiovascular mortality, comparable to benefits seen with distributed daily exercise. The findings carry direct clinical relevance for physicians counseling time-constrained patients, suggesting that volume and intensity may matter more than frequency.

Why it matters: This challenges longstanding public health messaging that emphasizes daily movement as the primary target. Clinicians monitoring cardiometabolic risk should consider total weekly activity load as the key prescribing metric.

Breast Tissue Epigenetic Clocks Unlock New Cancer Risk Stratification Tools

A new study demonstrates that DNA methylation-based measures of biological aging derived directly from breast tissue, not blood, carry independent predictive value for obesity-related breast cancer risk. The finding is clinically significant because it suggests tissue-specific epigenetic clocks may outperform systemic aging biomarkers in organ-level cancer surveillance.

Why it matters: Physicians managing patients with obesity and elevated cancer risk should watch for integration of these methylation panels into breast screening protocols. The research reinforces the growing case for localized epigenetic profiling as a precision oncology tool.

Elevated Tyrosine Levels Associated With Shortened Lifespan In Men

Large-scale cohort study reports that men with elevated blood tyrosine levels show reduced life expectancy, with potential loss of up to one year. Finding contrasts with branched-chain amino acid research and highlights amino acid balance—not individual amino acids—as lifespan modifier. Effect size varies by genetic background and metabolic phenotype. ScienceDaily

Why it matters: Amino acid composition, not quantity alone, predicts longevity. Tyrosine elevation may signal dysregulated catecholamine metabolism or impaired renal amino acid handling. Test comprehensive amino acid panels in male patients; consider tyrosine-to-BCAA ratio as emerging biomarker. Sex-specific effects require distinct clinical protocols.

Phosphatidylcholine Restoration Reverses Mitochondrial Aging and Cellular Energy Loss

Study identifies declining phosphatidylcholine as a primary driver of age-related mitochondrial dysfunction and ATP depletion. Researchers demonstrated that restoring phosphatidylcholine levels in aged cells restored youthful mitochondrial performance, electron transport chain activity, and cellular energy production. Finding identifies a reversible, nutrient-responsive mechanism underlying metabolic aging across tissues. ScienceDaily

Why it matters: Mitochondrial dysfunction is tractable through lipid supplementation. Phosphatidylcholine is accessible, low-cost, and shows rapid restoration of function in models. Consider phospholipid panels and targeted supplementation in patients with fatigue, cognitive decline, or metabolic dysfunction. Mechanism separates from senescence and offers layerable intervention.

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

TECH

Midjourney Announces New Medical Division

The first Midjourney Spa opens SF end of 2027 with the new Midjourney Scanner, a full-body Ultrasonic Computational Tomography system with 358,000 transducers, zero radiation, ~60-second scan time. Targets preventive body composition monitoring at consumer scale. Current prototype: 20-minute scan, 12 people tested, no FDA approved.

BIOTECH

Life Biosciences Doses First Patient With ER-100 Epigenetic Reprogramming Therapy

First patient dosed with ER-100, Life Biosciences' partial epigenetic reprogramming therapy for optic neuropathies (age-related vision loss and glaucoma). FDA cleared the IND in January 2026; June 2026 marks first human dosing. This is the inaugural clinical trial of a partial reprogramming approach in humans, translating years of Harvard-led research into the clinic.

BUSINESS

Winning the Longevity Market: 5 Trends Shaping the New Health Consumers

Longevity is becoming a consumer-led category in Southeast Asia, with patients acting as their own health CEOs, using wearables, digital tools, and health data to monitor themselves. Businesses across healthcare, hospitality, financial services, and consumer goods are being pushed to design for vitality, not just treatment. IPSOS

PUBLIC HEALTH

The Longevity Dividend: The Business Case for Linking Health and Wealth

The World Economic Forum and Marsh report finds that three low-cost interventions (fall-proofing homes, increasing physical activity, expanding hearing aid access) could save healthcare systems $5.8 trillion and add $645 billion in productivity by 2040. Based on data from 21 countries, the report argues that longevity is not a problem for aging nations alone but an economic opportunity for every country on the demographic spectrum, and that physical health and financial health must be treated as one system, not two separate policy domains. WEF

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Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of Longevity Docs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

Longevity Docs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

It is 6:00 AM in Eze, a small village in the hills above the French Riviera. A few days after the LongevityDocs Cannes Summit, and I am sitting with coffee, looking at the sea, trying to find the right words.

Here is what keeps coming back: grateful, privileged, responsible, proud, nostalgic, inspired.

Looking at this coastline, I keep thinking about a story. A hundred years ago, the French Riviera in summer was empty. Hotels closed in May. No festival or beach clubs. Then an American couple, Gerald and Sara Murphy, convinced the Hotel du Cap in Antibes to stay open, cleared the seaweed off the beach, and invited Picasso for lunch. He came in a black Stetson and bathing trunks. Fitzgerald followed. Cocteau, Léger, Stravinsky, Man Ray. Within a few years, the Riviera became the center of the creative world, and summer on the Mediterranean became the standard it still is today.

One family stayed when no one else would. They built something where nothing existed. And everyone followed.

That is what we are doing in Cannes with longevity medicine.

Physicians from 30 countries flew in to build this field together. People who could have been anywhere chose to be here. That is not something you forget.

Many of the 1,000+ doctors in our community could not make it. So I wanted to share the highlights with you, and what comes next.

Dr. David Luu, Founder, longevitydocs.™

What you missed in Cannes

We started the way the Murphys started: by showing up and inviting everyone to the table. The White Party on the deck of the Majestic, mocktails on the water, then dinner at the Palm Beach. Everyone in white. A celebration of community, and a reminder of what we stand for: pure, ethical, united by one mission.

Morning Rituals

Then we ran. The next morning was the first-ever LongevityDocs Run Club along La Croisette. Zone 2 pace, so people could actually talk while they ran. On day two, movement, yoga pose, and breath work on the sand.

The Summit

Then the Summit opened at the Palais des Festivals. Thomas de Pariente, Deputy Mayor of Cannes, linked urban lifestyle to longevity and made the case for Cannes as a longevity city. A hundred years after the Murphys put this coastline on the map for art, a deputy mayor is now pitching it as the home of longevity medicine. The field has already won the argument.

Nir Barzilai, President of the Academy of Geroscience, opened with the new biomarkers and the work ahead to standardize the field. He shared a number worth sitting with: centenarians incur roughly one-third the medical cost of everyone else in their final two years of life.

The Graduation

Then the graduation of the world’s first ever Certified Longevity Doctors (CLD). The Gala at the Carlton Hotel was the heart of it. 25 new CLDs crossed the stage, with a commencement address by Dr. Nir Barzilai, honored by Dr. Giovanni Campanile, Dr. Cynthia Keller, Dr. Melissa Loseke, and Dr. Saranya Wyles. The Murphys cleared a beach. We are clearing a path for a new generation of physicians.

The Longevity Docs Awards

• Dr. Ami Bhatt, Chief Innovation Officer of the American College of Cardiology, received the Impact Award.

• Dr. Nir Barzilai received the Legacy Award, presented by Ingrid Ansellem, Brand General Manager, L’Oréal Paris France.

• Dr. Sunita Mishra, Chief Medical Officer of Neko Health, received the Innovation Award, presented by Professor Zahi Fayad, Mount Sinai School of Medicine.

• Dr. Jessica Shepherd received the LongevityDocs Doctor of the Year Award, presented by Brenna Stone, L’Oréal Paris.

• Dr. Steven Murphy received the Community Leadership Award with a standing ovation from the audience.

What every doctor can take home for Monday morning

The Murphys did not just throw parties. They created the conditions for an entire movement. Every person who showed up on that beach carried something home and built on it. Here is what you carry home from Cannes.

1. It takes one physician to change a patient’s life. Every longevity doctor is that physician. Lead with ethics and compassion. The way you see your patient can change their trajectory. You make the call.

2. Small rooms build the partnerships that last. The Murphys did not host conferences. They hosted dinners. Community beats scale. We gather to build the infrastructure the field needs to move forward.

3. Longevity medicine is just born. Legitimize first, then standardize, then democratize. We are still in phase one. That is the exciting part. The Murphys arrived when the beach was empty. So did we.

4. Your personal brand is a clinical trust factor. Patients choose the physician before the protocol. Build it with intention.

5. The CBC may be the most underrated panel you order. Learn to read it as a longevity tool, not a checkbox. RDW and the neutrophil-to-lymphocyte ratio track biological age and mortality risk.

6. Use the safety you already have. The best-evidenced gerotherapeutics are repurposed and FDA-approved: GLP-1s, SGLT-2 inhibitors, metformin, bisphosphonates. Known safety beats a shelf of supplements/peptides with high hype and thin evidence.

7. The ecosystem is ready, cities included. When a deputy mayor pitches you on longevity, you are no longer clearing seaweed. The beach is open.

8. Real-world evidence will make longevity medicine the standard of care. Outcomes matter more than mechanisms, and this community is built to generate them.

9. Ambient longevity is already here. The watch, the ring, the home, the sensor are becoming the clinic. The physician who learns to read that data leads. The one who ignores it gets routed around.

10. Most patients are not looking for a fancy protocol. They are looking for a hand on their shoulder.

A message from Dr. Nir Barzilai, President of Academy of Geroscience

Dear David,

It is not every day that one receives a “lifetime” achievement award, particularly when one fully intends to keep going long enough to earn at least another half. Thank you!

Standing at the Cannes Film Palais of Festival, representing the Academy of Geroscience as its president, was both surreal and deeply meaningful. As someone who entered this field when it was still considered fringe, I felt a quiet satisfaction seeing how far we have come, from early skepticism to a field now rich with promise. The true test, of course, is whether that promise is being realized responsibly.

I arrived with some uncertainty. I expected a “tribe,” a small, enthusiastic but perhaps insular group. What I found instead was something much more encouraging: a movement. A community of nearly 1,000 physicians who are not only engaged, but eager to learn, collaborate, and move the field forward. Perhaps what we need next is not just a tribe, but a nation.

A great deal of credit goes to you, David. Your leadership set the tone: dynamic, innovative, and, importantly, joyful. From the thoughtful program design to the informal “Zone 2 jog” along the promenade, you created an environment where serious ideas could flourish alongside genuine human connection.

One of the most valuable aspects for me was gaining insight into the motivations and challenges faced by practicing longevity physicians. This is not my daily domain, and listening to their perspectives added an important dimension to my understanding of how our science is being translated into care. I will admit that I came prepared to discover some truly “creative” practices. While I cannot claim to know everything that is being done in clinics, much of what I heard was thoughtful and, given the scarcity of large-scale clinical trials in this space, reasonably grounded. This is an important point: innovation is occurring in the absence of perfect evidence, which makes judgment, restraint, and shared standards all the more critical.

I also made a call to use FDA approved drugs that are gerotherapies more aggressively, because knowledge of their safety is an advantage in particular over multi supplements where hype is high and promise lacks evidence

That said, I do want to raise a note of caution regarding peptide therapies. I was particularly struck to learn that several practitioners are administering MOTS-c—a peptide, which I helped develop with colleagues at CohBar Inc. While the enthusiasm is understandable, there are real concerns. Antibody formation is a known issue and could have significant immunological consequences. Additionally, the peptide’s tendency to dimerize and its limited solubility raise serious questions about efficacy in addition to safety in its current form. More broadly, peptides should not be used without clear, short-term, measurable phenotypes—sleep being one example—where benefit and risk can be assessed more immediately.

Looking ahead, it is clear that coordination across organizations will be essential. Groups such as HLMS, the Longevity Institute, and others each bring unique strengths. Aligning efforts and defining complementary roles could significantly accelerate progress and help establish much-needed standards.

Finally, I would like to emphasize a concept that I believe is central to our future success. We have recently refined Geroscience’s positioning. It is not just a field of study—it is the mechanism that leads to the clinical field. It is the discipline that connects interventions to outcomes such as healthspan and longevity, and holds us accountable for delivering both safely and effectively.

My call to this community is simple: come from geroscience. Let it serve as the foundation that guides practice, informs innovation, and ensures that what we do is not only exciting, but right.

And to David, thank you for your generous words, your leadership, and your energy. I look forward to continuing this conversation in New York, and well beyond.

Nir Barzilai
President, Academy of Geroscience

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longevitydocs™ Announces 2026 Award Winners: Five Physician Honorees Advancing Longevity Medicine at Cannes presented by L'Oréal Paris —Dr. Jessica Shepherd, Dr. Nir Barzilai, Dr. Steven A.R. Murphy, Dr. Sunita Mishra, Dr. Ami Bhatt.

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Subscribe to the Longevity Docs Newsletter

Longevity medicine is moving fast. Every week, we bring you what matters: clinical insights, research signals, and perspectives from 1,000+ physicians across 68 countries. One newsletter. Built for the physicians shaping this field.

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of Longevity Docs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

Longevity Docs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

Just landed in the French Riviera. Cannes Longevity Summit is in ten days, production is starting tomorrow. As I sat down to write this week’s newsletter, I kept coming back to the question I hear most from physicians right now: what is a longevity doctor, and how do I become one?

So I wrote about it. Ten traits that define what a longevity doctor actually is. Not a title. Not a certification alone. A way of practicing medicine that most of us were never trained for but all of us can build toward.

Issue 96 is out.

Dr. David Luu, Founder, longevitydocs.™

PS: today’s office view in Monte-Carlo

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

What’s a Longevity Doctor?

10 traits that make a longevity doctor

When I started medical school, I wanted to save lives. Surgery, transplants, the adrenaline of the ER. I trained to treat disease. But by the time I saw most patients, the damage was already done. What if we could get there earlier? What if we could prevent the disease before it appears, and help people live better, not just longer?

The medicine has changed. The technology has changed. The patients have changed. The doctor should change too. Focused on maintaining health for longer. Here are ten traits that define what a longevity doctor actually is.

1. Focus on aging mechanisms: most chronic diseases have an aging mechanism underneath them. Cardiovascular disease, neurodegeneration, metabolic syndrome, cancer. All downstream of the same biology: genomic instability, telomere attrition, epigenetic drift, mitochondrial dysfunction, cellular senescence. A longevity doctor understands these hallmarks as clinical targets. Treat the mechanism. The diseases slow down.

2. Monitor the exposome, longitudinally: we take cardiac troponin for granted now, but it only entered the guidelines in 2000. A longevity doctor measures markers most of traditional medicine still dismisses: genomics, epigenetics, proteomics, metabolomics, air quality, endocrine disruptors, heavy metals, microplastics, stress, social isolation. And they don't measure it once a year. Wearables, continuous monitors, and ambient clinical intelligence can track it daily, turning a single snapshot into a continuous picture of where the patient is heading.

3. Apply N-of-1 thinking: the randomized controlled trial tells you what works for the average patient across a thousand people, but your patient is not the average. They have their own genetics, their own environment, their own response curves. A longevity doctor tracks individual responses in real time, measures the impact of every intervention, and adjusts faster and more precisely than population-based medicine ever could. Measure, intervene, measure again, because every patient is a study of one.

4. Combine medicines: a longevity doctor treats the patient and their close environment: family and home using nutrition, sleep, movement optimization, pharmacology, peptides, hormones, stem cell biology. Lifestyle first, pharmacology second, advanced intervention third. Old therapies and modern ones, combined strategically and sequenced intelligently.

5. Use innovation ethically: gene editing is reaching the clinic. Stem cell therapies are already here. Senolytics, epigenetic reprogramming, and mitochondrial transplantation are in the pipeline. A longevity doctor understands the science before consensus but waits for evidence before applying it to a patient. The line between early adoption and recklessness is ethics, and it matters because your patients trust you with their biology, with their life, and that trust is not something you get to rebuild once you've broken it.

6. AI-augmented: a longevity doctor uses AI to expand the quality of care and to run their practice from anywhere, with more time for the patient in front of them. AI scribes handle documentation so the physician can focus on the conversation, not the screen. AI lab interpretation flags trends a manual review would miss. Ambient AI captures patient metrics longitudinally and surfaces risk before symptoms appear. Clinical decision support tools guide intervention in real time. The technology improves the experience, the physician improves care.

7. Publish real-world data: every patient you treat is a data point the field doesn't have yet. The big trials matter, but their exclusion criteria screen out most of the patients we actually see in clinic. Track what you're doing, write up the cases that surprised you, and share your findings. It helps your patients, it helps the longevity medicine community, and the physician who publishes becomes the physician other physicians call.

8. Align incentives with outcomes: fee-for-service rewards visits. Concierge medicine rewards hospitality. Neither rewards health. A longevity doctor should be compensated for keeping patients healthy, not for seeing them only when they're sick, and not for serving as an expensive insurance policy. Build pricing around what actually matters: biological age reduction, cardiovascular risk improvement, metabolic markers, patient-reported quality of life. When the doctor succeeds only when the patient gets healthier, everything changes. That should be the economic model of modern medicine.

9. Collaborate and educate: longevity medicine doesn't live inside one specialty. A longevity doctor builds relationships with other specialists where the conversation goes both ways, learns constantly from the science and technology emerging across disciplines, and values peer learning and real-world evidence over competition. And they teach, through social media, newsletters, lectures, workshops, and community events, because the knowledge you carry compounds when you give it away.

10. Build for access: a longevity doctor is not just a concierge provider for the wealthy. They advocate for the education, policies, culture change, and economic models that make longevity medicine available to everyone. The infrastructure, the credentialing, the education, and the clinical tools we build must reach every population, every geography, every income level. Democratizing longevity medicine is not a business strategy. It is improving humanity.

These ten traits are not a checklist you complete overnight. I tried to identify the patterns I see in the physicians who are building this field and translate them into something practical, something you can adapt to your own practice, your own patients, your own timeline. Pick one this quarter. Build it in. Then pick the next one.

A longevity doctor is a physician trained to treat the biological mechanisms of aging rather than disease alone. They combine traditional, preventive, regenerative, and performance medicine, monitor the exposome longitudinally, apply N-of-1 interventions, use AI-augmented clinical tools, publish real-world data, and align their incentives with patient outcomes.

Every doctor should be a longevity doctor.

Every week, the Longevity Docs App feels like a front-row seat to the future of medicine. Here’s what had doctors buzzing:

Teens are doing peptides

A physician reported high schoolers using Retatrutide, GHK-Cu, and Tesamorelin with a parent helping reconstitute. The group flagged real risks in adolescents: accelerated epiphyseal closure, disrupted spermatogenesis, and shortened adult stature.

Stem cells: promise vs. noise

A neurosurgeon's viral reel questioning stem cell therapy split the room. The consensus: autologous has decent data, allogeneic is early, the overselling is real, and the field needs physician-led evidence before it gets regulated out of reach.

GHK-Cu: topical wins

Injectable GHK-Cu causes significant site reactions and the hair growth signal may be placebo. A dermatologist in the group recommended topical post-microneedling as the cleaner option with better evidence.

Testosterone pens?

Xyosted is a prefilled testosterone enanthate autoinjector, $200 for four pens, works in men and women, and most of us aren’t using it. A compliant pen solution for peptides and hormones is also coming to the US market soon.

Verve-102: one-shot PCSK9 gene editing

Remarkable science, not ready for patients. No long-term safety data, irreversible, off-site editing in adrenals and spleen, and no outcomes data. Watching.

ROOMS

Anatomy of a Longevity AI Agent

Dr Neil Panchal

• An AI agent differs from a chat session: it takes a goal, breaks it into steps, pulls context, uses tools, and reports back, rather than requiring the physician to orchestrate every step

• A clinical AI workflow has four parts: a trigger (patient message, lab result), reasoning through an LLM, memory and retrieval for persistent context, and execution via APIs and model context protocols

• You don’t need to code. The entire system runs on markdown files as instruction manuals, saved skills for repeatable workflows, slash commands to trigger them, and plugins for clinical or business operations

• HIPAA-compliant AI tools (Open Evidence, ChatGPT Clinician, Perplexity Health, Amazon HealthAI) are maturing but still require enterprise-level deployment for high-risk patient data

• Patient consent can enable use of non-compliant tools like NotebookLM if properly documented

• De-identification remains imperfect and liability-bearing

• There is a cost-benefit tipping point where building your own AI system costs more in time and tokens than outsourcing to a vetted platform

• Longevity medicine generates more data per patient than almost any specialty, making AI workflow automation especially valuable for freeing up time for clinical reasoning and patient relationships

Stay up to date with the latest news & rooms inside longevitydocs.ai

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Alzheimer's Plasma Biomarkers Detect Neuropathology in Midlife

CARDIA cohort, 1,350 adults, mean age 61. Plasma p-tau217 and Aβ42/40 detected Alzheimer’s neuropathology in 4 to 15% of midlife participants. Those positive showed worse processing speed, executive function, and up to 4x higher odds of accelerated memory decline. Stronger associations in women, Black participants, and APOE ε4 carriers. Lancet

Why it matters: Alzheimer’s neuropathology is detectable with a blood test years before symptoms. Plasma p-tau217 is becoming the troponin of neurodegeneration. Consider adding it to midlife panels, especially for patients with family history or APOE ε4 status.

Universal transcriptomic hallmarks of mammalian ageing and mortality

Transcriptomic and DNA methylation clocks showed correlated age acceleration in human blood, which was strongest for the chromatin-associated module clock, highlighting mechanistic links between molecular ageing modalities. This study reveals conserved signatures and a modular architecture of mortality regulation, providing a framework for quantifying and targeting ageing of cellular subsystems across species and tissues. Nature

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

TECH

Sunrise Air: Sleep Apnea Diagnosis Without the Lab

80M+ American adults have obstructive sleep apnea. Untreated OSA elevates risk of stroke, heart failure, type 2 diabetes, and premature mortality. Sunrise has launched a rechargeable chin sensor that delivers clinical-grade diagnosis over multiple nights at home, no wires, no mask, no lab.

WEARABLES

Luna Band: No Screen, No Subscription, $149

A wearable from India’s top smartwatch brand (Noise, backed by Bose) that strips out the screen and the monthly fee. Research-grade sensors, voice-first logging for meals, mood, workouts, and symptoms. Pay once, wear continuously. Voice-first health logging mirrors how physicians actually gather information. Credible sensors without subscription lock or screen fatigue is where continuous monitoring should be heading.

AI

Insilico Medicine x Human Longevity: AI Foundation Model for Longevity

Insilico Medicine and Human Life Foundation Models (new entity from Human Longevity, Inc.) announced multi-million-dollar co-development of industry's first large-scale foundation models dedicated to human longevity science. Leverages Human Longevity's decade-long multi-omic and longitudinal clinical datasets (thousands of subjects) for early disease detection, risk prediction, and AI-driven therapeutic discovery.

CULTURE

Harvard Publishes Consumer Longevity Guide

Harvard Health Publishing released "Pathways to Longevity," covering hallmarks of aging, biological age, lifestyle interventions, and emerging therapies (rapamycin, metformin, GLP-1s, senolytics), edited by Dr. David Barzilai. When Harvard validates longevity medicine as a clinical discipline, it gives you institutional language for patient education and peer credibility.

CARE

Dubai Opens Part-Time Consulting for International Doctors

Dubai Healthcare City's C37 platform lets overseas physicians consult patients in a fully managed clinical environment without opening a permanent practice. A longevity specialist in Barcelona can now see patients in Dubai on demand, no clinic setup required. The infrastructure for distributed, global physician networks is live.

Discover who is going Back to Medicine

Longevitydocs Cannes Summit & Awards- June 9-11

Discover the Pioneers & Agenda

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longevitydocs.™ is the world’s leading longevity physician community - 1,000+ physicians across 68 countries united by a single conviction: every doctor should be a longevity doctor. Founded by Dr. David Luu, the platform offers its members network, education, and experience with the mission to democratize longevity medicine.

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Longevity medicine is the personalized, evidence-based practice of modifying the root mechanisms of aging (biological, cognitive, and psychosocial) before they become disease, extending healthspan, not just lifespan. Using advanced diagnostics, precision interventions, and AI-enabled monitoring, it translates measurement into action across every medical discipline. Success is measured in functional capacity, vitality, and disease-free years.

Subscribe to the Longevity Docs Newsletter

Longevity medicine is moving fast. Every week, we bring you what matters: clinical insights, research signals, and perspectives from 1,000+ physicians across 68 countries. One newsletter. Built for the physicians shaping this field.

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of Longevity Docs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

Longevity Docs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

Back from Memorial Day weekend. I walked on the beach. Coffee dates with Moana. Met dozens of friends. Amazing dinners, great lunches, crepes for breakfast. I cooked, swam, ran, lifted, did webinars, played games. Friends laughed at me, I made fun of them. Tried golf for the first time with Tayron, talked about the future of the world with family, and laughed a lot too. I lived.

I started writing this newsletter somewhere between the crepes and the pool. Over the weekend I talked to several doctors. The same two problems kept coming up. Some don’t have enough patients to make a good living. Others have too many patients to live a good life. Both feel stuck.

I had a cover story ready on the Enhanced Games and performance medicine. It can wait. The doctors I talked to this weekend aren’t thinking about the Enhanced Games. They’re thinking about Monday morning. So I rewrote this week’s newsletter for them.

How to find the right patients. How to build a practice that sustains you. And how to make sure the life you’re building for your patients is one you’re also living yourself.

Issue 95 is out.

Dr. David Luu, Founder, longevitydocs.™

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

Acquire Patients Better: The Physician-Patient Fit Checklist

In startups, nothing happens until you find product-market fit. In longevity medicine, nothing happens until you find patient-physician fit (PPF).

Your Ideal Patient Profile (IPP)

Before you build anything, create your IPP by answering questions like these. Prevention or performance? Content creators or hedge fund managers? Weight, hormones, cognition, or annual checkups? Digital or in person? $2K or $20K annually? Social media or country club?

If you can’t answer these in one sentence each, you’re fishing in the ocean. Fish in a pond. Write your IPP on one page. Every decision flows from it.

Pillar 1: Authority

How the right patient finds you and trusts you before the first call.

• Speak where your IPP gathers. One talk at a wealth advisory dinner converts better than 10,000 Instagram impressions.

• Do research. Case series, posters, clinical letters. Content says you’re informed. Research says you’re contributing.

• Become certified. Get your CLD credential. It answers the question every prospective patient is already asking: how do I know this doctor is serious?

• Short-form builds attention. 60-second explainers, study carousels, quick commentary. Top of funnel. Earns the click to your long-form.

• Local press and PR. One newspaper feature puts you in front of 50,000 people in your market. Start local.

• Long-form content builds trust. Monthly newsletter, YouTube, LinkedIn articles. Let the right patient spend 20 minutes inside your clinical thinking before they call.

• Write a book. Could be a 50-pages ebook. A clear thesis on how you practice longevity medicine. It works while you sleep.

• Volunteer. Free workshops, pro bono screenings, community webinars. Earns trust no marketing budget can buy.

Pillar 2: Community

How the right patient gets referred to you.

• Build your physician referral network. Cardiologists, endocrinologists, concierge PCPs. Coffee plus a one-page summary of your practice. Remove every barrier to that referral.

• Nuture your patient referral network. A patient who feels seen over years tells their inner circle. That compounds faster than any ad spend.

• Join a professional community. Inside Longevitydocs, 1,000+ physicians across 68 countries. A CLD graduate in Miami refers a relocating patient to a CLD graduate in San Francisco. Trust transfers.

• Host events. Annual retreat/summit, dinner talks, small-group Q&As. Builds loyalty and generates referrals no platform can replicate.

• Build an ecosystem of partners. Country clubs, gyms, media, other clinics, personal trainers, hotels.

Pillar 3: Strategy

Authority gets you found. Community multiplies your reach. Strategy makes it run.

• Write a plan. One page. New patients per month, conversion rate, retention at 12 and 24 months, revenue per patient, referral rate, cost per acquisition by channel. Review monthly. What gets measured gets managed.

• Hire the team. You cannot be the clinician, marketer, scheduler, and content creator. Hire a concierge manager who owns the patient experience between visits. Contract a content coordinator. Delegate everything that doesn’t require your medical license.

• Invest in tools. CRM that tracks every patient touchpoint and referral source. Website that answers three questions (measure, prescribe, relationship). Analytics on every channel. Digital intake forms that screen for fit before you invest time.

• Design the experience. NPS survey quarterly. Design every touchpoint: first email after enrollment, lab results delivered with context (not a portal dump), quarterly reviews, annual reassessments. Patients leave practices that feel transactional. They stay in practices that feel intentional.

• Message your patients. Monthly newsletter. Quarterly check-in from the concierge manager. Lab reminders before they’re due. Reactivation outreach for patients who lapse. Silence between visits communicates that you only care when they’re paying.

• Leverage AI. Documentation tools give you 60 minutes back per day and can compound. AI lab interpretation flags trends across panels. Automated scheduling reduces no-shows. Use AI to expand quality of care, not just volume.

What’s next

Define your IPP. Build authority so that patient finds you. Build community so that patient gets referred to you. Build strategy so that patient stays.

I put it all into a one-page checklist. Adapt it to your practice and your market. Then pick your IPP this week. Everything downstream gets easier once you do.

Every week, the Longevity Docs Chat feels like a front-row seat to the future of medicine. Here’s what had doctors buzzing:

HRT After Breast Cancer with Dr. Jordan Emont

Dr. Emont (OBGYN, Menopause Society-certified, founder of Meridian Medical) argued that millions of breast cancer survivors are denied hormone therapy based on outdated trial data using synthetic progestins, not the bioidentical hormones used today. The key evidence: the Stockholm trial (10-year follow-up) found no increased recurrence in ER-positive patients on tamoxifen + HRT, while HABITS (stopped early, weaker methodology) did. These trials used older regimens, not transdermal estradiol or micronized progesterone.

Key Takeaways:

• Breast cancer is not one disease. Receptor status changes the entire risk calculus. ER-negative survivors have front-loaded recurrence in the first 5 years, then less than 1% per year, making HRT conversations very different after that window.

• Duavee (conjugated estrogens + bazedoxifene) is underutilized. It acts as a SERM in breast tissue and deserves wider consideration for ER-positive patients who need symptom relief.

• Testosterone may be protective. Preclinical data show apoptosis in ER-positive tumors, plus cognitive and mood benefits.

• Neurokinin antagonists handle vasomotor and sleep symptoms without systemic hormone exposure in the first 5 years post-diagnosis.

• Even low-dose vaginal estradiol (4 mcg Imvexxy) can trigger breast sensitivity in some survivors. Dose matters.

• GLP-1 agonists and metformin provide adjunctive anti-growth signaling through insulin sensitization, relevant for survivors with concurrent metabolic risk.

Bottom line: Survivors face greater long-term mortality from cardiovascular disease and osteoporosis than from cancer recurrence, yet are routinely denied HRT. The modern evidence supports individualized risk stratification using receptor status, tumor genetics (ctDNA, Oncotype, Breast Cancer Index), and patient preference over blanket contraindication.

Perimenopausal Weight Loss Resistance with Dr. Catherine Johnson

Dr. Johnson (triple board-certified, obesity medicine + menopause) reframes perimenopause as a precision diagnostic window: the woman gaining weight despite unchanged discipline is showing you her future cardiometabolic, sarcopenic, and osteopenic trajectory in real time. The physiology is estrogen/progesterone chaos producing fragmented sleep, elevated fasting glucose, insulin resistance, and visceral fat accumulation, typically starting in the late 30s and accelerating two years before and after the final period.

Key Takeaways:

• BMI lies in perimenopause. Use body composition (body fat ≥30% = overweight regardless of BMI) and HOMA-IR (fasting insulin × fasting glucose ÷ 405) instead.

• Screen every perimenopausal woman for Hashimoto’s. It’s present in 20% of this population, and estrogen fluctuation shifts thyroid binding globulins, producing clinical hypothyroidism with normal-looking TSH.

• Progesterone first, estrogen last. Progesterone restores sleep and improves insulin sensitivity. Testosterone replacement is deferred until weight is down to avoid fluid retention and growth-factor signaling.

• Don’t prescribe exercise first. When cortisol is high, ferritin is low, and sleep is broken, exercise sabotages weight loss in the first six weeks. Fix sleep, nutrients (vitamin D 45-65, ferritin, folate, B12), and cortisol before adding training.

• Her SAME framework: Structure (planning), Accountability (data-driven check-ins), Metabolic advantage (insulin sensitizers, GLP-1 agonists, phentermine/topiramate, Vyvanse for binge-eating/brain fog), Environment (social and relational context redesign).

• Pharmacologic toolkit spans progesterone, metformin, GLP-1 agonists (500-900 fewer daily calories), Contrave, and phentermine/topiramate ER. She teaches nutritional ketosis with finger-stick ketone monitoring to demonstrate the glycogen-to-fat-oxidation switch.

• Quarterly labs to show patients their own fluctuation pattern. Full panel includes androgens, DHEA-S, FSH, estradiol, progesterone, cortisol, insulin, ApoB, Lp(a), full thyroid with binding globulins, celiac screening, and uric acid.

Bottom line: Perimenopause is a systems-level metabolic crisis, not a discipline failure. 40% of a woman’s life is lived postmenopausally, and her trajectory is being written now. Validate her experience, protect her sleep and energy, optimize nutrients and hormones, then build strength. She’ll refer your entire network.

One-Shot Gene Edit Cuts LDL Cholesterol 62% Durably

Verve Therapeutics (now Eli Lilly) published Phase 1 results for VERVE-102, a base-editing therapy that permanently inactivates the PCSK9 gene in the liver via a single IV infusion. At the highest dose, PCSK9 dropped 88% and LDL fell 62% (78 mg/dL), with reductions holding for at least a year. No dose-limiting toxicities. 35 patients with familial hypercholesterolemia or premature CAD.

This is a potential one-and-done replacement for lifelong PCSK9 inhibitor injections. If it holds in larger trials, it fundamentally changes how we manage high-risk lipid patients. NEJM

Retatrutide Hits 30.3% Weight Loss at 104 Weeks

The AJMC piece adds a longer-term data point: patients on 12mg retatrutide lost an average of 85 lbs (30.3%) by week 104, up from the 28.3% at week 80. Even the low 4mg dose delivered 19% loss. The weight loss curve is still trending down past 80 weeks, which matters. It suggests the drug hasn’t plateaued where tirzepatide typically does.

Sleep as a global health priority

Researchers propose treating sleep the way we treat climate or infectious disease: as a planetary health issue requiring coordinated international action. The framework connects human sleep, animal sleep, and environmental exposures (light/noise pollution, climate change, screen time, shift work) into a single model. Key data points: sleep disorders affect roughly a third of the global population, costing $680B annually across five countries, and rising temperatures could strip 50-58 hours of sleep per person per year by century's end. Sleep regularity is a stronger mortality predictor than sleep duration. Cell

AI Predicts Alzheimer’s Trajectory From a Single MRI

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

CARE

HSBC Launches Longevity Care

HSBC Singapore is bundling longevity services (health concierge, preventive screenings…) into its premium banking tier through partnerships with IHH Healthcare and Raffles Medical Group.

For longevitydocs: Banks are becoming a distribution channel for longevity medicine. If HSBC is packaging healthspan programs for affluent clients, that’s a new referral pipeline and revenue stream for longevity-trained doctors who can plug into these ecosystems as providers or advisors.

INVESTMENT

Oura Files for IPO

Nourish Raises $100m for AI-native Metabolic Clinic

Nourish, the largest virtual dietitian-led clinic in the US, raised a $100M Series C to expand into physician-led metabolic care, including GLP-1 prescribing and lab testing. The company hit profitability in 2025 and is scaling its physician workforce through 2026.

For longevitydocs: Nutrition-first platforms are moving upstream into your lane. If insurers start routing metabolic patients to Nourish instead of specialist visits, the referral map changes fast.

Kin Health Raises $9M for a Patient-Facing AI Visit Notetaker

Free app records doctor visits, returns AI summaries with action items. Founded by GoodRx/HeyDoctor alumni and two physicians. Monetizes via referral commissions, not subscriptions. Plans to integrate EHR data later this year.

For longevity doctors: Patients will start arriving with AI transcripts of prior visits across multiple providers. Useful for continuity, but watch for hallucinated action items.

CULTURE

Enhanced Games Platform

The Enhanced Games launched in Vegas: openly doped athletes competing in swimming, sprinting, and weightlifting, funded by Silicon Valley at a $1.2B valuation. Results were mostly underwhelming, one swimming world record. The real play is a telehealth business selling testosterone and peptides to consumers.

For longevitydocs: This normalizes supervised performance-enhancing drugs (steroids, testosterone, HGH, peptides, stimulants, etc) and builds consumer demand for those substances. More patients will come asking, the question is whether they come to you or to a DTC app.

Discover who is going Back to Medicine

Longevitydocs Cannes Summit & Awards- June 9-11

Discover the Pioneers & Agenda

The Home of Longevity Medicine

longevitydocs.™ is the world’s leading longevity physician community - 1,000+ physicians across 68 countries united by a single conviction: every doctor should be a longevity doctor. Founded by Dr. David Luu, the platform offers its members network, education, and experience with the mission to democratize longevity medicine.

Not a member yet? Join longevitydocs™

We’re a physician-only network. Curated. Vetted. Built on trust. If you’re committed to practicing longevity medicine with rigor, peer support, and shared standards → this is your community. Apply to connect with our team.

Apply to Join

Longevity medicine is the personalized, evidence-based practice of modifying the root mechanisms of aging (biological, cognitive, and psychosocial) before they become disease, extending healthspan, not just lifespan. Using advanced diagnostics, precision interventions, and AI-enabled monitoring, it translates measurement into action across every medical discipline. Success is measured in functional capacity, vitality, and disease-free years.

Subscribe to the Longevity Docs Newsletter

Longevity medicine is moving fast. Every week, we bring you what matters: clinical insights, research signals, and perspectives from 1,000+ physicians across 68 countries. One newsletter. Built for the physicians shaping this field.

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of Longevity Docs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

Longevity Docs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

This one is not for everyone. Most physicians are exceptional at what they do: treating patients in clinical settings, saving lives, practicing medicine at the highest level. That is the backbone of healthcare and it always will be.

But some of you have decided to go a different route. To treat aging before it becomes disease. To extend healthspan by compressing the years we spend living with age-related chronic conditions. Some of you are just starting, either transitioning from another specialty or fresh out of residency. I have been there. I feel you.

Here is what nobody tells you: you need a plan. Not only a clinical plan. A business plan: accounting, legal, marketing, hiring, pricing, operations. None of that is taught in medical school. And yet all of it determines whether your practice survives year one.

Longevity clinics are growing everywhere in the world. There is no going back. But is yours profitable? How do you scale? How do you improve efficiency? I get these questions all the time. There is no perfect playbook, but I want to dedicate this week’s story to the math behind it.

So this week I am writing about how to build a $1M longevity clinic.

11:25am. 94 is out.

Dr. David Luu, Founder, longevitydocs.™

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

How to Build a $1M Longevity Clinic?

You are starting you longevity clinic or want to grow it. Like any business, you need a revenue target. I am using $1M because it is the number where investors start paying attention. Whether that means an investment round, or simply building a practice valuable enough to sell when you want to stop (and yes, work is longevity). $1M in revenue is the threshold where your clinic becomes an asset.

These are U.S. numbers. Adapt the math to your market. The models are universal. The price points are local.

And to be clear: we are talking about revenue, not profit. Profit varies based on your cost structure, your geography, your team, and how you run the practice. But you cannot have profit without revenue. So start here.

I get this question all the time. So here are three models, with their trade-offs. I am not including interventions, modalities, or prescriptions here. This is pure longevity care services: membership, testing, consults, coaching. The clinical add-ons are separate revenue lines that change the math significantly depending on your practice.

Three Roads to $1M

Model 1: Concierge

50 patients. $20K each.

This is the boutique clinic. You see fewer patients, spend more time with each, and charge accordingly.

The math: 50 patients × $20,000 per year = $1,000,000.

Your patients expect full access: your phone, same-day responses, comprehensive testing, personalized protocols. The higher the price, the higher the expectation for outcomes. More human in the loop at every step.

Margins per patient are strong, but your revenue has a ceiling. You are selling your time. At around 50 patients, one physician can deliver. Growth means either raising prices or adding another physician, which changes the business entirely.

• Pros: highest revenue per patient, deep relationships, strong retention, simple operations.

• Cons: you are the ceiling, burnout risk, small patient base means a few churns hurt, hard to sell the practice without you in it.

• Best for: physicians in affluent markets who want a small, high-touch panel and are comfortable being the product.

Model 2: Volume Hybrid

200 patients. $5K each.

Lower entry price, wider funnel. The membership fee covers the clinical relationship, but the clinic does not reach $1M on membership alone.

The math: 200 patients × $5,000 = $1,000,000.

In practice, your $1M usually looks like this: a few hundred thousand from memberships, the rest from labs, imaging, supplements, wellness programs, group consults, and products. Membership gives you the relationship; everything else lives on top of that.

You also need a team. One physician cannot see 200 patients, manage protocols, and run operations. A PA or NP handles follow-ups, routine check-ins, and protocol management. A medical assistant supports in-office testing. A part-time coordinator keeps the calendar and inbox under control.

A real tech stack is mandatory here: scheduling, intake, automated follow-up, patient communication, lab ordering, and data tracking. Without it, this model breaks around 70–80 active patients. Operationally heavier. More moving parts. But at 200 patients with multiple revenue streams, you have a real business.

• Pros: diversified revenue, more resilient to churn, buildable team, genuinely sellable business.

• Cons: operationally complex, staff management, higher fixed costs, upsell dependency, tech stack is not optional.

• Best for: most physician-owners who want a clinic that employs a small team, has an in-person footprint, and is built to be an asset, not just a job.

Model 3: Platform

500+ patients. $2K each.

Digital first. Lightweight physical footprint, if any. AI and automation handle intake, lab structuring, risk scoring, and routine patient communication.

The math: 500 patients × $2,000 = $1,000,000.

In this model, the physician is the trust layer, not the bottleneck. You are not selling your hours. You are selling access to a system with your name, judgment, and protocols behind it. The system does the heavy lifting; you do the thinking.

You review key labs, make decisions, write prescriptions, and coach where it really matters. You can work on an hourly or session-based model and adjust your lifestyle up or down. See patients from anywhere. Work 20 hours a week or 50. Your call.

This is where the physician becomes scalable. The technology makes your brain and your model available to far more people without adding a linear number of hours. This model barely exists at individual-physician scale today, but the economics point here. It has the lowest startup cost, the widest reach, and the highest scalability. It is also the hardest to build, because the technology and regulatory layer have to be right.

• Pros: location independent, lifestyle flexible, lowest overhead, highest scalability, highly sellable if built well.

• Cons: technology dependency, trust is harder without in-person, relationships are thinner, regulatory complexity across states, the AI layer does not yet exist off the shelf.

• Best for: tech-forward physicians willing to build or partner on a platform and expand across regions via telehealth.

The Metrics That Matter (for Every Model)

If you do not know your numbers, you do not have a business. You have an expensive hobby.

Track these monthly:

• LTV (lifetime value per patient).

• CAC (cost to acquire one patient).

• LTV:CAC ratio (you want at least 3:1 or you are buying revenue, not building a business).

• Churn (how many members leave per year).

• Revenue/margins per physician.

• Upsell conversion rate (how many members move into higher-value services).

• Lab and testing cost per patient.

• Staff cost as a percentage of revenue.

• Rent or lease as a percentage of revenue.

• Marketing spend as a percentage of revenue.

• Tech stack cost per patient.

• Breakeven patient count (how many active patients you need to cover your monthly burn).

These numbers tell you which model you are actually running, not which model you think you are running.

The Longevity Clinic Checklist: What You Need Before Patient One

You do not need everything on day one, but you do need a clear sequence. Think in three phases.

1. Before Launch: Non‑negotiables

Legal and Structure

• Entity formation (LLC, PLLC, or PC, depending on your state).

• Management Services Organization (MSO) with a Management Services Agreement (MSA) if you are separating clinical and business operations.

• Business bank account.

• Malpractice insurance (confirm longevity/preventive coverage).

• HIPAA compliance plan.

• Patient consent and waiver templates.

• Membership agreement terms.

• Accountant (monthly, not just tax season).

• Healthcare attorney (one call before launch saves ten later).

Licensing and Credentials

• State medical license (and additional states if telehealth).

• DEA registration (if prescribing controlled substances).

• CLIA waiver or lab partnership agreement.

• NPI number.

• Collaborative practice agreement (if hiring PA/NP where required).

Core Clinical Infrastructure

• Lab partner (or in-house CLIA-waived testing).

• Imaging partner (DEXA, CT calcium score, MRI referral pathway).

• Pharmacy relationship (including compounding if applicable).

• EMR (as your clinical dashboard, not just a billing tool).

Essential Tech and Presence

• EMR (there is plenty of them now)

• Patient messaging (HIPAA-compliant).

• Scheduling (built into EMR or separate).

• Payment and membership billing (Stripe, Square, or membership platform).

• Telehealth option (HIPAA-compliant).

• Simple website: clean, fast, with one clear call to action (book/apply).

2. First 90 Days: Build the Funnel

Team (Part-time is fine)

• Front desk / patient coordinator (part-time).

• Virtual assistant (scheduling, follow-ups, inbox).

• Bookkeeper (weekly).

Marketing and Acquisition

• Brand: name, logo, colors, one clear positioning statement.

• Website live before you open.

• Google Business profile claimed and optimized.

• Social media presence (LinkedIn minimum; Instagram if consumer-facing).

• Referral network started (PCPs, cardiologists, endocrinologists, therapists).

• One lead magnet (free consult, webinar, or guide).

• CAC tracking from day one (how much you spend per new patient).

3. Next 12 Months: Scale and Systematize

Advanced Clinical and Data Infrastructure

• Wearable data integration (Oura, Whoop, CGM, etc.).

• Data aggregation platform for labs and wearables.

Expanded Team (Depends on Model)

• PA or NP (essential for Model 2 and Model 3; not required day one for Model 1).

• Medical assistant (if you are doing in-office labs or vitals).

• Marketing support (freelancer or agency, not full-time yet).

Financial Planning and Review

• 12-month cash runway or clear revenue plan.

• Monthly burn rate calculated before launch and revisited quarterly.

• Pricing model locked (membership, per-visit, or hybrid).

• Break-even patient count known and updated.

• Revenue per patient target set.

• LTV and churn assumptions documented and then replaced with real data.

• Quarterly P&L review on the calendar.

Where AI Fits

AI coaching on labs will become a commodity. Every report will start to sound the same. That is fine. Let the machines summarize.

What remains scarce is the physician: your trust, your guidance, your judgment, your ability to motivate and hold patients accountable. That layer is not going away in three years. Probably not in ten.

Build your clinic so that AI and software handle everything repeatable—and you focus on the work that only you can do.

Choose Your Model, Know Your Math

Pick the model that matches your risk tolerance, your lifestyle goals, and your market:

• Boutique (50 × 20K).

• Volume hybrid (200 × 5K).

• Platform (500 × 2K).

And if $1M feels far away, remember: Model 2 is 200 patients at $5K. That is 17 new patients a month for a year. One physician, one PA, one tech stack, one year.

The time to build is now. We will go deeper into these models in at the Longevity Docs Summit in Cannes in few weeks.

Every week, the Longevity Docs Chat feels like a front-row seat to the future of medicine. Here’s what had doctors buzzing:

Is there a clinical difference between tirzepatide and semaglutide for reducing alcohol cravings and tolerance?

A physician who prescribes both shared his experience: tirzepatide is more effective for cravings specifically, but semaglutide also works well for reducing overall intake. AUDIT score reductions are comparable in his clinic.

Another member added a practical observation: patients eat less on both medications, which means they hit higher blood alcohol levels faster when they do drink. “They end up pregaming harder than they used to party.”

A third member asked whether the effect differs between branded formulations (Mounjaro vs Zepbound vs semaglutide). The consensus: the molecule matters more than the brand. Tirzepatide’s dual GIP/GLP-1 mechanism may explain the stronger craving reduction, though head-to-head data in alcohol use disorder does not yet exist.

Separately, a member flagged two GLP-1 drug interactions from recent literature: risk of hypercalcemia when combined with thiazide diuretics or calcium supplements, and increased lithium levels in patients on lithium therapy.

Key Takeaways: tirzepatide may have an edge over semaglutide for alcohol cravings, but both reduce intake. Monitor patients who drink on GLP-1s for faster intoxication due to reduced food intake. Check for thiazide and lithium interactions. Head-to-head data is needed.

PCOS Is Now PMOS

Polycystic Ovary Syndrome is officially renamed Polyendocrine Metabolic Ovarian Syndrome (PMOS). The Endocrine Society and more than 50 global patient and professional organizations led the change after 14 years of collaboration. The old name reduced a complex, long-term hormonal disorder to a misunderstanding about ovarian cysts. There is actually no increase in abnormal cysts on the ovary. PMOS affects 1 in 8 women worldwide, more than 170 million. The new name leads with hormones and metabolism, reflecting what the condition actually is: a multi-system endocrine disorder with impacts on weight, metabolic health, mental health, skin, and the reproductive system. A three-year transition period begins now, with full implementation in the 2028 international guideline update. Endocrine Society

Why it matters: the name was a barrier to diagnosis and care for decades. Physicians and patients both defaulted to thinking “ovarian cysts” when the real drivers are hormonal and metabolic. For longevity physicians treating women’s health, this reframe aligns PMOS with the metabolic and endocrine lens already used in practice. Update your clinical language now. The guidelines will follow.

Sleep Duration and Biological Aging: The U-Shaped Curve Across Every Organ

A new Nature study of nearly 500,000 UK Biobank participants mapped sleep duration against 23 biological aging clocks across organs and omics layers. The pattern is U-shaped everywhere. Both short (under 6 hours) and long (over 8 hours) sleep accelerate aging in the brain, liver, lung, immune, endocrine, and adipose systems. The sweet spot: 6.4 to 7.8 hours. Both extremes raise all-cause mortality (HR 1.4 to 1.5), but through different routes. Short sleep acts directly on systemic disease risk. Long sleep appears to be a signal of underlying organ aging already in progress.

Why it matters: Sleep duration is a cheap, modifiable vital sign that tracks biological age across the whole body. Seven hours is not a lifestyle recommendation. It is a biomarker. Ask about it at every longevity visit.

Beta-Blockers May Protect Against Vascular Dementia. ACE Inhibitors May Not.

Researchers used Mendelian randomization across 46 drug targets and nearly 900,000 controls to test whether existing lipid-lowering, antihypertensive, and anti-inflammatory drugs could be repurposed to prevent vascular dementia. Beta-blockers targeting the ADRB1 receptor showed the strongest protective signal. ACE inhibitors showed the opposite: a potential increase in vascular dementia risk. Most other drug classes showed no effect. Nature Aging

Why it matters: vascular dementia is the second most common form of dementia and shares biology with cardiovascular disease. Many longevity patients are on antihypertensives. If beta-blockers protect the brain while ACE inhibitors do not, that changes how physicians weigh cardiovascular and cognitive risk together. For patients on ACE inhibitors, this is worth watching as pharmacovigilance data catches up.

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

AI / TECH

Doximity Launches Free Prescribing for Physicians

Doximity released Doximity Prescribe, a free prescribing tool built into the platform through a partnership with Photon. Physicians write the prescription inside Doximity. The patient receives a text to choose their pharmacy and view estimated costs before pickup. No extra portals, no pharmacy calls. Fully mobile. Free for all verified U.S. physicians, NPs, and PAs. For longevity physicians running cash-pay practices, patients seeing costs upfront and choosing their own pharmacy removes the friction that eats clinical time. Doximity

Function Health Acquires SuppCo. The Supplement Trust Problem Gets a Data Layer.

Function Health acquired SuppCo, a supplement verification platform that has rated 35,000+ products and analyzed 500,000+ routines. SuppCo’s independent testing found roughly half of top-selling supplements failed basic label accuracy. Function plans to connect supplement data to its existing biomarker platform so patients can see whether what they take actually moves their numbers. No supplement sales, just scoring and verification. For longevity physicians, this is the infrastructure that turns “should I take this?” from an opinion into a lab-verified answer. Longevity Technology

POLICIES

Makary Out at FDA. What It Means for Longevity Therapeutics.

Marty Makary resigned as FDA Commissioner on May 12. His replacement, acting commissioner Kyle Diamantas, is a food-industry lawyer with no medical or scientific background. Makary was polarizing, but he lowered the bar for drug approvals in ways that mattered for aging science: single pivotal trials instead of two, and a plausible mechanism pathway for rare disease drugs. Senolytics, rapamycin analogs, NAD precursors don’t fit traditional approval frameworks. Makary’s FDA was at least asking the question. Physicians should watch whether those pathways survive the transition or get quietly shelved. STAT News

SCIENCE

900 “Dark Proteins” Mapped Across 32 Cancers. Proteomics Is Moving Faster Than Genomics.

Researchers mapped roughly 900 "dark proteins," proteins with no known function, across 32 cancer types using mass spectrometry on more than 1,100 tumor samples. Several of these dark proteins sit on cell surfaces, making them viable targets for immunotherapy. One candidate, C1orf116, showed up consistently in head and neck squamous cell carcinoma and is now being tested as a CAR-T target. The study reframes the proteome: the proteins we have ignored may matter more than the ones we have studied. For longevity physicians tracking cancer risk as part of biological aging panels, this is a signal that protein-level diagnostics are moving faster than genomics alone. STAT News

Discover who is going Back to Medicine

Longevitydocs Cannes Summit & Awards- June 9-11

Discover the Pioneers & Agenda

The Home of Longevity Medicine

longevitydocs.™ is the world’s leading longevity physician community - 1,000+ physicians across 68 countries united by a single conviction: every doctor should be a longevity doctor. Founded by Dr. David Luu, the platform offers its members network, education, and experience with the mission to democratize longevity medicine.

Not a member yet? Join longevitydocs™

We’re a physician-only network. Curated. Vetted. Built on trust. If you’re committed to practicing longevity medicine with rigor, peer support, and shared standards → this is your community. Apply to connect with our team.

Apply to Join

Longevity medicine is the personalized, evidence-based practice of modifying the root mechanisms of aging (biological, cognitive, and psychosocial) before they become disease, extending healthspan, not just lifespan. Using advanced diagnostics, precision interventions, and AI-enabled monitoring, it translates measurement into action across every medical discipline. Success is measured in functional capacity, vitality, and disease-free years.

Subscribe to the Longevity Docs Newsletter

Longevity medicine is moving fast. Every week, we bring you what matters: clinical insights, research signals, and perspectives from 1,000+ physicians across 68 countries. One newsletter. Built for the physicians shaping this field.

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of Longevity Docs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

Longevity Docs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

4:12am. Sunday. NYC. Newsletter 93. We organically reached 10,000 followers on Instagram and 7,770 readers with 373K all-time views. Thank you all!

This week: we are launching Jobs, a new feature for physicians to refer patients, hire talent, and find research collaborators directly inside the platform.

I also deep dive on The Longevity Care Race and what it means for physicians.

11:58am. 93 is out. Happy mother’s day to all

Dr. David Luu, Founder, longevitydocs.™

Every week, we ship something new for this community. Features, experiences, and products built by physicians, for physicians. The platform grows because you do.

APP

Launching Jobs: Refer, Hire, Partner

Every day we get demands for a new medical director, or a physician asking to refer a patient to another specialist. Hiring. Referrals. Partners. So we built Jobs.

One network. Three post types. Two minutes to publish.

Refer a patient. Post the clinical need, location, and remote availability. Longevitydocs in the network can respond directly.

Find a research partner. Post your study scope and find a co-investigator in Tokyo.

Hire a longevity physician. Medical director roles, clinical positions, enterprise advisory seats. NextHealth, Sha, and L’Oréal recruited directly from Longevitydocs.

How Jobs works

To post: Open the app. Tap Jobs. Pick a post type. Title, description, location, remote toggle. Submit. Every post is moderated before it goes live. Track everything from “My offers.”

To browse: Filter by Referrals, Collaborations, or Hiring. Search by specialty or location. Apply or respond inside the platform.

Every physician is vetted. Every post is reviewed.

Open the app. Tap Jobs.

Jobs is now available on the longevitydocs.ai

Download the App

ROOM OF THE WEEK

Next Rooms

Rooms are available on the longevitydocs.ai

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

The Best Longevity Care Platform Does Not Exist Yet. Everyone Is Building It.

Longevity care is medicine for people who want to age well and do not wait for disease or complications. The goal: improve age-related biomarkers and outcomes. Reduce biological age. Lower inflammatory markers. Restore hormonal balance. Improve cardiovascular risk profiles. Extend the number of years lived without disease, disability, or cognitive decline.

Longevity care is clinical medicine applied before disease, measured in biomarkers, and accountable to outcomes. And right now, every major platform in health is racing to deliver it. It runs on three pillars.

• Personalized data: genomics, proteomics, metabolomics, wearables, imaging, and lab panels that build a biological profile specific to one person.

• Outcomes-based interventions: pharmaceuticals, nutraceuticals, nutrition, exercise, sleep, and behavioral protocols matched to that profile.

• Continuous care: longitudinal tracking that measures whether the interventions are working and adjusts them when they are not.

Some build for scale

Every major platform in health is racing to deliver longevity care.

WHOOP added on-demand clinician consultations, EHR syncing, and was selected into the CMS Innovation Center ACCESS program. A wearable company is now a care delivery company.

Google launched Health Coach. $9.99/month. Gemini-powered. Fitness, sleep, and health advising inside the Fitbit app. Apple is building Health+, an AI coach trained on physician data across cardiology, nutrition, sleep, and mental health. Expected later this year.

Hims & Hers has 2.5 million subscribers, at-home labs, telehealth, in-house pharmacy, and a longevity specialty launching in 2026. Noom acquired a compounding pharmacy, launched telehealth-led weight management with GLP-1 prescribing, and is building care plans that pair medication with behavioral coaching

Function Health built a Medical Intelligence Lab unifying lab testing, imaging, wearables, and medical records with AI. Midi Health serves 25,000 patients per week across 500 providers in 50 states with an AgeWell longevity program.

Equinox launched EQX Arc: diagnostics-led women’s health powered by Function’s biomarker panels, integrated with Oura Ring, backed by a Women’s Health Advisory Board of physicians.

They have the technology, the capital, and the distribution. What they do not have is the physician expertise to deliver longevity care with clinical depth and accountability. AI can interpret labs. Platforms can scale access. But the clinical judgment, the risk stratification, the treatment decisions that actually change outcomes

Some build for precision

On the other side, physicians, clinics, and health systems have something none of these platforms can build from scratch: trust. Decades of patient relationships, clinical credibility, and the license to treat. But trust alone does not scale.

Health systems are the slowest to move. Most lack the consumer experience, the digital infrastructure, and the service offerings patients now expect. Patients are not waiting. They are moving to platforms that answer faster, even when those platforms have less clinical depth.

Longevity clinics have the expertise. Advanced diagnostics, personalized protocols, physician-led care. They cannot scale. Overhead is high. Infrastructure is limited. Most serve hundreds, not millions. The clinical knowledge is there. The delivery model is not.

The healthcare expertise is there. What needs to improve is the longevity medicine knowledge, the delivery model, the patient experience, the messaging, and the convenience. The platforms building for scale solved those problems first.

8 Steps to Build a Longevity Care Program

Whether you are a clinic, a health system, or a platform, these are the 8 components you need. Every company in this article is assembling some combination. No one has all eight yet.

1. Brand and Acquisition. A reason people show up before they are sick. This could be a wearable, a gym, an app, or a physician’s reputation. You need a front door.

2. Care Offering. Weight management. Hormone optimization. Full-body diagnostics. Women’s health. Cardiovascular prevention. The strongest programs offer multiple lanes under one roof. Start with one. Build from there.

3. Testing. Biomarkers, imaging, DEXA, CT scans, VO2 max.... Testing is what separates longevity care from reactive care. It gives you the data to personalize interventions and track outcomes over time.

4. Data and Wearables. Continuous data from wearables turns a single visit into a longitudinal relationship. HRV, sleep architecture, glucose, activity. The data layer is what makes longevity care different from annual physicals.

5. EMR. The EMR is no longer a billing tool. It is the clinical dashboard. Testing, imaging, wearables, and clinical notes need to live in one place. Without a unified record, there is no care delivery.

6. Physician Consultations. Telehealth, in-person, or both. The physician is still the trust layer. No program scales without clinicians who can interpret the data, adjust the plan, and manage risk.

7. Pharmacy. Prescribing without fulfillment creates friction. The programs that own pharmacy own the patient relationship. GLP-1s, HRT, cardiovascular medications, nutraceuticals.

8. AI. AI connects the other seven into a single operating system. Lab interpretation, risk scoring, patient communication, clinical decision support, operations, and personalized care.

Longevity care for all

AI coaching based on labs will become a commodity. More accessible, more affordable, more available. That is a good thing. Millions of people who never had access to biomarker data will get a personalized report on their phone. But every AI-driven report will start to sound the same.

What remains rare: the trust, the guidance, the motivation, and the accountability that come from a physician. That layer stays precious. People will have more data than ever. They will still need a doctor to help them act on it.

Longevity care is entering its industrialization phase. The platforms are being built. The infrastructure is being assembled. LongevityDocs is building the physician infrastructure that powers it: the community, the education, the credentialing, and now the tools to refer, hire, and collaborate.

Longevity care for all is closer than the field thinks. Every platform above is building toward it. Physicians shaping thew conversation will be in Cannes.

Every week, the Longevity Docs Chat feels like a front-row seat to the future of medicine. Here’s what had doctors buzzing:

Beta-Blocker Protocol Before Cleerly CTA

A member asked the group:

should I hold Toprol in an athletic patient with a sleeping heart rate in the low 40s before a Cleerly CTA?

Standard prep calls for low-dose metoprolol (25-50 mg) the night before and morning of. The concern: the nighttime dose pushing heart rate dangerously low during sleep.

A cardiologist offered a clear threshold:

if asymptomatic and HR above 45, no need to hold. Below 45, lower the dose or stop entirely.

An interventional specialist went further:

no beta blockade at all for HR below 55. Athletes have high resting vagal tone. Endurance athletes often run in the 30s at night.

A cardiology-focused internist took a different approach: she still gives a low dose day-of because anxiety and the contrast bolus spike heart rate. She skips the PM dose for bradycardic patients. She also noted nitroglycerin during the scan causes compensatory tachycardia, which is part of why the beta-blocker protocol exists.

Then a real case made the discussion concrete. A member shared that his wife’s scan was cancelled. Toprol held for HR of 52. Contrast pushed her to 80.

Multiple members responded:

find a cardiology-run center with IV metoprolol on standby.

One confirmed his center does every scan this way.

The discussion shifted to whether CTA was the right test at all. With Lp(a) of 250 and ApoB of 130, one cardiologist laid out her approach: drive ApoB as low as achievable, use Repatha (drops Lp(a) 25-30%), add ezetimibe and bempedoic acid especially for ApoE4 carriers, monitor with CIMT. For younger women, she raised breast cancer risk from CTA radiation and recommended CIMT plus CAC as alternatives.

Key Takeaways: HR above 45 and asymptomatic: proceed with beta-blocker. HR below 45: reduce or stop. Always skip the PM dose for bradycardic patients. Always have IV metoprolol on standby at the imaging center. Before ordering Cleerly, ask whether the result will change management. In very high Lp(a) with elevated ApoB, aggressive lipid-lowering may be the move regardless of imaging. Find a cardiology-run center. The cancelled scan was preventable.

Core Capacity clock of human aging

Researchers built an aging framework from 2,019 individuals integrating clinical, physiological, and molecular data across three tiers: physiological decline, multimodal precision, and organ-specific aging rates. Plasma protein clocks proved to be efficient proxies for whole-body functional status. The framework also identified coagulation factor accumulation as a driver of multi-organ senescence and systemic inflammation. Cell

For longevitydocs: most biological age tools measure one layer. This connects molecules to function in a single system. Coagulation factors as an aging driver are measurable and potentially targetable. A more comprehensive clock is coming. Physicians running proteomic panels are already on the right track.

Semaglutide Reduces Heavy Drinking in Alcohol Use Disorder

108 adults with alcohol use disorder and obesity received weekly semaglutide (2.4 mg) or placebo alongside cognitive behavioral therapy for 26 weeks. Semaglutide reduced heavy drinking days by 41% (12 fewer days per month vs. 8 for placebo). Total alcohol consumption dropped nearly 50% more than placebo. Weight loss: 11.2 kg vs. 2.2 kg. Number needed to treat: 4.3, lower than any approved AUD medication.

For longevitydocs: GLP-1s keep expanding beyond metabolic disease. Alcohol use disorder accounts for 5% of deaths globally and accelerates biological aging across every organ system. A single weekly injection that reduces drinking, weight, and cravings simultaneously is a longevity intervention whether or not it is labeled as one. For physicians already prescribing semaglutide, this is a new clinical indication to watch.

Lifestyle Intervention Did Not Change Brain Biomarkers but Protected Cognition in At-Risk Adults

POINTER trial: 983 adults aged 60-79 with risk factors for cognitive decline received either a structured or self-guided lifestyle intervention (exercise, nutrition, social engagement, cardiovascular monitoring) over two years. Neither group showed changes in amyloid, tau, hippocampal volume, or white matter lesions. But adults with lower baseline hippocampal volume or increasing tau showed significantly better cognitive outcomes in the structured group. JAMA Neurology

For longevitydocs: lifestyle interventions may not reverse brain pathology, but they protect cognition in people who need it most. The benefit was greatest in those already showing signs of neurodegeneration. For longevity physicians: brain imaging can identify which patients will benefit most from intensive lifestyle protocols. Precision prevention, not one-size-fits-all.

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

CARE

WHOOP Adds Clinician Consultations and EHR Syncing

WHOOP is launching on-demand video consultations with licensed clinicians inside the app this summer. Consultations start with months of continuous biometric data, not a blank intake form. EHR syncing through HealthEx connects diagnoses, medications, and procedures. New AI features include persistent memory, proactive check-ins, and voice-based habit journaling. WHOOP

Why it matters: a wearable company with continuous data, clinical consultations, and medical record integration is now a care delivery platform. WHOOP was also selected into the CMS ACCESS program for Medicare beneficiaries. The line between consumer health and clinical medicine is disappearing. Physicians should pay attention to who is building the infrastructure around their patients.

AI

Google Launches AI Health Coach with Gemini

Google Health Coach is live for Fitbit and Pixel Watch users. Gemini-powered. Personalized workout plans, sleep analysis, recovery insights, and nutrition advising built on continuous biometric data. Members can connect CGMs through Health Connect and ask the coach how specific meals or workouts affect glucose. Medical record syncing lets the coach summarize clinical history in plain language. Included free with Google AI Pro and Ultra subscriptions. Google Blog

Why it matters: Google just built a longitudinal health advisor that reads your wearable data, your glucose monitor, and your medical records. For $9.99/month. At that price and distribution, this reaches hundreds of millions of people before any physician does. The AI health coach is becoming the first point of contact for health decisions. Physicians need to be inside these ecosystems, not outside them.

Hims & Hers Launches Labs AI Care Agent

Hims & Hers launched Labs AI, an AI agent that reasons across up to 130 biomarkers, personal health profiles, and historical trends to deliver personalized analysis. It identifies patterns across markers (e.g., LDL, ApoB, and Lp(a) together signaling cardiovascular risk) and connects customers to licensed clinicians when needed. Built on clinician-designed guardrails, not the open internet. Hims & Hers

Why it matters: 2.5 million subscribers now have an AI that reads their labs the way a longevity physician would, for the cost of a subscription. When it flags an ApoB and Lp(a) pattern and recommends a clinician, that referral goes to a Hims provider, not yours. The platform that interprets the labs controls the patient relationship.

POLICIES

ARPA-H Launches AI-Powered Research Acceleration Program

ARPA-H announced IGoR (Intelligent Generator of Research), a five-year program to build an AI-enabled research ecosystem targeting complex chronic diseases including Alzheimer’s, Parkinson’s, and autoimmune conditions. The system uses AI to identify knowledge gaps, recommend experiments, standardize protocols for reproducibility, and continuously refine disease models. Goal: accelerate biomedical discovery at least ten times faster.

Why it matters: the replication crisis and fragmented research have slowed breakthroughs for decades. IGoR builds infrastructure to fix both. For longevity medicine, where complex multi-system aging mechanisms resist traditional single-lab approaches, a networked AI-guided research ecosystem could compress timelines on the diseases we care about most.

SCIENCE

Genome editing can be risky. Meet the epigenome editors

Scientists are using CRISPR’s guidance system with the cutting enzyme disabled. Instead of altering DNA, epigenetic editors silence or modulate genes by adding chemical markers. Clinical trials are targeting PCSK9 (atherosclerosis), hepatitis B, and muscular dystrophy. A single dose could replace daily pills. The Economist

Why it matters: lower risk than gene editing, with direct relevance to aging. Chronic inflammation and cellular senescence have epigenetic components. PCSK9 silencing as a one-time injection would reshape cardiovascular prevention.

The Thymus May Be a Key Longevity Organ

Adults who had their thymus surgically removed were twice as likely to die of any cause and twice as likely to develop cancer within five years, per a landmark NEJM study. New research using AI-scored CT scans found that a healthier thymus predicted lower lung cancer, cardiovascular death, and all-cause mortality over 12 years, plus better response to cancer immunotherapy.

Why it matters: the thymus trains T cells, shrinks after puberty, and was dismissed as vestigial for decades. It is now being reconsidered as a regulator of aging, immune surveillance, autoimmunity, and cardiovascular risk. Researchers are working to regenerate it. For longevity physicians: immune aging starts with thymic involution. This organ may be the missing variable in how we think about immunosenescence.

Washington Post

Discover who is going Back to Medicine

Longevitydocs Cannes Summit & Awards- June 9-11

Discover the Pioneers & Agenda

The Home of Longevity Medicine

longevitydocs.™ is the world’s leading longevity physician community - 1,000+ physicians across 68 countries united by a single conviction: every doctor should be a longevity doctor. Founded by Dr. David Luu, the platform offers its members network, education, and experience with the mission to democratize longevity medicine.

Not a member yet? Join longevitydocs™

We’re a physician-only network. Curated. Vetted. Built on trust. If you’re committed to practicing longevity medicine with rigor, peer support, and shared standards → this is your community. Apply to connect with our team.

Apply to Join

Longevity medicine is the personalized, evidence-based practice of modifying the root mechanisms of aging (biological, cognitive, and psychosocial) before they become disease, extending healthspan, not just lifespan. Using advanced diagnostics, precision interventions, and AI-enabled monitoring, it translates measurement into action across every medical discipline. Success is measured in functional capacity, vitality, and disease-free years.

Subscribe to the Longevity Docs Newsletter

Longevity medicine is moving fast. Every week, we bring you what matters: clinical insights, research signals, and perspectives from 1,000+ physicians across 68 countries. One newsletter. Built for the physicians shaping this field.

Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of Longevity Docs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

Longevity Docs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

4:45am. Like every Sunday, blank page. What’s this week’s cover story?

Then I remembered yesterday. Press day. A reporter asked me for my most underrated longevity secret. When I said community, she looked surprised. Then very interested.

Social longevity is the bet every patient, every doctor, every society should be making. In an era of AI and self-optimization, the highest-leverage move is the oldest one: community, purpose, altruism.

Took a break for lunch in sunny SoHo with family and friends. Walking the talk.

Back at the desk, inspired by the street art on the way home, designing the cover.

4:57pm. App is live. Cannes is five weeks out. Newsletter 92 is out.

Dr. David Luu, Founder, longevitydocs.™

Every Wednesday, we ship something new for this community. Features, experiences, and products built by physicians, for physicians. The platform grows because you do.

APP

The Longevitydocs mobile app is live.

Longevity medicine in one place. In your pocket. Every day.

Here’s what’s inside:

News. Curated longevity medicine intelligence, daily. New research, business moves, regulatory shifts. Two minutes. You’re current.

Hippo AI. Trained on the full CLD curriculum. Ask it anything. Generate quizzes. Build flashcards. Get protocol summaries before a patient visit. Your second brain for longevity medicine.

School. The complete Certified Longevitydocs program. 50 units. 100+ hours. Syncs between desktop and mobile so you can learn in fifteen-minute windows between patients.

Community. Meet physicians, exchange protocols, debate the literature, share clinical insights in real time. Plus live Rooms with guest experts every week.

Every doctor should be a longevity doctor. Now you can carry that mission in your pocket

If you’re a member, download and log in with your existing credentials. If you’re not yet a member: apply to join here

Available now on the Apple App Store. iPhone only. Android coming soon.

Download the App

ROOM OF THE WEEK

How Should We Treat High Lp(a)?

5 Key Takeaways from LongevityDocs Rooms

by Dr. Giovanni Campanile

1. Test once, then test the family. Lp(a) is 80-95% genetic. A first-degree relative has a 50% chance of also being elevated. One test per patient, one conversation per family. Flag >30 mg/dL even though guidelines say >50.

2. You cannot lower Lp(a) directly, so lower everything else harder. PCSK9 inhibitors are the go-to today. Push ApoB to <40 (not the usual <60). Keep statins despite the paradoxical 10-20% Lp(a) rise. Add aspirin for the thrombogenic profile. Add HIIT for the plaque reduction data.

3. Image the coronaries before starting HRT in postmenopausal women with high Lp(a). If plaque looks unstable, stabilize first. Transdermal over oral in year one. Women who started HRT premenopausally and enter menopause on it do not carry the same plaque-rupture spike risk.

4. Three RNA therapies landing in 2026-2027 will change the field. Pelacarsen (Lp(a) down >80%), olpasiran (down 95%, quarterly injection), muvalaplin (oral). One of them may become the first medical therapy for aortic stenosis.

5. Obicetrapib is the sleeper for the trifecta patient. Oral CETP inhibitor, EU-approved, lowers LDL 50% plus Lp(a) meaningfully, and slows Alzheimer’s progression in ApoE4 carriers. If your patient has elevated ApoB, Lp(a), and ApoE4, this is the one to watch.

Join our next Room tomorrow

Rooms are available on the longevitydocs.ai

Each week, I try to explore one idea that could advance longevity medicine and hopefully support physicians in bringing it to life.

Social Longevity: 12 Reasons Community Is the Longevity Superpower

Did we make longevity selfish? Most protocols and innovations in this space are self-centered, performative, and isolating. The entire movement has been reduced to a single-player game.

But being social is not a lifestyle trend. It is the oldest survival mechanism our species has. What I call social longevity is the combination of community, purpose, and altruism. For 300,000 years, humans survived because we belonged. That is what separated us from other species. Not our teeth, not our speed. Our ability to cooperate, bond, and build trust across generations.

Isolation kills. Comparable to smoking 15 cigarettes a day. The WHO linked social disconnection to 871,000 deaths annually. Most longevity clinics do not screen for it.

The most powerful longevity intervention is not a molecule. It is other people. It is free. Yet it is the greatest investment you will ever make in your health.

Here are twelve reasons why.

1. Inflammation. Loneliness elevates CRP, IL-6, and fibrinogen in a dose-dependent manner. The more isolated you are, the more inflamed you become. Social connection suppresses NF-kB inflammatory signaling at the genomic level. Belonging could be anti-inflammatory.

2. Immunity. Isolated individuals show reactivation of latent herpes viruses. Wound healing slows by 40 percent. NK cell activity declines. Connection keeps your immune system vigilant.

3. Stress Hormones. Loneliness compresses cortisol dynamic range, reducing your ability to mount and recover from stress. Chronic isolation produces cortisol blunting, the same pattern seen in PTSD and burnout. Social interaction restores HPA axis flexibility.

4. Cardiovascular. Loneliness increases heart disease risk by 45 percent and stroke by 28 percent. Social integration reduces cardiovascular mortality by two to three times independent of traditional risk factors.

5. Telomeres. Social isolation is associated with shorter telomere length. Caregiving stress without social support accelerates telomere shortening by ten years of cellular aging. Disconnection ages you at the chromosomal level.

6. Cognition. Social isolation has a direct causal effect on cognitive decline. Loneliness increases dementia risk by 40 percent. Purpose reduces Alzheimer’s risk by 2.4 times, even with amyloid pathology at autopsy.

7. Behaviors. Social isolation activates the Conserved Transcriptional Response to Adversity: 53 pro-inflammatory genes upregulate, antiviral defenses shut down. Purpose-driven well-being reverses this pattern. Pleasure-driven well-being does not. Your genome distinguishes between types of happiness.

8. Nervous System. Social engagement activates the ventral vagal complex, promoting parasympathetic dominance. This could predict greater cognitive flexibility and lower inflammatory gene expression. Connection calms your sympathetic nervous system at a level you cannot consciously control.

9. Oxytocin. Social bonding triggers oxytocin release, which modulates the HPA axis, has anti-inflammatory properties, and increases trauma resilience. Prosocial behavior activates dopaminergic reward circuits. Helping others feels good because, biologically, it is good.

10. Purpose. Purpose reduces all-cause mortality by 15 percent across 136,000+ participants. Ikigai is associated with a 36 percent reduction in cardiovascular mortality over seven years.

11. Generosity. Volunteering cuts mortality risk by 22 to 44 percent. Giving support is more protective than receiving it. Prosocial spending lowers cortisol more than self-directed spending across cultures.

12. Network Effect. Health behaviors propagate through social ties up to three degrees of separation. Your friends’ friends’ friends are shaping your physiology. Isolation is not just the absence of connection. It is the absence of the upward pull that connected people exert on each other.

What’s Next

Who do you eat dinner with? Who calls you when something goes wrong? What are you building that is bigger than yourself? Most longevity intakes never ask these questions. They should.

My next passion project: building a Social Longevity Score. Three pillars. Connection. Purpose. Altruism. Measured with the same rigor we apply to biomarkers, correlated with the same panels we already run, and scored in a way a clinician can act on. In the coming months I will go deeper on each of these twelve reasons, and the research behind it.

Every doctor should be a longevity doctor. But no longevity doctor should practice alone.

A Note on the Evidence

These are associations and mechanisms, not clinical trials. The data suggests social connection is biologically active. It does not yet prove that prescribing community saves lives the way prescribing a statin does. We need evidence-based research using multi-omics (genomics, proteomics, metabolomics, epigenomics) integrated with longitudinal outcomes to move from association to intervention. If social disconnection carries the mortality risk of 15 cigarettes a day, we owe it that rigor. The tools will never be ready if nobody builds them.

Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Medicine. 2010;7(7):e1000316.

U.S. Surgeon General. Our Epidemic of Loneliness and Isolation. Washington, DC: HHS; 2023.

WHO Commission on Social Connection. Social connection linked to improved health and reduced risk of early death. June 2025.

Smith KJ, et al. The association between loneliness, social isolation and inflammation: a systematic review and meta-analysis. Psychosomatic Medicine. 2020;82(8):801-812.

Cole SW, et al. Social regulation of gene expression in human leukocytes. Genome Biology. 2007;8(9):R189.

Cole SW. Human social genomics. PLoS Genetics. 2014;10(8):e1004601.

Fredrickson BL, et al. A functional genomic perspective on human well-being. PNAS. 2013;110(33):13684-13689.

Van Bogart K, et al. Daily loneliness and cortisol dynamic range. Biological Psychology. 2026;109247.

Stout DM, et al. Loneliness and blunted cortisol reactivity to social exclusion. Social Neuroscience. 2023;18(4):289-301.

Haucke M, et al. Loneliness and cortisol during COVID-19 lockdown. Psychoneuroendocrinology. 2022;144:105894.

Valtorta NK, et al. Loneliness and social isolation as risk factors for coronary heart disease and stroke. Heart. 2016;102(13):1009-1016.

Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology. 1979;109(2):186-204.

Glaser R, et al. Stress-related impairments in cellular immunity. Psychiatry Research. 1985;16(3):233-239.

Kiecolt-Glaser JK, et al. Slowing of wound healing by psychological stress. The Lancet. 1995;346(8984):1194-1196.

Pressman SD, et al. Loneliness, social network size, and immune response to influenza vaccination. Health Psychology. 2005;24(3):297-306.

Steptoe A, et al. Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses. Psychoneuroendocrinology. 2004;29(5):593-611.

Epel ES, et al. Accelerated telomere shortening in response to life stress. PNAS. 2004;101(49):17312-17315.

Kivimaki M, et al. Social disadvantage accelerates aging. Nature Medicine. 2025;31:1635-1643.

Hale JM, et al. Causal effect of social isolation on cognitive function. Journal of Gerontology B. 2026;gbaf254.

Sutin AR, et al. Loneliness and risk of dementia. Journal of Gerontology B. 2020;75(7):1414-1422.

Boyle PA, et al. Effect of a purpose in life on risk of incident Alzheimer disease. Archives of General Psychiatry. 2010;67(3):304-310.

Porges SW. The polyvagal perspective. Biological Psychology. 2007;74(2):116-143.

Colzato LS, et al. Variable heart rate and a flexible mind. Cognitive, Affective, and Behavioral Neuroscience. 2018;18:600-610.

Gimpl G, Fahrenholz F. The oxytocin receptor system. Physiological Reviews. 2001;81(2):629-683.

Sharma SR, et al. Oxytocin and trauma resilience. Pharmacology and Therapeutics. 2020;214:107602.

Moll J, et al. Human fronto-mesolimbic networks guide decisions about charitable donation. PNAS. 2006;103(42):15623-15628.

Cohen R, et al. Purpose in life and its relationship to all-cause mortality and cardiovascular events: a meta-analysis. Psychosomatic Medicine. 2016;78(2):122-133.

Sone T, et al. Sense of life worth living (ikigai) and mortality in Japan: Ohsaki Study. Psychosomatic Medicine. 2008;70(6):709-715.

Okun MA, et al. Volunteering by older adults and risk of mortality: a meta-analysis. Psychology and Aging. 2013;28(2):564-577.

Brown SL, et al. Providing social support may be more beneficial than receiving it. Psychological Science. 2003;14(4):320-327.

Dunn EW, et al. Spending money on others promotes happiness. Science. 2008;319(5870):1687-1688.

Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. New England Journal of Medicine. 2007;357(4):370-379.

Christakis NA, Fowler JH. The collective dynamics of smoking in a large social network. New England Journal of Medicine. 2008;358(21):2249-2258.

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Every week, the Longevity Docs Chat feels like a front-row seat to the future of medicine. Here’s what had doctors buzzing:

HRV: Are Doctors Built Different?

It started with a simple question about magnesium glycinate and a spike in HRV on WHOOP. One member quickly flagged the confounders:

WHOOP’s HRV isn’t an overnight average, it’s weighted towards deep sleep. And detecting deep sleep itself uses HRV, creating a circular measurement problem.

Another physician agreed and raised excipient sensitivity in specific supplement formulations as a variable worth checking.

Then a member shared something remarkable: 840 days of simultaneous WHOOP and Oura data showing chronically low HRV that never once reached normal range. But within that low range, HRV still predicted recovery with strong correlation (r = 0.68, 834 nights).

Best-HRV nights: recovery 79%. Worst: 47%. System is adaptive. Just running on a different scale.

That prompted a provocative hypothesis from another physician:

doctors may carry a constitutional low-HRV phenotype.

The idea is that elite test-takers are selected in part for higher baseline sympathetic tone, a trait that helped survive the MCAT but may leave us running hot for life. He cited research from the Israeli Defense Forces showing autonomic regulation as an independent predictor in elite military selection.

A colleague pushed back thoughtfully:

I’d be cautious about extending this to a constitutional low-HRV phenotype or selection bias in physicians. The evidence I’m aware of tends to support state over trait, with training and practice environments shaping autonomic patterns over time.

Key Takeaway:

Stop comparing your HRV to population norms. Within-individual trends matter more than absolute values. Track your own baseline. Measure your own trajectory. And if your HRV runs low, consider the possibility that it reflects your autonomic wiring, not just your lifestyle. The data to prove or disprove that is not here yet. But the question is worth asking.

Elevated Ferritin: Case Study

Community Case: Elevated Ferritin with Normal Iron Studies

A member posted a clinical question:

ferritin at 482, positive for one HFE H63D variant, normal iron and TIBC. What else beyond phlebotomy?

What followed was a 24-hour clinical deep dive involving gastroenterologists, cardiologists, and longevity physicians across multiple time zones.

One physician laid out the systematic workup:

Check transferrin, TIBC, liver enzymes, CRP, ESR, uric acid, LDH. Rule out alcohol, intense exercise within 72 hours, and inflammation.

A cardiologist cut to the core:

Measure transferrin saturation first. If TSAT is above 45%, this is iron overload. A common cause of elevated ferritin is fatty liver or a neoplasm or any other inflammatory condition.

Another member added hepatitis screen, CGM, and liver imaging to the list, then shared a case where unexplained hyperferritinemia turned out to be SAPHO syndrome presenting as severe acne and dermatitis.

Two other physicians shared their own cases of persistent ferritin elevation post-COVID (ranges of 377 to 700) with normal inflammatory markers and no clear etiology. One is trialing lactoferrin with an 8-week follow-up.

One member challenged the group to think upstream: why is the body sequestering iron before we rush to treat? She cited evidence on iron withholding as an immune defense mechanism.

Another connected it to hepcidin upregulation in patients on rapamycin, linking mTOR inhibition to mild iron deficiency anemia.

Key Takeaways

Isolated ferritin elevation is never simple. TSAT is your first branch point. Then think broader: liver, inflammation, autoimmune, post-COVID, and medication-induced causes including rapamycin. Do not reflexively phlebotomize without understanding the mechanism.

AI vs. ER Physicians in Triage Differential Diagnosis

Study published in Science showing AI models outperforming real ER physicians in triage differential diagnosis across multiple phases of clinical reasoning. Why it matters: Models used were from mid-2025. Current frontier models are significantly stronger. The gap between AI and physician performance at pattern recognition is widening. The physician value shifts to context, continuity, and care. Science

Caloric Restriction Reduces Inflammaging Through Complement C3a Suppression

Yale researchers analyzed proteomics from the CALERIE trial and identified complement C3a suppression as the key mechanism behind caloric restriction’s anti-aging benefits. The source: a macrophage subset in visceral adipose tissue that expands with age and drives complement activation. Neutralizing C3a in aged mice reduced inflammation and shifted macrophages toward an anti-inflammatory profile. An FDA-approved C3 inhibitor (pegcetacoplan) already targets this pathway.

Why it matters: C3a is now a measurable biomarker for inflammaging, visceral fat is confirmed as the epicenter, and a druggable CR-mimetic pathway already has an approved drug.

Current Status and Future Perspectives on Long COVID Pathophysiology

Review of 400+ million cases globally. Five mechanisms identified: immune dysregulation, viral persistence, microclotting, autonomic dysfunction, and neuroinflammation. Spike protein detectable in 60% of patients at one year. No validated biomarker. No cure. Why it matters: These are the same mechanisms we target in aging. Long COVID is accelerated biological aging triggered by infection. Our frameworks apply directly. Communications Medicine

They Are Certified Longevity Docs (CLD)

Congratulations to the physicians who earned their Certified Longevity Docs (CLD) designation this month. Empowering the next generation of physicians committed to the standard of evidence-based longevity medicine education.

Dr. Jorge Perez grew up in Cuba near a medical center, which inspired his desire to work in healthcare. Now a Cardiologist at the Chen Senior Medical Center in Miami, Dr. Perez focuses on supporting his senior patients in building happy, healthy lives. His recent research includes Echocardiographic Features of Longevity in Centenarians, noting that centenarians represent an under-studied population within cardiovascular medicine. He received Fellow of the Year Award for Excellence in Professionalism and Compassionate Care at Mount Sinai Medical Center of Florida.

Dr. Anna Chromcova is the Co-Founder and Medical Director of Doktůrek.ai, on a mission to revolutionize primary care. She is a graduate of First Faculty of Medicine, Charles University in Prague, starting her career in medicine as a Radiologist. Her passion for technology led her to join Carebot at Medical Director, a medical software company using AI and Machine Learning to evaluate radiology imaging. In addition to building Doktůrek.ai, she is a general practitioner in the Czech Republic where she supports her patients with hyper-individualized care throughout the their health journey.

The Certified Longevity Doctor designation is the standard our community is building. If you practice longevity medicine with evidence and accountability, this is the credential that says it.

Apply to Become Certified

Every week, I track funding, FDA approvals, product launches, and breakthrough announcements shaping longevity medicine.

CARE

CVS launches AI health platform with Google

CVS Health partnered with Google Cloud to launch Health100, an AI-powered health technology subsidiary. The platform uses Gemini models to deliver cross-network care management across pharmacy, provider, insurer, and PBM channels, with wearable integration and real-time biomarker tracking planned for 2026.

Why it matters: A $102.5B company building AI-driven preventive health infrastructure is moving into the data-rich space longevity medicine pioneered. Physicians who position themselves within these ecosystems early will have an advantage. Those who do not may find retail healthcare defining the category for them.

AI

Google DeepMind Launches AI Co-Clinician

Google DeepMind announced a “triadic care” model: AI agents that interact directly with patients under physician supervision. In blind evaluations, the system recorded zero critical errors in 97 of 98 primary care queries and matched or exceeded physicians in 68 of 140 consultation skills, including guiding physical exams via live video. Experienced physicians still outperformed on red-flag recognition.

Why it matters: AI is moving from information tool to clinical teammate. The physician value is no longer diagnosis. It is judgment, relationships, and the ability to design longitudinal protocols no AI can yet own. Build your practice around what AI cannot replace.

INVESTMENTS

Infinite Epigenetics Acquires Tally Health

TruDiagnostic’s parent company acquired David Sinclair’s Tally Health, creating a vertically integrated platform combining CLIA-certified lab infrastructure, 115+ research partnerships, the world’s largest private DNA methylation datasets, and consumer-facing at-home epigenetic age testing.

Why it matters: Epigenetic testing is moving from research curiosity to scalable infrastructure. The consolidation of methylation data at this scale will accelerate validation of biological age markers we already use. Physicians who can interpret epigenetic data will be essential partners in this ecosystem. Those who cannot will watch platforms deliver longevity medicine without them.

SquareMind Raises $18M for Robotic Skin Imaging

SquareMind’s Swan robot performs automated full-body dermoscopic imaging in minutes. Contactless, AI-paired, designed to track new or changing lesions over time. Round led by Intuitive Surgical founder Fred Moll’s fund. Commercial launch imminent in US and Europe.

Why it matters: 80% of melanomas are new lesions, not existing moles that changed. That makes comprehensive skin mapping a longevity screening imperative. For physicians building skin into their diagnostic framework, this turns a subjective visual exam into structured, trackable data at scale.

POLICIES

FDA Moves to Limit Compounded GLP-1s

The FDA proposed excluding semaglutide and tirzepatide from the 503B bulks list, finding no clinical need for outsourcing facilities to compound these drugs from bulk substances. Public comment open until June 29. Individual patient compounding under physician prescription (503A) remains intact for now.

Why it matters: The regulatory direction is clear. Build protocols around branded or FDA-approved pathways and document clinical rationale carefully. Affordable access through compounding is narrowing, not expanding. Be aware for your patients

PHARMA

LSD-Based Anxiety Drug Nears FDA Approval

Definium Therapeutics expects Phase 3 results for DT120, an LSD-based treatment for generalized anxiety disorder. Phase 2 showed 78% clinical response and 50% remission after four weeks. No new anxiety drug has been approved since Cymbalta in 2007. All 7,000 existing Spravato centers could deliver it.

Why it matters: DT120 works through 5-HT2A receptor activation and neuroplasticity, not symptom suppression. If approved, the first new class of anxiety treatment in nearly two decades. Mental health is a longevity intervention. This is the mechanism catching up to that reality.

CULTURE

Longevity Travel Goes Mainstream

ELLE reports luxury hospitality is embedding real diagnostics into the guest experience. Santa Monica Proper Hotel offers 160+ biomarker panels on-site. Clinique La Prairie leads clinical wellness tourism, now valued at $18B and projected to reach $48.2B by 2033. Properties are integrating pharmacogenetic testing, red light therapy, and IV drips alongside indigenous healing traditions.

Why it matters: Hotels are building longevity medicine into hospitality at scale. New referral channels, consulting opportunities, and clinical partnerships outside the clinic. People want longevity medicine woven into daily life, not confined to a waiting room.

Qantas Redesigns Long-Haul Flights Around Longevity

Qantas is adding wellbeing zones on its new A350 fleet for Sydney to London and Sydney to New York routes, launching 2027. Stretching handrails, exercise programs, hydration therapy. Clinical research with the University of Sydney confirmed the need to move during flights is physiological, not a luxury.

Why it matters: An airline just cited clinical research to redesign the flight experience around movement, hydration, and circadian reset. Longevity thinking at 40,000 feet. For physicians flying to Cannes in June: the flight is part of the protocol.

The Cannes Ecosystem Map

Cannes. June 9–11, 2026. Palais des Festivals.

We built this summit on a simple belief: longevity medicine will not scale inside silos. It scales when the hospital system, the AI lab, the beauty conglomerate, the clinic, the investor, and the regulator are in the same conversation. That conversation happens here.

This is the operating table where the ecosystem gets built.

Who you’ll meet in Cannes:

• Health Systems: Mayo Clinic. Mount Sinai. Sheba Medical Center. Cedars-Sinai.

• Academic Societies: American College of Cardiology, The Academy of Geroscience

• Clinics: Atria Institute, Clarify Clinic, Fountain Life, Next Health, Extension Health, Neko Health

• Big Tech & Consumer Health: Samsung, Noom, Hims & Hers, Hone Health, OpenLoop, Eli Health

• Beauty & Longevity: Lancôme, L’Oréal Group

• Investors & Capital: TPG, Primetime Partners

• Public Sector: City of Cannes, U.S. federal longevity initiatives.

The agenda includes: Nir Barzilai on the state of geroscience. Ami Bhatt and Zahi Fayad on the AI-augmented physician. Vania Lacascade on Lancôme’s longevity launch. Hon Pak on Samsung’s ambient longevity ecosystem. Saeju Jeong on scaling longevity to millions. Mayo, Mount Sinai, and Sheba on the longevity hospital of the future. Women’s Longevity 360. The Longevity Clinic Standard. The economics of a profitable clinic.

Off stage: White Party on Majestic Beach. Sunrise Run Club on La Croisette. Bioharmony on the beach. Leadership lunches on the sand. Black-tie Gala and the inaugural Certified Longevitydocs™ graduation at the Carlton.

Every seat in this room was earned. Every name on this list is building something. The question is not whether longevity medicine becomes the standard of care. It is who builds the infrastructure that makes it possible.

Will you be in the room?

Join us in Cannes - Book you Ticket

Mastermind Replays Now Available

3 Masterminds. 3 topics reshaping longevity practice: AI & Tech, Peptides, and Hormones - featuring the dozens of faculty. Trusted by hundreds of physicians

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Conferences

Jun 9–11 — Longevity Docs Cannes: Awards & Summit

Jun 29–Jul 1 — A4LI H-SPAN Summit · Washington, DC Longevity medicine meets regulation and policy.

Aug 24–28 — ARDD · Boston Where aging research meets drug discovery.

Oct 17 — Longevity Docs Skin Longevity Mastermind · New York, NY.

The Home of Longevity Medicine

longevitydocs.™ is the world’s leading longevity physician community - 1,000+ physicians across 68 countries united by a single conviction: every doctor should be a longevity doctor. Founded by Dr. David Luu, the platform offers its members network, education, and experience with the mission to democratize longevity medicine.

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Longevity medicine is the personalized, evidence-based practice of modifying the root mechanisms of aging (biological, cognitive, and psychosocial) before they become disease, extending healthspan, not just lifespan. Using advanced diagnostics, precision interventions, and AI-enabled monitoring, it translates measurement into action across every medical discipline. Success is measured in functional capacity, vitality, and disease-free years.

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Editorial Disclaimer:

This newsletter is published exclusively for licensed physicians and qualified healthcare professionals. It is not intended for consumers or patients.

All content, including the Buzz in the Chat section, is for continuing medical education and professional information purposes only. It reflects emerging research, science, and technology that may have implications for the practice of medicine. It does not constitute medical advice, clinical recommendations, or treatment guidance for any individual patient.

Peer-to-peer discussions reproduced in this newsletter represent the personal clinical opinions of individual physicians. They do not reflect the official position of Longevity Docs and have not been reviewed or endorsed by any regulatory, medical, or professional body.

References to specific therapies, compounds, devices, or protocols are provided for educational context only. Some may be investigational, off-label, or not approved by the FDA, EMA, or equivalent regulatory authorities in your jurisdiction. Physicians are responsible for independently evaluating all information in accordance with current evidence, applicable law, and the standards of their licensing board.

Longevity Docs does not promote, endorse, or recommend any specific product, treatment, or commercial entity. Nothing in this newsletter should be construed as a solicitation or as influencing prescribing behavior.

By reading this newsletter, you confirm that you are a licensed healthcare professional and that you will apply the information contained herein within the bounds of your clinical judgment, professional obligations, and applicable regulations.

If you are a patient or consumer reading this newsletter, please note that this content should not be used to make any health or medical decisions. Please consult your personal physician or a qualified healthcare provider for guidance specific to your situation.

Hey Doc,

It’s 4:10 in the morning in New York City. The apartment is quiet. It’s still dark outside, but my mind is already in Cannes: sun on La Croisette, coffee and a croissant (yes!), friends I haven’t met yet.

I’m a few days late on this newsletter. I always tell my team: if you wait until you’re ready and perfect, you’re too late. But I needed the time. Because building the experience in Cannes isn’t about filling an agenda. I wanted to think of this summit like a book. Who are the characters? What are the stories? What will you feel, and what will change when you go home?

Every person on this stage was curated because they are shaping the future of longevity medicine. Every moment is designed to mean something, one after the other. We’re creating an experience for physicians at every stage of the journey: learning, building, scaling, leading.

We’re not just hosting another conference. We’re building the home of longevity medicine.

Once Upon a Time

In 1959, my father landed in Cannes. He became a physician and participated in the creation of the first university diploma in acupuncture at the University of Montpellier.

Two years ago, the city of Cannes called me and asked if I would organize a longevity summit. The circle closed. Same city. Different generation. Same idea: medicine evolves when doctors decide to lead it.

Cannes is already home to some of the world’s most iconic cultural gatherings: the Film Festival for cinema, Cannes Lions for creativity. Longevity medicine is becoming a cultural moment. It needed a home.

And if you’ve ever walked La Croisette in the morning -the Mediterranean air, the markets, the pace of life- you’d swear Cannes looks like a blue zone. There is something poetic about gathering the world’s longevity physicians in a city that already lives like one.

Longevity medicine is at an inflection point. Patients are driving demand. Physicians are stepping into new roles as clinicians, investors, and founders. Companies are scaling the science. Governments are starting to fund it. What’s missing is the standard: the protocols, the credential, the community that turn longevity from a trend into a discipline.

Cannes 2026 is where we set that standard: with evidence, with ethics, and with equity.

If you already know you need to be in the room.

Apply for Cannes 2026

The White Party - Majestic Beach

The story begins Tuesday evening on the deck of the Majestic Hotel Beach. Mediterranean sunset. White‑evening dress code. Mocktails, music, and hundreds of physicians meeting face to face. Powered by Noom.

Speaker & VIP Dinner - Palm Beach

Most events hide the speakers at a back‑room dinner. We’re opening the table. For the first time, select VIPs join the faculty the night before the summit. We have 60 seats at the table. One Place. Every speaker. If you want real conversations, this is where they happen.