Interventions

Acarbose

An α-glucosidase inhibitor that blunts post-prandial glucose excursion. Among the most reproducibly life-extending drugs in mice in the NIA Interventions Testing Program.

Alpha-Ketoglutarate (AKG)

A Krebs-cycle intermediate sold as Ca-AKG or arg-AKG supplements. Extended mouse lifespan in one Buck Institute study; human longevity evidence is preliminary.

Alpha-Lipoic Acid

A mitochondrial cofactor and antioxidant. Used in diabetic neuropathy with reasonable evidence; longevity claims rest on weak human data and stronger rodent work.

Bempedoic Acid

Liver-selective ATP-citrate lyase inhibitor that lowers LDL without muscle effects (because skeletal muscle lacks the activating enzyme). Cardiovascular benefit confirmed in CLEAR Outcomes.

Berberine

An isoquinoline alkaloid (from Berberis spp.) with metformin-like effects on glucose, lipids, and gut microbiome. Sometimes marketed as 'nature's Ozempic' — not accurate.

BPC-157

A 15-amino-acid pentadecapeptide reportedly accelerating tissue repair (tendon, ligament, gut). Popular in 'research peptide' circles; no human RCTs and significant supply-chain risk.

Canakinumab

IL-1β monoclonal antibody. The CANTOS trial drug that proved inflammation lowering reduces cardiovascular events independent of LDL — a landmark finding. Not used routinely for CV prevention due to cost and infection risk.

Coenzyme Q10 (Ubiquinone / Ubiquinol)

Essential mitochondrial electron carrier. Endogenous synthesis declines with age and is reduced by statins. Strong evidence base in heart failure; weaker in general anti-aging use.

Cold Exposure (Plunges & Cold Showers)

Acute cold exposure triggers norepinephrine release, brown-fat thermogenesis, and a stress response. Long-term human longevity benefit is plausible but not robustly established.

Creatine Monohydrate

The most-studied performance supplement, with growing evidence for muscle, bone, and cognitive benefit in older adults — particularly when combined with resistance training.

Curcumin

The active polyphenol from turmeric. Strong anti-inflammatory and antioxidant effects in vitro; modest, inconsistent benefits in human RCTs due to very poor oral bioavailability.

EGCG (Green Tea Catechins)

Epigallocatechin-3-gallate, the principal catechin in green tea. Population-level association with reduced cardiovascular and cancer mortality; mixed RCT evidence; hepatotoxicity at high supplement doses.

Exercise (Zone 2 + Resistance)

The most robust modifiable predictor of healthspan and all-cause mortality. Combine aerobic base ("zone 2"), high-intensity intervals, and resistance training.

Ezetimibe

Cholesterol-absorption inhibitor that adds 15–25% LDL-lowering on top of statins, with cardiovascular outcome benefits proven in IMPROVE-IT.

Fisetin

A plant flavonoid with senolytic activity in mice. Human trials are in progress; bioavailability and the "right" oral dose remain open questions.

GLP-1 Agonists (Semaglutide, Tirzepatide, Liraglutide)

Incretin-mimetic peptides that drive substantial weight loss and reduce cardiovascular, renal, and possibly dementia risk — the most impactful new class in longevity-adjacent medicine.

Glycine + N-Acetylcysteine (GlyNAC)

A combination that raises endogenous glutathione, with promising small-RCT data in older adults on a wide range of aging-related parameters.

Growth Hormone & GHRH Analogs

Recombinant human GH (somatropin) and the GH-releasing hormone analogs (sermorelin, tesamorelin, CJC-1295, ipamorelin). Heavily marketed for 'anti-aging' despite mortality being higher with elevated lifetime GH in most studies.

Hyperbaric Oxygen Therapy (HBOT)

Pressurised 100% oxygen sessions. Established uses are narrow (decompression illness, non-healing wounds); longevity-oriented protocols are investigational with limited human data.

Inclisiran

An siRNA that silences PCSK9 mRNA in the liver. Twice-yearly injection produces sustained LDL reductions of ~50%. Cardiovascular outcomes trial (ORION-4) reading out later this decade.

Intermittent Fasting

Eating patterns that compress feeding into shorter daily windows or alternate fed and fasted days; effects on longevity outcomes in humans are modest and contested.

Low-Dose Aspirin

A century-old antiplatelet whose primary-prevention role has narrowed sharply: net benefit in established CVD, net harm in many primary-prevention older adults.

Low-Dose Colchicine

Ancient gout drug reborn as a cardiovascular event-reducer through partial NLRP3 inflammasome inhibition. Approved by the FDA in 2023 for ASCVD.

Low-Dose Lithium

Microdose lithium (a few mg/day) is investigated for cognitive and longevity effects. Therapeutic-dose lithium is a well-known mood stabiliser with substantial side-effects.

Magnesium

Essential mineral involved in 300+ enzymatic reactions. Mild-to-moderate deficiency is common; supplementation improves blood pressure, sleep, glucose handling, and possibly migraine in deficient adults.

Melatonin

The pineal sleep-onset hormone, declining with age, with multiple plausible longevity-relevant mechanisms beyond sleep regulation.

Menopausal Hormone Therapy (MHT/HRT)

Estrogen ± progestogen for menopausal symptoms. When started in the early-postmenopausal window, evidence supports cardiovascular and bone benefit; later initiation carries different risks.

Mesenchymal Stem Cell (MSC) Therapy

IV or intra-articular infusion of cultured mesenchymal stromal cells (or their exosomes). Heavily marketed by overseas clinics; evidence for systemic 'anti-aging' use is poor, with some legitimate orthopaedic and graft-versus-host applications.

Metformin

A first-line type-2 diabetes drug with epidemiological signals of reduced all-cause mortality, prompting the TAME trial of metformin in non-diabetic older adults.

Methylene Blue

An old industrial dye and FDA-approved medication for methemoglobinemia, now off-label-popular in longevity circles for putative mitochondrial and cognitive effects. Use cautiously.

NAD+ Precursors (NR & NMN)

Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) raise NAD+ levels, the cofactor for sirtuins and PARPs that declines with age.

Omega-3 Fatty Acids (EPA / DHA)

Long-chain marine n-3 polyunsaturated fatty acids. Strong evidence for high-dose icosapent ethyl in select cardiovascular populations; mixed evidence for routine supplementation.

PCSK9 Inhibitors

Monoclonal antibodies (evolocumab, alirocumab) that lower LDL ~50–60% on top of statins. Outcomes trials (FOURIER, ODYSSEY) confirmed cardiovascular event reduction.

Peptides (Overview)

Short amino-acid chains used (often off-label or unapproved) for tissue repair, growth-hormone modulation, and metabolic effects relevant to longevity.

Photobiomodulation (Red & Near-Infrared Light)

Low-level red and near-infrared light therapy claimed to enhance mitochondrial function and tissue repair. Evidence is mixed; the field is plagued by inconsistent dosing.

PQQ (Pyrroloquinoline Quinone)

Quinone cofactor proposed to stimulate mitochondrial biogenesis via PGC-1α. Some preclinical work, very thin human data.

Prebiotic Fibre

Fermentable carbohydrates (inulin, FOS, GOS, resistant starch, β-glucan) that feed beneficial gut bacteria and drive SCFA production. Stronger cardiometabolic evidence base than most probiotics.

Probiotics

Live microorganisms administered to confer health benefit. Effects are strain-, dose-, and condition-specific; generic 'probiotic' supplements have weak evidence vs. matched whole-food fermented diets.

Pterostilbene

A methylated analog of resveratrol with much better oral bioavailability. Usually paired with nicotinamide riboside in commercial NAD+ products.

Quercetin

A flavonoid used as the second half of the dasatinib+quercetin (D+Q) senolytic combination. As a stand-alone supplement, evidence is weaker.

Rapamycin

An mTOR inhibitor and FDA-approved immunosuppressant. The most reproducibly life-extending pharmaceutical in mammals. Off-label longevity use is widespread in private medicine despite lacking long-term RCT outcomes data.

Resveratrol

A stilbene polyphenol from grape skins, famous for the original sirtuin-activation hypothesis. Two decades on, mechanistic claims are disputed and human longevity evidence remains thin.

Sauna Therapy

Regular dry-sauna bathing associates with lower cardiovascular and all-cause mortality in Finnish cohort studies, with plausible mechanism via heat-stress hormesis.

Senolytics

Small molecules that selectively kill senescent cells, including the dasatinib+quercetin combination and fisetin.

SGLT2 Inhibitors (Empagliflozin, Dapagliflozin, Canagliflozin)

Glucose-lowering drugs that turn out to reduce cardiovascular events, heart-failure hospitalisations, and kidney decline — likely via mechanisms beyond glucose lowering.

Sleep Optimization

Consistent 7–9 hour sleep with healthy architecture is foundational for cardiometabolic, cognitive, and immune health. Quality, regularity, and timing matter as much as duration.

Spermidine

A polyamine found in wheat germ, soy, and aged cheese that induces autophagy and extends lifespan in mice; associated with lower all-cause mortality in human cohorts.

Statins

HMG-CoA reductase inhibitors that lower LDL/apoB and reduce cardiovascular events — likely the single highest-leverage longevity drug for most adults.

Sulforaphane

The isothiocyanate produced when broccoli (especially sprouts) is chewed or chopped. Potent NRF2 activator with cardiometabolic, oncologic, and possibly cognitive benefits.

Taurine

A semi-essential amino sulfonic acid that declines with age and extends mouse lifespan when supplemented. Human evidence beyond cardiovascular and metabolic indications is preliminary.

Testosterone Replacement Therapy (TRT)

Replacement for documented hypogonadism. Off-label use for "low-normal" testosterone in aging men is widespread, controversial, and not supported by long-term mortality data.

Therapeutic Plasma Exchange (TPE)

Removes plasma and replaces it with albumin/saline. Experimental "rejuvenation" protocols are extrapolating from heterochronic-parabiosis mouse work; human evidence is sparse.

Urolithin A

A gut-microbial metabolite of ellagitannins (pomegranate, walnuts) that induces mitophagy and improves muscle endurance in human RCTs.

Vitamin D

A fat-soluble hormone-vitamin essential for bone and immune health. Routine supplementation in vitamin-D-replete adults shows no clear healthspan benefit in large RCTs.

Vitamin K2 (MK-7)

The menaquinone form of vitamin K activates osteocalcin (bones) and matrix Gla protein (arteries), directing calcium into bone and away from arterial walls. Supplementation appears safe; cardiovascular outcomes data still limited.

Zinc

Essential mineral involved in 300+ enzymes and immune function. Deficiency common in older adults, vegans, and chronic diseases; supplementation has trial evidence for AMD, common cold duration, and selected dermatological conditions.