Blood-pressure lowering to target
ApprovedMeasuring blood pressure and treating it to a defined systolic target with approved antihypertensives.
SPRINT randomised 9,361 adults at increased cardiovascular risk without diabetes to a systolic target of <120 vs <140 mm Hg. Primary composite HR 0.75 (0.64–0.89), all-cause mortality HR 0.73 (0.60–0.90); the final report gave HR 0.73 and 0.75 respectively. The honest caveat: the intensive arm had significantly more hypotension, syncope, electrolyte abnormalities and acute kidney injury, and the trial excluded people with diabetes or prior stroke.
Approved drugs; randomised outcome evidence in high-risk adults.PMID 26551272 / PMID 34010531
LDL and ApoB lowering
ApprovedLipid panel, and lipid-lowering therapy where risk warrants it.
The Cholesterol Treatment Trialists' analysis of 170,000 participants found each 1.0 mmol/L LDL reduction produced a 22% proportional reduction in major vascular events (RR 0.78, 0.76–0.80) and a 10% reduction in all-cause mortality (RR 0.90, 0.87–0.93), with no threshold detected down to LDL below 2 mmol/L.
Approved drugs; individual-participant meta-analysis of 26 randomised trials.PMID 21067804
Smoking cessation support
ApprovedAssessment and structured cessation support.
Current smokers aged 25–79 had roughly three times the all-cause death rate of never-smokers and lost more than ten years of life expectancy; cessation before age 40 avoided about 90% of the excess risk.
Established; the single largest modifiable lever, and essentially free.PMID 23343063
Structured multidomain lifestyle coaching
Phase 3 trialsA coached programme combining exercise, diet, cognitive and social engagement and cardiovascular monitoring.
US POINTER randomised sedentary adults aged 60–79 at elevated risk of cognitive decline to a structured vs a self-guided version of the same programme. The structured arm improved faster on the global cognitive composite by 0.029 SD/year (0.008–0.050; P = .008). Read it carefully: the effect is small, the comparator was itself an active intervention, and the imaging ancillary found no effect on amyloid, tau, hippocampal volume or white-matter hyperintensity trajectories. Structured coaching beats self-direction, modestly; the biological story is not there yet.
Not a regulated product; tested in a 2,111-participant randomised trial.PMID 40720610 / PMID 42008251
GLP-1 receptor agonists for obesity
ApprovedSemaglutide and related agents prescribed for weight management.
SELECT showed semaglutide reduced major adverse cardiovascular events in adults with overweight or obesity and established cardiovascular disease but without diabetes. Note the population: established cardiovascular disease is not the typical clinic member, so the trial's benefit does not transfer automatically to a healthy 45-year-old buying a membership.
Approved; cardiovascular outcome evidence in a specific population.PMID 37952131
Off-label metformin and rapamycin as geroprotectors
Approved · off-label usePrescribing approved drugs to healthy people to slow ageing.
A registry search in August 2026 found 31 registered aging/healthspan studies of metformin, rapamycin, NAD precursors, caloric restriction or taurine in recruiting or active status. They are phase 1/2, tens to low hundreds of participants, surrogate endpoints, and several are sponsored by companies that also sell the intervention. Nothing there supports a clinical claim today, and clinics prescribe both drugs off-label at scale.
Approved for other indications; geroprotection is at phase 1/2 with surrogate endpoints.NCT05949658 / NCT06727305
NAD+ precursors (nicotinamide riboside, NMN)
Phase 2 trialsSupplements sold to raise cellular NAD+.
The NADage trial is a 100-participant phase 2 study of nicotinamide riboside in frailty and aging. Separately, FDA confirmed in letters dated 29 September 2025 that NMN is not excluded from the dietary-supplement definition — reversing its 2022 position — but NMN remains a New Dietary Ingredient requiring a notification, so 'not excluded' is not the same as cleared.
Phase 2 trials in progress; no human healthspan or mortality outcome data.NCT06208527
Whole-body MRI screening in asymptomatic adults
Sold · unprovenA non-contrast, non-targeted MRI sold as a general cancer and disease screen.
A systematic review of 12 studies and 5,373 asymptomatic subjects found a pooled 32.1% prevalence of critical and/or indeterminate incidental findings, 16.0% false positives, and no included study reporting long-term verification of negative findings. In June 2025 the Canadian Association of Radiologists stated that it 'opposes the use of whole-body or full-body magnetic resonance imaging (MRI) as a screening tool in asymptomatic individuals, outside of specific, evidence-based clinical indications.'
No approval as a screening test; opposed by the Canadian Association of Radiologists.PMID 30932247
Epigenetic 'biological age' clocks
Sold · unprovenA DNA-methylation test sold as a trackable score of how fast you are ageing.
Across 18 clocks evaluated in 2026, nearly all achieved excellent technical reproducibility, but biological reliability — consistency across samples taken hours apart, before and after meals, under stress — was markedly lower, and only PCGrimAge reached good biological reliability (ICC > 0.75). The authors' key sentence: technical reproducibility did not predict biological reliability. A number that moves because you ate lunch is not tracking your rate of ageing.
Laboratory-developed test under CLIA only; no clinical-validity requirement anywhere.PMID 42525215
Continuous glucose monitoring in people without diabetes
Sold · unprovenA sensor sold to healthy members to reveal 'glucose spikes'.
In a randomised crossover study in 15 healthy adults, CGM overestimated both fasting and postprandial glucose by about 0.9 mmol/L versus capillary sampling, mischaracterised the glycaemic index of some foods, and overestimated time above 7.8 mmol/L roughly four-fold (about two-fold after baseline correction). A tool that systematically overstates spikes in healthy people is well-suited to generating alarming reports.
No outcome evidence; a documented measurement bias in this population.PMID 40021059
Compounded peptides (BPC-157, epitalon, CJC-1295, TB-500)
Sold · unprovenInjectable peptides compounded for recovery, sleep, growth-hormone signalling or 'anti-ageing'.
A 503A compounder may only use a bulk substance that complies with a USP/NF monograph, is a component of an FDA-approved drug, or appears on the 503A bulks list. BPC-157, epitalon, thymosin beta-4 fragment (TB-500), thymosin-alpha-1, CJC-1295, AOD-9604, melanotan II, MOTS-c, selank and semax meet none of those tests, and their nominations were withdrawn by the nominators — placing them outside even the interim non-enforcement policy. FDA's stated safety concerns include serious adverse events with intravenous ipamorelin, vasodilatory reactions with CJC-1295, and melanoma and priapism with melanotan II.
No lawful route to compound these from bulk under section 503A.FDA 503A bulk drug substances lists
Human growth hormone for 'anti-ageing'
Sold · unprovenhGH prescribed for longevity, athletic or cosmetic enhancement.
Under 21 U.S.C. § 333(e), knowingly distributing or possessing with intent to distribute human growth hormone for any use other than a disease or condition authorised by the Secretary of HHS under FDA approval, pursuant to a physician's order, is punishable by up to five years' imprisonment (ten where a minor is involved) and counts as a felony CSA violation for asset-forfeiture purposes. The test is conjunctive: a prescription does not cure an unapproved indication. Anti-ageing is not an approved indication. Prescribing hGH for diagnosed adult growth hormone deficiency is legitimate medicine; this is not that.
A federal felony in the United States. This is the clearest bright line in the sector.21 U.S.C. § 333(e)
Stem-cell and exosome 'regenerative' offerings
Sold · unprovenInfusions or injections sold for ageing, joints or general rejuvenation.
A 2025 Cochrane review of human stem cells in decompensated cirrhosis — a far better-studied indication than ageing — pooled 12 trials and 823 adults and graded all evidence very low certainty, unable to determine effects on mortality, serious adverse events or quality of life. In January 2025 the FTC announced orders permanently banning the co-founders of the Stem Cell Institute of America from marketing any regenerative-medicine treatment, with $3,310,146 in redress and $1,845,000 in civil penalties.
No approval for these indications, and an enforcement history.PMID 41312789
