Medications, Supplements & Other Treatments

In our practice, we organize longevity tactics into five domains — one of which I call ‘exogenous molecules,’ a fancy way of talking about medications, supplements, hormones, or any other formulated molecule you put into your body. Although powerful, this tactic can be challenging to discuss as it is highly individual. So instead of telling you to “take X” or “never take Y,” I find it more beneficial to approach this tactic with a 3-part framework:

(1) What is the objective? The more clearly you can define your objective, the more clearly you can assess if this is the right tool for accomplishing that objective

(2) Is there a biomarker? How do you plan to customize, track, and adjust your treatment over time? If there is no biomarker to monitor as a measure of effectiveness, it doesn’t mean you shouldn’t take the supplement or medication; it just means you may need to be more intentional around monitoring results in other ways.

(3) Does the risk outweigh the reward? Everyone has a different tolerance for risk. Some questions to consider when weighing risk vs. reward: What is the mechanism of action? How many patient years of use exist? What are the short-term and long-term risks of taking the medication? What are the risks of not taking the medication?

Below is a collection of past content discussing some common supplements, medications, and other treatments.

#297 – AMA #58: Iron: its role in health, testing methods, and strategies for preventing and managing iron deficiency

“I’ve seen a lot of cases of iron deficiency. I’ve seen a lot of cases of iron deficiency anemia. I can’t tell you I’ve seen one that isn’t attributable to some combination of … low iron in the diet, poor absorption, or blood loss.” —Peter Attia

#291 ‒ The role of testosterone in males and females, performance-enhancing drugs, sustainable fat loss, supplements, and more | Derek, More Plates More Dates Pt.2

These things can all move the needle [on testosterone] like 100+ ng/dL potentially, depending on how deficient you are. So some of these are low hanging fruits with the sleep, micronutrients, minerals, actual macro intake.” —Derek, More Plates More Dates

Saunas: the facts, the myths, and the how-to

Sauna use appears to be genuinely beneficial, but not all claims stand up to scrutiny

Where a study on metformin and cardiovascular disease fell short – and what it can teach us

An investigation on metformin, diabetes, lipid biology, and cardiovascular disease offered little insight on any of these topics, but it illustrates common problems in scientific research

Research Worth Sharing, December 2023 Edition

MDMA for PTSD, the HALL aging database, peanut immunotherapy, blood pressure cuff sizes and accuracy, and the effects of swearing on strength

#283 ‒ Gut health & the microbiome: improving and maintaining the microbiome, probiotics, prebiotics, innovative treatments, and more | Colleen Cutcliffe, Ph.D.

You start out almost like a blank slate, you get a lot more diverse, and then as we age, you start to lose that diversity and therefore some key functions in the microbiome.” —Colleen Cutcliffe

#282 – AMA #54: Magnesium: risks of deficiency, how to correct it, supplement options, potential cognitive and sleep benefits, and more

The more deficient you are in magnesium, the more you will be helped by supplementing magnesium.” —Peter Attia

#281 ‒ Longevity drugs, aging biomarkers, and updated findings from the Interventions Testing Program (ITP) | Rich Miller, M.D., Ph.D.

What we try to do is quite simple. We try to find drugs that will slow aging and extend mouse lifespan.” —Rich Miller

Do GLP-1 receptor agonists improve cardiovascular health independently of weight loss?

A new trial has reported that the GLP-1 receptor agonist semaglutide reduces risk of cardiovascular events in patients with obesity – but that’s not the question we ought to be asking.

#279 – AMA #53: Metabolic health & pharmacologic interventions: SGLT-2 inhibitors, metformin, GLP-1 agonists, and the impact of statins

It is worth noting, and this is a very important question, that it does not appear that the effect of statins on insulin resistance is a function of lipids being lowered.” —Peter Attia

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