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Longevity Medicine

Longevity Medicine Example Patient Journeys

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Discover what your longevity journey might look like

You’re committing to your health and your future – it’s only natural you’d want to understand what that might look like.

Here, we provide a detailed breakdown of how your longevity journey might look, depending on which consultation or membership type you choose.

View a longevity medicine membership example patient journey and a comprehensive consultation example patient journey.

Get in touch to find out more

An illustrative case study with Karen Darke

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We are delighted to present to you a case study with British paralympic cyclist, Karen Darke, that demonstrates an example patient journey using one of our longevity medicine pathways.

We hope this will answer a lot of questions about how this area of medicine works both logistically, as well as clinically; providing you with an opportunity to take a peek into what our treatment plans can look like for patients when they come to see us.


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Longevity medicine comprehensive consultation

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Month 1 – Initial comprehensive consultation


Initial consultation

Who?: Female, 45 years old, marathon enthusiast

Patient goals:

  • Address perimenopausal symptoms, predominantly disturbed sleep and irritability
  • Interested in supporting brain health and Alzheimer’s prevention due to family history
  • Brain fog
  • Optimise exercise capacity

Our goals for this patient:

  • Hormone optimisation
  • Mitochondrial support
  • Deeper understanding of Alzheimer’s risk


Testing

  • Longevity blood test panel
  • 8 hour fasted blood test: advanced serum panel + hormones + thyroid + IGF1
  • APOE DNA test (cheek swab)
  • DUTCH test – metabolic pathways (urine sample)


Observations from test results for this patient

Serum tests

  • High total cholesterol
  • Oestrogen dominance
  • Low progesterone

Metabolic pathways

  • Phase 1 + 2 detoxification of oestrogen needs optimisation
  • Low melatonin
  • Cortisol dysfunction

DNA

  • APOE variant present
  • APOE report also showed a predisposition to the Alzheimer’s inflammatory subtype


Additional steps

  • Doctor’s report and treatment plan consultation completed
  • Phase 1 of management plan implemented
  • Health coach call scheduled


Month 3 – Follow-up consultation


Presentation

  • Sleep has improved and she is waking feeling more refreshed
  • Energy levels have increased
  • Overall she feels better in herself


Testing

  • Hormone blood test
  • (Retest cholesterol and advanced longevity blood test at a later stage)


Additional steps

  • Refinements to the Phase 1 plan discussed and implemented
  • Health coach call scheduled


Month 9 – Follow-up consultation


Presentation

  • Brain fog has lifted significantly
  • Sleep continues to be better
  • Reports improved exercise capacity
  • Feels increasingly more in control of her health


Testing

  • Re-test longevity blood test panel
  • Patient would now like to look at physical performance using a VO2MAX, functional movement assessment and a DEXA scan


Observations from test results for this patient

  • Longevity blood test show hormones optimised
  • Lipid parameters have improved
  • VO2MAX is in the superior category, but still has room for optimisation


Refining of treatment plan

Is doing exceptionally well on the current treatment plan. Although her DNA test earlier in the year showed that she did have the APOE gene, it feels less like a sentence and she feels more in control of her future


Future goals

Patient:

  • Improve marathon time
  • Continue training to complete her first Ironman towards the end of the next year
  • Would like to optimise nutrition to support with performance

Our goals for the patient:

  • Optimise performance
  • Other genetic testing (metabolics and hormone DNA)
  • Decrease inflammation overall (specifically neurological)


Additional steps

  • Health coach call scheduled

Longevity medicine membership – tier 3

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Q1 – Initial consult, testing, report + treatment planning consultation


Initial consultation

Who?: Male, 49 years old, professional

Patient goals:

  • Address mild recurrent issues, including slightly elevated blood pressure, increasing weight and mild anxiety
  • Improve libido
  • Build more muscle

Our goals for this patient:

  • Hormone optimisation
  • Address inflammation and oxidation
  • Optimise metabolism


Testing

In-clinic longevity blood test panel + physical testing

  • 8 hour fasted blood test: advanced serum panel + hormones + thyroid + IGF1
  • Pulse wave velocity (arterial age)
  • Advanced blood pressure screen

At home testing (kits collected from clinic)

  • GlycanAge – Immune-age
  • DNA/Genetics – Longevity-associated genes + Nutrient + Hormones
  • Gut testing

Physical testing

  • DEXA (Viscera + Bone)
  • VO2 MAX
  • Functional Movement Assessment


Observations from test results for this patient

Biological age (chronological age – 49)

  • Arterial age: 56
  • Glycanage: 61

Serum tests

  • Liver, kidney and haematology were all within normal ranges
  • Dyslipidemia
  • Omega 3 to omega 6 ratio suboptimal
  • Low normal testosterone
  • IGF1 is low

Gut and DNA

  • No gut barrier issues
  • Gut diversity needs improvement
  • Good result for longevity-associated genes (FOXO3, SIRT1)
  • Genetic result for fat absorption and utilisation are suboptimal and he is also a fast metaboliser of caffeine

Physical testing

  • VO2MAX midrange, showing scope for improvement
  • DEXA shows elevated risk due to suboptimal results for android, gynoid and visceral fat; bone density is optimal
  • Elevated blood pressure
  • Dual blood pressure within normal limits


Additional steps

  • Doctor’s report and second consultation to discuss treatment plan completed
  • Phase 1 of management plan implemented
  • Health coach call scheduled


Q2 – Third doctor consult + initial nutrition consult with report


Third doctor consult

Patient reported:

  • A significant increase in lean muscle mass
  • Improved mood
  • Decreased anxiety
  • Libido has improved with better quality erections


Initial nutritional therapy consult

  • Adjustments to macronutrient composition
  • Micronutrient considerations
  • A primary focus on cardiovascular health
  • Reduction in saturated fat due to nutrient DNA result


Nutritional therapy check-in after 6 weeks

  • Improvement in exercise capacity
  • Overall better digestion and specifically better transit time
  • Feels more informed about which specific dietary choices can support his presenting concerns


Additional steps

  • Refinements to Phase 1 plan discussed and implemented
  • Combined care – Nutritionist and doctor meeting to discuss patient care
  • Health coach call scheduled


Q3 – Repeat testing, fourth doctor consult with report + second nutrition consult


In-clinic blood test + physical testing

  • 8 hour fasted blood test: advanced serum panel + hormones + thyroid + IGF1
  • Advanced blood pressure screen

  • Fourth doctor consult

    • Test results discussed with patient
    • Refinements to the current plan made, taking into consideration that patient needs to travel a lot for work in Q3


    Observations from test results

    • Omega ratio improved
    • Some dyslipidemia remaining but has improved overall
    • Sex hormone levels optimal
    • IGF1 remains low (deferred management)
    • Blood pressure lowered


    Second nutritional therapy consultation

    Patient reported:

    • Increase in energy levels and better balance of energy throughout the day
    • Patient is pleased with the decrease in blood pressure
    • Reported better body composition, with less weight held around the midsection


    Additional steps

    • Refinements to the patients nutrition plan completed
    • Health coach call scheduled


Q4 – Fifth doctor consult + third nutrition consult


Fifth doctor consultation

Patient reported:

  • Functioning better at work, increased drive and motivation, as well as being able to handle work stress with more ease
  • Feels as though he has more control over his health which has alleviated the stress around his initial presentation of symptoms
  • Better understanding of his health and the ways in which he can support his health with longevity medicine; through the use of prescriptions, supplementation, nutrition and lifestyle recommendations

Reassess goals

  • Lose a little more weight
  • Increased focus on cardiovascular health
  • Further increase lean muscle mass

Refining of treatment plan
The patient is doing exceptionally well on the current treatment plan. He remained on the same regime as we prepared for the next steps.

Now in a better phase of health, he is keen to move onto the second year to take a deeper dive as we begin looking at:

  • Toxic load and detoxification capacity
  • Brain health (testing for APOE)
  • Optimising metabolic pathways


Third nutritional therapy consultation

Further refinements to his health plan made based on third consultation and patient updates

Additional steps

  • Health coach call scheduled

*This membership journey demonstrates the five scheduled doctor consults that are placed within each quarter (Q1-Q4). The two further consults can be placed where required based on the individual needs for each specific patient

Meet Aliyah, Our Health & Wellness Coach

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