Healthspan / longevity
Targets hallmarks of aging (mito decline, senescence, telomere attrition).
Decision support, not prescription. You decide.
Candidate agents
10 agents · tap to expand▶Rapamycin (Sirolimus)LeadEmergingAn FDA-approved mTOR inhibitor repurposed as the leading pharmacologic geroscience candidate; take the animal data seriously, but human healthspan proof is still early.expand
An FDA-approved mTOR inhibitor repurposed as the leading pharmacologic geroscience candidate; take the animal data seriously, but human healthspan proof is still early.
▸Full clinical story
Chronic mTORC1 signaling is a core driver of the aging hallmark of deregulated nutrient sensing; intermittent low-dose rapamycin dials mTORC1 down, restoring autophagy and proteostasis and slowing cellular senescence — the mechanism most consistently linked to lifespan extension across species.
Strongest at the preclinical level: rapamycin reproducibly extends lifespan in mice even when started late in life, and multiple invertebrate models agree (reviewed in Mannick & Lamming). Human data are emerging but thin — the 48-week PEARL randomized, double-blind, placebo-controlled trial in normative-aging adults found intermittent weekly rapamycin (5-10 mg) was relatively safe with modest signals (improved lean mass and self-reported pain in women at 10 mg) but no change in the primary visceral-adiposity endpoint. Grade emerging is appropriate: robust mechanism plus early human safety data, no hard longevity outcomes yet.
Anecdotal community signal only: a substantial off-label longevity community (often via telehealth prescribers) takes weekly oral rapamycin and self-reports subjective energy, joint, and metabolic benefits. This is uncontrolled self-report, not evidence of an aging benefit, and enthusiasm outpaces the data.
Context, not a protocol: longevity use is typically intermittent oral dosing (commonly ~5-6 mg once weekly, sometimes up to ~10 mg), deliberately spaced to bias toward mTORC1 over mTORC2 inhibition — far below daily transplant immunosuppressive dosing.
As an immunosuppressant it carries real condition-specific concerns even at low dose: impaired wound healing, mouth ulcers (stomatitis), possible dyslipidemia and glucose intolerance, and blunted vaccine/immune responses. Watch CYP3A4 interactions (statins, azoles, grapefruit) and avoid around surgery or active infection; chronic mTORC2 inhibition from over-dosing can paradoxically worsen insulin resistance.
The most credible drug in the geroscience pipeline mechanistically, now with first-in-class human safety data — but efficacy for human healthspan/longevity is unproven. Reasonable for informed, monitored off-label use; not a validated anti-aging therapy.
▶EpitalonLeadPreclinicalA pineal tetrapeptide with reproducible telomerase/telomere effects in cell culture and modest lifespan signals in mice, but no human outcome data for the synthetic peptide.expand
A pineal tetrapeptide with reproducible telomerase/telomere effects in cell culture and modest lifespan signals in mice, but no human outcome data for the synthetic peptide.
▸Full clinical story
Induces hTERT and telomerase activity in telomerase-negative human cells, elongating telomeres and permitting additional replicative divisions; can trigger the ALT pathway in cancer lines.
In vitro human fibroblast studies and a 2025 human-cell-line study show telomere elongation; SHR-mouse work showed ~12-13% increase in maximum/longest-decile lifespan and reduced leukemia, with unchanged mean lifespan. Human longevity data exist only for the related pineal extract epithalamin in non-blinded studies, not synthetic Epitalon.
No verifiable community threads were located through search (Reddit not indexed by the search agent).
No validated human dosing. Research-use protocols are extrapolated from intermittent animal dosing and community practice.
Research-use-only, not FDA/EMA approved; telomerase and ALT activation create unresolved theoretical cancer-promotion concerns; human safety uncharacterized.
Mechanistically interesting geroprotector with consistent preclinical telomere data but no rigorous human evidence; treat strictly as experimental.
- Epithalon peptide induces telomerase activity and telomere elongation in human somatic cells ↗
- Effect of Epitalon on biomarkers of aging, life span and spontaneous tumor incidence in female Swiss-derived SHR mice ↗
- Epitalon increases telomere length in human cell lines through telomerase upregulation or ALT activity ↗
▶NAD+EmergingNAD+ precursor supplementation (chiefly nicotinamide riboside/NMN) reliably raises NAD+ in older adults; whether that translates to healthspan gains is still unproven.expand
NAD+ precursor supplementation (chiefly nicotinamide riboside/NMN) reliably raises NAD+ in older adults; whether that translates to healthspan gains is still unproven.
▸Full clinical story
NAD+ is a required co-substrate for sirtuins and PARPs and for mitochondrial redox reactions, and tissue NAD+ falls with age; boosting it with precursors is intended to restore mitochondrial function and sirtuin-dependent stress responses — directly targeting the mitochondrial-decline hallmark.
Emerging human data. A randomized, double-blind, placebo-controlled crossover trial (Martens) showed chronic nicotinamide riboside is well tolerated and durably elevates NAD+ metabolism in healthy middle-aged/older adults, with a preliminary signal of lower blood pressure and arterial stiffness. The pharmacodynamic effect (raising NAD+) is solid; clinical healthspan endpoints remain suggestive, not established. Grade emerging fits.
Anecdotal community signal only: NR and NMN are among the most popular longevity supplements, taken orally daily; some users pursue IV NAD+ infusions or subcutaneous protocols. Reported benefits (energy, clarity) are subjective and unblinded, and the IV route in particular lacks controlled healthspan support.
Context, not a protocol: oral NR commonly 250-1000 mg/day and NMN roughly 250-900 mg/day in trials and community use; IV NAD+ protocols vary widely and are not standardized.
Generally well tolerated. Condition-specific caveats: raising NAD+ flux is theoretically relevant in active malignancy (some tumors are NAD-avid), so caution there; high-dose niacin-family metabolites can affect lipids/flushing. Precursor form matters — do not assume IV NAD+ equals oral-precursor evidence.
One of the better-substantiated supplement stories for engaging an aging hallmark: it does what it says biochemically. But rescuing NAD+ levels has not yet been shown to extend human healthspan, so treat it as a low-risk, mechanistically rational option rather than a proven one.
▶ElamipretidePreclinicalA cardiolipin-targeting mitochondrial peptide (SS-31) that has now acutely improved mitochondrial function in older human muscle — early but a real step beyond preclinical.expand
A cardiolipin-targeting mitochondrial peptide (SS-31) that has now acutely improved mitochondrial function in older human muscle — early but a real step beyond preclinical.
▸Full clinical story
Elamipretide concentrates in the inner mitochondrial membrane and binds cardiolipin, stabilizing cristae architecture and supercomplex assembly to restore oxidative phosphorylation — aimed squarely at reversing the age-associated mitochondrial-dysfunction hallmark rather than a downstream pathway.
Upgrading from preclinical to emerging. The cardiolipin/OXPHOS-protein mechanism is defined biochemically (Chavez, cross-linking mass spec), and a randomized, double-blind, placebo-controlled trial in 39 older adults with poorly functioning mitochondria showed a single infusion acutely raised in vivo skeletal-muscle ATPmax versus placebo (Roshanravan). Important caveat: the effect was transient (gone by day 7), did not improve fatigue resistance, and broader disease trials (e.g., primary mitochondrial myopathy) have been mixed. Emerging, with honest limits.
Anecdotal community signal only: SS-31/elamipretide circulates in research-peptide channels as a subcutaneous injectable for 'mitochondrial support' and recovery; reports are uncontrolled and the durable clinical benefit seen in trials was minimal, so community enthusiasm exceeds the data.
Context, not a protocol: the human aging RCT used a single ~2-hour IV infusion; the drug's short blood half-life explains the transient effect. Community subcutaneous dosing figures are vendor-derived and not clinically validated.
Condition-specific points: benefit appears acute and reversible, so intermittent self-dosing is unlikely to deliver sustained change; injection-site reactions are the main trial signal. Research-grade sourcing raises purity/safety concerns, and it should not be presented as an approved therapy.
The clearest human proof-of-mechanism among the mitochondrial peptides — it can measurably restore mitochondrial capacity in aging muscle — but effects are transient and functional benefit unproven. Promising target, not yet a healthspan treatment.
▶HumaninPreclinicalA mitochondrial-derived peptide tied to longevity in animal and human-cohort correlations; mechanistically intriguing but preclinical as an intervention.expand
A mitochondrial-derived peptide tied to longevity in animal and human-cohort correlations; mechanistically intriguing but preclinical as an intervention.
▸Full clinical story
Humanin is a small peptide encoded within the mitochondrial 16S rRNA with cytoprotective and metabolic-signaling actions; its decline with age and its links to stress resistance make raising or mimicking it a candidate strategy against the mitochondrial and proteostatic hallmarks of aging.
Preclinical for intervention, with supportive human correlational data. Overexpression extends lifespan in C. elegans, and the analogue HNG improved metabolic healthspan markers and lowered inflammation in middle-aged mice (Yen). Human data are associative — higher circulating humanin in centenarians' offspring and lower levels in Alzheimer's/MELAS — not interventional. Grade preclinical is correct.
Anecdotal community signal only: humanin analogues occasionally appear in research-peptide markets, but off-label use is far less common than MOTS-c or Epitalon and community reports are sparse and unreliable. Treat any efficacy claims as unsubstantiated.
Context, not a protocol: no validated human dose exists; animal work uses the potent HNG analogue on roughly twice-weekly schedules, which does not translate to a human protocol.
Condition-specific unknowns predominate: no human PK, safety, or purity standards; its growth/survival-signaling activity warrants caution regarding malignancy, and sourced material is unverified.
Strong biology of aging story anchored in animal and centenarian-cohort data, but no human intervention evidence — a research target, not a therapy.
▶MOTS-cPreclinicalA mitochondrial-derived peptide whose blood levels fall with age; a genuinely interesting aging target but essentially preclinical for healthspan.expand
A mitochondrial-derived peptide whose blood levels fall with age; a genuinely interesting aging target but essentially preclinical for healthspan.
▸Full clinical story
MOTS-c is a 16-amino-acid peptide encoded in the mitochondrial 12S rRNA that translocates to the nucleus under metabolic stress to regulate adaptive gene programs, improving insulin sensitivity and mitochondrial homeostasis — directly relevant to age-related metabolic and mitochondrial decline.
Preclinical. Improvements in glucose handling, exercise capacity, and mitochondrial function come from rodent and cell models, and the age-associated decline in circulating MOTS-c is observational (reviewed by Zheng). No adequately powered human efficacy trials for aging exist. Grade preclinical is accurate.
Anecdotal community signal only: sold in peptide/biohacker channels as a subcutaneous injectable, often marketed for metabolic and exercise-performance benefit and used in short cycles. Reports are uncontrolled, product purity is unverified, and none of it constitutes evidence of an aging benefit.
Context, not a protocol: community subcutaneous regimens are commonly cited in the ~5-10 mg per week range, sometimes divided, run in cycles — figures that trace to vendor lore, not clinical trials.
Condition-specific unknowns dominate: no established human PK, purity, or long-term safety data, and because it enhances insulin sensitivity it could compound glucose-lowering agents. Research-chemical sourcing carries contamination and mislabeling risk.
A biologically compelling aging-hallmark target with real preclinical support, but human evidence is absent — appropriate for research interest and cautious framing, not for clinical recommendation.
▶N-Acetyl Epithalon AmidatePreclinicalA synthetic tetrapeptide (Ala-Glu-Asp-Gly) with striking lifespan and circadian claims from a single research lineage; preclinical at best and independently unverified.expand
A synthetic tetrapeptide (Ala-Glu-Asp-Gly) with striking lifespan and circadian claims from a single research lineage; preclinical at best and independently unverified.
▸Full clinical story
Epitalon is proposed to act on the pineal axis — restoring melatonin/cortisol rhythms — and to modulate gene expression and telomerase activity, framed as countering telomere attrition and neuroendocrine aging. The telomerase and 'peptide theory of aging' mechanisms remain largely hypothesis-level.
Preclinical, and weakly so. The core claims — increased lifespan in mice and flies, restored circadian melatonin/cortisol in aged primates — derive overwhelmingly from Khavinson and the St. Petersburg group (reviewed in Khavinson 2002), with little independent replication and no rigorous, controlled human longevity data. Grade preclinical is generous but defensible; the evidence base is old, single-source, and not independently confirmed.
Anecdotal community signal only: Epitalon is one of the more popular longevity peptides in biohacker circles, used as subcutaneous injections (or occasionally nasal) in short 10-20 day 'courses' repeated a few times yearly, with users reporting better sleep and subjective vitality. This is entirely uncontrolled self-report and not evidence of benefit.
Context, not a protocol: community courses commonly cite ~5-10 mg/day subcutaneously for 10-20 days, one to a few cycles per year — figures from vendor and forum lore, not clinical trials.
Condition-specific unknowns dominate: no verified human PK or long-term safety, and the claimed telomerase-activating mechanism raises theoretical malignancy concerns for chronic use. Research-chemical sourcing means purity, sterility, and identity are unverified; independent human evidence is essentially absent.
Popular and inexpensive but evidentiarily thin — dramatic claims resting on one research group and no credible independent human data. Frame as experimental with unproven benefit and unquantified risk.
▶MetforminEmergingA cheap, well-characterized biguanide proposed as a geroprotector; a plausible hallmark-modifier, but with no proven healthspan benefit in non-diabetic people yet.expand
A cheap, well-characterized biguanide proposed as a geroprotector; a plausible hallmark-modifier, but with no proven healthspan benefit in non-diabetic people yet.
▸Full clinical story
Metformin acts on several aging hallmarks at once — it activates AMPK and inhibits complex I to improve nutrient sensing, and is reported to enhance autophagy, dampen senescence and inflammation, and reduce telomere attrition, positioning it as a broad rather than single-target gerotherapeutic.
Emerging and largely mechanistic/observational. The hallmark-modifying rationale is well reviewed (Kulkarni/Barzilai), and retrospective diabetic-cohort data hinted at lower all-cause mortality, but the definitive test — the TAME trial in non-diabetic older adults — has not reported. Grade emerging is honest: strong mechanism, decades of human safety data, and a first dedicated aging trial designed, but no positive randomized healthspan outcome in non-diabetics.
Anecdotal community signal only: widely taken off-label for longevity, usually as standard oral extended-release, often stacked with exercise and other geroprotectors. Reported effects are mostly metabolic and subjective; there is no community-level evidence of lifespan benefit.
Context, not a protocol: longevity users typically take the diabetes range, commonly 500-1500 mg/day of extended-release (often 500 mg titrated up), taken with food to limit GI upset.
Two condition-specific flags matter for healthspan use. First, evidence that metformin can blunt the mitochondrial and cardiorespiratory adaptations to exercise training — a real trade-off for otherwise-healthy, fit adults. Second, long-term use lowers B12 (monitor and supplement). Avoid in significant renal impairment and hold around contrast/surgery for lactic-acidosis risk.
Attractive on cost, safety record, and mechanism, but currently a bet rather than a proven intervention — and the exercise-blunting signal means it is not obviously beneficial in already-healthy people until TAME-class data arrive.
▶GHKPreclinicalAn age-declining peptide that switches on DNA-repair and antioxidant genes, giving an anti-aging hypothesis without human outcome data.expand
An age-declining peptide that switches on DNA-repair and antioxidant genes, giving an anti-aging hypothesis without human outcome data.
▸Full clinical story
GHK modulates a large fraction of the genome toward DNA repair, antioxidant defense, and anti-inflammatory tissue-remodeling, and plasma levels fall with age.
Gene-expression and mechanistic reviews only; no human longevity or cognitive endpoints.
No verifiable community threads located.
No validated systemic dosing; oral peptide expected to be degraded, and no human PK for free GHK.
Genome-wide 'reset' language comes from array studies and reviews, not clinical trials; healthspan benefit is speculative.
Interesting longevity biology, but strictly preclinical — experimental.
▶SLU-PP-332PreclinicalDrives mitochondrial biogenesis and protected rodent hearts — a healthspan hypothesis, not a proven one.expand
Drives mitochondrial biogenesis and protected rodent hearts — a healthspan hypothesis, not a proven one.
▸Full clinical story
ERR activation upregulates mitochondrial and fatty-acid-oxidation genes across muscle and heart, with cardioprotection mediated mainly by ERRγ.
Improved mitochondrial function in muscle; in pressure-overload heart failure, improved ejection fraction, reduced fibrosis and increased survival in mice.
No verifiable community reports.
No human dose established.
Mechanistic extrapolation only; no aging or longevity endpoints tested in humans.
Mechanistically attractive for mitochondrial healthspan, but purely preclinical.
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The platform surfaces evidence, community signal and peer outcomes with enforced cautions. It never decides treatment — the licensed clinician orders labs, writes notes, and prescribes.