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SUPPLEMENTS AND MEDICATIONS

Coenzyme Q10 (CoQ10) is a fat-soluble compound naturally produced in the body and found in every cell. It plays a central role in mitochondrial energy production and acts as an antioxidant, helping neutralise oxidative stress.

CoQ10 exists in two forms:

  • Ubiquinone (oxidised)
  • Ubiquinol (reduced, active antioxidant)

Levels decline with age, chronic illness, and stress, and supplementation has been studied for its role in supporting:

  • Cardiovascular Health
  • Brain Function
  • Fertility
  • Skin Ageing
  • Physical Performance

Benefits:

Mitochondrial Support – CoQ10 supports energy generation and oxygen utilisation while reducing reactive oxygen species (ROS) and mitochondrial DNA damage. It also supports mitochondrial turnover and biogenesis.

Cardiovascular Health – Shown to reduce blood pressure, improve endothelial function, and enhance cardiac output in heart failure.

Cognitive Function – Supports neuronal energy metabolism and reduces inflammation. Clinical studies suggest improvements in mental fatigue, memory, and processing speed in older adults and those with Parkinson’s or cognitive impairment.

Fertility – Improves sperm motility, count, and quality. In women, supports ovarian response and embryo quality, and may improve ovarian reserve markers.

Skin Health – Topical and oral supplements reduce wrinkle depth, stimulate collagen, and improve skin hydration and elasticity.

Muscle Function – Enhances mitochondrial energy production in muscle tissue. Combined with exercise, CoQ10 supplementation improves strength, endurance, and physical performance in older adults.

Longevity – Rodent studies show lifespan extension and delayed onset of age-related disease. In humans, trials such as KiSel-10 show improved quality of life and reduced cardiovascular mortality over 10 years.

Risks:

Generally well tolerated with a good safety profile.

May cause mild gastrointestinal upset.

May reduce the effect of warfarin.

DHEA is a hormone produced by the adrenal glands. It is a precursor to testosterone and oestrogen, and it plays a significant role in making these sex hormones. Its levels in the body are highest during young adulthood and gradually decline with age.

DHEA is an essential hormone in the body because of its role in the production of other hormones and its potential effects on various aspects of health and ageing.

As an oral preparation it is not a prescription drug, however we think it needs to be used under medical supervision, a little bit like hormone replacement therapy (HRT).

We offer it to pre-menopausal women, and men for its potential beneficial effects. We don’t use it with oestrogen and testosterone HRT. Recently introduced preparations of DHEA can be prescribed (prasterone) to increase local levels of oestrogen and testosterone in post-menopausal women.


Benefits:

Improves skin health in terms of hydration and firmness, reducing the appearance of ageing such as wrinkles and age spots.

Mental well-being – improved mood and memory.

Improvement in bone health in perimenopausal and postmenopausal women.

Improved libido and sexual function.

It may improve the outcomes of egg freezing and in vitro fertilization (IVF) by stimulating ovarian function.

DHEA is often used as an adjuvant treatment in conjunction with other therapies.


Risks:

Hormonal side effects may include oily skin, acne and hair growth.

Avoid if you have heart issues, liver disease or a history of hormone sensitive tumours.

DHEA may interact with medications including antidepressants, antipsychotics, and hormonal treatments.

Fisetin is a naturally occurring flavonoid found in small amounts in foods such as strawberries, apples, onions, and cucumbers. It has attracted attention in the field of healthy ageing due to its antioxidant, anti-inflammatory, and senotherapeutic properties.

Research has focused on its ability to reduce the burden of senescent cells, which accumulate with age and contribute to chronic inflammation and tissue dysfunction. Most of the evidence to date comes from animal studies or in vitro research, with human trials currently underway.


Benefits:

Reduces cellular senescence – Fisetin has shown senolytic effects in animal models, reducing senescent cells in tissues such as blood vessels, brain, liver, and lungs, potentially improving function and reducing inflammation.

Supports vascular health – In aged mice, fisetin supplementation improved arterial stiffness and endothelial function by reducing senescent cell accumulation (Aging Cell, 2023).

Neuroprotective properties – Fisetin has demonstrated protective effects in Alzheimer’s disease models by reducing amyloid-beta accumulation and improving neuronal markers and oxidative stress (Neurology Letters, 2024; Neuroprotective Fisetin, 2022).

Anti-inflammatory effects – Preclinical studies show fisetin lowers inflammatory markers and may help restore tissue balance disrupted by chronic inflammation (Antioxidants, 2023).

Potential anti-cancer activity – In cell and animal studies, fisetin has been shown to influence cancer-related pathways (e.g. PI3K/Akt, VEGF, MAPK) and may reduce tumour growth in prostate and bladder models (EJMR, 2023; Nutrients, 2021).

Metabolic effects – animal models suggest improvements in insulin sensitivity and fat metabolism, with implications for conditions such as fatty liver and obesity.


Risks:

Generally well tolerated in preclinical studies.

No major adverse events were reported in early clinical studies such as the Gulf War Illness trial (Fisetin-GWI, 2021).

Fish oil, derived from fatty fish, like salmon, herring, tuna and mackerel, is rich in omega-3 fatty acids, Eicosapentaenoic acid (EPA), and Docosahexaenoic acid (DHA) – essential fatty acids the body can’t make for itself.

These nutrients have anti-inflammatory effects, helping reduce inflammation associated with ageing. Omega-3s also promote cognitive function and heart health, slowing down age-related decline, while supporting skin hydration, leading to healthier looking skin.

Research suggests that omega-3 fatty acids may slow down the process of cellular ageing by protecting telomeres.


Benefits:

Omega-3 fatty acids have anti-inflammatory properties, which can help mitigate the effects of inflammation on the body.

DHA is crucial for brain health. It supports cognitive function and helps maintain the structure and integrity of brain cells.

Omega-3 fatty acids reduce the risk of cardiovascular disease by lowering triglyceride levels, reducing blood pressure and preventing the formation of blood clots.

Fish oil supplements have been found to reduce joint pain and stiffness.


Risks:

May interact with blood thinning medication.

Folic acid is the synthetic form of folate, a water-soluble B vitamin critical for DNA synthesis, methylation, and cell division. Natural folate is found in leafy greens, legumes, and liver. Folic acid is used in supplements and fortified foods. Levels drop with age, illness, and genetic mutations (e.g. MTHFR C677T), which can impair conversion to active forms.


Benefits:

Cardiovascular Health – Folic acid lowers homocysteine, a risk factor for vascular disease. Meta-analyses show reduced stroke and cardiovascular events in populations without folic acid fortification.

Cognitive Function – Supports neurotransmitter production, methylation, and mitochondrial function. Associated with reduced Alzheimer’s risk and slower brain atrophy in mild cognitive impairment.

Cancer Prevention – Adequate folate supports DNA repair and cell regulation. Associated with reduced risk of colorectal and pancreatic cancers. High-dose folic acid may be harmful if pre-malignant cells are present.

Longevity – Supports DNA stability, immune function, and methylation. Observational studies link higher folate to lower all-cause mortality and slower biological ageing.

Fertility and Pregnancy – Reduces neural tube defects. Improves sperm quality and supports healthy implantation. Recommended for all women of reproductive age.

Skin, Immunity, and Musculoskeletal Health – Supports collagen synthesis, wound healing, T-cell function, and bone health through homocysteine reduction.


Risks:

May mask vitamin B12 deficiency if used in isolation.

Some concern exists about over-supplementation in individuals with pre-malignant conditions.

Magnesium is an essential mineral vital for over 300 biochemical reactions, including muscle/nerve function, blood pressure regulation, and energy production. Benefits include stronger bones, reduced fatigue, and improved sleep. Deficiencies may cause nausea, weakness, and cramps.

Nicotinamide mononucleotide (NMN) is a compound naturally found in the body and serves as a precursor to nicotinamide adenine dinucleotide (NAD+).
NAD+ is a coenzyme involved in metabolic processes within cells, including energy production and DNA repair.
NMN supplementation aims to boost NAD+ levels, supporting mitochondrial function and DNA repair mechanisms, both of which are linked to anti-ageing effects.

Benefits

  • Enhanced Energy Production – NAD+ is essential for mitochondrial function, where it participates in oxidative phosphorylation,
    the process by which cells generate energy. By supporting NAD+ levels, NMN may help optimise mitochondrial function,
    leading to increased energy production and improved cellular metabolism.
  • Improved Metabolic Health – Studies show improvements in metabolic parameters such as glucose tolerance and insulin sensitivity.
    This suggests a potential role for NMN in managing metabolic disorders such as type 2 diabetes and obesity.
  • DNA Repair and Cellular Integrity – NAD+ is involved in DNA repair mechanisms, and higher levels of NAD+ may enhance the cells’
    ability to repair DNA damage caused by various factors, including oxidative stress and UV radiation.
    This could contribute to maintaining genomic stability and cellular integrity, potentially reducing the risk of cancer and other age-related diseases.
  • Anti-ageing Effects – NMN has been studied for its potential anti-ageing effects, with research suggesting that NMN supplementation
    may help mitigate age-related decline in cellular function and improve overall health span.
    This includes benefits such as improved cardiovascular health, cognitive function, and physical performance.
  • Neuroprotective Properties – NAD+ plays a crucial role in maintaining neuronal health and function.
    NMN supplementation has shown promise in animal studies for its neuroprotective effects,
    suggesting potential benefits in conditions such as Alzheimer’s disease, Parkinson’s disease, and other neurodegenerative disorders.
  • Cardiovascular Health – NMN may have beneficial effects on cardiovascular health by improving endothelial function,
    reducing inflammation, and enhancing vascular integrity.
    These effects could help lower the risk of cardiovascular diseases.
  • Longevity – Some studies suggest that NMN supplementation may extend lifespan and improve health span in animal models,
    indicating its potential as an anti-ageing intervention.

Risks

  • NMN is safe when taken in recommended doses.
  • Can cause gastrointestinal upset.
  • Can cause flushing.

Quercetin is a natural antioxidant flavonoid found in many fruits, vegetables, and beverages, notably onions, apples, and berries. It has anti-inflammatory and antihistamine properties that may support immune health, lower blood pressure, and 
alleviate allergy symptoms. It is often taken as a supplement but may cause headaches or tingling at high doses.

Resveratrol is a natural compound found in various plants, particularly in grapes, red wine, berries, cocoa, soy and peanuts. It was first isolated in 1939 in Japanese knotweed and is often used in traditional Chinese and Japanese medicine.

Orally its potential health benefits are due to various mechanisms. These include anti-oxidation, anti-inflammation, and regulating cellular senescence. It is thought to activate sirtuins which are proteins associated with longevity.

Trans-resveratrol is a bioactive isomer and is more effective than resveratrol. Although found in red wine, you would have to drink too much red wine to gain therapeutic doses – based on a therapeutic dose of 500mg of trans resveratrol a day, it’s over 80 bottles a day!

Benefits:

Studies suggest that resveratrol may have positive effects on cardiovascular health by reducing LDL cholesterol and reducing insulin resistance.

Antioxidant properties may reduce the risk of age-related diseases including cancer.

Anti-inflammatory effects.

Skin protection via collagen synthesis, UV protection and regeneration. It is often used topically.

Risks:

Resveratrol is generally considered to be safe.

May cause side effects such as nausea, and headaches with higher than recommended doses.

Resveratrol may interact with blood thinners and drugs broken down by the liver. This should be assessed before starting.

Vitamin D is produced by the skin upon sun exposure and is key in the fight against ageing.

It supports bone health by aiding calcium absorption to maintain bone density and reduces the risk of osteoporosis.

Recent preclinical studies suggest that vitamin D exhibits anti-inflammatory effects, including the modulation of genes involved in immune regulation and pro-inflammatory factors.

Phytochemicals in fruits and vegetables upregulate the immune benefit and absorption of Vitamin D, maximising the potential health benefits.

Benefits:

There is a close interaction between vitamin D and the immune system. Vitamin D may have a direct impact on the body’s ability to fight off infections and diseases.

It aids calcium absorption and bone mineralisation, so helps maintain bone strength and density. Adequate intake is essential for optimal bone health.

It preserves muscle strength and mobility.

Maintains the gut barrier by the production of antimicrobial peptides and modulating gut hormone secretion.

Risks:

Vitamin D supplements are safe when taken in recommended doses.

Vitamin K2 plays a busy role in activating proteins essential in the fight against age-related diseases. Vitamin K2 helps with blood clotting so helps with wound healing. It strengthens bone health when used in combination with vitamin D3.

Benefits:

Vitamin D3 enhances calcium absorption in the intestines, while vitamin K2 aids in the activation of osteocalcin, a protein involved in bone mineralisation. Together, these vitamins contribute to maintaining optimal bone density and reducing the risk of fractures.

Vitamin K2 has been associated with a reduced risk of arterial calcification which is a risk factor for cardiovascular disease. Vitamin D3 also plays a role in cardiovascular health by helping to regulate blood pressure. The combination of these vitamins may have synergistic effects in promoting heart health and reducing the risk of cardiovascular events.

Some research suggests that vitamin D3 and K2 may play roles in cognitive function and reducing the risk of neurodegenerative diseases. They may help protect brain cells from oxidative stress and inflammation.

Both vitamin D3 and K2 have anti-inflammatory properties, which can help combat chronic inflammation age-related diseases.

Risks:

Vitamin K2 is safe when taken in recommended doses.

It can interact with blood thinning medication.

HRT is simply what it says it is. It is used around the menopause when the ovaries essentially go to sleep and stop producing oestrogen.

Lack of oestrogen can produce physical symptoms like night sweats, hot flashes, irregular bleeding, reduced energy levels, dyspareunia and urinary tract infections. There is a loss of muscle mass, bone density and loss of skin elasticity.

There are also significant mental effects including depression, anxiety, mood swings, irritability and lack of libido.

Treatment involves replacement hormones like DHEA, oestrogen, progesterone and testosterone, all aimed to restore hormonal balance. This is mainly given transdermally or orally.


Benefits:

We would suggest starting HRT early to achieve the best effects, as soon as you notice any symptoms or signs.

Symptom relief – HRT reduces common menopausal symptoms such as hot flashes, night sweats, low energy.

Bone health – Oestrogen helps maintain bone density, reducing the risk of osteoporosis and fractures. It improves muscle mass.

Improved collagen levels, elasticity in skin and as such anti-wrinkle.

Heart health – Some studies suggest that HRT may have cardiovascular benefits lowering the risk of heart disease in younger women.

Reduction in colon cancer.

Mood stabilization – HRT improves mood swings, irritability, and anxiety. Although there is an improvement in cognitive function, there have been mixed views regarding reducing the risk of dementia.


Risks:

Increased risk is multifactorial and often related to family history and other associated health issues such as obesity and pre-existing disease.

A very small increase in breast and gynaecological cancers especially with long term use and a family history.

A small increase in the risk of blood clots, especially in women who smoke or have a history of this.

Some studies show a slight increase in the risk of stroke with HRT use, particularly in older women again with co-morbidity.

Belonging to a family of medications called biguanides, Metformin is the generic name of the drug.

It is the first choice of medication prescribed by doctors for type 2 diabetes and pre-diabetes; risk factors for developing heart disease, stroke, and other serious medical conditions.

It has been in use since the late 1950s and is considered to be a very safe drug with little in the way of side effects.

Currently there is a major ongoing clinical trial known as The Targeting Ageing with Metformin (TAME) Trial. This is a six-year clinical trial involving over 3,000 individuals.

It is also widely regarded as a ‘wonder drug’ because of its many modes of action:

It improves insulin sensitivity and metabolism and helps with weight maintenance.

It appears to have strong senomorphic properties making senescent cells less aggressive.

It improves the gut microbiome and therefore helps the immune system.

It decreases inflammatory markers.

It improves bone mineralisation – a modest 7% increase in tissue mineral density is associated with a three-fold increase in bone stiffness and a doubling in breaking strength.


Benefits:

Reduction of osteoarthritis and osteoporosis.

Reduction of coronary heart disease.

Potential effect in reducing the risk of neurodegenerative diseases such as Alzheimer’s. Reduces fatty liver disease.


Risks:

Some people may get mild gastrointestinal upset.

Very rare accumulation of lactic acid in people with underlying kidney or liver disease.

PCSK9 inhibitors have revolutionised the treatment of hyperlipidaemia and atherosclerotic cardiovascular disease.

PCSK9 (Proprotein convertase subtilisin/kexin type 9 ) is a protein that regulates the amount of harmful LDL cholesterol receptors you have in your liver. The higher the PCSK9 level, the higher the LDL.

Inclisiran is a small interfering RNA (siRNA) that inhibits the production of PCSK9, which in turn increases the liver’s ability to remove harmful LDL-cholesterol from the body.

By doing this, it dramatically reduces LDL cholesterol, triglycerides, Apolipoprotein B, and lipoprotein(a).

Who Should Consider PCSK9 Inhibitors?

Inclisiran is licensed for hypercholesterolaemia, one of the biggest risk factors in developing atherosclerotic cardiovascular disease.

This is especially important:

  • When LDL levels are high
  • When there is a strong family history of cardiovascular disease
  • When there are other cardiovascular risk factors such as hypertension and obesity
  • When statins do not work to reduce LDL enough or are not tolerated due to side effects

This applies even in the absence of pre-existing heart disease, aortic aneurysms, strokes, or peripheral vascular disease.


Benefits:

Large randomised controlled trials have shown a 50-60% reduction in LDL, cutting the risk of a heart attack by almost a quarter.

There is emerging evidence suggesting that PCSK9 inhibitors have beneficial effects on longevity, with ongoing studies to confirm these findings.

After the initial dose, Inclisiran is administered once at 3 months and then one injection every 6 months, eliminating the daily need for a statin.

Inclisiran provides a highly effective, well-tolerated alternative for individuals seeking to reduce LDL cholesterol and lower cardiovascular risk. For those focused on longevity and preventative health, PCSK9 inhibitors offer a promising solution that is both effective and convenient.


Risks:

Inclisiran was approved for use in 2021 after clinical trials involving thousands of participants. It has been found to be safe for over six years, with no documented long-term harmful effects. The most common side effect is localised injection site reactions, such as redness, swelling, or itching.

Inclisiran provides a highly effective, well-tolerated alternative for individuals seeking to reduce LDL cholesterol and lower cardiovascular risk. For those focused on longevity and preventative health, PCSK9 inhibitors offer a promising solution that is both effective and convenient.

Rapamycin, a compound discovered in the soil of Easter Island, has garnered significant attention for its potential to extend lifespan and improve health span.

Initially used as an immunosuppressant in organ transplants, rapamycin’s ability to inhibit the mTOR (mechanistic target of rapamycin) pathway has opened new avenues in understanding and addressing ageing.

Discovery and Initial Use 

Rapamycin was discovered in the late 1960s by Canadian researchers on Easter Island. The compound, produced by the bacterium Streptomyces hygroscopicus, was initially recognised for its antifungal properties and later for its immunosuppressive effects, leading to its use in
organ transplants under the brand name Rapamune (Sirolimus).

Mechanism of Action

Rapamycin inhibits the mTOR pathway, which regulates cell growth, metabolism, and cellular ageing. By inhibiting mTOR, rapamycin shifts the body from a state of growth to repair and maintenance, promoting cellular clean-up (autophagy) and reducing inflammation.

Current Research and Future Directions

Several clinical trials are underway to evaluate rapamycin’s effects on human ageing. These studies aim to determine the optimal dosing and assess the drug’s safety and efficacy in extending healthspan and lifespan.

Researchers are also exploring next-generation rapalogues and combination therapies to enhance the benefits while minimising risks.

Conclusion

Rapamycin holds significant appeal as a potential anti-ageing drug. Its use should be clinically-led and closely monitored. Ongoing research will provide more insights into its long-term safety and effectiveness, adding to the significant evidence from animal studies. However, it remains a promising and viable option for extending human lifespan and healthspan.


Benefits:

Animal studies have shown that rapamycin can extend lifespan by up to 25%. Its effects appear significant even when administered later in life. It also delays the onset of age-related diseases such as heart disease, cancer, and cognitive decline.

Rapamycin appears to improve healthspan by promoting autophagy, reducing chronic inflammation and preventing cellular senescence.

At lower doses used for anti-ageing, rapamycin seems to enhance elements of immune function in older adults, improving their response to infections and vaccines.

Evidence from animal studies suggests rapamycin may help
prevent neurodegenerative diseases such Alzheimer’s and Parkinson’s Disease.


Risks:

At higher doses, rapamycin can suppress the immune system increasing the risk of infections.

Prolonged use can lead to glucose intolerance and insulin resistance, potentially increasing Type 2 Diabetes risk.

NOTE: The use of another anti-ageing, anti-diabetic medication, Metformin, can mitigate this.

Some users report mouth ulcers as a side effect.

Though there is no evidence of significant harm, the long-term effects of rapamycin use for longevity are not yet fully understood.

Statins reduce harmful LDL (low density lipoprotein) and total cholesterol levels. They do this by reducing the production of LDL. They also increase beneficial HDL (high density lipoprotein) levels. They reduce triglyceride levels.

Overall, they reduce the build-up of plaque in the arteries which can lead to heart attack or stroke. They also reduce the risk of developing liver disease and dementia.

Preliminary research suggests that statins may have effects on telomeres, the protective caps at the end of chromosomes that shorten with age. Shortened telomeres are associated with cellular ageing and increased risk of age-related diseases.

Statins may help maintain telomere length or slow down the rate of telomere shortening. They may upregulate the expression of the Klotho gene and may play a protective role in age-related diseases.

Benefits:

Improved cardiovascular health in all ages. Some studies show that with a one-unit reduction in harmful LDL

Cholesterol, the incidence of heart attack is reduced by 25% and stroke by 21%.

May reduce the risk of Alzheimer’s as cholesterol affects the protein (Amyloid Beta) that causes Alzheimer’s disease.

It is anti-inflammatory as it enhances the benefits of nitric oxide which improves blood flow and slows the progression of all cardiovascular diseases including vascular dementia.

Cognitive improvement. The evidence regarding the association between statins and cognitive impairment is mixed, with some studies suggesting an improvement in cognition, some a decline and some no significant association.

Risks:

10% of statin users report muscle pain, true myalgia is circa 1% – for side effects this is common, often goes away by swapping one statin to another.

Statins work by promoting LDL cholesterol removal through the liver which can cause an elevation in liver enzymes. Again, this is rare.

Hormone Replacement Therapy (HRT) is the word we associate with women, but HRT is also important in men.

We don’t like the term andropause /male menopause as there is no abrupt stop in hormone production as in women, however, signs and symptoms can develop insidiously. Oestrogen protects against the effects of ageing in women so why shouldn’t testosterone do the same for men? (and in low doses for women).

Testosterone is produced in the testes and adrenal glands and levels peak at age 18 and decline very slowly from about age 30.

What to use? Its personal preference. Gels give an absorption rate of up to 90% and are simple to use at home. Injections can be given every 3 months, so it is your preference.

Benefits:

Improved sexual drive, function.

Improve muscle strength and mass, bone density and reduce abdominal fat. Exercise plays an important role here.

Improve mood, lethargy, motivation and possible aggression. There is apparently some association between testosterone levels and different professions.

Risks:

All will be dose dependent. So, if you replace what’s not there (and review) and you feel better, it’s our opinion that its right to use.

Acne and oily skin if too much is given. The latter might be helpful as age makes you lose skin elasticity.

Peptides are short chains of amino acids (the building blocks of proteins) that function as “messengers” in the body, regulating key processes such as metabolism, cell repair, hormone production, and inflammation control.

Peptides are smaller than proteins and can be tailored to carry out specific roles in the body — from improving metabolic function to supporting tissue repair. Because of their size and structure, many can work precisely at a cellular level, often mimicking natural messenger molecules like hormones or neurotransmitters. They can be powerful tools in helping the body respond better to exercise, stress, ageing, and recovery.

Peptides occur naturally in the body, but their levels decline with age. This decline can manifest in decreased energy levels, slower healing, reduced muscle mass, and weakened immune responses. Peptide therapy uses selected or modified peptides to help patients with enhanced metabolic health, accelerated tissue repair, improved skin quality, and optimised immune function, among other advantages.

Although not readily used in the UK due to ongoing regulatory ambiguities, they are increasingly prescribed in other countries and subject to intensive ongoing research. Topical, cosmetic-grade peptides are often integrated into advanced skincare products.

Peptide therapy is recognised for its high safety and low side-effect profile compared to traditional medications or supplements. However, it’s important that peptides are prescribed and monitored by a qualified doctor to ensure safe use and minimise health risks.

The Peptides You’ll Know About

Insulin was discovered in 1921 by Banting and Best, marking a revolution in diabetes care. Frederick Sanger went on to discover the exact amino acid sequence, earning the first of his 2 Nobel Prizes. The first successful and life-saving injection of insulin was given to 14-year-old Leonard Thompson, who had type 1 diabetes. It remarkable to think how many lives this crucial peptide has saved!

Next, it would difficult not to know about semaglutide (branded Ozempic or Wegovy) and tirzepatide (branded Mounjaro). Semaglutide works on GLP-1 receptors and tirzepatide on GLP-1 and GIP receptors.

Recently a new peptide called retatrutide has been developed which in our opinion will be shown to have even more enhanced effects. This works on metabolic health, appetite control, fat loss and glucose regulation. It does this by not only working on GLP-1 and GIP receptors, but Glucagon Receptors. The ‘face off’ interaction to opposing peptides – insulin and glucagon receptors – is fascinating. These peptides regulate blood glucose levels keeping them in the healthy range. Insulin lowers blood sugar by facilitating glucose uptake into cells. While glucagon raises blood sugar by promoting glucose release from the liver.

Medications such as semaglutide, tirzepatide, and the newer agent retatrutide are often described as weight-loss drugs. In our opinion, they’re much more.Their greater value lies in how they improve metabolic function over time. They influence how the body behaves in handling energy, fat, insulin, and inflammation. Increasingly, longevity doctors are prescribing them as a tool for reducing metabolic strain and preserving long-term health.

What Is Semaglutide?

Semaglutide is a GLP-1 receptor agonist. It’s a man-made version of a naturally occurring incretin hormone released after eating.It improves glucose handling, reduces appetite, and slows gastric emptying. This leads to reduced caloric intake and improved insulin sensitivity. Semaglutide has been in widespread clinical use long enough to demonstrate cardiovascular risk reduction independent of weight loss. Its safety profile and outcome data are well established.

What Is Tirzepatide?

Tirzepatide is a dual incretin agonist acting on both GLP-1 and GIP receptors.The addition of GIP activity appears to enhance insulin sensitivity and fat mobilisation, particularly from visceral and liver stores. This means greater reductions in fat mass for many patients, often with similar or improved tolerability compared with Semaglutide. Tirzepatide also produces favourable changes in lipid profiles.

What Is Retatrutide?

Retatrutide is a next-generation triple agonist acting on GLP-1, GIP, and glucagon receptors.By adding controlled glucagon signalling, retatrutide increases energy expenditure while preserving appetite suppression and metabolic control. Clinical data shows substantial fat mass reduction and marked metabolic effects. Long-term cardiovascular and safety outcomes are still evolving, but will likely be similarly positive to semaglutide and tirzepatide.

What happens to weight, muscle and body composition on GLP-1s?

Average weight reduction increases across the group: lower with semaglutide, higher with tirzepatide, and higher again in retatrutide studies.The more important change is where weight is lost. Visceral and liver fat tend to fall. Insulin resistance improves. These changes occur early and are closely linked to lower long-term disease risk.Loss of muscle can occur if treatment medically supervised to ensure weight loss is gentle, paired with strength training and adequate protein intake. Maintaining strength and muscle is essential. Weight reduction without muscle and strength preservation compromises some of the longevity benefits.

Heart and Blood Vessels

Semaglutide has been shown to reduce heart attacks and strokes independently of weight loss. This establishes its role in lowering cardiovascular risk.Tirzepatide is expected to show similar benefits, though final outcome data are pending. Retatrutide is too new for firm conclusions but appears to confer significant visceral fat reduction.Taken together, these effects appear to reflect improved vascular health and reduced inflammation rather than just benefits from weight loss alone.

Kidney Health

These therapies slow early kidney damage in people with metabolic disease. This is seen as reduced protein loss in urine and slower decline in kidney function. The effect is clinically meaningful and supports their use in long-term risk reduction strategies.

Liver Health and Inflammation

Fatty liver disease is increasingly common with age and metabolic stress. Tirzepatide shows consistent reductions in liver fat and inflammatory activity. Retatrutide seems to enhance this effect, though longer follow-up is needed.Across all GLP-1 agents, reduction in chronic low-grade inflammation is a recurring finding. This matters because chronic inflammation underpins many age-related diseases.

Brain and Behaviour

These medications act on brain centres involved in appetite and reward. Many patients notice reduced food cravings and better control around eating. Some also report reduced pull towards other compulsive behaviours.They’re not treatments for neurological disease, but their effects on metabolic and inflammatory stress may be relevant to long-term brain health.

Side Effects and Safety

The main side effects involve digestion: nausea, constipation, or diarrhoea, usually during dose increases. These are generally manageable with careful dosing.Risks such as muscle loss, dehydration, or gallbladder issues arise mainly when treatment is poorly supervised. With appropriate monitoring, these risks can usually be avoided.Long-term safety data are strongest for semaglutide and sparse for retatrutide. This influences doctors recommend these treatments for patients.

Maintenance and Long-Term Use

After initial fat loss, many patients move to a lower maintenance dose. The goal at this stage is stability rather than continued weight reduction.The focus shifts to preserving (or even building) muscle, maintaining metabolic efficiency, and keeping inflammation low. This approach is individualised and closely monitored with medical supervision.

How GLP-1s Fit Into Longevity Medicine

GLP-1s are a powerful tool used as part of a structured longevity programme. Following assessment with body composition analysis, metabolic and cardiovascular risk evaluation, and assessment of strength and function, they can be incredibly valuable.They’re not used in isolation and don’t replace the ‘holy trinity’ of longevity: exercise, nutrition, and sleep optimisation. They’re tools to support a broader strategy aimed at maintaining function and reducing long-term disease risk.

Summary

Semaglutide, tirzepatide, and retatrutide represent a massive progression in metabolic medicine.Their primary value in longevity is not cosmetic weight loss, but improved metabolic control, lower inflammatory burden, and reduced stress on key organs over time.When used carefully with medical-supervision and in the right context, they’re a vital aid to supporting healthier ageing.

Essentially these reduce inflammation, promote tissue healing and collagen production.

BPC-157

Body Protection Compound-157 (BPC-157) is a synthetic peptide consisting of 15 amino acids. Originally derived from a protein found in the stomach, it is well-known for its powerful muscle healing, anti-inflammatory effect and protective effects on various organ systems especially the gut. It promotes new blood vessel formation. Often used in combination with TB4 to treat chronic fatigue, long covid, inflammatory bowel disease, osteoarthritis, backpain and tendinopathy.

THYMOSIN BETA-4 or TB4 

Thymosin Beta-4 (TB4) is a naturally occurring peptide composed of 43 amino acids, primarily found in the thymus gland, but it is also present in various tissues throughout the body, including blood platelets, wound fluid, and other body fluids. TB4 is crucial for promoting cell migration, tissue repair, immune regulation, and inflammation reduction. It is widely recognised in medical and regenerative fields for its ability to enhance the body’s natural healing processes, improve cardiovascular health, and accelerate recovery from injuries. Works synergistically with BPC-157.

GHK-Cu

GHK-Cu is a naturally occurring copper peptide, composed of three amino acids bound to copper. It is widely recognised for its regenerative and anti-aging properties, with well-documented benefits in clinical and cosmetic settings, especially in skin, hair and nail health, tissue repair, and anti-aging. It works by binding copper ions, which are essential for several biological functions such as enzymatic activity and antioxidant defence.

Growth hormone (GH) peptides are designed to stimulate the body’s natural production of growth hormone, leading to various benefits like muscle growth, burning body fat, improved muscle recovery, and anti-aging effects. They can improve sleep and libido. When there has been muscle wasting associated with often rapid weight loss due to the use of GLP1 analogues, they can be particularly helpful in increasing muscle mass.

SERMORELIN is probably the least potent and often used in young people and women.

CJC/IPAMORELIN is most commonly used and falls somewhere in the middle in terms of potency.

TESAMORELIN is the most potent and often used in men and older people and is especially good at burning visceral fat.

These essentially improve energy levels, reduce oxidative stress and inflammation associated with ageing.

SS-31

SS-31, also known as Elamipretide, is a mitochondria-targeted tetrapeptide designed to enhance mitochondrial function. It interacts with cardiolipin, a critical phospholipid on the inner mitochondrial membrane, stabilizing mitochondrial structure, boosting energy production, and reducing oxidative stress. SS-31 has shown promise in treating age-related diseases, muscle wasting, and other mitochondrial dysfunctions. It has been extensively studied for conditions like age-related macular degeneration, heart failure, chronic kidney disease, and chemotherapy-induced muscle wasting.

MOTS-C

MOTS-C is a critical mitochondrial-derived peptide (MDP) involved in regulating cellular metabolism, stress response, and longevity. MOTS-C supports metabolic flexibility, promotes glucose metabolism, and maintains mitochondrial function, making it beneficial for metabolic health, stress resistance, and overall well-being. Its levels decline with age, and supplementation aims to restore its natural functions, potentially improving both age-related conditions and general health.

EPITALON 

Epitalon is a synthetic peptide that works by stimulating the pineal gland to produce melatonin, a hormone that regulates sleep. It also has powerful anti-aging effects by promoting cellular repair, supporting the lengthening of telomeres (the protective caps on chromosomes that naturally shorten with age). Epitalon has been extensively studied and has shown significant potential in promoting longevity, improving sleep quality, and reducing oxidative stress, which contributes to its popularity as an anti-aging supplement.

PINEALON 

Pinealon is a synthetic tripeptide composed of glutamic acid, aspartic acid, and arginine. It is classified as a peptide bioregulator due to its potential to interact directly with cellular DNA and influence gene expression. Research suggests that Pinealon offers neuroprotective benefits, supports cognitive function, and promotes overall brain health.

SELANK

Selank is a nootropic peptide that helps improve your brain function, reduce feelings of stress and anxiety, and support your overall emotional well-being. It works by balancing chemicals in the brain to help you feel calmer, more focused, and more mentally clear.

MELANOTAN 2 

Melanotan 2 (MT2) is a peptide designed to stimulate melanin production, helping the skin tan naturally while reducing the risk of sunburn. It is popular for its ability to enhance skin pigmentation without excessive sun exposure. In addition to tanning, Melanotan 2 is used to increase libido, promote weight management through appetite suppression, and support overall skin health.

THYMOSIN ALPHA-1 OR TA-1 

Thymosin Alpha-1 (TA-1) is a 28-amino acid peptide naturally produced in the thymus gland, which plays a crucial role in immune regulation and enhancement. TA-1 stimulates the development and differentiation of T cells, a vital part of the immune system that helps the body recognise and fight off infections, cancer cells, and other foreign agents. It has been used clinically to boost immune function, especially in individuals with weakened immunity, such as those undergoing chemotherapy or suffering from chronic infections.

VASOACTIVE INTESTINAL PEPTIDE OR VIP 

Vasoactive Intestinal Peptide (VIP) is a naturally occurring neuropeptide composed of 28 amino acids. It is widely recognised for its potent regulatory effects on the immune system, respiratory health, and various other biological systems. VIP has significant therapeutic potential in treating conditions such as asthma, COPD, and Chronic Inflammatory Response Syndrome (CIRS). It works by promoting vasodilation, reducing inflammation, and improving blood flow to critical tissues. VIP also plays an essential role in regulating circadian rhythms and supporting gastrointestinal health. As the body’s production of VIP may decline under stress or chronic illness, VIP supplementation can be given through nasal spray helps restore these vital functions.

LL-37

LL37 is an antimicrobial and immune-modulating peptide known for its role in fighting infections and reducing inflammation. It is naturally produced by the body as part of the innate immune response and has broad-spectrum antimicrobial activity, targeting bacteria, viruses, and fungi. Additionally, LL37 supports wound healing, gut health, and inflammation control, making it beneficial for autoimmune conditions, chronic infections, and inflammatory disorders.

Hydra is a genus of small freshwater hydrozoans belonging to the phylum Cnidaria. These organisms are solitary, carnivorous, and jellyfish-like in form, typically found in temperate and tropical regions.

Unlike most animals, Hydra do not possess a natural lifespan and are considered biologically immortal. They continuously regenerate their cells using interstitial stem cells, preventing aging (senescence) and enabling them to avoid death from old age. Instead, they typically die only due to external causes such as predation or lack of food.