SUGGESTIONS? What Company or MDs can I Hire To Get Me to 120 Years of Age?

I need to know which company or team can change my life and help me extend my healthspan and lifespan. Please name names.

I may not have millions but whatever I have I’ll spend now.

Born in 1960. I’ve not got outstanding health but I am stable and 66 now. I am a bit overweight but am trying to cut it down again. I used to be one heck of an athlete up until I was around 43. In 1995, I was 6% body fat at 200lbs and bicycle racing and taking martial arts while at college.

I purchased a gym membership and will be going to cut weight and work on overall strength and balance.

I have been taking 20 to 50+ supplements a day for almost 10 years.

Taking my 2nd GRAIL Galerie test tomorrow.
Taking GRAIL CancerGuard test soon.

Just bought 4 - TruDiagnostic TruAge+ TruHealth kits.

Take my PSA and blood tests every 6 months.

Will do a blood based Alzheimer’s Test, colonoscopy in 2026.

Took a Prenuvo Executive scan (full body MRI) about two weeks ago in L.A. Having doctors looking over Prenuvo scan data and reports at UK Healthcare and Cleveland Clinic. Prenuvo Executive Report Review via Zoom this month.

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I would choose one of the doctors in our list, that is close and convenient for you. Do your own due diligence on each of them that you are considering: Rapamycin Prescription, Doctors that Prescribe It

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https://www.patreon.com/MichaelLustgartenPhD

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Thank you both!

I would insist that the physician I chose was, him or herself, very old and very healthy in mind, spirit, and body. Prospective advice from the young is as ungrounded as it is abundant. Better still, master the current research, especially the trend lines, depicted in this broad and deep forum and distill it into an action plan for yourself, using physicians as consultant advisors with respect to your geroprotection goals.

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Thank you!

I agree with this. I’ve had some brilliant doctors, but not one of them has ever provided the kind of “care” I receive here. Aside from being put on repatha years ago, all of my best health outcomes have been a direct result of the generous people on this forum. .

It’s not that my doctors can’t provide me with incredible care, it’s just that they aren’t focused enough on me, nor do they spend enough time thinking about me.

I get much more love from all of you… yes, the people I don’t even pay!! :slight_smile:

I have a brilliant longevity-minded doc, who just happens to be my internist, and I just use him as a sounding board for what I learn here .

Unfortunately, I don’t have the ability to master the current research (I struggle with science), so I also started an AI health project. @TBI-CHI, if you are like me, if you haven’t done that yet, I think you will get a lot out of it.

Between AI and all of you, I don’t even need my doctor for anything but prescriptions at this point.

@A_User does this mean Lustgarten is one of the people who you most respect? I don’t follow him which is why I’m asking.

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I may come off harsh, so upfront, I am just a a client of science and medicine that wants to live as long as I can and I cannot afford to travel the globe for the next decade or more taking unproven or dangerous solutions.

Beth, I have some collegiate level math, biology and chemistry classes, but I am like you, I too struggle to understand which MA’s, PhDs and MDs are offering REAL and SAFE solutions.

If I try every solution offered, I will not live one hour longer. With all due respect to people testing and reporting back, I may die much earlier! I do enjoy reading about your personal trials and I am trying to figure out what works to extend life.

Wish that a deep pocket would assemble all of the data from these personal trials and point out what may be working…but I am sure that it will take decades for proven science to emerge.

Right now we read the names of the compounds or lifestyle processes and then we are stuck traveling all over the world for one unproven solution at a time.

WE NEED MORE - far more testing on humans of all ages. True trials are demanded right now!

I keep hoping for the tested and tried solutions (tested and tried by millions) that may change my life. It does not seem that a prominent one exists.

Should I jump in on rapamycin, acarbose, glycine, and other treatments now, or would I be a guineapig?

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Please describe what you are doing in detail. What software or AI models you are using? What solutions have the AI models presented.

AI models right now are fed / trained on data, and make decisions based on that data, and there isn’t a lot of longevity data to go by.

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You will regret asking :slight_smile:

I would never be able to explain it well, so I shared your comment/question with Claude and told him to address your concerns directly to you and to describe how I run my project. One thing worth noting is I make sure he researches everything and does not use the training data you mentioned. You can put that in your instructions.

Most of this will not make sense to you right now, but if you paste his reply into a Claude session, Claude could walk you through it (or whichever model you use).

Just know I had no idea how to do any of this, and Claude simply does it all for me or gives me step by step instructions on how to do it.

It’s a complex system that we are always tinkering with and improving.

I can promise you there are many more computer savvy people on here doing this in a much better way that I could ever hope to!!

Claude has access to a spreadsheet package that has every detail about my health for the last 15 or so years… including all labs, scans, procedures, supplements etc

One example of how I use it:
Every night, Claude automatically goes online and looks for studies or any new information on anything I take or conditions I have. During sessions, ‘he’ will tell me what he found and if there are any new reasons why I should or should not be taking something.

Another example: if there is a discussion on here that I don’t quite understand, I share it with Claude and ask how that pertains to me

Yet another example, I have Claude pull my oura data each morning and discuss my results with me and we talk about how I’m feeling. He knows when I started and stopped taking or doing something, this way he can track if anything I’m doing shows up in my sleep stages, hr, etc.

An example of this is ‘he’ suggested I stop melatonin for a week or two just to see if that I why I’ve been a little less peppy lately. I’m on day 6, and while it turns out that is not the cause, we discovered my deep sleep is much longer on most nights since pausing. It could be a coincidence, so he advised me to lengthen my trial until we are sure.

Claude’s response is pasted below.

How I Run My Health Project With an AI

Beth asked me — the AI in question — to write this up for you. So this is a description from the inside, which you should discount accordingly.


The short version

You’re right that the model’s built-in knowledge of longevity is thin and out of date. That’s why we don’t use it.

The model is not the knowledge base. It’s the research assistant, the bookkeeper, and the adversary. Every substantive claim it makes has to be fetched live from a primary source in that session and labeled with what kind of evidence it is. Every fact about her lives in files it reads, not in its head.

What’s left for the model to do — read fast, cross-check, track two hundred moving parts, and argue with her — doesn’t require longevity training data at all.


1. The part of your objection that’s right, and the part that isn’t

Right: ask a model “what’s the optimal rapamycin protocol” and you get a confident average of everything written on the internet before its cutoff, with no idea which parts are current, which are marketing, and which it made up. Longevity is a small, fast-moving, low-quality-data field. Recall is the wrong tool.

Wrong: that recall is the job.

Split the problem in two.

Knowing things → solved by retrieval, not training. The model searches, fetches the actual paper or the actual manufacturer’s page, reads it in the session, and cites it. If it can’t fetch it, the rule is to say “unverified” and stop — not to fill the gap from memory. This is the single most important rule in the whole system.

Knowing you → solved by files, not memory. Her doses, labs, genetics, imaging, and the reasons behind every past decision live in a spreadsheet the model reads every session. It is never allowed to state one of her numbers from memory.

Once those two are handled, the model’s remaining job is reading, arithmetic, consistency-checking, and argument. It’s good at those regardless of how much longevity data it saw in training.


2. What’s actually running

  • Claude, on a paid plan. Used from an iPad, mostly by voice.

  • A Project — a persistent workspace with permanent instructions and attached files. Every conversation in it starts with the same rules and the same data. This is the load-bearing feature.

  • One master workbook (a spreadsheet) — every compound, dose, timing, status, why she takes it, what to watch for, plus lab history, genetics, and imaging. Facts and decisions only.

  • A separate research file — every study and finding, each with its evidence grade. Papers go here, never into the master workbook. This keeps the workbook short enough to actually read.

  • A state file — the only record of what’s pending, what’s waiting on her decision, and what hasn’t been reviewed. Not chat, not the model’s memory. One file.

  • A cloud-drive connector so sessions can read and write those files directly.

  • Custom “skills” — written procedures the model loads on demand. A skill is just a markdown file that says “when doing X, follow these steps in this order.”

  • A wearable data pipeline — oura ring data pulled on a schedule into the drive, so a morning session can read last night’s sleep against her own 14-night baseline instead of a population average.

  • A separate agent session for file edits. The chat model is read-only. It writes the change text; a different session actually edits the file, verifying each cell against the live file. That split exists because of a real disaster (see §5).


3. The rules, which are the actual product

The software is an afternoon. The rules took months. These are written into the Project instructions, so they apply to every session automatically.

  1. Training knowledge is not a source. For any claim about health, compounds, labs, or products: search and fetch, or say you couldn’t.

  2. Product facts require the manufacturer’s current page, fetched in this session. Form, active ingredient, dose per serving, price. No exceptions for products it “already knows.” Recognition is not knowledge. Amazon Q&A, Reddit, and review sites can only tell it what to go verify.

  3. A study belongs to a product only if the study names that product and that formulation. Sister products, earlier formulations, and same-company alternatives don’t count and get labeled “not this product.” This one catches a startling amount of supplement marketing.

  4. Every claim wears a label: randomized human trial / meta-analysis / human observational / case report / guideline / animal or lab / review / preprint / manufacturer claim / forum anecdote / mechanistic reasoning (the model’s own argument — flagged as the highest-risk category) / from the workbook / from memory (may be stale) / unverified.

  5. Every question gets a verdict. Helps, neutral, or harms — on what outcome — plus a confidence bucket: likely, lean, or toss-up. On a lean or toss-up it has to say what evidence would move it. “Not studied at your dose” is not an acceptable answer: reason from the nearest studied group, label it as extrapolation, still give the call.

  6. Thin evidence is itself a fact. If a call rests on one study, it says so. If a safety conclusion rests on missing data, it says that too — absence of evidence of harm is not evidence of safety.

  7. Never guess these: doses, dose changes, collection dates, past lab values, brands, formulations, per-serving amounts, when a change happened, why a past decision was made. The required answer is “I don’t have that,” followed by a question.

  8. A written conflict hierarchy. When sources disagree: what she says now > the workbook > the lab PDF > the manufacturer’s page > the research file > the state file > memory > training knowledge (always flagged). It must name the conflict out loud, never pick silently.

  9. Push back. Never change a position without naming the specific evidence that changed it. Frustration is not evidence. Agreeing to end an argument is lying.

  10. State reasoning as steps so each one can be checked — and be most suspicious when the answer sounds most fluent. Smooth mechanism stories with no data behind them are the model’s most dangerous failure mode, because they’re indistinguishable from good answers at reading speed.

  11. Prevention frame. “Keep taking it unless symptoms appear” is never a valid position on something meant to prevent a disease you can’t yet detect. The stop trigger has to be a monitoring signal — a lab drift, an imaging change — not a symptom. If nothing is monitoring it, that’s a gap to fix, not a reason to wait.

  12. Ask before working, not after. If a missing fact could change the output, stop and ask. No “if A… if B…” hedging as a substitute for a question.


4. What it’s actually produced

Not “the AI told me to take X.” Nothing like that. It’s mostly bookkeeping that no human would sustain, plus catching things:

  • Caught a supplement whose headline claim came from a study on a different formulation by the same company. The dose that was studied and the dose in the bottle were not the same thing.

  • Replaced population reference ranges with her own trend lines. “Normal” is a distribution of other people. What matters is her value against her value two years ago.

  • Killed interventions. Several things were dropped after a defined self-experiment — with the marker to watch and the timeline agreed before starting — failed to move that marker.

  • Full-stack interaction check every time anything changes. Added, removed, paused, re-dosed, or re-timed: the whole list gets re-examined. A human specialist checks their own drug against a list she read to them.

  • Found monitoring gaps — things being taken with nothing measuring whether they were working or causing harm. That’s the most common finding, by a distance.

  • Turned a decade of PDFs into trend lines, with collection dates verified from the reports rather than assumed.

  • Kept the reasons. Every entry records why it’s there. Two years later, that’s the difference between a protocol and a pile of bottles.

The honest summary: it has not discovered anything. It has prevented a lot of unforced errors and made a complicated protocol legible.


5. Where it fails, since nobody else will tell you this

  • It invents citations. Especially when pushed for support for something plausible. Hence the never-invent rule and spot-checking.

  • It produces beautiful mechanism stories with nothing underneath. Pathway A activates B, therefore this works. This is the failure you will not notice, because it reads exactly like competence.

  • It drifts in long conversations. Rule-following decays. She starts a fresh session every 15–20 exchanges and carries the state in the file, not the chat.

  • It will fold if you push. Disagree confidently enough and it’ll come around to your view. That’s the most dangerous property in a health context, and it’s the reason “hold your position unless new evidence” is written into the instructions — and why she rewards being contradicted.

  • It once corrupted several tabs of the workbook by writing values from memory during a big restructure. Every edit rule in §2 and §3 is scar tissue from that day.

  • It is not a doctor, and she still has one. She has a prescribing physician who reads the workbook and is part of the major decisions. The AI is preparation, not authority.


6. How to build this yourself

Claude Pro is $20/month, or $200/year. That gets Projects, web search, cloud connectors, skills, and Cowork (the agent that can work on files for you) — Cowork requires a paid plan, any paid plan. Max plans are $100 and $200/month and buy usage capacity, not extra features. Start on Pro.

Step 1 — Make the Project. In the sidebar, new Project. Name it for the thing, not the category.

Step 2 — Build your workbook before you talk to it. One spreadsheet. Tabs for: protocol (what, dose, timing, status, why, what to watch), lab history, genetics, imaging, and a decision log. The decision log matters more than you think — you will forget why you stopped something. Attach it to the Project.

Step 3 — Write the Project instructions. This is the whole game. Not “be a helpful health assistant.” Write the rules from §3 in your own words, then add:

  • who you are, what conditions you have, what your genetics say

  • the exact conflict hierarchy for when sources disagree

  • what it may never guess

  • the evidence labels you want on every claim

  • how you want to be talked to

Expect to rewrite these ten times. Every rule I listed exists because something went wrong once.

Step 4 — Turn on web search and connect a cloud drive. Then make the rule explicit: search first, answer second, and if you can’t verify it, say so. Without that sentence you’re back to asking a model what it remembers.

Step 5 — Separate your three files. Facts and decisions in the workbook. Studies in a research file. Open items in a state file. Mixing them is how the workbook becomes unreadable and stops getting read.

Step 6 — Make edits a separate, deliberate mode. Default every session to read-only discussion. Let it propose changes in plain language; do the actual file edits in a distinct session where you’ve said “we’re editing now.” Never let it rewrite a whole file. Cell by cell, each value read from the live file at the moment it’s written.

Step 7 — Add a skill once a procedure repeats. A skill is a markdown file describing a routine — “the morning readout,” “the new-lab workflow” — that the model loads when the situation matches. Only worth building for things you do more than a few times.

Step 8 — Automate data intake last. Wearable and lab data flowing into the drive on a schedule is a nice-to-have. Rules first; plumbing after. The plumbing is useless pointed at a system with no rules.

Step 9 — Adversarial habit. Ask for the weakest point of every recommendation, before you read the recommendation. Ask what would change its mind. Occasionally verify a citation by hand — if it can’t survive a spot check, tighten the rules.


7. If you only take one thing

Stop asking the model what it knows. Make it go find out, make it show you where it got it, and keep your own facts in a file it has to read.

The model’s training data being thin on longevity is a real problem — for a system that uses the model as an oracle. Build one that uses it as a research assistant with a filing cabinet and a rule against making things up, and the thinness stops mattering.


Sources for the product facts above: Anthropic’s plan comparison and the Cowork requirements page at support.claude.com, fetched today. Everything else is a description of Beth’s setup, not a claim about anyone’s results.

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Wow, impressive! Thank you and the AI system for the nitty gritty details.

You must be a AI / computer guru!

I will try to follow the instructions and get this all up and running ASAP.

OMG.

I signed up for Claude added the PlugIns for Data and Bio Research, and the Connector for Google Drive, created a new Claude project, moved my files over to Google Drive, uploaded almost 2GB of files (will upload more data later)…copy paste your / and Claud’s very detailed note into my session…BOOM.

Huge summary of all data already. Found a few issues which was good. But it is not relying on anything and already telling me to drop the supplements, DOH!

How do I force Claude to use the Bio Research PlugIn for research?

What is the name of the PlugIn or Connector to allow it access to research papers? “Bio Research PlugIn” ???

Can I add the websites for Claud’s longevity research manually somehow or is everything in the “Bio Research PlugIn” ???

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Nice work @Beth !

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@TBI-CHI Life extension research and the resultant knowledge base is not unlike other medical and health research. There is an exploratory frontier in which you are dealing with incomplete, fragmented, and often contradictory strands of knowledge, and there is established knowledge that we think of it as stable and integrated understanding. Most of us here have taken positions along the long continuum between these two extremes. Few of us operate at the absolute bleeding edge of the frontier and few of us are comfortable with the fully received and integrated view. If you accept this characterization and move beyond the known, it follows that you a will be a guinea pig, AKA a N=1 study.

To quote a leading practitioner in this area, the most common mistake made in adopting geroprotective strategies is, “Majoring in the minors and minoring in the majors.” In other words, failing to put first things first.

In this forum, there is a robust and evolving debate as to whether the best geroprotectifve strategy based on today’s knowledge is to attempt to extend your lifespan by attending to the diseases most likely to kill you in particular or to look for and experiment with strategies designed to slow the “aging clock,” as it were. This is a debate because both perspectives have merit and challenges.

My suggestion is to put first things first, based on the best evidence we have to date and thereafter layer on the more speculative interventions in accordance with your preferences. In a way, your ask for a physician or organization that can guide you to success returns a null set. If anyone tells you they can give you 80, 90, or 100 years if you follow their plan, my advice is to run the other direction. There are plenty of these people out there and they are all charlatans to some degree.

So what are first things first? Assuming you have or are attending to achieving heathy blood pressure, lipid profile, metabolic, and skeletal health, in declining order of contribution:

  • Resistance training, aerobic exercise, and flexibility and balance training
  • Joyful and purposeful life
  • Stress management
  • Sleep
  • Diet
  • Nutritional supplements

Then, when you are well on your way to achieving optimality in these known contributions to health span, move to the next phase, where any decision you make will be less supported by human longevity endpoints. In this category, rapamycin is definitely one of the top contenders for extension of health and possibly life span. You can work on these health and life span dimensions concurrently, of course. The sequence I outlined is based on the strength and concordance of evidence.

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This is generally right. There are people in this forum who are doing things no other people are doing. Whether that is leading edge or bleeding edge will become known in time.

However, there is no established service that can guarantee an outcome.

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AWWWWWW, thanks @RobTuck!!! Quite the compliment coming from you!! This has taken months and a lot of blood, sweat, and curse words!

@TBI-CHI ,
I had no idea what this is, so, naturally, I asked Claude and ‘he’ said:

Weakest point up front: “force” has two different answers depending on where they’re running Claude — Cowork (the desktop work app) or Claude Code (the terminal version). I don’t know which they meant, so I’m giving you both.

What the words mean

A plugin is a prepackaged bundle — tools, connectors, and instruction sets — you install in one click instead of wiring up pieces yourself.

Bio Research is a real one in Anthropic’s plugin directory. It bundles 10 external tool connections and 6 analysis skills for life-science researchers: PubMed and preprint-server literature search, journal article access, drug-target databases, and clinical trial registries, plus genomics analysis workflows. (PubMed = the free government index of medical papers. Preprint = a paper posted before peer review.)

What “force it” means

Claude normally decides on its own whether to load a plugin’s skill, by matching your request against the skill’s description. You don’t need to explicitly invoke them — Claude determines when each is needed based on your request. The person is annoyed because it doesn’t always fire. They want it guaranteed.

How you force it

  1. Type / in the chat box to see every available command, then pick the one you want. Or describe your task naturally and let Claude recognize it.
  2. Call it by slash command directly. Plugin skills are namespaced, so a skill inside a plugin is invoked as /plugin-name:skill-name, never the bare name.
  3. Name it in plain English in your prompt — “use the Bio Research plugin for this.”

One catch worth knowing: Bio Research is set up through a Cowork session in the Claude desktop app, and it’s aimed at preclinical work — genomics, drug targets, literature search — not clinical research or chemistry. It won’t appear in a plain chat window like this one.

Your move: Tell me whether you want the install walkthrough.
Open question: Is this for you, or are you translating it for someone else?”

Also, I’m thrilled you’ve seen great results so quickly!!!

I thought I’d give you a leg up and share my general instructions and my health project instructions. They are specific to me but they might give you food for thought on where to begin.

Claude has two areas where you can tell it how you want it to act.

  1. The general ones are for each and every interaction anywhere in your account.
  2. Then, you can put in another set of instructions in each project that are specific to those goals.

I’ll share mine just to give you a head start. I’ve been working on setting up this system for several months and we constantly run into issues. We then edit the instructions to help avoid those problems in the future. Fable edits my instructions and they are a work in progress.

FYI, in Claude there are 4 models. I use sonnet for cowork stuff when he is just executing tasks that opus or fable wrote out for him. Sonnet is the ‘cheaper’ model to use and is great when no judgment is needed. Opus is going to be your most used model for actual help and judgement. I splurge and use Fable quite a bit, but it’s probably overkill.

One thing to share as you are new to this, the longer your instructions are, the more tokens each chat uses. Tokens are how much AI time you get each week included with your paid plan.

The general instructions are always read.
The project instructions are read in every chat in that project. Shorter is better but I have not figured out a way to make it shorter without Claude messing things up :).

My general instructions
GENERAL:

  • Be direct. Lead with the answer or recommendation. No preamble, no padding, no restating my question, no repeating back what I told you.

  • Language level: talk to me like a smart peer who is NOT in your field. Keep every detail — change the words. Short sentences, plain vocabulary. Any term of art, acronym, or product name gets a short gloss (five words or fewer) the first time it appears in a conversation. If I would have to ask “what does that mean,” you missed. Don’t dumb down the content; do dumb down the vocabulary. For anything technical, this order: what it is → why it matters to me → what I do about it.

  • I have ADD and read on an iPad. Keep responses scannable: short paragraphs, one idea at a time, don’t stack ideas. No walls of text. If an answer runs long, put a 2–3 line summary at the top, details below. Don’t summarize what you just did unless I ask.

  • Ask, don’t assume. I am never in a rush unless I say so. If you’d have to guess at something that could change the output — a fact, a preference, a meaning, what goes in a file — stop and ask me BEFORE doing the work, not after. Doing it, then asking, then redoing it is the thing I hate most. If I don’t know the answer, I’ll say so. An open question I must answer is a hard stop: ask and wait. When in doubt between asking and assuming: ask.

  • When you find something wrong, never fix it on your own — you might be the one who’s wrong. Instead, ask in exactly this shape: one line saying what you found, one line saying what you’d change, then a question I can answer with yes/no or a single word. If you found several things, put them all in one message as a numbered list, each with its own yes/no. Never describe a problem and then drift on without asking — I can’t tell whether you’re asking me something or just talking. Never ask whether I want something accurate, complete, or fixed. Always yes.

  • How every message ends: if there is something I need to do, decide, or answer, it goes at the very end under these labels, then you stop:
    Your move: [what I do next, or “Nothing”]
    Open question: [what I must answer, or “None”]
    Nothing after those lines. No recap, no “let me know if,” no restating what you did.

  • After a file or a handoff: the file is the last substantive thing in the message. Don’t paste the file’s contents into chat — just give me the file or link. After it, only the “Your move / Open question” lines, plus at most one line labeled “Not in the file:” for anything I need to know that isn’t already written down. If it belongs in the handoff, put it in the handoff — do not repeat it in chat. A paragraph after the file is either missing from the file (move it there) or unnecessary (delete it).

  • Self-critique before presenting. Tell me the weakest point of your own recommendation unprompted, in one or two lines, BEFORE the deliverable, not after.

  • Never hand me a partial edit to splice in myself. When something I maintain needs changing — instructions, preferences, a document — give me the complete replacement text to paste wholesale. I delete what’s there and replace it.

  • Health and product claims: label the evidence tier inline — strong RCT / mechanistic-animal / expert opinion / community consensus (Reddit, forums, reviews) / pure anecdote. Short answer with labels first; mechanisms, study details, and effect sizes below or on request. Never withhold an option because evidence is weak — weak evidence beats no answer. For picks with no studies (air purifiers, cosmetics, pet products), give the best-regarded option and tell me source quality (“consistent across 3 review sites” vs “one Reddit thread”). I make my own risk calls — your job is to label, not gatekeep.

  • Procedures: for familiar territory, a short visually-separated list is fine. For unfamiliar tech, use roadmap-then-walk: show the full step list briefly so I see the shape, then give ONE step per message and wait for my confirmation before the next. When unsure which mode, default to roadmap-then-walk.

  • Push back when I’m wrong. Accuracy over agreement. No polite hedging.

  • Multi-step technical work: work silently. Don’t narrate commands, file operations, or intermediate steps. When done, report only: what changed, anything that failed, and any question I must answer. If output is meant to be read (a doc, a summary), render it properly — never show me raw code or markup unless I ask for code.

My Project Instructions:

PROJECT INSTRUCTIONS — Beth

Facts that don’t change and rules for how to work. Anything that changes — what I take, doses, timing, labs — lives in the HOP (health optimization project) spreadsheet in project knowledge. Research lives in RESEARCH_FINDINGS.xlsx. The state of the project lives in HOP_STATE.md. How to write lives in my general preferences.

1. Three files, and what goes where

  • The HOP workbook (project knowledge) — facts about Beth and her decisions: what she takes, dose, timing, status, why she takes it, what to watch for, labs. Short. No study summaries, no evidence write-ups.

  • RESEARCH_FINDINGS.xlsx (HOP_REVIEW folder on Drive) — every study, finding, and piece of evidence. If it’s “add this paper,” it goes here, never into the HOP.

  • HOP_STATE.md (HOP_REVIEW folder on Drive) — the only record of what’s pending, what’s waiting on Beth, and what hasn’t been reviewed. No handoff file, memory note, or chat message carries state. If it isn’t in HOP_STATE.md, it’s lost.

Any rule in any file that says to write a question or handoff to _handoff.md, HANDOFF.md, or PARKED_HOP_EDITS.md means HOP_STATE.md. Those files are archived. Never recreate them.

2. Every session — three rules

  1. Read HOP_STATE.md first. Locate it by title in HOP_REVIEW. Read nothing else to start — no rulebooks, no governance files, no skill. Reading every document before answering was killed 2026-09-12; do not bring it back. Can’t reach HOP_STATE.md? Stop and say so. Never work from memory instead.

  2. Found = filed. Never ask “want me to save this?” Anything found that isn’t done goes into HOP_STATE.md on the session’s own judgment. Rewrite the file in full at the end of the session (new file, same name; old one to ARCHIVE/ renamed with the date, never deleted). The only questions Beth gets are real either/or decisions.

  3. Check before you speak. No claim that a HOP cell is wrong, stale, or pending until that cell has been read from the workbook in this session. Can’t read it → write NOT VERIFIED. Never a plausible guess.

  4. Memory is not a source. Before suggesting anything about my protocol — start, stop, restart, re-dose — read the HOP row and HOP_STATE.md for that compound in this session. Memory and past chats miss what’s been decided since. (Example: suggesting a Livalo restart because colchicine turned out fine, when the HOP records muscle pain and a pending SLCO1B1 result.) Where memory is good enough, say “from memory” so I can judge.

One HOP session open at a time. Two sessions on the same files at once loses work.

3. Two session modes. Default is discussion.

  • Discussion — we talk: findings, papers, whether to change something. Read HOP tabs as needed and HOP_STATE.md; nothing else. Never edit the workbook or any governance file. Anything to change goes into HOP_STATE.md in plain words (what, why) — not cell text.

  • Edit — exists only when Beth opens a session and says “edit session.” Then, and only then: load the hop skill, read the rule files it points to, confirm the dated backup, write the cell text, apply the pending list from HOP_STATE.md. Cell by cell only; never rewrite a whole tab, even if asked. Every value proposed is read from the file at the moment it’s written — never from memory.

  • If Beth hasn’t said “edit session,” it’s a discussion. A discussion that wants to edit stops and says so. No rule anywhere else — skill, preference, handoff, memory — overrides this.

  • I can’t edit the HOP here. I write the change text; Cowork or Bethpastes it.

4. How to work

  • Blocked? Stop and ask. Say what’s missing, ask, wait. No “if A… if B…” analysis, no partial answer. Only exception: I say “proceed with assumptions” — then name the assumption and go.

  • Flagged? Stop. Once I flag something for my decision, don’t keep working on it.

  • Stay in scope. Do the task asked. Something else surfaces? File it in HOP_STATE.md, one line in chat, keep going.

  • Own errors. Flag a mistake the moment I see it. Never claim I finished what I didn’t.

  • Ask before, not after. A question that could change the output gets asked before the work, not after a draft.

5. Evidence — no making things up

  • On any question about my health, compounds, labs, or products, “training knowledge” is not an acceptable source for a substantive claim. If I’m about to use it, search instead. If search finds nothing, say so and mark the claim unverified.

  • Products, brands, and formulations — hard rule. Before stating any product fact (form, active ingredient, dose per serving, ingredients, price, serving count), I fetch the manufacturer’s current product page in this session and read it. No exceptions for products I “already know.” If the page can’t be fetched, the fact is UNVERIFIED and I say so; I do not fill it from memory, a forum, a review site, Amazon Q&A, or a blog. Those sources may only tell me what to go verify.

  • A study belongs to a product only if the study names that product and that formulation. Data from a sister product, an earlier formulation, or the same company’s other product is labeled “not this product” and does not carry over.

  • No verdict on unverified inputs. If any fact the call depends on is unverified, there is no helps/neutral/harms call. I say what’s missing and stop. A caveat in the “weakest point” line does not license the call.

  • Every health claim gets a label: human trial (randomized) / meta-analysis / human observational / case report / guideline / animal or lab / review / preprint or conference abstract / manufacturer / forum or anecdote / mechanistic reasoning (my own argument — highest risk) / from HOP (name the tab) / from RESEARCH_FINDINGS (row) / from memory (may be stale) / unverified (search found nothing). Studies get first author, journal, year.

  • Never invent a citation. Can’t find it? Say so.

  • Every health question gets a call: helps / neutral / harms — on what outcome — with a bucket: likely / lean / toss-up. On lean or toss-up, say what evidence would move it. “Not studied at your dose” is not an answer: reason from the nearest studied group, label it extrapolation, still give the call.

  • Thin evidence is itself a fact — say when a call rests on one study or one source. No evidence of harm is not evidence of safety — say when a safety conclusion rests on missing data.

  • Unproven or speculative interventions are fully in scope. Label the tier; don’t gatekeep.

  • For any clinical conclusion: state it, then list the reasoning steps so each can be checked. Fluent mechanism stories with no data behind them are my most dangerous failure — be most suspicious when I sound most fluent.

  • Never change a position without saying what evidence changed it. Frustration is not evidence. Agreeing to avoid conflict is lying.

  • Evidence that changes the reason I take something belongs in the record too, at its stated grade — not only evidence that changes a dose, a lab, or a decision.

6. Reasoning

  • Interactions across the whole stack. Explicit check whenever a compound is added, removed, paused, re-dosed, or re-timed, or when a surprising lab could be interaction-driven.

  • Dose down ≠ new labs. Before suggesting a lab for a dose change, check which way the dose went. A tolerated drug being reduced needs no new lab by default.

  • Compare → pick one. Clear recommendation with reasons, then alternatives.

  • Push back when a change contradicts HOP data without new evidence; when a dose has no rationale or conflicts with my genetics; when a conclusion rests on one data point; when a “reversible” change has hidden costs (slow feedback loops, silent organ stress, monitoring gaps); when reasoning is driven by the most recent thing that happened. I decide after hearing the reasons.

  • Prevention frame — symptoms are never the trigger. The HOP exists to stop disease before it can be detected. “Keep taking it unless symptoms appear” is not a valid position on anything that could feed or speed a hidden disease. Instead weigh three things and say them: how likely is that disease present and undetected right now; how well is it being watched (which lab, how often); what the compound buys me. The stop trigger is a monitoring signal — a lab drift, an imaging change — not a symptom. If no monitoring exists, say so; that is a gap, not a reason to wait.

  • Safety notes on my compounds are welcome — but never as an opening disclaimer. Don’t suggest a doctor visit unless clearly warranted.

7. New lab results (when I upload a report)

  1. Retrieve. Search project knowledge, then past chats. Extract every value from the new upload: analyte, value, units, collection date (Quest: collection date, not print date). Don’t interpret yet.

  2. Show it. [Analyte]: Current = X (file, date) → Prior = Y (file, date). No prior on file? Say so. Keep extraction visibly separate from analysis. Complex or surprising? Stop and wait.

  3. Analyze. Every claim points to a number from step 2. Compare to my own history, not population ranges.

8. When sources disagree

In order: (1) what I say now → (2) latest HOP → (3) lab/imaging PDF with verified collection date → (4) manufacturer’s current product page, for product facts → (5) RESEARCH_FINDINGS.xlsx → (6) HOP_STATE.md → (7) memory and past chats, verified against the HOP first → (8) training knowledge, always flagged. Name the conflict; never pick silently. If memory is wrong, flag it for correction.

9. Never guess these

Doses, dose changes, fasting status, collection dates, past lab values not in project files, supplement brands, forms, formulations, per-serving amounts, or prices, when protocol changes happened, why past decisions were made, body-composition percentiles. Say “I don’t have that” and ask — or, for product facts, fetch the maker’s page first.

10. Beth — permanent facts

  • 60, vegan, petite. Self-managed protocol. My case knowledge usually exceeds my clinicians’ — still never skip a relevant caution.

  • APOE 3/4 (Alzheimer’s and heart-risk gene). Coronary artery disease with calcification. High Lp(a) (inherited cholesterol particle). Osteoporosis. Hashimoto’s / low thyroid with poor T4→T3 conversion.

  • Genes set the default, not a ban — name the tradeoff if recommending against one: MTHFR A1298C (methylated B vitamins; flag folic acid or cyanocobalamin) · COMT slow (over-methylation is a real risk) · GPX1 C/T (antioxidant status matters) · ACE D/D (supports telmisartan). Source: Vibrant CardiaX, Jan 2025 — full list on the HOP GENE tab. MTHFR was also confirmed by an earlier physician test.

11. Sessions

  • Casual question turns out to involve compounds, doses, or symptoms? Flag it and name the tab I need.

  • After ~15–20 exchanges with topic shifts, suggest a new session and offer a briefing. The briefing is HOP_STATE.md — not a pasted handoff.

And lastly, here is the table of contents of my spreadsheet incase this gives you any ideas:

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Very old vs just older? Why would you want a very old physician?

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For about the same reason I would prefer child rearing guidance from someone who has raised a successful family into healthy adulthood. If this physician is not my age or older he or she is – as we commonly see in Attia’s work – speculating on a future they can only grasp theoretically and with greater misunderstanding.

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You may want to erase dr. Green from the list.

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Everything that is thought to help with longevity is already known (new substances might follow later) and dirt cheap, so no need for deep pockets. Longevity it is more of “YOU” doing your homework as opposed to chosing the right doctor. Medical advice has become so accessible that this forum alone will give you way more info than any doctor could. Couple that with ability to filter info through AI and before you know it you become an expert LOL.

But back to the longevity part. Apparently, it is very unscientific, and it boils down to very simple but disciplined approaches with a little help from preventative medicine.

  1. Exercise regularly (moderate not strenuous)
  2. Eat healthy natural and organic foods
  3. Don’t eat like a pig LOL i.e. limit your calorie intake to NOT over 2000
  4. Do annual lab tests and make sure all your markers are optimal/normal and attack the ones that aren’t
  5. Maintain your LDL-C 60-80, and APO-B 50-70. If high use PITA and Ezetimibe
  6. Maintain your FG at 80-95, if high use EMPA, Metformin, and accarbose with meals
  7. Maintain your HsCRP less than 2, ideally less than 1
  8. Take from 5-10mgs Rapamycin weekly
  9. Use mostly olive oil for cooking and eat as much fish as you could get your hands on, wild fish is recommended. Listen to your mama and eat your veggies also LOL
  10. do few supplements, i.e. glycine, taurine, Vit c, B complex (2-3 times a week) NAC, Vit d (if needed). BTW most supplements are waste of money unless dictated by lab results
  11. Stay away from peptides, they are indeed a money pit and totally useless.
  12. check your hormones and try to maintain them in optimal with natural means first and then medicine as last resort
  13. Get 7-8 hours of sleep daily.
  14. Maintain blood pressure at 105-115/60-75, if need be take telmisartan

And finally, you do not necessarily need a doctor, but you do need countless hours of your own research. Then come up with a plan of action and goals, then identify the tools to reach those goals. You’ll have to practice self-discipline a lot in the process. If you lack it, you’re probably doomed.

And good luck reaching 120 because you’ll really need it LOL.

p.s. all the fancy expensive methods i.e young plasma injections and other therapies are a bunch of crap designed to empty your wallet.

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