Six systems, one page. Every intervention ranked by human evidence tier. Click any tab to see its ranked interventions, evidence summary, and retest cadence.
Priority: medications and baseline labs first. Run Medication Reality Check before starting any supplement protocol. Retest lipid panel, ApoB, hsCRP, and Omega-3 Index at 12 weeks.
A
Omega-3 EPA/DHA 2–4g/day
REDUCE-IT: 25% MACE reduction at 4g icosapent ethyl. Test Omega-3 Index first — target ≥8%. Form: ethyl ester (prescription) or rTG fish oil.
Retest: 12 weeksO3 Index
A
Magnesium Glycinate 300–400mg elemental
34-RCT meta-analysis: −2mmHg systolic BP. Deficiency common. Serum magnesium is insensitive — use RBC magnesium if testing.
Retest: 8 weeksRBC Mg
A
Resistance training 2–3×/week
Largest independent predictor of CVD risk reduction outside of medication. Reduces resting BP, improves lipids and insulin sensitivity across all-age RCTs.
Retest: 12 weeksBP, lipids
B
CoQ10 Ubiquinol 200–300mg/day
Q-SYMBIO: 43% reduction in MACE in HF population. Standard dose for statin users: 100–200mg. Ubiquinol form preferred in adults 50+.
Retest: 12 weeksCoQ10 plasma (optional)
B
Plant sterols 1.6–2g/day with largest meal
Cochrane review: −10% LDL-C consistently. Competitive absorption with dietary cholesterol. Best combined with dietary modification.
Retest: 8 weeksLipid panel
B
Vitamin D3 2,000–4,000 IU + K2 MK-7 100mcg
VITAL trial: 25% cancer mortality reduction. K2 directs calcium to bone vs. arterial walls. Test 25-OH-D first — target 40–60 ng/mL.
Retest: 12 weeks25-OH-D
C
Aged garlic extract 1.2–2.4g/day
Multiple small RCTs showing modest BP reduction and plaque stabilization. Allicin-free form reduces GI side effects. Bioavailability variable.
Retest: 12 weeksBP, ApoB
Baseline cognitive assessment recommended before starting. MOCA or MoCA-BLIND take 10 minutes and provide a retest benchmark. Retest at 16 weeks minimum — cognitive changes are slow.
A
Creatine 3–5g/day
~500 RCTs. Cognitive benefit confirmed under sleep deprivation and stress (meta-analysis 2023). Phosphocreatine system is used by neurons, not just muscle. Monohydrate form — any timing.
Retest: 12 weeksCognition battery
A
Aerobic exercise (Zone 2) 150 min/week
BDNF induction is the most consistent and robust cognitive longevity intervention with human outcome data. Hippocampal volume preservation confirmed in RCTs.
Retest: 16 weeksCognition, VO₂max
B
Bacopa Monnieri 300–600mg (55% bacosides)
12+ RCTs: improved memory acquisition and recall at 8–12 weeks. Slow onset — minimum 8 weeks for effect. GI side effects with food reduce. Only standardized extracts studied.
Retest: 12 weeksCognition battery
B
Omega-3 DHA 1–2g/day
DHA preferentially concentrated in brain. MIDAS trial: improved memory in healthy adults 55+ at 900mg DHA over 24 weeks. Independent of EPA cardiovascular benefits.
Retest: 24 weeksCognition battery
C
Lion's Mane 1,000mg (fruiting body)
Mori 2009: improved MMSE in MCI at 16 weeks, but small n=30 trial. NGF stimulation mechanism. Needs larger replication. Fruiting body only — mycelium on grain has poor active content.
Retest: 16 weeksCognition battery
C
Phosphatidylserine 300mg/day (soy-derived)
FDA-qualified health claim for cognitive decline. Some RCTs positive in MCI — others null. Soy-derived form replaces bovine brain source. Kosher: soy is pareve.
Retest: 12 weeksCognition battery
Run Medication Reality Check first if on metformin, GLP-1 agonists, SGLT-2 inhibitors, or insulin. Drug interactions in this category are clinically significant. Retest fasting glucose, HbA1c, and fasting insulin at 12 weeks.
A
Magnesium Glycinate 300–400mg
Insulin sensitivity improvement consistent across 13 RCTs in metabolic syndrome patients. Cofactor in >300 enzymatic reactions including glucose metabolism. Test RBC magnesium.
Retest: 8 weeksFPG, HbA1c
A
Resistance training 2–3×/week
Skeletal muscle is the largest glucose disposal organ. Every kg of muscle gained improves insulin sensitivity. Dose-response confirmed. Effect independent of weight loss.
Retest: 12 weeksFPG, insulin, HbA1c
B
Berberine 500mg 3×/day (with meals)
Head-to-head vs. metformin: HbA1c −2.0%, LDL −21%. Significant drug interactions with many medications — mandatory interaction check before starting. GI side effects common at full dose.
Retest: 12 weeksHbA1c, lipids
B
NMN 250–500mg/day (morning)
Yoshino 2021 (Science): +25% muscle insulin sensitivity in postmenopausal women. NAD+ repletion in skeletal muscle confirmed in humans. Grade B — one strong RCT; needs replication for Tier A.
Retest: 12 weeksInsulin sensitivity
B
Alpha-Lipoic Acid (R-ALA) 300–600mg fasted
Insulin sensitizer via GLUT-4 upregulation. R-form only — racemic ALA is 50% biologically inactive. Consistent effect in multiple RCTs on fasting glucose and insulin sensitivity in T2D.
Retest: 12 weeksFPG, HOMA-IR
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Why Exercise lives here as a peer tab
Of every longevity input, resistance training and VO₂max have the largest, most consistent human-trial effect sizes. The current EBL nav buries Exercise under a dropdown. In this architecture, it's a first-class peer alongside Cardiovascular and Cognitive — because the evidence demands it.
A
Resistance training 2–3×/week (progressive overload)
All-cause mortality −30–40% in multiple large cohort studies. Sarcopenia prevention confirmed in RCTs. Glycemic control, bone density, cognitive function — dose-response confirmed across all age groups. The single highest-effect-size longevity intervention with the best evidence base.
Retest: 12 weeksGrip strength, 1RM
A
VO₂max training (Zone 2 + intervals)
Cardiorespiratory fitness is the strongest single modifiable predictor of all-cause mortality independent of other risk factors. Norwegian 4×4 protocol has the strongest RCT data for VO₂max improvement. Target: ≥75th percentile for age/sex.
Retest: 16 weeksVO₂max, resting HR
A
Grip strength training (as biomarker and intervention)
Grip strength is an independent predictor of biological aging, mortality, and hospitalisation in prospective studies. Train it explicitly — don't assume it improves from general resistance work. Dead hangs, farmer's carries, thick-bar training.
Retest: 8 weeksHand dynamometer
B
Plyometric and power training
Power (force × velocity) declines faster than strength with age. Explicit power training after 50 preserves fast-twitch fiber function. Box jumps, medicine ball throws, trap bar jumps — not just slow heavy lifting.
Retest: 12 weeksVertical jump, 30m sprint
B
Mobility and fall-prevention protocols
Falls are a major late-life mortality driver — hip fractures have 20–30% 1-year mortality in adults over 80. Balance training RCTs (Tai Chi, proprioceptive training) consistently reduce fall risk by 20–30%. Often omitted from longevity stacks — shouldn't be.
Retest: 16 weeksBalance test, fall log
B
Daily step count — threshold ~7,000–8,000 steps
Multiple large prospective cohorts (n>70,000 combined) show inflection in all-cause mortality benefit at 7,000–8,000 steps/day. Diminishing returns above ~10,000. Steps capture NEAT (non-exercise activity thermogenesis) independent of formal training.
Retest: ongoingWearable tracker
Sleep is the most underrated longevity intervention. No supplement stack compensates for chronic sleep restriction. Structural interventions (light, temperature, timing) before pharmacological or supplement support.
A
Sleep restriction treatment (CBT-I)
CBT-I outperforms sleep medication in RCTs for chronic insomnia — 70% improvement rate, durable at 12 months. First-line recommendation. No pharmacology required. Digital CBT-I programs (Sleepio, Somryst) have equivalent efficacy in head-to-head trials.
Retest: 6 weeksPSQI score
A
Magnesium Glycinate 300–400mg at bedtime
Multiple RCTs: improved sleep onset latency and sleep efficiency. Glycinate form crosses BBB more readily than oxide. Acts on GABA receptors and melatonin pathways. Start here before any other sleep supplement.
Retest: 4 weeksSleep diary, PSQI
B
Melatonin 0.5–1mg (low dose) · 90 min before sleep
Chronobiotic — shifts circadian phase, not a sedative. Low dose (0.5mg) as effective as high dose for sleep onset with fewer side effects. Timed correctly: 90 minutes before target sleep time. Not for all-night sleep maintenance.
Retest: 2 weeksSleep diary
B
L-Theanine 200mg · 30–60 min before sleep
Promotes alpha-wave activity and relaxation without sedation. Consistent across multiple RCTs in adults with elevated stress. Synergistic with magnesium. Not habit-forming.
Retest: 4 weeksSleep quality
B
Ashwagandha KSM-66 300mg at bedtime
Langade 2019 RCT: improved sleep quality, morning alertness, and cortisol AUC. Effect largest in adults with elevated baseline stress. Branded extract required — KSM-66 or Sensoril only.
Retest: 8 weeksPSQI, cortisol
Device evidence is tiered separately. The device with the most marketing is rarely the device with the best evidence. See the Devices page for full tab-by-tab breakdown with key RCT data.
B
Hyperbaric Oxygen (HBOT) · 60 sessions at 1.5 ATA
Efrati 2020: +38% telomere length, −37% senescent cells. Hadanny 2022: improved cognition in MCI. Serious science — small samples, limited replication. Available through ConciergeO₂ (LA/Greater Los Angeles).
Sessions: 605×/week protocol
B
Red Light / Near-Infrared (630–850nm)
Consistent biomarker signal across pain, wound healing, skin aging, and some cognitive applications. Device quality matters enormously — irradiance at distance is the key variable most consumer devices misrepresent.
Retest: 8 weeksIndication-specific
B
Pneumatic Compression (sequential)
Validated for lymphedema (strong), athletic recovery post-exercise (moderate). DOMS reduction consistent across multiple RCTs. NormaTec-style devices studied directly. Not a general longevity intervention — specific recovery tool.
Retest: 4 weeksDOMS, HRV
C
PEMF (Pulsed Electromagnetic Field)
FDA-cleared for bone fracture non-union (solid evidence). Consumer longevity application is Tier C — mixed data, no hard outcome trials, significant device parameter variability. More marketing than evidence at the longevity application level.
Indication-specificCheck parameters
C
Molecular Hydrogen (H₂-enriched water)
Selective antioxidant — neutralizes hydroxyl radicals without quenching useful ROS. Biomarker RCTs positive (oxidative stress, metabolic markers). No hard longevity endpoint. Safety profile excellent. Low-risk, evidence-limited.