How to evaluate a longevity clinic

What a good longevity clinic does

A good longevity clinic practises good medicine with a longer horizon. It begins with your history, your family history and your goals, uses tests with evidence for your age and risk, explains what each result means, and turns the findings into a plan you can follow and measure.

The field is growing faster than its evidence. Researchers writing in Cell in 2023 noted that the lack of standards and consensus on what makes an aging biomarker reliable holds back its validation for clinical use [1]. A clinic worth your time is open about which of its tests are established and which are still being studied.

Biological age tests

Biological age tests, often called epigenetic clocks, estimate age from patterns of chemical marks on DNA. They are valuable research tools, and their reliability for one person is still being worked out. One study found that technical noise produced differences of up to 9 years between repeat measurements of the same samples across six well known clocks [2].

If you have one, treat the number as a prompt for a conversation rather than a verdict. Blood pressure, cholesterol, blood sugar and fitness are measured reliably and come with clear guidance on what to do about them, so they make better markers of progress.

Supplements

Supplements are regulated differently from medicines. In the United States the FDA does not approve dietary supplements before they are marketed, and a firm generally does not have to give the FDA its evidence of safety [3].

The evidence for prevention is thin. The USPSTF found the evidence insufficient to judge multivitamins or most single nutrients for preventing heart disease or cancer, and recommends against beta carotene and vitamin E for that purpose [4]. A supplement can make sense to correct a measured deficiency, and a doctor should check it against your medicines.

IV drips

Vitamin drips are popular, and the bar for claims about them is high. The UK advertising regulator expects evidence that an IV nutrient drip works better or faster than diet or oral supplements, and says studies of regular oral supplements or of treating a deficiency are unlikely to be enough [5].

It also notes that medicinal claims are not allowed for these drips unless the product is licensed as a medicine for that purpose [5]. A drip carries the small risks of any cannula, such as bruising or infection at the site, so it should have a clear medical reason.

Full body scans

A full body scan can be reassuring, and it can also find things that need follow-up without ever mattering. The FDA states that it knows of no scientific evidence that whole body CT scanning of people without symptoms does more good than harm, and notes that the radiation may be linked to a very small increase in later cancer risk [6].

MRI uses no ionising radiation, and incidental findings are its main trade-off. In a review of MRI in adults without symptoms, potentially serious incidental findings were found in 3.9% of people having brain and body scans [7]. A good clinic explains this before you agree to a scan and has a doctor ready to act on what it finds.

Questions to ask a longevity clinic

The Academy of Medical Royal Colleges suggests four questions for any test or treatment, about its benefits, its risks, the alternatives and what happens if you do nothing [8]. They work just as well for longevity offers.

• What evidence supports this test or treatment for someone like me?
• Who interprets my results, and are they GMC registered doctors?
• What happens if a scan or test finds something unexpected, and who arranges the follow-up?
• Which markers will we use to see whether the plan is working?
• What does the whole programme cost, including follow-up?
• What would you advise if I chose to do nothing for now?

Signs of a good clinic

Look for a clinic that will tell you when a test is not worth having for you, and for these signs.

• Doctors you can check on the GMC register
• Tests chosen after a consultation, rather than sold as a fixed menu
• Clear explanations of what each test can and cannot tell you
• A plan for incidental findings agreed before any scan
• Progress measured with markers that have clinical guidance behind them
• Every fee set out in writing before you start

Who longevity medicine suits and who it does not

It suits someone who is well and wants a plan to stay well for longer, built on measures with evidence such as fitness, sleep, blood pressure and cholesterol.

It is no substitute for care when you have symptoms. New or worsening symptoms need a GP appointment, and chest pain, sudden breathlessness, severe bleeding or signs of a stroke need a call to 999 in the UK or the local emergency number.

How The Wellness can help

The longevity consultation at The Wellness is free and held by video. A doctor goes through your history and goals and tells you which tests are worth having for you and which are not.

If you choose to go further, the Longevity Foundation programme brings together a full body MRI, a metabolic and hormone panel, DEXA and VO2max testing, with a physician roadmap. The physician talks through incidental findings with you before the MRI. Every doctor is GMC registered, and regulated services are delivered through registered partner clinics and accredited laboratories.