If I generate insights about my medical condition using ChatGPT, should I share the output with my doctor?  Should I upload it to my healthcare portal? 

Also: Is there a way to enter my whole medical record into ChatGPT and have it come up with tests I should take?  If I do that, is my medical information not protected enough?

— Russ A., Marblehead

Dear Russ A.,

These are outstanding questions, and you are clearly a proactive “patient.” The medical arena offers some of the most promising and beneficial ways artificial intelligence can help us humans. But there are still loaded mines to navigate, mainly for confidentiality and accuracy (not nothing!). I will gladly offer my personal opinion here, but have sourced two experts who deal with these questions every day: Waichi Wong, of Boston Medical Consulting, and Emilia Javorsky, director of the Futures Program at the Future of Life Institute.

Both agree that AI is an excellent tool that democratizes medical information and enables folks to learn more about their medical needs. But as Javorsky—who describes herself as an AI advocate and ethicist—puts it, “ChatGPT is not a doctor, and general purpose LLMs [large language models] like ChatGPT have not been cleared by the FDA as medical devices for diagnosis.” In other words, there is zero guarantee that what ChatGPT shares with you is accurate. Still, AI is a good way to translate complicated medical jargon into words that anyone can understand. So, sure, ask ChatGPT (or Perplexity, Claude, Gemini, etc.) for medical insights, but make certain that you use that material as a conversation starter with your human doctor.

As for uploading that AI-generated data into your healthcare portal…hey ho, not so fast. The issue with artificial intelligence is that it can be Just. Plain. Wrong. If you upload your AI findings to your portal, future providers could get confused and misguided by erroneous information. That’s a big deal! Now, if you feel there is low risk of a fiasco like that, Wong advises uploading a brief summary with a short list of questions. “Practically,” she says, “many portals have message length limits, and clinicians may not have time to read a long attachment.”

Regarding entering your entire medical history into ChatGPT for guidance on tests and diagnosis; how cool would that be? The short answer is yes, someday that will be the case and AI is tracking toward that by the nanosecond. But today? AI has some hurdles. First, there’s a possibility that it will recommend tests that are not necessary. “Lab interpretation is context-dependent—reference ranges differ by laboratory, and small deviations can be clinically meaningless,” Wong says. “Physicians interpret results in the setting of the whole clinical picture and decide whether a borderline abnormality is truly important.” Additionally, while cost can be, of course, a factor in deciding what tests a patient receives, so is the risk of false positives. “Such findings then require follow up testing and procedures that are often not risk free, meaning patients take on risks without benefit,” Javorsky says.

Finally, on your question of whether your medical information is protected if you share it with ChatGPT: In most cases, it’s a big fat no. Doctors are bound by HIPAA, a U.S. federal law that prevents a patient’s medical information from unauthorized disclosure. Your records are confidential, and you have legal rights if HIPAA is not honored. Big tech companies abide by no such law. In fact, your shared medical record and personal identifiers could be used to train future AI models. No problem with that? Go for it.

Previously: How Can AI Help My Senior Mom Communicate Better?

Welcome to “The Salty Cod,” a monthly column in which humorist Steve Calechman grapples with uniquely New England dilemmas. 

God, I hope not, because I screwed up big time. I grew up on the course, right at the top of Heartbreak Hill, and watched pretty much every race during my childhood, and nothing, not the chance to eat a lot of pasta or run by my own house, ever made me want to do it. Then again, not everyone who grows up in Winthrop becomes a pilot.

And that’s fine. We don’t have to do or like all sports. And marathons, especially, are nothing to trifle with. You can’t just show up at the starting line on a whim. You gotta run a lot. You gotta run outside in January. And you never hit a downhill and get to coast for a mile. It really is all you.

Some of us are happy to be on the sidelines and remind you of just that. Think about it, runners. I know you feel you’ve done something medal- and massage-worthy at the end, and maybe you have. But without the crowds, that Monday is just 26.2 miles on concrete. Are all the splits and intervals and lost toenails still worth it? Now think about what those fans are going through. Standing—most likely sitting—for three, four hours, cheering “You got it!” over and over and over again, meaning it each and every time, even making the effort to occasionally decipher your shirt in order to say, “You got it, Mike!”—all while not spilling a drop of their chili. Sometimes it’s also drizzling, maybe a touch chilly, and they still don’t quit. Who’s the marathoner now?

We all are. Is it the classic definition of one? No. But there are a lot of ways to be part of something. Sometimes it’s hoofing it. Sometimes it’s yelling supportive stuff at people we don’t know. But the thing we have in common is that we both willingly keep coming back because it makes us feel good. If it didn’t, we wouldn’t. “It’s not rocket science,” says Jeff Brown, psychologist for the Boston Marathon’s medical team and author of The Runner’s Brain.

It’s the basis for most traditions and rituals, and it’s a way to make something feel like ours. So no, you don’t have to run to be a part of the marathon. Now, a question for you, readers. What’s one of your traditions that could only happen here, one you wouldn’t miss for all the pasta in the world?

This article was first published in the print edition of the April 2026 issue, with the headline,“Do I Have to Run the Boston Marathon to be a Real Bostonian?”

You’re best known for your work on “the Singularity”—the point of accelerating technological change when human intelligence merges with AI. What connection do you see between this concept and the challenge of extending human longevity?
Singularity includes longevity. We’re already making very substantial gains in terms of overcoming health problems. Right now, if we come up with a new cure or treatment, it has to undergo human testing, and that could take years. We’re moving toward being able to simulate this using computers, which can be done in days. For example, with the COVID vaccine, they tried out thousands of formulations and did it in two days; otherwise, it would’ve taken years. This is going to be done for everything [as part of the AI revolution]. It’s not fully there yet, but it will be there in about five years.

You’ve popularized the concept of “longevity escape velocity”—in the simplest terms, what exactly is the theory, and why do you believe we’re so close to reaching it?
Eventually, [medical advancements] will be able to overcome what causes our bodies to expire. Right now, if you use up a year of your longevity, you’re a year older. But by 2032, you’ll gain back one year for each year lived. Beyond that, you’ll actually get back more than a year. It doesn’t guarantee immortality; accidents can happen, but we’re also reducing accidents. For example, the 40,000 deaths a year we have from humans driving cars, we’ll be able to reduce through automated driving.

You’re well known for your personal longevity routine. What are some of the things you do to stay healthy?
I do TPE, therapeutic plasma exchange, on a regular basis. Plasma holds toxins, and if you never replace it, it gets more and more filled with toxins. This process replaces the plasma in your blood with plasma that’s free of toxins. Also, my father died at age 58 of heart disease. We didn’t have the ability to control it back then. Right now, we have something called Repatha, which is an injection, so my LDL cholesterol, which is the bad, is now 10. I have no plaque because of this treatment. Then I take maybe 70 or 80 supplements a day, some through injections.

For the average person who simply wants to live a longer, healthier life, what is the most encouraging message you can share about the future of medicine?
AI is merging with medicine, so breakthroughs will be exponential. You want to be as healthy as possible, and even if you have a disease, you want to slow it down, because new things will come up very quickly. We’re going to be able to try out a billion different solutions in one weekend, find one that works, and then test it on a million different humans in a matter of days, rather than years. Within seven years, we’re going to come up with things that will overcome disease very quickly.

This article was first published in the print edition of the February 2026 issue with the headline: “Forever Young?”

We were in the bland hinterlands of Greater Boston, skiing along the ho-hum Leo J. Martin Golf Course—otherwise known as the worst golf course in America. The traffic of I-95 hummed nearby; a passenger train clanged in the darkness. But my mind knew nothing of the setting, for I was at war.We clambered toward a narrow hairpin turn, four Lycra-clad cross-country ski racers so close I could see the dried white spittle on my competitor’s whiskery face. The pack constricted like water through a pinched hose. Then suddenly we were on a wider expanse of groomed trail, snow glimmering under the floodlights at the Weston Ski Track’s winterlong Tuesday Night Race Series (TNR), which has been around since the facility’s inception in the early 1980s, and I knew it was my moment to pass. I squeezed past the guy flagging before me, our ski poles clacking. Then I kept digging, hoping, a mile into this 3-mile Nordic race, to hang onto 12th place in a field of about 100 competitors spread between two waves.

The TNR Series is essentially a beer league, offering amateur skiers the same thrills and bare-knuckled rivalry that basketballers might find playing pickup at Peters Park. The series’ nine annual races, staged between January and March, are cumulatively scored, with everyone scrapping for age-group bragging rights. And they typically play out, thanks to climate change, on tight stripes of manmade snow—on snaking, polycone-lined courses that deliver what may be Nordic skiing’s closest approximation of stock-car racing. Still, a sporting bonhomie prevails. Passing people at Weston, I often get a kindly wheeze of solidarity: “Go for it, dude!”

Often, but not always. Now, in Race 9 of the 2025 season, the guy I’d passed shouted, “I’m going to fucking deck you after the race!”

I skied on, gratified that he was receding behind me, and I reflected on the absurdity of my quest: I am 60 years old, and even three decades ago, I never had the zip and power you’ll see on TV this month when the world’s best cross-country skiers—among them, Johannes Høsflot Klaebo of Norway and Julia Kern of Waltham—take to the snow at the 2026 Winter Olympics in Italy. Still, for me, Weston is the Olympics, for my AARP years have come with a swarm of anxieties. My career as a writer has not gone gangbusters. In my family life, there’s an estrangement so painful I cannot divulge the details. My late middle-aged campaign to find wholeness hinges in large part on skiing. Living in the sticks of New Hampshire, I ski daily in winter. I own 10 pairs of skis. I study technique videos on YouTube. I endeavor, with each race, to eke all I can out of my diminishing sinew.

I finished Race 9 in 10th place, and when my impassioned friend crossed the line 30 or so seconds later, he was yelling and jabbing his finger at me. I considered the possible headlines: “Man, 60, Mauled at Cross-Country Ski Race,” and then I drifted away to find safety in a crowd of recent finishers doubled over in the snow, catching their breath.

For years, I’d heard about the Weston Ski Track. Its habitués would show up at the races I do in northern New England, telling improbable tales of a ski venue whose only sizable hill—a 30-foot-high, skateboard-ramp-steep massif referred to as Mount Weston—was shaped by a bulldozer. I knew that the place had some claims to glory. Kern learned to ski there, taking to the snow as soon as she could walk and then improving so quickly that, by around age 12, she was mixing with grown men in the A Wave every Tuesday. Kern placed fifth in the sprint at last year’s World Ski Championships. “I credit a lot of my drafting tactics to those Tuesday Night Races,” she told me.

Still, I’ve always harbored a northerner’s snobbery toward podunk Weston, with its man-made snow and its rinky-dink hills. That changed only when I decided, early last January, to enter Weston’s Race 1. I found myself hooked by the urban vibe—the rush-hour jostling, and the way 100 skiers would crowd post-race into Weston’s barracks-like, concrete-walled golf shop to scarf down pizza and beer. Their voices formed a happy din; their sweat steamed the windows. I liked how there were skiers who’d recently relocated to Boston bearing the accents of the world’s chicest ski locales—Norway, Sweden, and Japan—and I liked how everyone found joy amid the industrial inflections of Weston’s orange polycones.

Soon, I developed a ritual. Traveling south to visit my partner, V, in Worcester each Tuesday, I’d detour to Weston to race. Each week, I’d arrive to find but a few stray novices poking around like lonely ants on the snow. But then, gradually, the TNR faithful would show up to glide along through their warm-ups. We’d strip off our jackets, and then we’d stand on the starting line, shivering in tights, to share an almost spiritual moment.

Since the early 1990s, the jefe of TNR has been Andy Milne, a retired high school teacher who says he’s witnessed, over his decades in the classroom, a sad decay of the American social fabric. “I used to see kids walking home from school in big groups,” Milne says. “Now they’re almost always alone.”

At the TNR starting line, Milne forces skiers to shake the hands of their competitors. He endeavors to salt the races’ cutthroat energy by telling a groan-worthy dad joke each week. (“What did the snowman say? I don’t know about you, but I smell carrots.”) In a booming, rasping, and slightly menacing exam proctor’s voice, he enunciates a distinct social code. “You are expected to talk to people when you are warming up,” he tells the assembled starters, “to congratulate the person in front of you and in back of you.”

There’s a bit of the tyrant about Milne, but his approach draws the multitudes. He says TNR attendance has increased fivefold under his long watch. Which, of course, makes the racecourse more crowded and the dogfight more intense. Moments after Milne’s weekly disquisition, almost inevitably, some chucklehead will eat it trying to make a dicey pass on the 180-degree turn 200 yards into the race.

The critical question at Weston, I learned, is: How and where to pass? On the turns? Hazardous. On the course’s short, gentle downhills? Not easy, because descent speed is dictated in large part by the type of wax under one’s skis, and my peers and I were equally waxed. On uphills? Yes, that does work, but being old—and thereby lacking in fast-twitch muscle fiber—I didn’t have a ton of game there.

I fared poorly in the first two races, finishing 15th, then 21st. Meanwhile, there was a frustrating inevitability at work: Seconds into each race, a clump of five or six twentysomething chums who’d connected while racing in college bolted out in front. Leading them, always, was James Kitch, recently an All-American at Harvard. Kitch is tall and ripped. In his resplendent white Harvard race suit, he seemed to occupy a caste of his own. Not far behind, always, was the Crimson’s assistant coach, 2022 Olympian Hannah Halvorsen. Her poles punched the snow with smooth, machine-like power and precision.

But every race was a new ball game. When the days were warm and the evenings cool, the slush froze, and the track was a skating rink, wicked fast, so that the leaders averaged more than 15 miles an hour. On cold days, Weston Ski Track made lots of snow, and we skied amid a slow, sticky powder reminiscent of confectionery sugar. As the snow guns opened up new terrain, more polycones appeared. The races grew to 4.02 miles and, eventually, 5.75 miles long.

Race 3 came after a blizzard. Weston was, for a few days, a paradise of soft, fluffy snow, so the Tuesday series time-traveled back to skiing’s roots. Almost invariably, Weston races see skiers invoking a fast, newfangled technique: Ski skating, invented in the 1980s, involves skiers pushing their legs to the side, as ice- and roller-skaters do. But skating through deep powder is laborious, so Race 3 was a “classic” race, with participants scissor-stepping their way along, just as Norwegian émigrés like Herman “Jackrabbit” Smith-Johannsen did when they brought skiing stateside in the late 19th century. I so wanted to be there, racing classic, but the snowy route south from my home was impassible, and I missed the season’s most magical night.

During Race 5, I embraced a new tactic: start as fast as you can and hang on.

During Race 5, I embraced a new tactic: Start as fast as you can and hang on. This actually worked. I’m an ornery old bastard, and midway, I found myself eerily all alone under the lights, way ahead of my old peers. There was a fiftysomething guy ahead of me, and the recent collegiate stars were roistering along, as always, in their own rarefied bubble ahead, but I’d arrived in a new land. All I saw before me was a thin white line of snow, spooling out into space like a rope, and it seemed that if I clung to that rope—if I thought of nothing else but clawing my way along it—all the troubles of the world would fall away and, for a moment at least, I’d glimpse bliss.

Could I have arrived in such a flow state skiing alone through the woods of New Hampshire? I don’t think so, for there was something communal about the moment: It sang because I was laboring with like-minded diehards, with some of the few people around who understand that our obscure sport is worthy of fanatical devotion.

I finished 12th that night (trust me, I am a student of results sheets) in a stacked field. In Worcester afterward, I was so ecstatic that V had no choice but to stay up late and listen as I told the unabridged tale of that evening’s journey, polycone by polycone.

In the next race, I finished ninth. It was becoming clear that I’d take the 60-plus men’s laurels for the season. Then came Race 9, during which I wriggled past bodily threat and managed to take a three-way finish-line sprint and crack the top 10 for a second time. Afterward, a friend emailed me, dropping the name of a young Weston racer who typically finished around eighth. Could I reel him in?

It seemed mathematically possible: Race 9 fell on March 4 with tons of snow still on the ground. Hopes for a rare Race 10 rippled through the TNR regulars, and as if to celebrate winter’s lingering bounties, one competitor, Will Meehan, cradled a can of craft IPA as he skied a few dawdling post-race laps. Later, on social media, he proclaimed, “If you aren’t doing the no pole, beer in hand, cool-down ski, why are you even here?”

Meehan, mid-20s, stocky and mustachioed, was my favorite among the series’ top dogs, for he brought a punk-rock insouciance to the proceedings. As I skied beside him after one race, he reveled in the cat-and-mouse game that played out among the leaders, and on the TNR email thread, he encouraged all of us to head north to Vermont for bizarre “Nordic Ski Cross” races featuring “jumps and downhill slalom turns, all on Nordic skis,” he wrote. “It is truly awesome.”

I was with Meehan in hoping that our weekly Weston bacchanal would play on forever—or into April, at least.

But winter is shorter and shorter these days, and in the week following Race 9, temperatures reached the mid-50s in Greater Boston. Race 10 became a costume party—an unscored tragicomedy that played out on tiny islands of melting snow. I skipped it, and now my Weston racing career is officially over. V is no longer in Worcester—she left the city this summer, and we now live together in New Hampshire’s Monadnock Region, where, inspired by those Tuesday nights, I just helped resurrect a moribund ski-race series: the Headlamp Hustle, held Thursday nights at the Dublin School.

Whenever a highlights reel of the TNR series plays in my mind, the racing action seems high octane—it’s as though the soundtrack should be AC/DC’s “Highway to Hell.” But then I see pictures of myself racing, and the story becomes more poignant. I see an old man, stiff and hunched, fighting to hang on.

I’m pretty sure that I was not the only TNR skier bringing my foibles to the starting line. None of us on hand, not even James Kitch, was a pro. No, we were all amateurs, and sometimes we stepped on each other’s skis. Sometimes we even yelled at one another. But we found connection under the lights. In the darkest season of the year, we shone brightly. We lived.

This article was first published in the print edition of the February 2026 issue with the headline: “The Other Winter Games.”

The Psychological Toll

Paying attention to what goes into your body is all well and good. But if you’re so fixated on optimizing every meal that you can’t enjoy your own birthday cake, things may have gone too far. “Being able to break the rules, on occasion, is just as important as following the rules,” says Ipsit Vahia, chief of the Division of Geriatric Psychiatry at McLean Hospital.

Don’t underestimate the power of a joyful life—or the toll of a rigid one. One 2020 study estimated that heavy stress can shave almost three years off your lifespan. On the flip side, mindfulness, specifically the ability to stay grounded in the present, may help promote healthy aging by reducing stress and anxiety, Vahia says. “There is a certain irony to being so preoccupied with staying healthy that you cannot live in the moment,” he says. “It increases the likelihood of the things you don’t want.”

And here’s the elephant in the room: No matter how carefully you optimize, you will not live forever. Accepting that is an important psychological milestone, Vahia says. And, as with most things in life, that wisdom tends to come with age. “You don’t hear a lot of older people talking about wanting to conquer death,” he says. “That talk is mostly the domain of people in their early or midlife.”

The Extreme Edge

For a certain subset of longevity warriors, NAD+ infusions and off-label rapamycin barely register as extreme. Boston-based concierge primary care physician Jay Luthar has heard it all. Some people are taking clandestine trips abroad for gene therapies unapproved in the United States, such as those meant to boost production of anti-aging proteins. Others are dropping thousands on off-label plasma-exchange therapy—a procedure where doctors remove your old blood plasma and replace it with fresh fluid, theoretically resetting your body to its youthful prime.

Risk-taking in pursuit of a longer life is nothing new. Just look to the human growth hormone (HGH) craze of the 1990s and early 2000s, says Thomas Perls, director of the New England Centenarian Study at Boston University. Even though HGH is illegal to prescribe off-label—and linked with increased risks of cancer, heart disease, diabetes, and other serious complications—that didn’t stop people from trying to get their fix.

The difference is that today’s biohackers have 24/7 access to the underbelly of the anti-aging world, thanks to the devices we’re all glued to constantly. A network of dubious telehealth clinics, compounding pharmacies, and direct-to-consumer websites makes it almost too easy to buy all kinds of alleged anti-aging therapies. Take peptides, a wide-ranging class of amino acids that includes synthetic hormones, GLP-1 drugs, and experimental compounds like epitalon. Many are not approved for medical use, yet “unfortunately, people are buying them online,” says Katherine Lantsman, a functional medicine doctor who practices in Brookline. Welcome to the DIY longevity underground.

It should go without saying that legit doctors discourage this kind of daredevil behavior. Luthar would much rather his patients stick to the evidence-backed basics, rather than go extreme. “Do they actually want longevity,” he wonders, “if they’re willing to take that level of risk with their current health?”

When It Gets Dangerous

Good luck getting proper treatment when your doctor hasn’t even heard of the pill you just swallowed. The risks of radical longevity seeking aren’t only theoretical for Matthew Mostofi, an emergency medicine doctor at Tufts Medical Center. In his ER, he’s seen the consequences firsthand. Patients have taken untested supplements, traveled outside the country for shady stem cell injections, and everything in between. “Oftentimes, since we don’t know a lot about it, we don’t have records, and it’s not approved, it’s hard to even research it, so we’re left just trying to figure it out,” he says.

As Mostofi sees it, there are far better ways to extend your lifespan and stay out of the ER. To start, wear your seatbelt.

This article was first published in the print edition of the February 2026 issue, as part of a package on longevity, with the headline: “The Immortality Trap.”

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The Longevity Craze

• What Actually Works
• Longevity Drugs: What Might Work
• Distinguishing Facts from Fiction
• Is Wellness Culture Ruining Social Fun?
• Boston Is Becoming the Next Leading Longevity Hub
• When Too Much ‘Healthy’ Is Bad: The Dark Side of Biohacking
• Boston’s Top Doctors 2026 List Is Here

This article was first published in the print edition of the February 2026 issue with the headline: “The Social Cost.”

What Actually Works

1. Going Back to Basics

“The four pillars of health are generally nutrition, exercise, sleep, and mental well-being,” says Lynne Ahn, an anti-aging and regenerative medicine specialist practicing in Wellesley. Nail those down, and you’ll be rewarded: Research has shown that people who adopt wellness practices like these may enjoy up to six extra disease-free years. Not flashy, but essential. Mom was right all along.

2. Quit Smoking. Drink Less (Or Not at All)

This one’s “critically important,” says JoAnn Manson, chief of the division of preventive medicine at Brigham and Women’s Hospital. Both smoking tobacco and drinking alcohol are strongly associated with higher risks of cancer and other life-threatening conditions, so it’s a no-brainer to lay off if your goal is getting to 100 candles.

3. Have a Smaller Piece of Cake

If you’re trying to live longer, “The biggest bang for the buck comes from maintaining a normal body mass index,” says Mark Benson, director of preventative cardiology at Beth Israel Deaconess Medical Center. There’s some debate among scientists about what constitutes an “ideal” BMI, or if that imperfect measurement should be used at all. But Benson says it still matters. A BMI under 25—the threshold at which someone is considered overweight—seems to be the sweet spot, he says, and large studies back that up. Translation: Keep the weight off, however you do it.

4. Statin Helps

Humble statins, the affordable cholesterol-lowering medications taken by millions of Americans, are longevity drugs. Taking them significantly slashes the risk of death, recent research studies have found. “Some will say, ‘Put statins in the water,’” says Pradeep Natarajan, director of preventive cardiology at Massachusetts General Hospital. Natarajan wouldn’t go quite that far. But for people with cardiovascular risk factors, they’re a slam dunk.

5. Go to the Doctor!

George Murphy does cutting-edge stem cell research as codirector of the Center for Regenerative Medicine at Boston University and Boston Medical Center. But his advice is rather simple: Show up for your annual physical. Vaccinations, routine physicals, and screenings may not be exciting, but they can be lifesaving. One striking example: From 1975 to 2020, better screening and prevention efforts averted more cancer deaths than treatments did. The unsexy stuff works.

6. Friends Have Benefits

Strong relationships predict longevity as powerfully as your genes or your bank account. In a famous 80-year-long study, researchers tracked a group of male Harvard students to see how their lives turned out. The healthiest, longest-lived subjects weren’t necessarily the richest or the most successful—they were the ones with close relationships. In other words: Your spouse matters more than your supplement stack. “That’s counter to the idea that longevity is all about biohacking yourself,” says Jay Luthar, a Boston-based concierge primary care doctor. “It’s really also about having happiness and a quality of life that’s meaningful and engaged.”

Longevity Drugs: What Might Work

Officially, most experts will tell you there’s no shortcut to longevity. Behind closed doors, though, you might get a slightly different answer. All over the city, devoted longevity seekers are quietly snagging prescriptions for off-label drugs, injecting peptides bought online, and trying not to age—that is, if they know who to ask.

GLP-1s
The Accidental Longevity Drug

What they are: Ultra-popular injectable weight-loss and type 2 diabetes drugs.

Why longevity fanatics want them: By now, everyone and their mother knows that drugs like Ozempic and Wegovy treat diabetes and help people shed pounds. But some in-the-know experts are also calling them the “first true longevity drugs” because they seem to also protect the heart, kidney, liver, and other organs.

Which docs will prescribe off-label: Endocrinologists for diabetes and obesity. But healthy-weight longevity seekers are increasingly asking their primary care providers for prescriptions—and finding mixed responses.

The evidence: The meds can spare people with obesity and diabetes from heart attacks, strokes, and other life-threatening conditions, major studies show. Regulators have approved them to treat some types of liver and kidney disease, too. And despite some disappointing results debunking the theory that they could help treat dementia, there’s strong evidence that they can help prevent it. More research is needed—but the accumulating evidence is strong enough that one expert called them “vitamin G.”

Metformin
The Old Standby with New Potential

What it is: A decades-old, inexpensive drug approved to treat type 2 diabetes.

Why longevity fanatics want it: Some studies suggest that taking metformin helps ward off diseases ranging from cancer to heart and liver disease—and, possibly, slows the process of aging itself.

Which docs will prescribe off-label: Some functional medicine doctors in private practice.

The evidence: Metformin is one of the most widely prescribed drugs in the United States, so while it can cause some GI side effects, doctors are pretty confident it’s safe. But will it add years to your life? The jury’s still out. The buzz about its (potentially) life-extending powers mostly comes from animal research or studies of diabetes patients taking the drug. Whether healthy adults without diabetes should be popping metformin to live longer, nobody knows for sure.

Rapamycin
The One That Makes Doctors Nervous

What it is: An immunosuppressant prescribed to organ transplant patients.

Why longevity fanatics want it: Certain animals, such as fruit flies and mice, have been shown to live longer when given rapamycin, seemingly because it targets a biological pathway involved in the aging process.

Which docs will prescribe off-label: Some integrative medicine doctors in private practice—though even they’re extremely cautious.

The evidence: The animal studies are interesting—and mounting, with researchers now dosing dogs—but don’t rush to your doctor yet. There’s no firm proof that rapamycin helps people live longer. Plus, the drug can cause a long list of side effects, including kidney injury, allergic reactions, and infections (yikes!). These drawbacks were enough to dissuade even the extreme bio-hacker Bryan Johnson, who infamously took rapamycin for almost five years but stopped in 2024. And if Johnson won’t take it, maybe you shouldn’t either.

NAD+ Supplements
The Medspa Gamble

What they are: Infusions or pills meant to boost levels of nicotinamide adenine dinucleotide (NAD+), a coenzyme found in every cell in the body.

Why longevity fanatics want them: NAD+ levels seem to decrease with age, and some think this drop contributes to age-related ailments such as metabolic disease and cognitive decline.

Where to get them: Many medspas and wellness clinics throughout the Back Bay, the Seaport, and other neighborhoods offer NAD+ injections, prescription-free. You can find oral supplements all over the internet.

The evidence: It’s possible to raise NAD+ levels through supplementation. But are those higher levels translating to any actual health benefits? Scientists don’t know. There’s not a ton of research on this topic, and what does exist isn’t all that promising. For now, excitement is far outpacing evidence—and your wallet is bearing the cost.

The Longevity Bubble: Fact or Fiction?

The anti-aging industry is a minefield of snake oil and pseudoscience. So we asked Boston’s top docs what’s real.

True or false: We can all live to 100 if we try hard enough.
False. Research on centenarians suggests reaching this milestone, and particularly getting past it, mostly comes down to a mix of good genes and good luck. So stop obsessing over your 100th birthday and focus on living well today—the longevity lottery doesn’t take tickets.

True or false: Red wine boosts longevity.
False. For years, you probably heard that moderate drinking is good for the heart. No longer. Recent research shows alcohol provides no health benefits—and even moderate drinking carries some risk.

True or false: You can biohack your way out of a bad diet.
False. For most people, eating better is the single best longevity hack, according to Dariush Mozaffarian, director of the Food Is Medicine Institute at Tufts University. In other words: more fresh produce, seeds, legumes, nuts, and whole grains; fewer sodas, processed meats, and packaged carbs. No amount of NAD+ will undo a rubbish diet.

True or false: You can  optimize your “biological age.”
False. While there are tons of tests that claim to tell you how old you are physiologically, rather than chronologically, there’s no universal consensus on the best way to measure biological age, what that information really means, and what to do about the results.

True or false: Vitamin supplements are a waste of money.
True. “For the vast majority of people, they don’t do anything,” Mozaffarian says. See a doc if you think you have an actual deficiency; otherwise, save your money.

True or false: Eating less might buy you more years.
Maybe. Research is ongoing, but some studies have found that restricting your daily calories—specifically, cutting back by about 25 percent—seems to slow the aging process in animals and possibly humans. But it’ll make you miserable, and the human evidence is still limited, so this is one to watch, not necessarily try.

True or false: Strength training is key as you age.
True. Muscle mass and grip strength are both strong longevity predictors. Translation: Pick up heavy things often. Women who lift and exercise regularly may be even more likely to see benefits than men who do the same, some research suggests. Either way: lift.