I have often commented here on specific longevity interventions and why I’m skeptical of some claims that circulate in the field.
I recently wrote a piece describing the framework I use when evaluating longevity interventions.
The core idea is that many interventions fail not because the underlying biological mechanism is wrong, but because the effect does not survive translation across biological scales, from a mechanistic idea to a meaningful effect in a whole organism over long time horizons.
The article walks through several examples (apigenin, MSC therapies, IL-11 inhibition, and hyperbaric oxygen therapy) and then summarizes the recurring failure modes that often prevent promising mechanisms from producing real anti-aging effects.
Link to article:
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Which is why I like pharma drugs. You have a better chance to assess long term effects and outcomes in a rigorous fashion and it’s immediately relevant to humans on top of it. Meanwhile with supplements the data is frequently sparse and confounded. This doesn’t mean supplements are useless, just that pharma drugs get you closer to decision making results faster. I can look at a drug and more readily see if it’s likely a useful addition to my stack. The gambling odds are better. However with supplements the path to that decision is more often long and winding. Doesn’t mean drugs can’t have the same kinds of problems, just the process is easier with more data and more reliable data. Of course, ultimately there’s also individual variation to any drug/intervention effect, and also your personal profile - if you have CVD vulnerabilities, your longevity stack will look different from someone with a different profile of vulnerabilities. We all age, but we age slightly differently and need to adjust our interventions to fit our particular physiology. Individualized approach insofar as is practical, but most often it’s just a gamble based on something observed in consolidated averages from studies. Testing is essential, but the things we can test for are limited. We’re just playing the odds, over and over again. We need to get lucky quite a number of times. The more interventions, the more often we need for things to break our way. It’s all a gamble in an information constrained environment. Game theory is relevant surprisingly often.
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I agree, and many of the things I take are a gamble in the long run. My main criterion is the physicians’ “Do no harm.” There are many drugs/supplements that I don’t take because of meaningful harmful side effects, even though some people swear by them.
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