Longevity Global

Some VCs have told me to “pick a lane”, here’s why I think this is fundamentally wrong Biotech companies have been told to focus on either diagnostics or therapeutics but not both, which is a holdover from 1995 industry structure. That structure no longer reflects the value proposition of Biotech in the age of AI. Foundation models need millions of multi-modal patient observations to learn patterns of disease progression and treatment response. Only the integrated company can generate that dataset. A few things readers might not know: 🔬 Roche has spent ~$4.3B assembling integrated capability through M&A: $1.9B for Flatiron Health (oncology real-world evidence) and $2.4B for Foundation Medicine (cancer genomic profiling) 📊 Tempus reached public markets at a $6.1B valuation in June 2024 and reported ~$1.27B in 2025 revenue, up 83% year over year. 95% of top pharma companies by revenue are customers 💊 The integrated model can plausibly take Phase 2 to approval probability from ~10% to 30-50%, with per-approved-drug development cost falling 60-80% 🧬 Brain aging has measurable biomarkers decades before clinical Alzheimer's symptoms but we don't yet have the datasets that we need to create personalized therapeutics. At NeuroAge, we are building an integrated closed loop system from day one. The consumer platform generates the privacy protected multi-modal data in that powers the AI to surface drug targets, and the same data tells us which patients are most likely to respond. That feedback loop only exists because the data and discovery live in one company. The next decade of medicine will be defined by vertical specialists building this natively across brain aging, cardiometabolic disease, autoimmune disease, mental health, and rare disease. We will see the loops present in tech companies like Google and Tesla emerging in biotech, creating huge data advantages and finally executing with the speed that we need to cure diseases quickly. Full post: drglorioso.substack.com/p/why-the-pick…

Looking forward to seeing some folks at the NeuroAge Therapeutics booth at Vitalist Bay tomorrow in Berkeley! Come test your reaction time. Faster reaction time predicts sharper brain function and less future dementia risk- and you can train it! So where you are now is movable. with @StephenGHubbard

Viruses as a Risk Factor for Dementia, and the Vaccines That May Lower It (new study) There is mounting evidence for viruses increasing dementia risk and the efficacy of vaccination to reduce this risk. A new study of 1.5M older adults, published in Alzheimer's & Dementia last month, found that adults who received both doses of the recombinant shingles vaccine (Shingrix) had: 33% lower risk of any dementia 28% lower risk of Alzheimer's disease 33% lower risk of vascular dementia Bottom line: viral reactivation in the brain looks like a real, modifiable contributor to dementia, and several routine vaccines may be functioning as inadvertent brain-health interventions. 📜 How the field got here: 1990s: Dr. Ruth Itzhaki finds HSV-1 DNA in Alzheimer's brains, especially in APOE4 carriers. Treated as fringe for two decades. 2010: Dr. Robert Moir shows amyloid beta has direct antimicrobial activity. 2022: Dr. Kjetil Bjornevik shows EBV is a near-necessary cause of MS (32-fold risk, Science). 2025: Welsh natural experiment in Nature shows the live shingles vaccine reduces dementia by ~20%. 2026: 1.5M Medicare adults, Shingrix → 33% lower dementia risk. 🧠 SARS-CoV-2 infection produces brain volume changes on MRI equivalent to 1-2 years of brain aging (Douaud, Nature 2022). 💉 High-dose flu vaccine: 55% lower Alzheimer's risk in adults 65+ (Bukhbinder, Neurology 2026). The jury is still out on whether treating active HSV-1 infections is protective for dementia. Everyone should consider yearly flu and COVID-19 vaccinationand shingles vaccination after 50 years old for brain health. Link to full post: drglorioso.substack.com/p/viruses-as-a… #AlzheimersPrevention #BrainHealth #LongevityScience

A New Study in 495 Centenarians Points to a Brain Aging Biomarker You Probably Have Not Heard Of Most people know about blood pressure for heart disease and blood sugar for diabetes. Far fewer know that there's now a blood biomarker quietly building a case as one of the more informative readouts for brain aging. A new JAMA Network Open paper followed 495 Japanese centenarians for 17 years. NfL (neurofilament light) predicted both cognition and lifespan more reliably than the classical Alzheimer's-specific markers did in this cohort. 🧬 NfL is released into blood when axons get damaged from any cause, including aging, stroke, MS flares, concussion, and neurodegeneration 📊 Each 1 SD higher NfL meant 36% higher mortality, even after adjusting for kidney function and APOE4 🧠 Phosphorylated tau did not predict mortality after full adjustment in this cohort. Only NfL did. 💉 Plasma NfL tests now run $200-400 at Labcorp, Quest, and several direct-to-consumer services This does not replace amyloid and tau testing. It adds a different lens. Plaques and tangles are part of the story, but aging, vascular wear, and injury also drive cognitive trajectories, and NfL captures those. This is why brain aging assessment is moving toward multimodal panels that combine NfL with imaging and genetics, each catching what the others miss. Link to full post: drglorioso.substack.com/p/a-new-study-… #BrainAging #Longevity #BrainHealth

I'm speaking at the AI × Longevity Summit by @LongevityGL at @nyuniversity Langone BioLabs during NYC Tech Week by @a16z. I will share work from @lifebiosciences using epigenetic restoration to reverse age-related diseases. Registration: eventbrite.com/e/nyc-ai-x-lon…

Excited to be speaking at the AI × Longevity Summit by @LongevityGL at NYU Langone BioLabs during NYC @ Tech Week by a16z. I will share work from @ShiftBioscience focused on translating AI and multi-omics into clinically meaningful aging biomarkers and interventions. If you are serious about AI and longevity, you should be in the room. Registration: eventbrite.com/e/nyc-ai-x-lon…

@just_kyunjung @Techweek_ @stevenwardell @LongevityGL Will do. Come to think of it a lot happening here in Boston, aging code summit next, later ARDD & biomarkers of aging. Enjoy the event, Steve is a lovely host for all his events and mega-connector across this special community.

Excited to be speaking at the Aging Code Summit in Boston May 26-27. Hope to see some folks there! RSVP: longevitygl.org/boston/

The future of medicine is invisible, frictionless, AI-matched, continuous, and at home This is not only going to be nice, it's also going to save us a lot of money It is a Tuesday in 2036. The toilet has already finished a microbiome read and the bathroom mirror noticed a small new mole on my left temple that AI thinks is benign but wants to recheck in 3 mos. I head out for a morning run. By the time I am back, the patch on my arm has logged the BDNF spike from the workout, a 38 percent rise from my pre-run level. BDNF is a growth factor that drives the formation of new connections between brain cells. The system updates my weekly plasticity score, with today’s run clearing the threshold for my brain health goals. Overnight My GFAP trend, the brain inflammation marker that the patch on my arm has been tracking, crossed the threshold the system flags as worth investigating. GFAP is the protein that brain immune cells release when they are stressed or inflamed, and it has been climbing slowly for 19 weeks. While I am making coffee, my phone surfaces the matching engine’s ranked recommendations for what to do about the GFAP drift. At the top is a Phase 2 trial for a brain-penetrant anti-inflammatory drug that targets the reactive astrocytes producing my signal. Drug delivery, blood draws, and continuous monitoring all happen from my home. Below the trial, the engine surfaces lower-risk lifestyle options with smaller predicted effects on my GFAP signature. The trial drug has the highest predicted effect but with unknown side effects from a novel class, while the lifestyle alternatives are gentler and slower-acting and unlikely to fully reverse the drift on their own. On the way to work, the self-driving imaging vehicle picks me up at my building and the cabin’s portable MRI maps hippocampal volume, cortical thickness, and white matter integrity. All come back within range for the trial, and the report arrives in my inbox before I reach the office. The next decade is when biotech companies gain the chops and advantages of tech companies. Six shifts have to come together for that Tuesday morning to be ordinary: 📊 Diagnostics run continuously through devices you already use, not at scheduled appointments ➰ Biology is measured as real-time streams of dozens of biomarkers, not annual snapshots 🎛️ Monitoring connects directly to specific recommendations, not just alerts on your phone 🤖 AI matches you to treatments that worked for patients with your specific data profile, not population averages 💊 Drugs and doses are chosen to fit your full molecular profile, not the average patient 👨‍👩‍👧‍👦 🩺 Clinical trials find you when your data fits, instead of you searching for trials The total addressable savings from a fully realized version of this vision is somewhere in the $1 to $2 trillion/yr range, or roughly 20 to 40% of current US healthcare spending. What are we going to need to invest in to get there? Full post: drglorioso.substack.com/p/the-future-o…

Second gathering of @LongevityGL ATX. ✅ Last night three VCs spent 2 hours getting candid for a crowd of 50 attendees about what they're actually looking for in health and longevity right now. Thank you to @aneilbaboo (Partner, Humain Ventures), Bill Gerard (HealthQuest Capital), and Prerna Sharma (General Partner, @AntlerGlobal US) for the incredible conversation and the candor. Founders, clinicians, and researchers came with sharp questions. The answers were refreshingly honest. Here are some takeaways from last night’s panel: 1. For early-stage companies, it's important that founders do their "homework" and research their ICP (ideal customer profile) thoroughly and show PMF with a smaller group of people. Also, founder track record or tenacity is important. In all stages, story telling is so important; founders who have great tech/company but can't sell the vision won't get funded. 2. In later stages, funds look for validated markets and strong unit economics — signs that you've built a real business model with strong fundamentals. 3. What funds pass on: if a company doesn't fit within the fund’s thesis, or if funds can't underwrite certain risks that founders haven't derisked yet. The lesson? With every pitch, figure out what objections they have and come up with a way to address them in an appendix slide. If those objections keep coming up, address them up front and turn them into selling points! 4. What's real vs hype in longevity: wellness = more woo woo; longevity = more science-backed with real clinicals. All panelists think supplements are overrated and prefer basics like sleep, human connection, and exercise. It’s refreshing to hear lifestyle factors being brought up instead of just pharmaceuticals. 5. The panel also said there's an overload of biomarker data and different “longevity products” now, which creates a lot of noise. Companies trying to sell you more and more. They want to see companies that can provide the signal on interpretation and real action with outcomes. 6. Finally, policy and legislation are changing quickly to support more cash-pay consumer demand (e.g. movements to increase the HSA/FSA cap to support lifestyle interventions, which will benefit companies like @truemed and Flex). Also, policy to support alternatives to traditional health insurance is underway and will support innovation in the space! Huge thank you to @jpmorgan and @audvisor for sponsoring, and to Antler for hosting. John Forrest and I started this chapter because we believed Austin needed a consistent gathering point for the people building the future of longevity. Nights like last night are exactly why. If you're building in digital health, biotech, or longevity, drop a comment or send me a DM to get on the list to stay in the loop for all there is to come. 👀

Excited to co-host a Boston Health Innovation Night focused on hashtag #LongevityTech on Thu, May 28, during this year’s Boston @Techweek_ (May 26–31). For the first time, Tech Week is coming to Boston! @stevenwardell @LongevityGL 👉 Register now : partiful.com/e/Pg2f8DHkLfdr…

Longevity Global had a great time hiking in Land's end today. Fun collabs with The Alliance for Longevity Initiatives and good to see some Don't Die SF folks there as well.

The future of longevity medicine will not be decided by the loudest protocol. It will be decided by standards. Which biomarkers are real enough to act on? Which interventions change outcomes, not just pathways? Which patients benefit, which patients are exposed to cost and risk, and how do we tell the difference before the market decides for us? That is the lens I’m bringing to the 2026 Aging Code Summit in Cambridge, May 26-27, during Boston Tech Week. I’ll be speaking on Day 2 about evidence-based best practices in longevity medicine, from the perspective of an internal medicine physician trying to turn a very noisy field into something clinically useful. The science is finally getting concrete. Aging biology is becoming therapeutics, diagnostics, AI models, biomarker systems, skin and immune longevity, neurodegeneration work, and new company formation. The next question is harder: what deserves to become medicine? Hosted by @LongevityGlobal in partnership with @Mindvyne and @3cubedAi, with speakers including @agingdoc1, @manoliskellis, Li-Huei Tsai at @MIT_Picower, @kpfortney at @bioagelabs, Sharon Rosenzweig-Lipson at @lifebiosciences, @mahdi_moqri at @agingbiomarkers, Amy Proal @microbeminded2 at @polybioRF, Saranya Wyles @drwyles_derm, Jens Eckstein @AkikoaCom at @hevolution_f, @DrGlorioso at @NeuroAgeTX, @JamieHeywood, @AldenScientific, Fiona Miller @quadrascope, @Dr_RayMak, José Navarro Betancourt, Justin Taylor, Noriko Yokoi, Daniel Dacey, Spring Behrouz, Raghav Sehgal @rv_sehgal, Jay Luthar, @usnehal, @tomzuber, Robin Mansukhani, Fernanda Cerqueira, David Hall, Yeh-Chuin Poh, Salah Mahmoudi, and @RutaLaukien. If you are building, funding, prescribing, regulating, or seriously studying longevity medicine, this is the conversation worth having in person. Event details and registration: longevitygl.org/boston More here: hillarylinmd.com linkedin.com/in/hillarylinmd

@LongevityGL ATX is back for our second gathering. 🧬 One of the most common asks I get from founders building in longevity: introductions to investors. On Wednesday, April 29th, I'm moderating an intimate panel with 3 VCs actively writing checks in longevity, digital health, and biotech – early stage to later stage. Our panelists: Dr. @aneilbaboo – Partner at Humain Ventures. PhD from UCSF, co-founder of the Lifespan Project. Invests at the intersection of AI and life sciences. Bill Gerard – HealthQuest Capital. 20+ M&A and capital markets transactions totaling ~$5B. Deep experience evaluating and scaling healthcare businesses. Prerna Sharma – General Partner at @AntlerGlobal US (Austin). One of Antler's earliest global team members, backed founders from day zero, and helped scale Uber across Asia. We'll cover: → What investors actually look for at the early stage → How expectations shift across diagnostics, biotech, and wellness → What makes a founding team stand out → Where capital is flowing next 📍 Antler, Austin 🕕 7:00 – 9:00 PM | Open networking after If you're building in longevity and you're in Austin, drop a comment below and I'll DM you the invite. 👇

Do rapamycin and exercise combine to improve function and reduce biological age? New study results from @mkaeberlein and @BradStanfieldMD 💊 🐭 Rapamycin is a darling drug of longevity enthusiasts. It has shown consistent lifespan extension in mice across multiple independent laboratories and has become a popular off-label therapy in the longevity community. Results from a placebo-controlled trial pairing rapamycin with structured exercise in older adults have been long-awaited, both by people already taking it and by clinicians fielding questions about whether to recommend it. 👨‍👩‍👧‍👦 📊 The RAPA-EX-01 trial, led by Dr. Brad Stanfield with Dr. Matt Kaeberlein as co-author and senior scientific collaborator, was funded entirely by public donations. The crowdfunding campaign was facilitated by Lifespan.io and VitaDAO, and the funds (totaling $724,637) were administered by Dr. Brad Stanfield Ltd. The work was published this month in the Journal of Cachexia, Sarcopenia and Muscle. The trial asked whether once-weekly low-dose rapamycin would enhance the functional gains from a home-based exercise program in sedentary older adults. The work is small and exploratory, but the short answer is no, at least not in this study. Topline conclusions of the study Functional tests 🪑 On the trial’s main test, the 30-second chair-stand, the placebo group did about 2 more repetitions than the rapamycin group at 13 weeks, non-significant. 🚶 The 6-minute walk distance favored placebo by 4.87 meters, non-significant. ✊ Hand-grip strength favored placebo by 1.13 kg, non-significant. 📊 SF-36 quality of life subscores all favored placebo, with small and non-significant differences. Aging clocks ⏱️ Four DNA methylation aging clocks were measured (PCGrimAge, SystemsAge, OMICmAge, DunedinPACE). None reached statistical significance. PCGrimAge trended toward a younger biological age in the rapamycin arm. The other three clocks showed no clear pattern or slightly favored placebo. Blood biomarkers and safety 🩸 C-reactive protein, a marker of inflammation, was higher in the rapamycin arm by 4.26 mg/L on average, driven by two outliers. With those two excluded, the difference fell below 1 mg/L. 🍡 HbA1c (average blood sugar) and LDL cholesterol both rose slightly in the rapamycin arm. ⚠️ Adverse events totaled 99 in the rapamycin arm versus 63 in placebo. One possibly drug-related serious adverse event (a case of pneumonia) was reported in the rapamycin arm. The next generation of trials may benefit from larger subject numbers and longer study duration. For people considering rapamycin specifically because they think it will help them get more out of training in their 60s and 70s, the current human evidence does not support that use. Well designed clinical trials, such as this one, are the most important tests that we can run to move the longevity field forward. This study has added to our knowledge of the benefits of rapamycin. Full post: drglorioso.substack.com/p/do-rapamycin…

Creatine is having a moment in longevity circles. The supplement has been used by athletes for decades, but over the past few years the research has expanded into cognitive performance, resilience under stress, and dementia prevention. Bottom line. The trial evidence makes me cautiously optimistic that creatine is helpful for brain health, but not for everyone equally. A few things people may not know: 🧠 The brain is 2% of body weight but uses 20% of the body's energy at rest, and cells only hold a few seconds' worth of ATP at a time. Creatine is the backup system. 💊 The 5 gram daily dose in most trials is not correcting a deficiency. The body's actual daily creatine requirement is only about 2 grams, half of which your liver and kidneys make themselves. Trial doses are pharmacologic, not physiologic. 🥩 Getting 5 grams from food alone is difficult. That works out to about 2 pounds of raw beef or salmon per day, or 1.5 pounds of herring. Cooking destroys another 30-50%. This is why most meat eaters who want trial-level doses supplement. 🧬 Meta-analyses in healthy adults show the clearest cognitive benefit in the 66 to 76 year old subgroup. Younger healthy adults show small, inconsistent effects. Vegetarians and vegans with lower baseline stores show stronger effects than meat eaters. 😴 A single high dose during sleep deprivation rapidly increased brain creatine and improved working memory within hours. This was a surprise because brain creatine usually takes weeks to change. 🔬 "Creatine" and "creatinine" look similar but are different molecules. Most consumer blood panels (including Function Health) measure creatinine for kidney function, not creatine for brain or muscle stores. Creatine supplementation itself raises creatinine modestly without any kidney damage. My take. Creatine has a strong safety profile across hundreds of trials, costs almost nothing, and the evidence is strongest for older adults, vegetarians and vegans, and people under chronic sleep stress. At NeuroAge, we recommend creatine for clients whose cognitive testing shows room for improvement, not as a blanket recommendation for everyone. I am not personally taking it but could conceivably experiment in the future. Full post: drglorioso.substack.com/p/creatine-sup… #BrainHealth #Longevity #Creatine

Join @LongevitySF for a hike in Lands End in SF May 2nd. Co-hosted by @beappbeapp of @theA4LI. RSVP: luma.com/28djoi7q

Gut microbiome testing has become one of the fastest-growing areas in consumer health. The science is growing quickly but there are substantial gaps in our knowledge. My new deep-dive covers what we know about which organisms matter, what tests can and can't tell you, and what interventions work. A few things that stood out: 🧑‍🧑‍🧒 Two people can both be in excellent health and share fewer than 30% of their gut bacterial species. 🧬 If your genetics, ancestry, or long-term eating pattern don't match the reference population the company used, the comparison may not be meaningful for you. 💊 The organisms with the strongest evidence across multiple research methods, Faecalibacterium, Akkermansia, and Bifidobacterium, are well established. The rest of the report deserves a more nuanced interpretation. 🔁 A single test result is less useful than two. Test, make a targeted change, and then retest in three to six months. 🥒 Most commercial pickles are not fermented. If the label shows vinegar, there are no live cultures. 💊 Taking a commercial probiotic after antibiotics makes your microbiome recovery slower, not faster. 🌱 Two of the most important butyrate-producing bacteria in the gut cannot be taken as supplements as they die on contact with oxygen. Dietary fiber from diverse whole plants is the only way to increase them. 🫐 The polyphenols in berries, dark chocolate, and green tea independently increase Akkermansia, a bacterium strongly linked to metabolic health, regardless of fiber content. A supplement can't replicate that mechanism. 🧠 APOE4 carriers consistently have lower levels of butyrate-producing gut bacteria. A 2025 Framingham analysis found this microbiome shift partially mediates the APOE4 effect on amyloid accumulation in the brain, which is one of the first data points connecting gut composition to Alzheimer's risk mechanistically. The gut-brain connection is moving from plausible hypothesis to testable clinical target. Full post: drglorioso.substack.com/p/gut-microbio…

The inaugural Longevity Global Chicago conference starts tomorrow with an incredible lineup of speakers! Still time to grab your tickets: luma.com/e80a7o09 You can take 50% off with code Christin50

How to Measure and Reduce Your Exposure to Toxins A study published in Nature Medicine this month analyzed brain aging data from 18,701 people across 34 countries. The combined burden of environmental exposures was associated with 3.3 to 9.1 times higher risk of accelerated brain aging. Reading it pushed me to think carefully about whether I and my clients at NeuroAge should be doing environmental toxin testing, and if so, to what extent. The bottom line The most useful approach is targeted testing anchored to a specific unexplained clinical finding. Declining kidney function points to different tests than unexplained thyroid disease or immune suppression. Ordering a broad panel without a clinical question to anchor it often generates numbers that are hard to act on. And the tests themselves vary widely in reliability. Some use the same validated methods the CDC uses for national health surveillance, others compare results against poorly characterized reference populations. A few things most people don't know: 🧪 Your standard urine toxin panel completely misses PFAS (forever chemicals). PFAS bind to serum proteins and don't appear in urine. A serum PFAS test is a separate draw and is arguably the most important toxin test most people aren't getting. 🐟 High mercury fish are high mercury because they are large, long-lived predators at the top of the food chain. Mercury accumulates with every fish they eat over decades. Shark, swordfish, and bigeye tuna sit at the top. Sardines, anchovies, and wild salmon sit near the bottom. 🍓 Washing produce helps but doesn't solve the problem. Glyphosate is absorbed into plant tissue and cannot be washed off. For strawberries, spinach, peppers, peaches, and grapes, studies still find pesticide residues after washing. Those are the categories to prioritize for organic. 🏠 The single highest-impact action costs under $200. A water filter reduces PFAS, lead, perchlorate, glyphosate, arsenic, and pesticides in one intervention. 🧴 "Fragrance" on a personal care label is often a vehicle for undisclosed phthalates. Companies that publish full ingredient lists eliminate this exposure category entirely. 🏗️ If your home was built before 1978, a water test and paint inspection are low-cost starting points for lead. Lead paint and lead pipes remain the primary exposure route for millions of households. My take: The chemicals with the strongest case for testing are blood lead and mercury, where intervention benefit is well-documented, and serum PFAS, where knowing your level helps you identify and stop ongoing exposure. A mycotoxin panel makes sense when there's a compatible clinical picture or a known history of water damage. The new article walks through the full matching table, evidence ratings, cost breakdown, and practical exposure reduction steps. Full post: drglorioso.substack.com/p/how-to-measu…