Guides

How I Evaluate Longevity Interventions

I plan to live to 110. That long horizon changes how I evaluate almost everything being marketed today as “cutting-edge” longevity medicine. When decades matter, short-term wins, clever hacks, and fast feedback lose their appeal. What matters instead is whether an intervention strengthens the body’s ability to regulate itself over time, or quietly replaces that ability with an external lever that feels helpful now but may cost resilience later.

Longevity is not achieved by silencing signals. It is achieved by responding to them intelligently. Hunger, fatigue, stress, load, and repair are not enemies to be overcome or inconveniences to be muted. They are the body’s language of survival, shaped by millions of years of adaptation. I am not interested in muting that language to make a plan feel easier or more attractive. I am interested in understanding it well enough to still be listening decades from now.

That belief sits underneath every decision I make about health, aging, and new therapies. Before I care whether something “works,” I care about what it touches.

Some interventions affect core life-sustaining signals, such as:

• appetite
• fatigue
• pain
• stress response
• sleep drive
  

These are not minor pathways or optional systems. They are central regulators designed to keep us alive.

Other interventions support capacity systems, such as:

• circulation
• oxygen delivery
• strength
• balance
• recovery
• resilience

These systems determine how well we respond to stress, injury, illness, and aging over time. When an intervention interferes with a core survival signal, it immediately faces a much higher bar than one that supports capacity.

One question clears most debates for me: does this build capacity, or does it replace it?

Capacity-building interventions make the body more capable. They strengthen systems, increase reserve, and create adaptations that remain even if the intervention stops. Capacity-replacing interventions substitute an external control for internal regulation. They often suppress signals rather than address underlying causes. They may work, sometimes impressively, but frequently at a long-term cost that only becomes visible years later. Longevity depends on capacity.

Replacement may have a role in acute medicine, but it is a poor foundation for a multi-decade health strategy.

Because of that, signal-muting is my line. If an intervention works primarily by:

• suppressing hunger
• blunting fatigue
• flattening stress
• bypassing effort
• overriding adaptation
  
  

I pause. Signals exist for a reason. They are feedback, not flaws. Turning them down may feel helpful in the short term, but over decades it risks weakening the very systems that sustain life. I am not interested in becoming more comfortable by becoming less aware.

Proof matters, and the kind of proof matters even more. “Promising” is not enough. Elegant mechanisms are not enough. Animal data and short trials can be interesting, but they are not a green light for long-term use. For anything intended to be ongoing, I look for:

• human data that lasts long enough to matter
• outcomes that reflect real function and independence
• honest accounting of risks, failures, and tradeoffs

Absence of evidence does not equal safety, especially when interventions affect fundamental regulatory systems.

I also ask a practical question that cuts through enthusiasm quickly: would I want this operating in my body for the next ten, twenty, or thirty years? If stopping the intervention leaves the body worse off, if dependency is built into the design, or if regulation is progressively outsourced rather than strengthened, it fails that test. Longevity is about durability, not dependence.

This way of thinking shapes how I distinguish between approaches that build capacity and those that replace it. Capacity-building approaches engage the body’s intelligence. They tend to improve resilience, preserve reserve, and reward consistency rather than cleverness. They usually require effort, and that effort is part of why they work. Capacity-replacing approaches rely on chemistry or external control to do work the body would otherwise have to do itself. They often promise results with less friction. Over a long horizon, that tradeoff matters.

I study emerging longevity science closely. I read, review, and follow the research. I am not opposed to pharmaceuticals, injections, or innovation. When something is proven safe in humans, demonstrates meaningful long-term benefit, and supports capacity rather than replacing it, I am open, even to interventions many people assume I would reject. Until then, I observe, learn, and wait. That is not fear. It is judgment.

Living to 110 is not about finding ways around the body. It is about learning how to work with it. I am not willing to mute the body’s language just to feel better about the conversation. I am willing to listen carefully, respond intelligently, and choose coherence over convenience. That is the standard I hold for myself, and for anything I consider adopting or recommending.