Protocol | Max Ghenis

This is my personal protocol, not medical advice. Most supplement evidence is observational and heavily confounded. I use a Bayesian QALY framework (Optiqal) to account for confounding and publication bias. Consult your doctor before making health decisions.

At a glance

Daily items

$1,342

Annual cost

+1.2yr

Expected QALY gain

+48d

Ground-up audit

Philosophy

I treat health optimization as a portfolio problem under uncertainty. Each intervention has an expected benefit (measured in QALYs), a cost, and uncertainty about whether the observed effect is causal or confounded.

The framework: estimate each intervention's hazard ratio from literature, shrink it toward null by a tiered publication-bias correction (10% for preregistered RCTs with hard endpoints, 20–30% for standard RCTs and cohorts, 50% for supplement-industry RCTs, 70% for animal-only evidence), apply a Bayesian causal-fraction prior calibrated against observed RCT-vs-observational discrepancies, simulate 50,000 Monte Carlo samples through CDC life tables, and report the posterior hazard ratio the simulator actually applies — not the publication-bias-only HR.

Mechanism-cluster diminishing returns prevent correlated supplements from stacking additively. Anti-inflammatory polyphenols (curcumin, quercetin, apigenin, EGCG, luteolin, cocoa flavanols) share a cluster with within-cluster retention dropping fast past the first item; NAD+ precursors (NR, NMN) are tightened further; antioxidants, mitochondrial-support, and senolytics each have their own steep retention schedules. A portfolio-level QALY ceiling of 3 applies a concave saturation to the raw additive total so the stack can't claim multi-QALY gains that exceed primary-prevention CEA literature.

Key parameters: willingness-to-pay of $200K per QALY (with a sensitivity panel at $50K/$100K/$150K below), 40-year horizon, 3% cost discount, 3% QALY discount. Bundled products (Blueprint Essentials, Advanced Antioxidants, Longevity Mix) now carry an allocated per-ingredient cost so bundled items no longer free-ride on $/QALY.

I am not a doctor. I have no medical training. This is expected value reasoning applied to personal health decisions, not clinical guidance. Most of these effect sizes are small, uncertain, and could be entirely confounded.

Reference-case ground-up audit

This newer audit uses the US Second Panel-style 3% health and cost discounting path and item-by-item assumptions from the live protocol inventory. It is not yet a formal reference-case CUA: All 86 items now have explicit utility lineage or no direct-QOL overlay; 52 items still use disability-weight fallback lineage.

Ground-up full-state total: 0.1326 QALY (48.4 days). Additive standalone value 0.2465 QALY, shared stack adjustment -0.1139 QALY. Alignment: reference case discounting with fallback utility lineage.

Constrained optimizer	ΔQALY	Days	P(+)	Δcost	Actions
$200K/QALY net benefit	0.0358	13.1	68.4%	$-29,945	Add APAP nightly, HIIT 2x/week, Strength maintenance; Drop Apigenin 50mg, Ashwagandha 600mg, Cistanche 200mg, Cocoa flavanols ~500mg, Collagen 22g, Curcumin 250mg, Garlic 1200mg, Glycine 2g bedtime, Lions Mane 1g, NAC 1200mg, Nasacort nightly, Nasal strips nightly, Omega-3 CLO ~500mg, High-EPA Omega-3 +2g, Prebiotics combo, Daily probiotics, Taurine 500mg top-up, Trazodone 50mg, Vitamin D 2000 IU, Vitamin K2 MK-7+MK-4, Zinc carnosine 75mg
QALY only	0.0769	28.1	98.2%	$71,495	Add APAP nightly, HIIT 2x/week, Humidifier nightly, Infrared sauna 4x/week, Low-dose lithium 5mg, NR 300mg (unbundled), Quercetin 500mg, Strength maintenance, Traditional dry sauna 4x/week, Urolithin A 500mg; Drop Apigenin 50mg, Ashwagandha 600mg, Glycine 2g bedtime, Trazodone 50mg, Vitamin D 2000 IU

Action	Item	Type	ΔQALY	Days	P(+)	$/QALY
add	HIIT 2x/week	exercise	0.0274	10.0	95.4%	dominant
add	Tempo run 1x/week	exercise	0.0207	7.6	95.1%	dominant
add	HIIT 3x/week	exercise	0.0177	6.5	95.2%	dominant
add	HIIT 1x/week	exercise	0.0170	6.2	95.2%	dominant
add	APAP nightly	sleep	0.0164	6.0	89.9%	$214,052
add	Zone 2 cardio 2x/week	exercise	0.0109	4.0	95.2%	dominant

Willingness-to-pay sensitivity

The same item simulations rerun at four cost-effectiveness thresholds. At $50K/QALY — the bar common in public healthcare systems — only the highest-conviction items survive. My personal WTP is $200K, higher than standard clinical CEA because the marginal dollar on health beats the marginal dollar on most other spending for me; but the frontier is what to look at for the robust core.

WTP ($/QALY)	Items	QALY (saturated)	QALY (raw)	Days	$/yr
$50,000	16	1.04	1.27	+379	$692
$100,000	20	1.17	1.49	+429	$1,213
$150,000	22	1.23	1.59	+450	$1,553
$200,000	24	1.25	1.61	+456	$1,663

Core stack

The top 15 highest-conviction items I take daily, ranked by expected value. The posterior HR column is what the simulator actually applies after publication-bias and Bayesian confounding shrinkage — much weaker than the raw literature HR and the right column for comparing items.

Item	Status	Evidence	Posterior HR	E[days]	P(+)	$/yr	$/QALY
Tadalafil 2.5mg Details HR observed: 0.88 Pub-bias corrected (20% shrinkage, tier: rct standard): 0.9028 Posterior (sim-applied) HR: 0.974 (95% CI 0.836–1.070) Anderson 2016 obs HR 0.67. Endothelial RCTs.	taking	medium	0.974	+180	99%	$252	$11,484
Finasteride 1.25mg Details HR observed: 0.93 Pub-bias corrected (10% shrinkage, tier: rct preregistered hard endpoint): 0.9368 Posterior (sim-applied) HR: 0.963 (95% CI 0.835–1.087) PCPT RCT n=18882. Hair preservation.	taking	high	0.963	+135	96%	$171	$10,351
Magnesium 400mg Details HR observed: 0.9 Pub-bias corrected (20% shrinkage, tier: rct standard): 0.9192 Posterior (sim-applied) HR: 0.977 (95% CI 0.855–1.060) Current dose is 400mg supplemental magnesium. Benefit is capped for diminishing returns; watch GI tolerance because the NIH supplemental UL is 350mg/day.	taking	medium	0.977	+33	79%	$146	$36,130
Creatine 5g Details HR observed: 0.98 Pub-bias corrected (50% shrinkage, tier: supplement industry rct): 0.9899 Posterior (sim-applied) HR: 0.999 (95% CI 0.964–1.030) Bundle allocation: $135/yr from blueprint longevity mix No mortality RCTs. QoL decomposed into strength/lean-mass, cognitive-resilience, and functional-reserve components; nuisance harm captures GI/water-weight and creatinine lab noise. Product link	taking	medium	0.999	+37	96%	$255	$56,806
Omega-3 CLO ~500mg Details HR observed: 0.92 Pub-bias corrected (20% shrinkage, tier: meta analysis rcts): 0.9355 Posterior (sim-applied) HR: 0.978 (95% CI 0.871–1.059) Aung 2018 meta. VITAL.	taking	medium	0.978	+33	80%	$180	$43,984
Vitamin D 2000 IU Details HR observed: 0.94 Pub-bias corrected (20% shrinkage, tier: rct standard): 0.9517 Posterior (sim-applied) HR: 0.982 (95% CI 0.898–1.050) VITAL NS. Bolland meta D3 HR 0.97.	taking	medium	0.982	+20	74%	$30	$12,588
Prebiotics combo Details HR observed: 0.96 Pub-bias corrected (55% shrinkage, tier: observational speculative): 0.9818 Posterior (sim-applied) HR: 0.999 (95% CI 0.950–1.038) Gut health markers.	taking	medium	0.999	+24	91%	$180	$62,261
Astaxanthin 12mg Details HR observed: 0.95 Pub-bias corrected (55% shrinkage, tier: observational speculative): 0.9772 Posterior (sim-applied) HR: 0.998 (95% CI 0.934–1.049) Bundle allocation: $60/yr from blueprint advanced antioxidants CRP/HDL RCTs. Bundled.	taking	medium	0.998	+17	84%	$60	$28,401
NAC 1200mg Details HR observed: 0.93 Pub-bias corrected (50% shrinkage, tier: supplement industry rct): 0.9644 Posterior (sim-applied) HR: 0.993 (95% CI 0.881–1.088) Best-supported as a mucolytic in chronic bronchitis/COPD. Much weaker for upper-airway sleep problems, so any sleep benefit is scaled to mucus-heavy phenotypes. Product link	taking	medium	0.993	+15	71%	$40	$21,424
Vitamin K2 MK-7+MK-4 Details HR observed: 0.92 Pub-bias corrected (30% shrinkage, tier: cohort large): 0.9433 Posterior (sim-applied) HR: 0.989 (95% CI 0.871–1.078) Rotterdam obs. Calcification RCTs.	taking	medium	0.989	+14	67%	$25	$14,130
Lutein+Zeaxanthin Details HR observed: 0.97 Pub-bias corrected (55% shrinkage, tier: observational speculative): 0.9864 Posterior (sim-applied) HR: 0.999 (95% CI 0.952–1.039) Bundle allocation: $60/yr from blueprint advanced antioxidants AREDS2. Eye health. Bundled.	taking	medium	0.999	+15	86%	$60	$31,651
Ubiquinol 50mg Details HR observed: 0.96 Pub-bias corrected (50% shrinkage, tier: supplement industry rct): 0.9798 Posterior (sim-applied) HR: 0.997 (95% CI 0.913–1.068) Bundle allocation: $60/yr from blueprint essential capsules Q-SYMBIO RCT in HF. Healthy-pop extrapolation.	taking	medium	0.997	+10	71%	$60	$46,783
Zinc carnosine 75mg Details HR observed: 0.97 Pub-bias corrected (50% shrinkage, tier: supplement industry rct): 0.9849 Posterior (sim-applied) HR: 0.998 (95% CI 0.928–1.057) Gut barrier integrity. Already getting zinc 15mg.	testing	medium	0.998	+9	71%	$60	$53,202
Hyaluronic acid (oral) Details HR observed: 0.99 Pub-bias corrected (55% shrinkage, tier: observational speculative): 0.9955 Posterior (sim-applied) HR: 1.000 (95% CI 0.970–1.028) Bundle allocation: $6/yr from blueprint longevity mix Joint/skin support. No mortality effect.	taking	medium	1.000	+5	79%	$6	$9,306
Melatonin 300mcg Details HR observed: 0.97 Pub-bias corrected (20% shrinkage, tier: rct standard): 0.9759 Posterior (sim-applied) HR: 0.997 (95% CI 0.932–1.048) Sleep onset RCTs.	taking	medium	0.997	+5	65%	$30	$50,623

Supplement schedule

Dose timing for supplements, prescriptions, and services. Food recipes are separated below so the stack stays distinct from meal prep.

Morning mix

All powders mixed into water. I batch a 30-day dry mix into a half-gallon mason jar — one full Longevity Mix bag sets the batch size — and scoop daily.

Item	Dose	$/yr
Blueprint Creatine	5g morning mix	$138
Blueprint Longevity Mix	Morning, mixed in water	$537
Goddess Agave Inulin	1 tsp morning mix	$66
Vital Nutrients Arabinogalactan	1 tsp morning	$84

1 serving

Daily dose, mixed into water fresh each morning.

Ingredient	Amount	Where
Blueprint Longevity Mix	1 scoop (14.8g)	Powder jar
Blueprint Creatine	1 scoop (5g)	Powder jar
Goddess agave inulin	1 tsp (4g)	Powder jar
Larch arabinogalactan	1 tsp (3g)	Powder jar
Water	~500 ml	Mix fresh; don’t pre-mix liquid

30-day powder jar

One full Longevity Mix bag is exactly 30 servings, so the whole bag anchors the batch. Dry total 804g; a daily serving is 26.8g (~1.8 Longevity Mix scoops). Fits a half-gallon mason jar.

Ingredient	Amount	Where
Blueprint Longevity Mix	whole bag: 30 scoops (444g)	Jar
Blueprint Creatine	30 scoops (150g)	Jar
Goddess agave inulin	10 tbsp (120g; ~5/8 cup)	Jar
Larch arabinogalactan	10 tbsp (90g; ~5/8 cup)	Jar

Mixing order: half the Longevity Mix bag in first, then creatine, inulin, and arabinogalactan, then the rest of the bag. Shake hard ~30s to combine; shake before each scoop — creatine is dense crystal and settles under the lighter fibers. Add a food-safe desiccant packet (inulin is hygroscopic and clumps in humidity). Dry creatine is shelf-stable; it only degrades in solution, so mix into water fresh each morning.

Meal 1 supplements

Products taken with the first meal. The nutty pudding recipe itself is in the meal recipes section.

Item	Dose	$/yr
Blueprint Cocoa	1 scoop (5.76g) blended into nutty pudding premix	$249
Blueprint Collagen Peptides	1 scoop (22.3g) blended into nutty pudding premix	$548
Blueprint Essential Capsules	2 capsules with meal 1	$596
Blueprint NAC+Ginger+Curcumin	2 capsules meal 1, 1 capsule meal 2	$329
Cistanche 200mg	200mg with meal 1	$231
Finasteride	1.25mg daily (quarter 5mg tablet)	$171
Kyolic Aged Garlic Extract	2 capsules per meal, twice daily	$151
Lions Mane 1g	1g (2 capsules) with meal 1	$287
Nordic Naturals Arctic Cod Liver Oil	1 softgel with each meal	$172
Sports Research Daily Probiotics	1 capsule daily with food while finishing expiring bottle	$273

Meal 2 supplements

Products taken with the second meal, whether that meal is super veggie or something else.

Item	Dose	$/yr
Blueprint Advanced Antioxidants	1 capsule with meal 2	$596
Blueprint NAC+Ginger+Curcumin	2 capsules meal 1, 1 capsule meal 2	$329
High-EPA Omega-3	1 softgel with meal 2	$113
Kyolic Aged Garlic Extract	2 capsules per meal, twice daily	$151
Nordic Naturals Arctic Cod Liver Oil	1 softgel with each meal	$172
Tadalafil	2.5mg daily	$252

Sweet treat

Tru Fru dark chocolate covered cherries — frozen fruit in dark chocolate. Extra cocoa flavanols as a bonus.

Before bed

Item	Dose	$/yr
Ashwagandha KSM-66 600mg	600mg (2 x 300mg caps) before bed	$178
Glycine 2g	2g before bed	$28
Magnesium Lysinate Glycinate	400mg before bed	$146
Melatonin	300mcg (0.3mg) before bed — reduced from 1.5mg 2026-07-06	$27
Trazodone	50mg before bed	$223

Bedtime / overnight

Item	Dose	$/yr
Taurine 500mg	500mg top-up before bed	$4

Meal recipes

Food prep kept separate from the supplement stack. Nutty pudding amounts use the toggle for one serving, one 4-serving blender batch, or the 14-serving powder jar.

Nutty pudding

Optimized from Bryan Johnson's recipe for QALY/$ and adherence. Keeps pomegranate juice for taste, uses ground macadamias and walnuts in the powder jar, blends hazelnuts and blanched almonds whole, and keeps Blueprint fruit mix out by default.

1 serving

Single serving with blender items, powder mix, and toppings.

Ingredient	Amount	Where
Pomegranate juice	60 ml	Blender
Unsweetened nut milk	50-100 ml	Blender; add water to texture
Frozen berries + cherries	1/2 cup	Blender
Whole hazelnuts	1/2 tbsp	Blender
Whole blanched almonds	1/2 tbsp	Blender
Blueprint Metabolic Protein	1.5 scoops (55g; ~1/2 cup)	Powder jar
Collagen	1 scoop (22.3g; ~1/4 cup)	Powder jar
Ground macadamias	1 tbsp	Powder jar
Ground walnuts	1 tbsp	Powder jar
Ground flax seeds	1 tbsp	Powder jar
Blueprint Cocoa	1 scoop (5.76g; ~1 tbsp)	Powder jar
Sunflower lecithin	1 tsp	Powder jar
Ceylon cinnamon	1/2 tsp	Powder jar
Optional sumac	1/4 tsp	Powder jar
EVOO	1 tbsp	Topping
Chia seeds	2 tbsp	Topping, preferably soaked
Berries	1/2 cup	Topping

4-serving batch

Blender batch I make at once, then portion into containers and add toppings per serving.

Ingredient	Amount	Where
Pomegranate juice	1 cup	Blender
Unsweetened nut milk	200-400 ml	Blender; add water to texture
Frozen berries + cherries	2 cups	Blender
Whole hazelnuts	2 tbsp	Blender
Whole blanched almonds	2 tbsp	Blender
Blueprint Metabolic Protein	6 scoops (219g; ~2 cups)	Powder jar
Collagen	4 scoops (89g; ~1 cup)	Powder jar
Ground macadamias	1/4 cup	Powder jar
Ground walnuts	1/4 cup	Powder jar
Ground flax seeds	1/4 cup	Powder jar
Blueprint Cocoa	4 scoops (23g; ~1/4 cup)	Powder jar
Sunflower lecithin	1 tbsp + 1 tsp	Powder jar
Ceylon cinnamon	2 tsp	Powder jar
Optional sumac	1 tsp	Powder jar
EVOO	1/4 cup	Topping
Chia seeds	1/2 cup	Topping, preferably soaked
Berries	2 cups	Topping

14-serving powder jar

Dry jar only. Keep hazelnuts, almonds, berries, EVOO, chia, and liquids out of the jar.

Ingredient	Amount	Where
Blueprint Metabolic Protein	21 scoops (767g; ~7 cups)	Jar
Collagen	14 scoops (312g; ~3 1/4 cups)	Jar
Ground macadamias	14 tbsp (~7/8 cup)	Jar
Ground walnuts	14 tbsp (~7/8 cup)	Jar
Ground flax seeds	14 tbsp (~7/8 cup)	Jar
Blueprint Cocoa	14 scoops (81g; ~7/8 cup)	Jar
Sunflower lecithin	4 tbsp + 2 tsp	Jar
Ceylon cinnamon	2 tbsp + 1 tsp	Jar
Optional sumac	1 tbsp + 1/2 tsp	Jar

Mixing order: finest powders first (sumac if using, cinnamon, cocoa, lecithin, flax), then protein and collagen, then ground macadamias and walnuts. Shake hard to combine; shake before each scoop. Store the jar cold if keeping ground nuts or flax for more than a few days.

Super veggie

Blueprint base recipe plus avocado, shallots, cabbage, crispy onions, and crispy garlic.

Steamed broccoli, cauliflower, shiitake mushrooms
Black beluga lentils
Dressing: garlic, ginger, lime, cumin, apple cider vinegar
Hemp seeds
1 avocado
Chopped shallots, cabbage
Crispy onions + crispy garlic (not healthy, just tasty)
Hummus
Cleveland Kitchen kimchi
EVOO on top

Exercise

Daily morning workout, typically strength and cardio combined, following Bryan Johnson's workout protocol. Consistency matters more than intensity — the goal is a sustainable daily habit, not periodic heroic sessions.

Full catalog

All 92 items evaluated, organized by category. Items marked "bundled" are included in Blueprint products below.

Prescriptions (3)

Item	Evidence	E[days]	P(+)	$/yr	Net value
Tadalafil 2.5mg * Details HR obs: 0.88 → pub-bias: 0.9028 → posterior: 0.974 \| tier: rct standard \| QoL: +0.02/yr Anderson 2016 obs HR 0.67. Endothelial RCTs.	medium	+180	99%	$252	$92,670
Finasteride 1.25mg * Details HR obs: 0.93 → pub-bias: 0.9368 → posterior: 0.963 \| tier: rct preregistered hard endpoint \| QoL: +0.015/yr PCPT RCT n=18882. Hair preservation.	high	+135	96%	$171	$70,248
Trazodone 50mg Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.0005/yr Sleep maintenance. No mortality data.	medium	+-6	7%	$223	$-8,315

Current supplements (31)

Item	Evidence	E[days]	P(+)	$/yr	Net value
Cocoa flavanols ~500mg Details HR obs: 0.9 → pub-bias: 0.9289 → posterior: 0.972 \| tier: cohort large \| QoL: +0.001/yr COSMOS RCT HR 0.73 CVD. Blueprint Cocoa priced at $41/container with 60 scoops x 5.76g; at ~6g/day this is ~58 days/container, or ~$260/yr.	medium	+39	78%	$260	$15,384
Magnesium 400mg * Details HR obs: 0.9 → pub-bias: 0.9192 → posterior: 0.977 \| tier: rct standard \| QoL: +0.0005/yr Current dose is 400mg supplemental magnesium. Benefit is capped for diminishing returns; watch GI tolerance because the NIH supplemental UL is 350mg/day.	medium	+33	79%	$146	$14,825
Creatine 5g * Details HR obs: 0.98 → pub-bias: 0.9899 → posterior: 0.999 \| tier: supplement industry rct \| QoL: 0/yr No mortality RCTs. QoL decomposed into strength/lean-mass, cognitive-resilience, and functional-reserve components; nuisance harm captures GI/water-weight and creatinine lab noise. Product link	medium	+37	96%	$255	$14,318
Omega-3 CLO ~500mg * Details HR obs: 0.92 → pub-bias: 0.9355 → posterior: 0.978 \| tier: meta analysis rcts \| QoL: +0.001/yr Aung 2018 meta. VITAL.	medium	+33	80%	$180	$14,286
Vitamin D 2000 IU * Details HR obs: 0.94 → pub-bias: 0.9517 → posterior: 0.982 \| tier: rct standard \| QoL: 0/yr VITAL NS. Bolland meta D3 HR 0.97.	medium	+20	74%	$30	$9,983
Garlic 1200mg Details HR obs: 0.88 → pub-bias: 0.9144 → posterior: 0.978 \| tier: cohort large \| QoL: 0/yr Obs HR 0.88. BP + calcification RCTs.	medium	+29	78%	$300	$9,027
Prebiotics combo * Details HR obs: 0.96 → pub-bias: 0.9818 → posterior: 0.999 \| tier: observational speculative \| QoL: +0.003/yr Gut health markers.	medium	+24	91%	$180	$8,873
Astaxanthin 12mg * Details HR obs: 0.95 → pub-bias: 0.9772 → posterior: 0.998 \| tier: observational speculative \| QoL: +0.002/yr CRP/HDL RCTs. Bundled.	medium	+17	84%	$60	$8,079
NAC 1200mg * Details HR obs: 0.93 → pub-bias: 0.9644 → posterior: 0.993 \| tier: supplement industry rct \| QoL: +0.001/yr Best-supported as a mucolytic in chronic bronchitis/COPD. Much weaker for upper-airway sleep problems, so any sleep benefit is scaled to mucus-heavy phenotypes. Product link	medium	+15	71%	$40	$7,440
Vitamin K2 MK-7+MK-4 * Details HR obs: 0.92 → pub-bias: 0.9433 → posterior: 0.989 \| tier: cohort large \| QoL: 0/yr Rotterdam obs. Calcification RCTs.	medium	+14	67%	$25	$7,346
Lutein+Zeaxanthin * Details HR obs: 0.97 → pub-bias: 0.9864 → posterior: 0.999 \| tier: observational speculative \| QoL: +0.002/yr AREDS2. Eye health. Bundled.	medium	+15	86%	$60	$7,110
Curcumin 250mg Details HR obs: 0.9 → pub-bias: 0.9487 → posterior: 0.991 \| tier: supplement industry rct \| QoL: 0/yr Anti-inflam. Bioavailability issues.	low	+12	64%	$40	$5,404
Ubiquinol 50mg * Details HR obs: 0.96 → pub-bias: 0.9798 → posterior: 0.997 \| tier: supplement industry rct \| QoL: +0.001/yr Q-SYMBIO RCT in HF. Healthy-pop extrapolation.	medium	+10	71%	$60	$4,381
Hyaluronic acid (oral) * Details HR obs: 0.99 → pub-bias: 0.9955 → posterior: 1.000 \| tier: observational speculative \| QoL: +0.001/yr Joint/skin support. No mortality effect.	medium	+5	79%	$6	$2,738
NR 300mg Details HR obs: 0.97 → pub-bias: 0.9849 → posterior: 0.999 \| tier: supplement industry rct \| QoL: +0.001/yr NAD+ precursor. Bundled.	medium	+7	72%	$60	$2,288
Melatonin 300mcg * Details HR obs: 0.97 → pub-bias: 0.9759 → posterior: 0.997 \| tier: rct standard \| QoL: +0.0003/yr Sleep onset RCTs.	medium	+5	65%	$30	$1,973
Luteolin 100mg Details HR obs: 0.97 → pub-bias: 0.9864 → posterior: 0.999 \| tier: observational speculative \| QoL: +0.001/yr Anti-inflammatory. Neuroprotective. Bundled.	medium	+6	73%	$60	$1,935
Lithium 1mg orotate Details HR obs: 0.98 → pub-bias: 0.9909 → posterior: 0.999 \| tier: observational speculative \| QoL: +0.001/yr Ecological Li data. Neuroprotective. Bundled.	medium	+6	71%	$60	$1,725
Collagen 22g Details HR obs: 0.99 → pub-bias: 0.995 → posterior: 1.000 \| tier: supplement industry rct \| QoL: +0.003/yr No mortality data. Joint/skin RCTs.	medium	+17	96%	$360	$1,365
Glucosamine sulfate 750mg Details HR obs: 0.92 → pub-bias: 0.9632 → posterior: 0.998 \| tier: observational speculative \| QoL: 0/yr Glucosamine sulfate 750 mg (Blueprint Longevity Mix). The only Mix active with direct human all-cause mortality data: in the UK Biobank prospective cohort (n=495,077, median 8.9 y follow-up, 19,882 deaths), regular glucosamine use had a multivariable-adjusted all-cause mortality HR of 0.85 (95% CI 0.82-0.89) (Li et al., Ann Rheum Dis 2020;79:829-836, PMID 32253185). That association is almost certainly inflated by healthy-user / selection bias - Suissa et al. (Pharmacoepidemiol Drug Saf 2022) argue the apparent benefit largely reflects who chooses to take glucosamine, not the supplement. We therefore enter a conservative observed HR of 0.92 (well above the raw 0.85) and tier it observational_speculative (0.55 shrinkage) so the confounding machinery pulls it further toward null. Product link	medium	+4	63%	$41	$977
Broccoli Seed Ext 200mg Details HR obs: 0.95 → pub-bias: 0.9772 → posterior: 0.996 \| tier: observational speculative \| QoL: 0/yr Sulforaphane. Phase 2 enzyme induction. Bundled.	medium	+4	59%	$60	$751
Lycopene 15mg Details HR obs: 0.95 → pub-bias: 0.9772 → posterior: 0.997 \| tier: observational speculative \| QoL: 0/yr Song meta obs. Bundled.	medium	+3	59%	$60	$300
L-Theanine 200mg Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.0004/yr L-Theanine 200 mg (Blueprint Longevity Mix). No mortality, longevity, or healthspan evidence exists. Randomized placebo-controlled trials at this 200 mg/day dose show modest benefits for stress, sleep quality, and cognition in healthy adults (Hidese et al., Nutrients 2019, PMID 31623400; meta-analytic support for acute stress/anxiety at 200-400 mg). The mortality HR is held at the 1.0 null; a very small recurring quality-of-life term (~0.0004 QALY/yr) captures the stress/sleep benefit without implying any lifespan effect. Product link	medium	+1	100%	$11	$275
Magnesium citrate 150mg Details HR obs: 1 → pub-bias: 1 \| tier: observational speculative \| QoL: 0/yr Magnesium citrate 150 mg (Blueprint Longevity Mix). Cohort meta-analyses link higher total magnesium intake to lower all-cause and cardiovascular mortality (Fang et al., BMC Med 2016, PMID 27927203), but the effect is intake/deficiency-driven and confounded. Critically, Max separately takes 400 mg magnesium glycinate nightly, so this 150 mg is incremental on top of an already-adequate intake; to avoid double-counting any magnesium mortality benefit, the incremental HR is held at the 1.0 null (observational_speculative tier, very-low). Product link	medium	+0	0%	$8	$-178
Spermidine 10mg Details HR obs: 0.95 → pub-bias: 0.9772 → posterior: 0.998 \| tier: observational speculative \| QoL: 0/yr Madeo obs HR 0.70. Animal.	medium	+2	58%	$60	$-208
Ginger 400mg Details HR obs: 0.96 → pub-bias: 0.9878 → posterior: 0.999 \| tier: animal or mechanistic \| QoL: 0/yr Bundled. Anti-nausea.	medium	+1	56%	$25	$-244
Reduced glutathione 250mg (oral) Details HR obs: 1 → pub-bias: 1 \| tier: supplement industry rct \| QoL: 0/yr Oral reduced glutathione 250 mg (Blueprint Longevity Mix). A 6-month randomized, double-blind, placebo-controlled trial (n=54) of oral GSH at exactly 250 and 1000 mg/day raised body glutathione stores in blood, erythrocytes, lymphocytes and buccal cells and increased NK cytotoxicity (Richie et al., Eur J Nutr 2015;54:251-263, PMID 24791752). Those are biomarker/surrogate endpoints only - no clinical or mortality outcome was measured, and oral GSH bioavailability is inherently limited by gut degradation. With no hard-endpoint or mortality evidence, hr_observed is held at the 1.0 null. Tiered as a supplement-industry surrogate-endpoint RCT (0.50 shrinkage). Product link	medium	+0	0%	$14	$-312
Fisetin 100mg Details HR obs: 0.97 → pub-bias: 0.9849 → posterior: 0.999 \| tier: supplement industry rct \| QoL: 0/yr Senolytic. Animal. Bundled.	medium	+0	56%	$60	$-1,119
Boron 3mg Details HR obs: 0.97 → pub-bias: 0.9864 → posterior: 0.999 \| tier: observational speculative \| QoL: 0/yr Prostate/bone obs. Bundled.	medium	+0	56%	$60	$-1,171
L-Lysine 1000mg Details HR obs: 1 → pub-bias: 1 \| tier: animal or mechanistic \| QoL: 0/yr L-Lysine 1000 mg (Blueprint Longevity Mix). Lysine is an essential amino acid generally replete in an adequate-protein diet, so incremental supplementation has limited expected effect. No all-cause mortality, longevity, or healthspan RCT/cohort exists for lysine. The human RCT evidence is for unrelated outcomes: recurrent herpes labialis prophylaxis at >=1 g/day (Griffith et al. 1987, PMID 3115841; mixed across trials, Cochrane found no clear benefit), and reduced anxiety/cortisol only when COMBINED with L-arginine 2.64 g each (Smriga et al., Biomed Res 2007, PMID 17510493) - not lysine alone. With no mortality signal, hr_observed is held at the 1.0 null. Product link	medium	+0	0%	$54	$-1,203
Calcium AKG 2000mg Details HR obs: 1 → pub-bias: 1 \| tier: animal or mechanistic \| QoL: 0/yr Calcium alpha-ketoglutarate, the largest active in the Blueprint Longevity Mix (2000 mg). Lifespan/healthspan evidence is animal-only: in C57BL/6 mice, CaAKG begun at 18 months extended median lifespan ~12-16% and compressed morbidity/frailty (Asadi Shahmirzadi et al., Cell Metabolism 2020, PMID 32877690), an effect that was sexually dimorphic (stronger in females). The only human data is an open-label, uncontrolled biological-age (DNA-methylation) study of Rejuvant (Demidenko et al., Aging 2021) - not a mortality endpoint and heavily confounded. With no human all-cause mortality RCT or cohort, hr_observed is held at the 1.0 null (animal_or_mechanistic tier, speculative) rather than extrapolating the mouse effect to humans. Product link	medium	+0	0%	$108	$-2,405

Recently added (9)

Item	Evidence	E[days]	P(+)	$/yr	Net value
High-EPA Omega-3 +2g Details HR obs: 0.955 → pub-bias: 0.9638 → posterior: 0.986 \| tier: rct standard \| QoL: +0.002/yr Incremental over CLO. VITAL/REDUCE-IT. Product link	medium	+28	76%	$227	$10,423
Zinc carnosine 75mg * Details HR obs: 0.97 → pub-bias: 0.9849 → posterior: 0.998 \| tier: supplement industry rct \| QoL: +0.001/yr Gut barrier integrity. Already getting zinc 15mg.	medium	+9	71%	$60	$3,690
Lions Mane 1g Details HR obs: 0.98 → pub-bias: 0.9899 → posterior: 0.999 \| tier: supplement industry rct \| QoL: +0.003/yr NGF stimulation. Small RCTs: cognitive improvement. Product link	medium	+17	86%	$287	$2,960
Ashwagandha 600mg Details HR obs: 0.96 → pub-bias: 0.9798 → posterior: 0.998 \| tier: supplement industry rct \| QoL: +0.001/yr RCTs: cortisol, anxiety, sleep, testosterone. Rare liver concern.	medium	+6	66%	$60	$2,099
Apigenin 50mg Details HR obs: 0.96 → pub-bias: 0.9798 → posterior: 0.999 \| tier: supplement industry rct \| QoL: +0.0003/yr CD38 inhibitor. Anxiolytic. Product link	medium	+3	66%	$76	$-188
Cistanche 200mg Details HR obs: 0.95 → pub-bias: 0.9772 → posterior: 0.999 \| tier: observational speculative \| QoL: +0.002/yr Testosterone, anti-aging TCM. Very limited human data. Product link	low	+8	73%	$231	$-670
Glycine 2g bedtime Details HR obs: 1 → pub-bias: 1 \| tier: supplement industry rct \| QoL: +0.0002/yr Sleep/QOL helper only. Human evidence supports modest next-day fatigue and sleep-quality improvement, not a mortality claim. Product link	medium	+2	100%	$93	$-1,270
Taurine 500mg top-up Details HR obs: 1 → pub-bias: 1 \| tier: supplement industry rct \| QoL: +0.0001/yr Tiny marginal top-up over 1500mg already in Longevity Mix. Most human signals are at 1-3g+ or in non-lean phenotypes. Product link	medium	+1	100%	$85	$-1,501
Daily probiotics Details HR obs: 1 → pub-bias: 1 \| tier: supplement industry rct \| QoL: +0.001/yr Modeled as a low-evidence GI-support intervention, not a hard-endpoint longevity lever. Annual cost uses Sports Research Probiotic 60 Billion at the current official subscribe-and-save price; the currently owned expiring bottle has near-zero marginal cost. Product link	medium	+6	100%	$273	$-2,916

Prescription candidates (9)

Item	Evidence	E[days]	P(+)	$/yr	Net value
Metformin 500mg * Details HR obs: 0.9 → pub-bias: 0.9192 → posterior: 0.972 \| tier: rct standard \| QoL: 0/yr Bannister 2014: diabetics on metformin outlived controls. TAME pending.	medium	+34	77%	$48	$17,369
Statin (rosuvastatin 5mg) Details HR obs: 0.88 → pub-bias: 0.8913 → posterior: 0.964 \| tier: rct preregistered hard endpoint \| QoL: -0.002/yr CTT meta: 21% CVD reduction per mmol/L LDL.	high	+21	67%	$120	$8,709
Low-dose lithium 5mg * Details HR obs: 0.92 → pub-bias: 0.9632 → posterior: 0.993 \| tier: observational speculative \| QoL: +0.001/yr Ecological: municipal Li → lower suicide/dementia. No RCTs at low dose.	low	+15	70%	$60	$7,021
Low-dose aspirin 81mg Details HR obs: 0.94 → pub-bias: 0.9458 → posterior: 0.996 \| tier: rct preregistered hard endpoint \| QoL: -0.001/yr ASPREE (>70yr): no benefit, more bleeding. USPSTF equivocal at 39.	medium	+-9	36%	$15	$-5,433
17α-estradiol (topical) Details HR obs: 0.88 → pub-bias: 0.9624 → posterior: 0.992 \| tier: animal or mechanistic \| QoL: -0.002/yr ITP mice: +19% median lifespan (males only). No human data.	low	+-6	44%	$360	$-11,448
Rapamycin 5mg/wk Details HR obs: 0.85 → pub-bias: 0.9524 → posterior: 0.982 \| tier: animal or mechanistic \| QoL: -0.003/yr ITP mice: +26% median lifespan. Mannick 2014. Immunosuppression risk.	medium	+-5	49%	$600	$-15,881
Acarbose 50mg Details HR obs: 0.88 → pub-bias: 0.9624 → posterior: 0.988 \| tier: animal or mechanistic \| QoL: -0.005/yr ITP mice: +22% median lifespan (males). GI side effects.	medium	+-26	33%	$120	$-17,102
SGLT2i (empagliflozin) Details HR obs: 0.86 → pub-bias: 0.8731 → posterior: 0.931 \| tier: rct preregistered hard endpoint \| QoL: +0.002/yr EMPA-REG: HR 0.68 CV death (diabetics). Off-label in healthy unclear.	high	+95	94%	$3600	$-29,461
GLP-1 RA (semaglutide) Details HR obs: 0.8 → pub-bias: 0.8181 → posterior: 0.980 \| tier: rct preregistered hard endpoint \| QoL: +0.004/yr SELECT trial: HR 0.80 MACE in overweight/obesity with established CVD. Strong transport shrinkage applied for lean, low-risk profiles plus GI/gallbladder harms.	high	+9	59%	$6000	$-129,017

Supplement candidates (29)

Item	Evidence	E[days]	P(+)	$/yr	Net value
HIIT 2x/week * Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.0022/yr Structured interval training twice weekly, assumed to replace easier cardio. Modeled as a somewhat larger CRF stimulus with diminishing marginal return. Product link	medium	+8	100%	bundled	$4,207
HIIT 3x/week * Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.0019/yr Three structured interval sessions weekly, assumed to replace easier cardio. Modeled with extra recovery uncertainty and a small recurring downside because current frequency evidence suggests no clear added benefit over 2x/week in recreational runners. Product link	medium	+7	100%	bundled	$3,634
Tempo run 1x/week * Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.0016/yr One threshold/tempo-style run weekly, assumed to replace easier cardio. Modeled as intermediate between easy cardio and HIIT for CRF benefit. Product link	medium	+6	100%	bundled	$3,060
Ubiquinol 50mg (unbundled) Details HR obs: 0.96 → pub-bias: 0.9798 → posterior: 0.997 \| tier: supplement industry rct \| QoL: +0.001/yr Standalone ubiquinol using current Life Extension pricing, modeled at an Amazon-favored effective cost after 5% Prime cash back. Product link	medium	+10	71%	$120	$3,043
EGCG 400mg (green tea) Details HR obs: 0.92 → pub-bias: 0.9592 → posterior: 0.993 \| tier: supplement industry rct \| QoL: 0/yr Obs meta HR 0.74-0.85. Heavily confounded. Liver risk at high dose.	medium	+8	62%	$60	$2,911
Quercetin 500mg Details HR obs: 0.93 → pub-bias: 0.9644 → posterior: 0.994 \| tier: supplement industry rct \| QoL: 0/yr Senolytic. Anti-inflammatory. Animal lifespan.	medium	+7	62%	$60	$2,718
HIIT 1x/week * Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.0014/yr Structured interval training once weekly, assumed to replace an easier cardio session rather than add volume. Modeled through modest CRF/VO2max utility, not a direct mortality claim. Product link	medium	+5	100%	bundled	$2,677
Zone 2 cardio 2x/week * Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.001/yr Two structured low-to-moderate intensity cardio sessions weekly, assumed to replace unstructured easier running. Modeled as a small CRF and recovery-positive intervention. Product link	medium	+4	100%	bundled	$1,912
Vitamin C 500mg (extra) Details HR obs: 0.97 → pub-bias: 0.9789 → posterior: 0.995 \| tier: cohort large \| QoL: 0/yr Already getting 250mg from Longevity Mix. Obs meta: modest CVD.	medium	+5	62%	$29	$1,895
Black seed oil 1g Details HR obs: 0.91 → pub-bias: 0.9584 → posterior: 0.996 \| tier: observational speculative \| QoL: 0/yr Thymoquinone. Anti-inflammatory. No mortality RCTs.	low	+6	61%	$60	$1,665
Luteolin 100mg (unbundled) Details HR obs: 0.97 → pub-bias: 0.9864 → posterior: 0.999 \| tier: observational speculative \| QoL: +0.001/yr Standalone luteolin using current Double Wood pricing, modeled at an Amazon-favored effective cost after 5% Prime cash back. Product link	medium	+6	73%	$115	$709
Strength maintenance * Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.0003/yr Structured maintenance lifting. Kept near flat because you already do strength work daily. Product link	medium	+1	100%	bundled	$574
Alpha-lipoic acid 300mg Details HR obs: 0.96 → pub-bias: 0.9818 → posterior: 0.998 \| tier: observational speculative \| QoL: 0/yr Antioxidant. RCTs for diabetic neuropathy.	medium	+2	58%	$60	$-193
TMG/Betaine 1g Details HR obs: 0.97 → pub-bias: 0.9864 → posterior: 0.999 \| tier: observational speculative \| QoL: 0/yr Methyl donor. Homocysteine reduction. Often paired with NR/NMN.	medium	+1	57%	$30	$-237
Ergothioneine 5mg Details HR obs: 0.94 → pub-bias: 0.9725 → posterior: 0.997 \| tier: observational speculative \| QoL: +0.001/yr Longevity vitamin hypothesis. Obs: low ergo → higher mortality.	medium	+9	70%	$240	$-619
GHK-Cu peptide (topical) Details HR obs: 0.99 → pub-bias: 0.9955 → posterior: 1.000 \| tier: observational speculative \| QoL: +0.002/yr Wound healing, collagen. Skin only.	medium	+11	85%	$300	$-712
PQQ 20mg Details HR obs: 0.97 → pub-bias: 0.9864 → posterior: 0.999 \| tier: observational speculative \| QoL: +0.001/yr Mitochondrial biogenesis. Small RCTs. Expensive.	medium	+6	74%	$180	$-741
Pterostilbene 50mg Details HR obs: 0.96 → pub-bias: 0.9818 → posterior: 0.999 \| tier: observational speculative \| QoL: 0/yr Resveratrol analog. AMPK/SIRT1. Animal only.	medium	+1	57%	$120	$-2,250
Sulforaphane 20mg (extra) Details HR obs: 0.94 → pub-bias: 0.9816 → posterior: 0.996 \| tier: animal or mechanistic \| QoL: 0/yr NRF2 activator. Incremental over Broccoli Seed Ext.	medium	+3	58%	$180	$-2,599
Fisetin 100mg (unbundled) Details HR obs: 0.97 → pub-bias: 0.9849 → posterior: 0.999 \| tier: supplement industry rct \| QoL: 0/yr Standalone fisetin using current Double Wood pricing, modeled at an Amazon-favored effective cost after 5% Prime cash back. Product link	medium	+0	56%	$133	$-2,745
NMN 500mg Details HR obs: 0.96 → pub-bias: 0.9798 → posterior: 0.998 \| tier: supplement industry rct \| QoL: +0.001/yr NAD+ precursor (alt to NR). Already getting NR 300mg. Expensive.	medium	+7	71%	$360	$-3,976
NR 300mg (unbundled) Details HR obs: 0.97 → pub-bias: 0.9849 → posterior: 0.999 \| tier: supplement industry rct \| QoL: +0.001/yr Standalone NR option using current official Tru Niagen 300mg 180-count subscription pricing. Product link	medium	+7	72%	$396	$-5,198
Urolithin A 500mg Details HR obs: 0.94 → pub-bias: 0.9695 → posterior: 0.995 \| tier: supplement industry rct \| QoL: +0.003/yr Mitopure. RCTs: improved mitochondrial function. Expensive.	medium	+22	77%	$780	$-5,608
Berberine 500mg Details HR obs: 0.88 → pub-bias: 0.9381 → posterior: 0.989 \| tier: supplement industry rct \| QoL: -0.004/yr Metformin-like. RCTs in diabetes. GI side effects.	low	+-14	34%	$180	$-11,808
BPC-157 cycle Details HR obs: 1 → pub-bias: 1 \| QoL: +0.00005/yr Modeled for a generic annual cycle in an otherwise uninjured user. Human efficacy evidence is extremely thin and product-quality uncertainty is real. Product link	medium	+-3	0%	$1200	$-28,495
TB-500 cycle Details HR obs: 1 → pub-bias: 1 \| QoL: +0.00003/yr Treated as an even weaker evidence base than BPC-157 for a general healthy user. Product link	medium	+-4	1%	$1500	$-35,403
HBOT 60-session course Details HR obs: 1 → pub-bias: 1 \| QoL: +0.0002/yr Cost annualized from a clinic course. Healthy-aging evidence remains early and mostly surrogate-driven. Product link	medium	+-1	89%	$1800	$-40,422
Traditional dry sauna 4x/week Details HR obs: 1 → pub-bias: 1 \| QoL: +0.0008/yr Modeled as a modest Finnish-style dry sauna intervention, not a direct mortality claim. Effect assumes roughly 175-194F traditional dry sauna; cost uses current MINT DC club pricing as a local paid-access proxy. Product link	medium	+3	100%	$2178	$-47,062
Infrared sauna 4x/week Details HR obs: 1 → pub-bias: 1 \| QoL: +0.00035/yr Infrared sauna is modeled separately from Finnish dry sauna because the evidence is weaker and less directly transportable. Cost uses current Pure Sweat Georgetown unlimited pricing for 4x/week access. Product link	medium	+1	100%	$3588	$-79,597

Blueprint bundles

I use Blueprint products for items where bundling is cheaper than buying individually. Each bundle contains multiple catalog items.

Bundle	$/mo	Items used	Net value	Verdict
Blueprint Longevity Mix Contents creatine_5g, magnesium_200, hyaluronic_acid_120	$49	3/3	$8,361	worth it
Blueprint Advanced Antioxidants Contents vitamin_k2, lutein_zeaxanthin, astaxanthin_12, lycopene_15	$49	3/4	$-985	not worth it
Blueprint NAC+Ginger+Curcumin Contents nac_1200, ginger_400, curcumin_250	$27	1/3	$-5,520	not worth it
Blueprint Essential Capsules Contents vitamin_d_2000, nr_300, fisetin_100, boron_3, lithium_1mg_orotate, spermidine_10, luteolin_100, broccoli_seed_200, ubiquinol_50	$49	2/9	$-9,157	not worth it

Portfolio optimization

The optimizer greedily adds items by marginal net value (QALY gain × $200K − cost), applying diminishing returns and a complexity penalty. It stops when the next item would have negative marginal value.

Result: 24 items selected, +453 expected days (1.2 years), $1,342/yr.

Selection order (24 steps)

#	Item added	+days	Marginal $	Cumulative $/yr	Ceiling retention
1	tadalafil_2.5mg	+166	$85,038	$252	0.92
2	finasteride_1.25mg	+108	$55,184	$423	0.87
3	metformin_500mg	+24	$12,295	$471	0.86
4	creatine_5g	+26	$8,639	$591	0.84
5	vitamin_d_2000	+13	$6,554	$621	0.84
6	astaxanthin_12	+12	$5,098	$621	0.83
7	magnesium_200	+15	$4,895	$767	0.82
8	nac_1200	+10	$4,512	$807	0.82
9	vitamin_k2	+9	$4,381	$832	0.81
10	prebiotics	+15	$4,257	$1,012	0.81
11	lithium_5mg	+9	$3,812	$1,072	0.80
12	hiit_2x_week	+5	$2,635	$1,072	0.80
13	hiit_3x_week	+4	$2,260	$1,072	0.80
14	ubiquinol_50	+6	$2,137	$1,072	0.79
15	tempo_run_1x_week	+3	$1,875	$1,072	0.79
16	hyaluronic_acid_120	+4	$1,795	$1,072	0.79
17	hiit_1x_week	+3	$1,624	$1,072	0.79
18	zone2_cardio_2x_week	+2	$1,156	$1,072	0.79
19	omega3_clo	+9	$1,028	$1,252	0.78
20	lutein_zeaxanthin	+4	$653	$1,252	0.78
21	zinc_carnosine_75	+3	$406	$1,312	0.78
22	strength_maintenance	+1	$338	$1,312	0.78
23	head_elevation_nightly	+0	$130	$1,312	0.78
24	melatonin_300mcg	+1	$113	$1,342	0.78

Excluded from portfolio (38 items)

Items not selected due to negative marginal value after diminishing returns and complexity penalty.

Item	E[days]	$/yr	Net value	Why excluded
Cocoa flavanols ~500mg	+39	$260	$15,384	Marginal value below threshold after DR
High-EPA Omega-3 +2g	+28	$227	$10,423	Marginal value below threshold after DR
Garlic 1200mg	+29	$300	$9,027	Marginal value below threshold after DR
Curcumin 250mg	+12	$40	$5,404	Marginal value below threshold after DR
Lions Mane 1g	+17	$287	$2,960	Marginal value below threshold after DR
NR 300mg	+7	$60	$2,288	Marginal value below threshold after DR
Ashwagandha 600mg	+6	$60	$2,099	Marginal value below threshold after DR
Luteolin 100mg	+6	$60	$1,935	Marginal value below threshold after DR
Lithium 1mg orotate	+6	$60	$1,725	Marginal value below threshold after DR
Collagen 22g	+17	$360	$1,365	Marginal value below threshold after DR
Glucosamine sulfate 750mg	+4	$41	$977	Marginal value below threshold after DR
Broccoli Seed Ext 200mg	+4	$60	$751	Marginal value below threshold after DR
Lycopene 15mg	+3	$60	$300	Marginal value below threshold after DR
L-Theanine 200mg	+1	$11	$275	Marginal value below threshold after DR
Magnesium citrate 150mg	+0	$8	$-178	Negative expected value
Apigenin 50mg	+3	$76	$-188	Negative expected value
Spermidine 10mg	+2	$60	$-208	Negative expected value
Ginger 400mg	+1	$25	$-244	Negative expected value
Reduced glutathione 250mg (oral)	+0	$14	$-312	Negative expected value
Cistanche 200mg	+8	$231	$-670	Negative expected value
Fisetin 100mg	+0	$60	$-1,119	Negative expected value
Boron 3mg	+0	$60	$-1,171	Negative expected value
L-Lysine 1000mg	+0	$54	$-1,203	Negative expected value
Glycine 2g bedtime	+2	$93	$-1,270	Negative expected value
Taurine 500mg top-up	+1	$85	$-1,501	Negative expected value
Humidifier nightly	+0	$80	$-1,623	Negative expected value
Nasacort nightly	+2	$120	$-1,829	Negative expected value
Doxepin 3mg	+-1	$60	$-2,102	Negative expected value
Calcium AKG 2000mg	+0	$108	$-2,405	Negative expected value
Daily probiotics	+6	$273	$-2,916	Negative expected value
Nasal strips nightly	+1	$180	$-3,608	Negative expected value
Mouth tape nightly	+-1	$220	$-5,454	Negative expected value
APAP nightly	+2	$400	$-8,064	Negative expected value
Trazodone 50mg	+-6	$223	$-8,315	Negative expected value
Custom oral appliance	+2	$500	$-10,291	Negative expected value
Lemborexant 5mg	+-1	$4350	$-97,278	Negative expected value
Suvorexant 10mg	+-3	$5686	$-127,995	Negative expected value
Daridorexant 25mg	+-0	$6156	$-137,229	Negative expected value

Sleep optimization

Sleep is the highest-leverage health behavior. I track it obsessively with two devices and have made several environmental interventions.

Devices

Eight Sleep Pod 5 — bed temperature control, sleep scoring, HRV, respiratory rate, snoring detection, sleep stages
Whoop MG — recovery score, strain, HRV, RHR, SPO2, sleep performance

Environmental interventions

Hamvay-Lang PureDelight 800fp winter duvet ($885) — Bayesian analysis showed bed temperature has a +3.0 score/°C causal effect on Eight Sleep sleep score. The duvet raises bed temperature, improving sleep quality. Estimated 165-day payback period.
Bed incline — Eight Sleep adjustable base, slight incline for reflux and breathing
Nasal strips + Nasacort — first night with this combination: zero snoring (vs. 13.2 min/night average). The clearest win in the protocol.

Medications

Trazodone 50mg — sleep maintenance. Whoop data confirms it wears off at 4-5 hours, leading to second-half fragmentation.
Melatonin 300mcg — low-dose for sleep onset. Higher doses are not more effective.

Key findings

Sleep duration is the #1 lever: +8.6 Whoop recovery points per hour
Bedtime before 11pm yields a 13-point recovery advantage
SPO2 drops below 95% on 36% of nights (flagged for apnea investigation)
Disturbances trending up (+0.009/day, p<0.0001)

Tracking

I maintain a SQLite database of nightly health data with 12+ tables, synced from Eight Sleep and Whoop APIs. Metrics that actually influence decisions:

Sleep score (Eight Sleep) — primary outcome for environmental experiments
Recovery (Whoop) — composite of HRV, RHR, sleep quality; guides training intensity
HRV — parasympathetic tone; trending metric for stress and recovery
Snoring duration (Eight Sleep) — proxy for airway obstruction; guides nasal interventions
SPO2 (Whoop) — blood oxygen; apnea screening metric

Most other metrics (strain, respiratory rate, sleep stages) I log but rarely act on directly.

What I'm investigating

Sleep apnea — Bayesian estimate: 66% probability based on SPO2 patterns, snoring, and family history. Pending home sleep study. Treatment options: CPAP, Inspire nerve stimulator, Dayvigo (lemborexant).
Rapamycin — strongest longevity candidate in the Rx list (ITP mice +26% lifespan). Requires physician willing to prescribe off-label. Immunosuppression concern.
Semaglutide — SELECT trial HR 0.80 for MACE. High cost ($6K/yr) but enormous effect size. Watching for generic timeline.
Lion's mane, cistanche — recently added to stack. Low evidence confidence but low cost.
Trazodone alternatives — wears off at 4-5h. Evaluating lemborexant (Dayvigo) for better second-half sleep maintenance.

Methodology

This page is generated from the Optiqal Python package. The data pipeline:

Literature hazard ratios are entered into a structured catalog with uncertainty estimates, study-quality tiers, and confounding priors
Each HR is shrunk toward null by a tiered publication-bias correction: 10% for preregistered RCTs with hard endpoints, 20–30% for standard RCTs and cohorts, 50% for supplement-industry RCTs, 70% for animal-only evidence
A Beta-distributed confounding prior discounts the causal fraction (e.g., Beta(2.5, 4) means ~38% of the observed effect is believed causal for medical interventions, calibrated against observed RCT-vs-observational gaps)
50,000 Monte Carlo simulations propagate uncertainty through CDC life tables for a 39-year-old male. The resulting posterior hazard ratio (what the simulator actually applies) is reported alongside the literature HR so readers can see the shrinkage that matters
Mechanism clusters (anti-inflammatory polyphenols, NAD+ precursors, antioxidants, mitochondrial-support, senolytics, neurotrophics, methylation-donors) apply within-cluster diminishing-returns schedules so correlated supplements don't stack additively
Expected days gained = mean QALY gain × 365.25
Greedy portfolio optimizer selects items by marginal net value; a portfolio-level QALY ceiling (3) applies a concave saturation to the additive total, bounded by primary-prevention CEA literature
Bundled products carry an allocated per-ingredient cost share so bundled items contribute to $/QALY accounting

Evidence confidence labels: high = strong causal prior + tight uncertainty; medium = moderate evidence or wider uncertainty; low = weak causal evidence, speculative.

Profile: 39yo male, BMI normal, never smoker. WTP $200,000/QALY, 40-year horizon, 3% QALY discount, 3% cost discount, 50,000 simulations. Saturated QALY total: 1.2398 (raw additive: 1.5996). Ground-up audit total: 0.1326 QALY (48.4 days).