1. Overview and Core Mechanisms

1.1. Common Clinical Indicators

• Brain fog
• Reduced exercise tolerance
• Unexplained fatigue
• Loss of lean muscle mass (sarcopenia) and increased visceral adiposity
• Disrupted sleep architecture
• Joint stiffness and aches
• Slower recovery times
• Increased visceral fat
• Bone mineral loss
• Reduced sexual function
• Frequent infections
• Joint swelling
• Numbness and weaknes
• Reduced physical capacity

2. Diagnostic & Functional Testing

2.1. Recommended Lab Panels

2.2. Targeted Measurements & Functional Ranges

3. Therapeutic Interventions

3.1. Clinical Nutrition & Lifestyle Prescriptions

• Nutritional Strategy & Metabolic Timing:
  Implementation of a high-protein, nutrient-dense diet focusing on 1.6 to 2.2g/kg of body weight to maintain lean muscle mass. Incorporation of Time Restricted Feeding (TRF) within an 8-10 hour window to promote autophagy and metabolic flexibility.
• Exercise Prescription: Mitochondrial & Muscular Health:
  A balanced regimen including 150-180 minutes of Zone 2 aerobic training per week to enhance mitochondrial density, combined with two sessions of high-intensity resistance training to prevent sarcopenia and improve bone mineral density.
• Sleep Hygiene & Circadian Alignment:
  Optimization of the circadian rhythm through consistent wake times, morning sunlight exposure, and a 'dark' period 2 hours before bed. Aiming for 7-9 hours of sleep with a focus on maximizing Deep and REM sleep stages.
• Hormetic Stress & Thermal Therapy:
  Utilizing heat (sauna) and cold (cold plunge) exposure to trigger heat shock proteins and cold-shock proteins, enhancing cellular resilience and reducing systemic inflammation.

3.2. Targeted Supplementation Protocol

1. Omega-3 Fatty Acids:
   Essential for cardiovascular protection, reducing neuroinflammation, and maintaining cell membrane integrity.
2. Vitamin D3:
   Plays a central role in immune regulation, musculoskeletal integrity, insulin sensitivity, and inflammation control. Adequate vitamin D status is associated with reduced risk of fractures, infections, metabolic disease, and overall mortality, particularly in aging populations.
3. Vitamin B12:
   Vitamin B12 is critical for neurologic function, red blood cell formation, methylation pathways, and mitochondrial energy production. Adequate B12 status supports cognitive performance, energy levels, and cardiovascular health, and is particularly important for individuals under chronic stress, aging populations, and those with dietary or absorption challenges.
4. Vitamin B5 (Pantothenic Acid):
   Vitamin B5 plays a central role in the formation of coenzyme A, which is required for fatty acid metabolism, mitochondrial energy production, and steroid hormone synthesis. In optimization protocols, B5 supports adrenal resilience, metabolic flexibility, and the efficient conversion of nutrients into usable cellular energy.
5. Vitamin B6 (Pyridoxine / P5P):
   Vitamin B6 is involved in amino acid metabolism, neurotransmitter synthesis, immune regulation, and homocysteine metabolism. Optimal B6 status supports cognitive function, cardiovascular health, and nervous system balance, making it particularly relevant for stress resilience and long-term brain health.
6. Vitamin B9 (Folate):
   Folate is essential for DNA synthesis, methylation, red blood cell production, and cellular repair. In longevity-focused care, folate supports genomic stability, cardiovascular health through homocysteine regulation, and proper cell turnover, which becomes increasingly important with aging.
7. Vitamin B3 (Niacin):
   Vitamin B3 is essential for energy metabolism and the production of NAD⁺, a critical cofactor involved in mitochondrial function, DNA repair, and cellular stress resilience. Adequate B3 status supports metabolic efficiency, cardiovascular health, and healthy aging by maintaining cellular energy production and repair mechanisms.
8. Creatine:
   Beyond athletic performance, creatine supports muscle mass preservation, cognitive function, mitochondrial energy buffering, and healthy aging. It is increasingly recognized for its role in preventing sarcopenia, supporting brain energy metabolism, and improving functional capacity with age.
9. CoQ10:
   A key component of mitochondrial electron transport and cellular energy production. CoQ10 levels decline with age and statin use, and supplementation supports cardiovascular health, endothelial function, and cellular energy efficiency.
10. Polyphenols (e.g., Resveratrol, Quercetin, Curcumin):
    Plant-derived compounds with antioxidant, anti-inflammatory, and senolytic-adjacent properties. These compounds support vascular health, metabolic signaling, and cellular stress responses, often acting as hormetic agents that enhance resilience rather than blunt adaptation.
11. Protein & Essential Amino Acids:
    Adequate protein intake is critical for maintaining lean mass, bone density, immune competence, and metabolic rate with aging. Optimization protocols emphasize sufficient total protein and leucine intake to preserve muscle and functional independence over time.
12. Probiotics & Prebiotic Fibers:
    Support gut barrier integrity, immune modulation, metabolic signaling, and inflammation control. A resilient gut microbiome is increasingly recognized as a key determinant of healthy aging and disease prevention.
13. Berberine:
    A plant alkaloid that improves insulin sensitivity, glucose metabolism, lipid regulation, and gut microbial balance. Often described as a “metabolic optimizer,” berberine targets pathways associated with cardiometabolic aging.
14. N-Acetyl Cysteine:
    NAC is a key precursor to glutathione, the body’s primary intracellular antioxidant and detoxification molecule. It supports liver function, mitochondrial resilience, oxidative stress reduction, and immune balance. In longevity and optimization protocols, NAC is used to enhance cellular defense systems, support detoxification capacity, and mitigate the cumulative effects of metabolic and environmental stress over time.
15. Glycine:
    A conditionally essential amino acid involved in collagen synthesis, detoxification, glutathione production, and sleep regulation. Emerging research suggests glycine may support longevity pathways through improved metabolic efficiency and reduced oxidative stress.
16. Magnesium:
    Essential for mitochondrial energy production, glucose metabolism, nervous system regulation, and vascular tone. Higher magnesium intake is linked to lower risk of type 2 diabetes, cardiovascular disease, and arrhythmias, while also supporting stress resilience and sleep quality.