A great question.
I think all the items I’ve put in my blog on neurocognitive decline are also longevity meds.
If your BMI is high - why not, if no contraindication get on a GLP-1 agent? Cost is always an issue, but depending upon where you reside, compounded ends up often coming in ~$100/month.
A PDE-5, primarily tadalafil, due to the long half life should be on the list.
Hormone normalization for life is also sensible, goaled at levels you’d have had in your 20’s.
There is then all the supplements, which I think we have less evidence for.
Depending upon your age, do you do Dasatinib/Fisetin every 3 months for 3 days?
Do you do Methylene Blue, Nattokinase, Serrapetase, and/or BPC 157?
The challenge is do we end up not benefiting you as we add more medications, as they hit the same pathways, and do we just add toxicity or other risks? There is a need to streamline this.
Our data is often focused on testing just one drug - what happens when we combine 10 drugs - which is probably on the conservative side for most on the board?
I liked the recent study showing synergism with SGLT2-i and GLP-1 agents as being more beneficial together than in isolation.
The only other comment - I think, if not good medical reason for it - I’d get rid of metformin. We have much better agents - go with an SGLT2-i, GLP +/- acarbose. Optimize metabolism that way - I think sarcopenia is an independent health risk, and metformin seems to increase the risk.
I’m no longer prescribing this as part of a longevity protocol.
