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

$1,495

Annual cost

+2yr

Expected QALY gain

Sleep devices

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, 5% cost discount, 0% 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.

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	19	1.82	2.79	+663	$981
$100,000	23	1.90	3.01	+694	$1,315
$150,000	26	1.95	3.14	+711	$1,615
$200,000	27	1.95	3.16	+714	$1,695

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	+321	76%	$252	$4,863
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	+252	71%	$171	$4,198
Magnesium 200mg 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) Fang meta. BP RCTs.	taking	medium	0.977	+82	77%	$120	$9,061
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	+79	75%	$180	$14,046
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) Muscle/cognitive RCTs. No mortality.	taking	medium	0.999	+59	57%	$120	$12,482
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	+50	74%	$30	$3,695
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	+37	67%	$25	$4,135
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	+39	59%	$180	$28,424
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	+32	62%	$40	$7,683
Curcumin 250mg Details HR observed: 0.9 Pub-bias corrected (50% shrinkage, tier: supplement industry rct): 0.9487 Posterior (sim-applied) HR: 0.991 (95% CI 0.862–1.091) Anti-inflam. Bioavailability issues.	taking	low	0.991	+31	64%	$40	$8,041
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	+30	60%	$60	$12,376
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	+20	59%	$60	$18,814
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	+16	58%	$60	$22,591
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	+11	58%	$30	$16,768
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: $80/yr from blueprint longevity mix Already 120mg in Longevity Mix. Joint/skin. No mortality.	taking	medium	1.000	+8	54%	$80	$63,512

Daily schedule

How the stack breaks down by time of day. Generated from a private health database I maintain on GitHub. Bundles contain multiple catalog items.

Morning mix

All powders mixed into water. I pre-mix several days' worth into a smaller mason jar 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
LiftMode GOS	0.5 tsp morning	$41
Vital Nutrients Arabinogalactan	1 tsp morning	$84

Nutty pudding + pill batch 1

Based on Bryan Johnson's recipe. My modifications: double the cocoa powder (extra flavanols) and blend in collagen. I blend 4 servings at a time and refrigerate.

Item	Dose	$/yr
Blueprint Cocoa	12g blended into nutty pudding premix	$520
Blueprint Collagen Peptides	22g blended in nutty pudding	$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
Double Wood Fisetin 100mg	100mg with meal 1	$133
Double Wood Luteolin 100mg	100mg with meal 1	$115
Finasteride	1.25mg daily (quarter 5mg tablet)	$171
Kyolic Aged Garlic Extract	2 capsules per meal, twice daily	$151
Life Extension Ubiquinol 50mg	50mg with meal 1	$120
Lions Mane 1g	1g (2 capsules) with meal 1	$287
Nordic Naturals Arctic Cod Liver Oil	1 softgel with each meal	$172
Tru Niagen 300mg	300mg with meal 1	$396
Zinc Carnosine 75mg	75mg with meal 1	$153

Recipe

Blended base:

60 ml pomegranate juice
50–100 ml nut milk
3 tbsp ground macadamia nuts
2 tsp ground walnuts
1 tsp ground flaxseed
¼ Brazil nut
¼ cup berries + 3 cherries
1 tsp sunflower lecithin
½ tsp ceylon cinnamon
Blueprint Cocoa (12g per serving, all in premix)
1 scoop (22g) Collagen
2 scoops Blueprint Metabolic Protein (73g, 30g protein)

Toppings (per serving):

1 tbsp EVOO
Blueprint Blueberry Nut Mix
2 tbsp chia seeds
1/4 cup berries

Bulk dry mix (12 servings in 1-gallon mason jar)

Workflow: open a fresh bag of protein, scoop 8 scoops (4 servings) straight into the blender, then dump the remaining 22 scoops into the jar with 12 servings of everything else. Each jar scoop has slightly less protein (~1.83 vs 2 scoops), but it evens out across all 16 servings per bag. Scoop ~1¼ cups per serving (or ~5 cups for 4 servings).

Ingredient	Per serving	×12 (full jar)
Ground macadamia nuts	3 tbsp	2¼ cups
Blueprint Metabolic Protein	~1.83 scoops	rest of bag (22 scoops)
Collagen protein	1 scoop (22g)	2¾ cups
Blueprint Cocoa	~2 tbsp	1½ cups
Ground walnuts	2 tsp	½ cup
Ground flax seeds	1 tsp	¼ cup
Sunflower lecithin	1 tsp	¼ cup
Ceylon cinnamon	½ tsp	2 tbsp

Mixing order: finest powders first (cinnamon, cocoa, lecithin, flax), then proteins (pea/metabolic, collagen), then coarsest (ground nuts). Shake hard to combine; shake before each scoop.

Second meal + pill batch 2

Blueprint super veggie about half of days, otherwise pills with any meal.

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

Super veggie recipe

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

Sweet treat

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

Before bed

Item	Dose	$/yr
Apigenin 50mg	50mg before bed	$76
Ashwagandha KSM-66 600mg	600mg (2 x 300mg caps) before bed	$178
Glycine 2g	2g before bed	$28
Magnesium Lysinate Glycinate	200mg before bed	$73
Melatonin	1.5mg before bed	$27
Trazodone	50mg before bed	$223

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 86 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	+321	76%	$252	$171,285
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	+252	71%	$171	$135,175
Trazodone 50mg Details HR obs: 1 → pub-bias: 1 \| tier: rct standard \| QoL: +0.0005/yr Sleep maintenance. No mortality data.	medium	+-11	0%	$223	$-9,751

Current supplements (25)

Item	Evidence	E[days]	P(+)	$/yr	Net value
Magnesium 200mg * Details HR obs: 0.9 → pub-bias: 0.9192 → posterior: 0.977 \| tier: rct standard \| QoL: +0.0005/yr Fang meta. BP RCTs.	medium	+82	77%	$120	$42,811
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 ~12g/day this is ~29 days/container, or ~$520/yr.	medium	+93	74%	$520	$42,184
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	+79	75%	$180	$40,332
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	+74	78%	$300	$35,641
Creatine 5g * Details HR obs: 0.98 → pub-bias: 0.9899 → posterior: 0.999 \| tier: supplement industry rct \| QoL: +0.005/yr Muscle/cognitive RCTs. No mortality.	medium	+59	57%	$120	$30,429
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	+50	74%	$30	$26,956
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	+37	67%	$25	$20,024
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	+39	59%	$180	$18,343
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	+32	62%	$40	$16,919
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	+31	64%	$40	$16,143
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	+30	60%	$60	$15,359
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	+25	57%	$60	$12,854
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	+20	59%	$60	$9,758
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	+27	54%	$360	$8,781
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	+11	58%	$30	$5,536
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	+11	57%	$60	$5,169
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	+10	59%	$60	$4,373
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	+10	56%	$60	$4,262
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	+9	55%	$60	$3,715
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	+8	59%	$60	$3,183
Hyaluronic acid (oral) * Details HR obs: 0.99 → pub-bias: 0.9955 → posterior: 1.000 \| tier: observational speculative \| QoL: +0.001/yr Already 120mg in Longevity Mix. Joint/skin. No mortality.	medium	+8	54%	$80	$2,902
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	+5	58%	$60	$1,867
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	$344
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	+1	56%	$60	$-513
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	+1	56%	$60	$-648

Recently added (7)

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	+59	66%	$227	$28,284
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	+27	55%	$287	$9,914
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	+16	58%	$60	$7,956
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	+14	56%	$231	$3,476
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	+5	58%	$76	$1,608
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	0%	$28	$809
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	0%	$4	$566

Prescription candidates (9)

Item	Evidence	E[days]	P(+)	$/yr	Net value
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	+231	91%	$3600	$65,288
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	+87	77%	$48	$46,972
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. LDL already 64.	high	+69	75%	$120	$35,485
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	+32	62%	$60	$16,696
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	+11	63%	$600	$-4,114
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	+-8	57%	$15	$-4,579
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	+-2	61%	$360	$-6,884
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	+-32	62%	$120	$-19,347
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	+26	51%	$6000	$-87,197

Supplement candidates (31)

Item	Evidence	E[days]	P(+)	$/yr	Net value
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	+22	63%	$60	$10,926
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	+19	62%	$60	$9,457
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	+20	59%	$120	$8,745
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	+17	57%	$60	$8,322
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	+39	59%	$780	$7,919
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	+14	61%	$60	$6,749
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	+12	62%	$15	$6,226
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	+17	59%	$240	$5,016
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	+9	0%	bundled	$4,917
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	+8	0%	bundled	$4,247
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	+17	54%	$300	$4,071
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	+7	0%	bundled	$3,576
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	+10	56%	$115	$3,334
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	+6	0%	bundled	$3,129
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	0%	bundled	$2,235
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	+10	56%	$180	$2,229
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	+5	58%	$60	$1,880
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	+13	58%	$360	$1,199
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. Product link	medium	+9	0%	$258	$704
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	0%	bundled	$671
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	+7	58%	$180	$605
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	+2	57%	$30	$542
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	+11	57%	$396	$-504
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	+2	57%	$120	$-981
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	+1	56%	$133	$-1,745
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	+-8	67%	$180	$-7,289
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	+-6	0%	$1200	$-23,303
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	+-6	0%	$1500	$-28,754
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	0%	$1800	$-30,711
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	0%	$2178	$-35,006
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	0%	$3588	$-60,208

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	$52,621	worth it
Blueprint NAC+Ginger+Curcumin Contents nac_1200, ginger_400, curcumin_250	$27	2/3	$20,102	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	$13,195	worth it
Blueprint Advanced Antioxidants Contents vitamin_k2, lutein_zeaxanthin, astaxanthin_12, lycopene_15	$49	2/4	$11,863	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: 27 items selected, +714 expected days (2.0 years), $1,495/yr.

Selection order (27 steps)

#	Item added	+days	Marginal $	Cumulative $/yr	Ceiling retention
1	tadalafil_2.5mg	+278	$147,934	$252	0.87
2	finasteride_1.25mg	+168	$89,153	$423	0.78
3	metformin_500mg	+50	$26,420	$471	0.75
4	creatine_5g	+32	$15,272	$591	0.73
5	magnesium_200	+29	$13,831	$711	0.72
6	vitamin_d_2000	+24	$12,707	$741	0.70
7	vitamin_k2	+17	$9,030	$766	0.69
8	nac_1200	+14	$7,204	$806	0.68
9	lithium_5mg	+14	$6,688	$866	0.67
10	curcumin_250	+13	$6,431	$906	0.67
11	omega3_clo	+16	$5,829	$1,086	0.66
12	prebiotics	+15	$5,403	$1,266	0.65
13	ubiquinol_50	+8	$3,127	$1,266	0.64
14	statin_5mg	+9	$2,914	$1,386	0.64
15	hiit_2x_week	+3	$1,825	$1,386	0.63
16	hiit_3x_week	+3	$1,564	$1,386	0.63
17	astaxanthin_12	+4	$1,377	$1,386	0.63
18	tempo_run_1x_week	+2	$1,294	$1,386	0.63
19	hiit_1x_week	+2	$1,126	$1,386	0.63
20	zinc_carnosine_75	+4	$910	$1,446	0.62
21	zone2_cardio_2x_week	+1	$794	$1,446	0.62
22	melatonin_300mcg	+2	$668	$1,476	0.62
23	strength_maintenance	+0	$236	$1,476	0.62
24	vitamin_c_500_extra	+1	$202	$1,491	0.62
25	hyaluronic_acid_120	+3	$138	$1,491	0.62
26	head_elevation_nightly	+0	$123	$1,491	0.62
27	taurine_500_topup	+0	$71	$1,495	0.62

Excluded from portfolio (29 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	+93	$520	$42,184	Marginal value below threshold after DR
Garlic 1200mg	+74	$300	$35,641	Marginal value below threshold after DR
High-EPA Omega-3 +2g	+59	$227	$28,284	Marginal value below threshold after DR
Lutein+Zeaxanthin	+25	$60	$12,854	Marginal value below threshold after DR
Lions Mane 1g	+27	$287	$9,914	Marginal value below threshold after DR
Collagen 22g	+27	$360	$8,781	Marginal value below threshold after DR
NR 300mg	+11	$60	$5,169	Marginal value below threshold after DR
Broccoli Seed Ext 200mg	+10	$60	$4,373	Marginal value below threshold after DR
Luteolin 100mg	+10	$60	$4,262	Marginal value below threshold after DR
Lithium 1mg orotate	+9	$60	$3,715	Marginal value below threshold after DR
Cistanche 200mg	+14	$231	$3,476	Marginal value below threshold after DR
Lycopene 15mg	+8	$60	$3,183	Marginal value below threshold after DR
Spermidine 10mg	+5	$60	$1,867	Marginal value below threshold after DR
Apigenin 50mg	+5	$76	$1,608	Marginal value below threshold after DR
Glycine 2g bedtime	+2	$28	$809	Marginal value below threshold after DR
Ginger 400mg	+1	$25	$344	Marginal value below threshold after DR
Fisetin 100mg	+1	$60	$-513	Negative expected value
Boron 3mg	+1	$60	$-648	Negative expected value
Nasacort nightly	+3	$120	$-676	Negative expected value
Humidifier nightly	+1	$80	$-1,097	Negative expected value
Nasal strips nightly	+1	$180	$-2,397	Negative expected value
Doxepin 3mg	+-3	$60	$-2,422	Negative expected value
Mouth tape nightly	+-2	$220	$-4,696	Negative expected value
APAP nightly	+3	$400	$-5,402	Negative expected value
Custom oral appliance	+3	$500	$-7,089	Negative expected value
Trazodone 50mg	+-11	$223	$-9,751	Negative expected value
Lemborexant 5mg	+-2	$4350	$-74,215	Negative expected value
Suvorexant 10mg	+-5	$5686	$-98,397	Negative expected value
Daridorexant 25mg	+-1	$6156	$-104,238	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, 50,000 simulations. Saturated QALY total: 1.9547 (raw additive: 3.163).