Longevity medicine focuses on extending the health span through evidence-based interventions to reverse cellular processes of ageing. The pillars of this field include novel diagnostics, personalised compounds such as NMN (nicotinamide mononucleotide) and rapamycin, and optimising mitochondrial function, inflammation, and gut microbiome health.
Unlike more commonly known anti-ageing measures such as moisturisers, retinoids, sunscreen, or cosmetic procedures, this field employs precision medicine to treat individual biological markers. The growing demand in the UK reflects a shift towards proactive, measurable strategies for maintaining cognitive and physical function throughout one’s lifespan.
What Is Longevity Medicine?
Longevity medicine is a personalised approach to healthcare that aims at extending quality years of life (healthspan) rather than just one's lifespan by slowing the biological aging process and preventing age-related diseases. It begins with state‑of‑the‑art diagnostics such as blood work, microbiome analysis, and biological age determination. It uses personalised interventions based on lifestyle, nutrition and regenerative therapies tracking progress through measurable outcomes.
Where anti‑ageing advertising promises solutions such as turning back the clock, defying age, or unlocking the fountain of youth, longevity medicine employs clinical methods to treat mitochondrial impairment, hormone loss, chronic inflammation, and gut‑brain well-being. According to Renata Sisto of the Department of Occupational and Environmental Medicine in Italy, keeping an active mind may be one of the most important factors in promoting healthy longevity. This can be achieved in different ways throughout life, such as engaging in lifelong learning, maintaining social engagement, and pursuing creative activities.
In the UK, this field is gaining traction due to the increasing recognition of metabolic and age-related decline. The UK Biobank is advancing a project called Regulation of age-related diseases by cellular metabolites, which explicitly investigates how metabolism changes with aging and aims to develop a ‘metabolomic clock’, a tool to measure biological aging via metabolite patterns in the blood.
In December 2024, Roseway Labs conducted a survey of 2001 adults which showed that 73 % of UK adults are open to personalised medicines. This signals increasing demand for customised interventions based on diagnostics and compounding, rather than standard, off-the-shelf medications and supplements.
Does Longevity Medicine Work?
Longevity medicine is increasingly becoming a clinical evidence-based discipline that is being widely embraced, with mounting research that shows it can increase health span. While anti-ageing creams and lotions merely offer cosmetic or skin-level effects, longevity protocols are seeking quantifiable enhancements in biological age, metabolic health, and cell turnover.
The approach is based mostly on biomarkers, including telomere length, inflammation, nicotinamide adenine dinucleotide (NAD+) levels, and biological age testing to quantify risk and guide treatment. Personalised treatments can include medicines such as NMN, rapamycin, or metformin, coupled with lifestyle interventions and precision diagnostics. The treatments are personalised to a person's genetic makeup, hormone levels, and biomarkers of ageing.
Many experiments are beginning to show some promising signs. Andrea B Maier from Amsterdam Movement Sciences, The Netherlands, et al.'s randomised trial of NMN supplementation showed impressive elevations in NAD⁺ and exercise tolerance. Additionally, early results from Dr Zev Williams et al. from the Columbia University Fertility Centre's VIBRANT trial at Columbia University suggest that rapamycin may slow ovarian ageing by approximately 20%.
Compounding pharmacies, such as Roseway Labs in the UK, support longevity medicine by providing individualised medication tailored to each patient’s unique needs. This allows clinicians to go beyond standardised, one-size-fits-all therapies and instead deliver precision treatments informed by biomarkers, genetics, and hormone profiles. By tailoring formulations and enabling ongoing monitoring, practitioners can adjust therapies over time ensuring patients receive the most effective support for long-term healthspan.
What Are The 5 Pillars of Longevity Medicine?
The five pillars of longevity medicine are mitochondrial function, inflammation and immune ageing management, gut microbiome health, hormonal balance, and cognitive and mental resilience. Understanding these underlying processes is imperative to creating effective, customised strategies that promote long-term health and resilience.
1. Mitochondrial Function: Control of Cellular Energy and Ageing
Mitochondria are the cell’s energy factories that produce ATP to power every biological process. They become less effective and generate more reactive oxygen species with age, leading to DNA damage and the gradual decline of cellular function.
According to Uddin, G., Youngson, from the School of Medical Sciences, Australia, et al., nicotinamide adenine dinucleotide (NAD+), an important metabolic cofactor, is decreased in obesity and type 2 diabetes. The conversion of NAD+ to NADH in the TCA cycle, β-oxidation, and oxidative phosphorylation is essential for mitochondrial metabolism. However, NAD+ levels may decrease by up to 50% with age.
2. Inflammation & Immune Ageing: Calming the Body's Fire
Chronic low-grade inflammation, or "inflammageing," is a long-term immune reaction associated with enhanced ageing, metabolic dysregulation, and neurodegeneration. Biomarkers such as IL-6 and CRP can indicate systemic stress even before the occurrence of any symptoms.
According to research by Adam R Konopka from the University of Wisconsin-Madison, USA, et al., rapamycin treatment has been repeatedly demonstrated to extend lifespan and prevent or delay age-related diseases in diverse model systems. Longevity medicine plays a crucial role in guarding tissues, ensuring metabolic homeostasis, and preventing the onset of age-related disorders by suppressing unwanted inflammation.
3. Gut Microbiome: The Ageing–Microbiota Connection
The gut microbiome plays a central role in digestion, immunity, and even mood regulation. With age, there is a loss of microbial diversity and an increase in pathogenic strains, an imbalance known as dysbiosis. This change leads to inflammation, insulin resistance, and compromised cognition. According to a study by Donald J. Davidson et al. from Queen's Medical Research Institute, UK, ageing-associated microbiota can lead to inflammation. Reversing these changes could be a potential strategy for reducing age-related inflammation and associated morbidities.
A healthy gut ecosystem maximises nutrient uptake, immune resilience, and general longevity outcomes.
4. Hormonal Health: Restoring the Body's Signalling Balance
Hormones act as the body’s messengers that harmonise energy, mood, metabolism, and repair. Ageing disrupts this process, decreasing oestrogen, testosterone, insulin sensitivity, and cortisol rhythm, all of which impair normal function. Longevity interventions typically involve restoring this balance through bioidentical hormone replacement, adaptogens, or metabolic modulators tailored to the individual
According to a UK study conducted by R Ross and Neurocrine UK Limited, restoring a more natural cortisol rhythm in patients with adrenal insufficiency improves cortisol levels, fatigue, and quality of life. For example, twice-daily modified-release hydrocortisone has been proven to replicate the morning cortisol spike, enhancing stress response and midday energy. Rebalancing hormonal communication allows the body to repair, respond to stress, and maintain optimal internal rhythms, which is necessary for healthy ageing.
5. Cognitive & Mental Resilience: Protecting the Ageing Brain
Brain cognitive impairment is one of the most concerning aspects of ageing. It is typically the result of cumulative stress, poor sleep, inflammation, and reduced neuroplasticity.
Longevity medicine addresses it by emphasising stress mitigation, sleep optimisation, cognitive training, and, in some cases, neuropeptide treatment. According to Frank Moriarty of the Royal College of Surgeons in Ireland, et al., data from The Irish Longitudinal Study on Ageing (TILDA) cohort suggest that people over 50 who start taking strong anticholinergic medications (which can make it harder for the brain to form and recall memories) tend to experience noticeable declines in memory recall over just two years.
Cognitive tests, biomarkers, and tracking medication exposure (like in the TILDA study) allow clinicians to measure the effect of interventions, ensuring patients’ cognitive health is protected.
Furthermore, staying mentally engaged in middle and later life is substantially connected to a lower risk of cognitive decline and dementia.
By supporting brain health, we protect memory and executive function while also promoting physical vitality, strengthening the link between mental resilience and overall long term health.
Key Compounds & Treatments in Longevity Medicine
Personalisation sets longevity medicine apart from overall wellness fads. Instead of utilising standardised doses, compounding pharmacies assemble customised preparations according to each patient's unique needs. When these treatments are tailored to the health profile of the individual as a result of diagnostic testing, they have the potential to better support patients in managing age-related changes and optimising their long-term health.
NMN and NAD⁺
NMN (nicotinamide mononucleotide) is a precursor molecule for NAD⁺, a coenzyme crucial for energy metabolism and cellular health. According to Georges E. Janssens from Amsterdam Cardiovascular Sciences et al., NAD⁺ declines naturally with age, which is related to fatigue, impaired mental function, and mitochondrial dysfunction. NMN supplementation increases the amount of available NAD⁺, which enhances sirtuin activation and healthy ageing.
Metformin
Metformin, the old reliable method of diabetes control, is increasingly being noted for its anti-inflammatory, insulin-signalling, and cellular metabolism effects. It lowers oxidative stress and promises to decelerate the onset of age-related cellular damage. According to Shan Luo, PhD from The University of Hong Kong et al., although its life-extending activities are still under investigation, observational data to date already indicate substantial gains in cardiovascular and metabolic indices.
Rapamycin
Rapamycin was found to block mTOR, a protein involved in growth and ageing. Low, intermittent doses trigger autophagy (cell renewal), decrease senescent cell burden, and potentially retard tissue ageing. According to Dr. Zev Williams, Director of Columbia University Fertility Centre, the UK Vibrant trial showed a 20 % decrease in ovarian ageing with weekly administration. However, the side effects of mouth ulcers or immune changes need close surveillance.
Resveratrol
Resveratrol, a polyphenol found in red grapes, is most often associated with cardiovascular health. It is an activator of sirtuins, proteins that control cellular repair, longevity and wellness mechanisms. While animal models indicate it enhances mitochondrial function and has protection against oxidative stress, the human evidence is less clear. In longevity medicine, it is often combined with NAD⁺ precursors to promote epigenetic stability and improve metabolic function.
Senolytics & Peptides
Senolytics target and eliminate senescent cells, those that fail to divide but cause inflammation and tissue destruction. Peptides, on the other hand, facilitate repair, regeneration, and hormonal communication. In combination, they hold the potential for tissue rejuvenation and immune system support.
Semaglutide
Semaglutide, a GLP-1 receptor agonist originally designed to treat obesity and diabetes, is being more and more considered in longevity medicine for its properties to improve metabolic health and reduce cardiovascular risk. According to Manoj K Mahapatra from Kanak Manjari Institute of Pharmaceutical Sciences, India, et al., early use of oral semaglutide will be a cheap treatment for patients with type 2 diabetes who have suboptimal glycaemic control on metformin plus an SGLT-2 inhibitor in the UK.
While weight loss or glucose lowering is typically accomplished with standard doses, interest is growing in the concept of microdosing, which involves administering lower, well-titrated doses to achieve metabolic benefits with a reduced risk of side effects.
Can Personalisation & Lifestyle Enhance Longevity Medicine?
Personalisation and lifestyle can enhance longevity medicine. With the guidance of sophisticated diagnostics such as biological age tests, hormone panels, and microbiome testing, medical professionals can design customised protocols that map a patient’s body's real-world ageing path.
Roseway Labs develops custom formulations to support a patient’s longevity and wellness goals. Pharmaceutical compounding enables customised dosing of compounds such as NMN, metformin, or peptide mixes to help reduce side effects and optimise treatment.
But personalisation is a journey that goes far beyond medicine. Lifestyle factors such as diet, stress management, exercise, and sleep are still vital. A collaborative study led by Professor Dag Aarsland between the Centre for Healthy Brain Ageing at King’s and the Centre for Age-related Medicine, Stavanger University Hospital, Norway, demonstrates that a supplement containing components of the Mediterranean diet can affect epigenetics associated with healthy ageing.
Roseway Labs compounds with niche ingredients such as glutathione, curcumin, green tea extract, guarana, tryptophan and DMSA to address specific patient needs, and also creates bespoke multivitamins tailored to meet micronutrient deficiencies.
Longevity medicine achieves its greatest impact when clinical therapies are integrated with sustainable, evidence-based lifestyle practices. By combining personalised medical interventions with long-term habits in nutrition, movement, stress management, and restorative sleep, patients can chart a clearer path toward lasting vitality, resilience, and well-being.
When to Consider Longevity Medicine
Research indicates that longevity medicine may benefit individuals experiencing metabolic decline, mental fog, hormonal imbalance, or chronic inflammation, conditions often linked to ageing. Through comprehensive evaluations, healthcare professionals assess biomarkers such as C-reactive protein, insulin sensitivity, and NAD⁺ levels, alongside genetic risk profiles and biological age calculations, to establish a detailed picture of a patient’s baseline health.
From this foundation, specialists design highly personalised health plans incorporating medications, supplements, and lifestyle strategies tailored to each patient’s needs. These plans are refined over time, with regular monitoring of blood tests, lab results, and patient feedback to optimise outcomes and minimise side effects.
Roseway Labs supports this process by providing diagnostic testing and custom-compounded medication formulations that help functional doctors and medical professionals deliver truly individualised care.