4 ms·

This is a great discussion on longevity, though the main article focuses heavily on mouse studies. To add to that, I've been thinking about a framework that pri

This is a great discussion on longevity, though the main article focuses heavily on mouse studies. To add to that, I've been thinking about a framework that prioritizes the existing human evidence. My take, which I wrote about in the linked post, is to use a tiered approach: 1. Top Priority (Human RCTs): Start with what we know works in human randomized trials. This is our most solid ground and includes sustained weight loss, lowering LDL (especially with statins), intensive blood-pressure control, "polypill" strategies, and appropriate TRT for men with a confirmed deficiency. Also in this tier are things with more modest but proven benefits, like flu shots, multivitamins, and specific fish oils. 2. Second Priority (Strong Correlation): Look at interventions with strong positive associations in human studies and/or robust lifespan benefits in mice. This is where things like exercise, Mediterranean diets, social well being, coffee, green tea, fiber, and garlic fit in. 3. Third Priority (Emerging Science): Finally, consider the more experimental options that have shown promise in mice but only have early human signals. This is a long list, including rapamycin, calorie restriction, glycine+NAC, taurine, acarbose, metformin, and NAD+ boosters. Throughout this process, the goal should be to treat existing medical issues, track what works for you personally (N=1), and always consult with your doctor. Things that are still purely theoretical should wait for better data. Here's the full post with more detail: http://mylongevityjourney.blogspot.com/2022/08/a-short-summary-of-antiaging.html http://mylongevityjourney.blogspot.com/2022/08/a-short-summa...

Aurornis 1y ago
> appropriate TRT for men with low T You lost me here since this doesn’t appear in the linked article at all. You seem to be speaking about your own link, not the linked article on Hacker News. Be especially careful with TRT advice on the internet or from local clinics that push TRT treatments. The definition of “low testosterone” used in the longevity studies is very different than the definition used by TRT clinics looking to grow their customer base. There was an alarming study recently that showed a high percentage of men on TRT didn’t even have baseline testosterone bloodwork showing a deficiency. The clinics “diagnosed” them based on vague symptoms or questions, which is how they get around the fact that most men seeking TRT are not clinically deficient these days. Taking TRT will suppress natural production of testosterone and can lead to a lifetime need for TRT. Inappropriate dosing (which is common at the TRT clinics who want their customers to feel something early on) can also be net harmful and lead to cardiac complications or even psychiatric side effects like anxiety. TRT should be a last resort for people with true clinical deficiencies after eliminating the typical contributing factors (alcohol, sleep, obesity, etc). It’s not appropriate to mix into a list of supplements to take because it’s on the short list of medicines that can make you permanently dependent by causing testicular atrophy. This isn’t a concern in patients who already have testicular damage leading to hypogonadism, but it should be a huge concern for the average guy walking into a TRT clinic because they heard it was going to give them an edge or help in the gym.
- oinfoalgo 1y ago
  Taking TRT or not is a personal choice. TRT is longevity to me. Feeling younger for as long as possible. An "alarming study". You just have a puritanical mindset and can't stand someone else doesn't share your shitty sex life.
- starchild3001 1y ago
  > You seem to be speaking about your own link, not the linked article on Hacker News. Correct. The hacker-news linked article talks about drugs that made mice live longer, my article talks about drugs that made humans live longer with some supporting evidence from mice studies. > Be especially careful with TRT advice on the internet or from local clinics that push TRT treatments. Correct. If you read my article, it repeatedly talks about working with a Dr on this. Ideally an endocrinologist (in USA), or potentially a urologist. Healthy doses of TRT, where studies found benefits are with hypogonadal men whose low T is verified via two separate tests (<200 or <250 total T). The dosages used (~100 mg / week or less) are nowhere near gym bro doses (~200, 300, 400 mg/week etc). An endo will ask you to make lifestyle changes first, and resort to supplemental testosterone as a last resort. > it’s on the short list of medicines that can make you permanently dependent by causing testicular atrophy. I believe you're factually wrong on this. I know a lot of people personally who stopped TRT successfully, some after being a decade on it. > It’s not appropriate to mix into a list of supplements to take This is a non-sensical idea, because supplements are much like drugs except they don't go through the FDA approval proceess. They're simply unregulated drugs with potentially significant sides. You shouldn't take a light view of them. Actually, if I were to choose between a drug and a supplement for the same problem (such as living longer), I think people should prioritize drugs first as they go through rigorous clinical trials, their side effect profile is well known, there's post-approval drug monitoring.

Aurornis 1y ago

> appropriate TRT for men with low T You lost me here since this doesn’t appear in the linked article at all. You seem to be speaking about your own link, not the linked article on Hacker News. Be especially careful with TRT advice on the internet or from local clinics that push TRT treatments. The definition of “low testosterone” used in the longevity studies is very different than the definition used by TRT clinics looking to grow their customer base. There was an alarming study recently that showed a high percentage of men on TRT didn’t even have baseline testosterone bloodwork showing a deficiency. The clinics “diagnosed” them based on vague symptoms or questions, which is how they get around the fact that most men seeking TRT are not clinically deficient these days. Taking TRT will suppress natural production of testosterone and can lead to a lifetime need for TRT. Inappropriate dosing (which is common at the TRT clinics who want their customers to feel something early on) can also be net harmful and lead to cardiac complications or even psychiatric side effects like anxiety. TRT should be a last resort for people with true clinical deficiencies after eliminating the typical contributing factors (alcohol, sleep, obesity, etc). It’s not appropriate to mix into a list of supplements to take because it’s on the short list of medicines that can make you permanently dependent by causing testicular atrophy. This isn’t a concern in patients who already have testicular damage leading to hypogonadism, but it should be a huge concern for the average guy walking into a TRT clinic because they heard it was going to give them an edge or help in the gym.

oinfoalgo 1y ago
Taking TRT or not is a personal choice. TRT is longevity to me. Feeling younger for as long as possible. An "alarming study". You just have a puritanical mindset and can't stand someone else doesn't share your shitty sex life.
starchild3001 1y ago
> You seem to be speaking about your own link, not the linked article on Hacker News. Correct. The hacker-news linked article talks about drugs that made mice live longer, my article talks about drugs that made humans live longer with some supporting evidence from mice studies. > Be especially careful with TRT advice on the internet or from local clinics that push TRT treatments. Correct. If you read my article, it repeatedly talks about working with a Dr on this. Ideally an endocrinologist (in USA), or potentially a urologist. Healthy doses of TRT, where studies found benefits are with hypogonadal men whose low T is verified via two separate tests (<200 or <250 total T). The dosages used (~100 mg / week or less) are nowhere near gym bro doses (~200, 300, 400 mg/week etc). An endo will ask you to make lifestyle changes first, and resort to supplemental testosterone as a last resort. > it’s on the short list of medicines that can make you permanently dependent by causing testicular atrophy. I believe you're factually wrong on this. I know a lot of people personally who stopped TRT successfully, some after being a decade on it. > It’s not appropriate to mix into a list of supplements to take This is a non-sensical idea, because supplements are much like drugs except they don't go through the FDA approval proceess. They're simply unregulated drugs with potentially significant sides. You shouldn't take a light view of them. Actually, if I were to choose between a drug and a supplement for the same problem (such as living longer), I think people should prioritize drugs first as they go through rigorous clinical trials, their side effect profile is well known, there's post-approval drug monitoring.