The desire to live longer and in good health has made popular technologies and practices that until yesterday were reserved for a few. From metabolic measurements to intravenous therapies, the market today offers “packages” accessible to everyone. However, an underlying problem emerges: people often look at price or fashion, ignoring that these practices, if performed outside a rigorous clinical context and without a thorough medical history and assessment, can be ineffective or, worse, risky.
“The fundamental point is not that longevity medicine — which is a serious and promising science — is dangerous in itself. The real risk lies in practices suggested without control, verification and personalization — explains Alberto Cerasari, Medical Director and clinical lead of the SoLongevity Clinic in Milan — That is why it is necessary to distinguish between simply purchasing a service and a genuine medical pathway”.
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Diagnostics: measuring does not mean knowing how to assess
A striking example concerns diagnostics, the starting point of every pathway. Today there is a great deal of talk about measuring VO2 max (the maximum amount of oxygen an individual can use during intense physical exercise), an excellent indicator of physical fitness and longevity potential.
“Many facilities offer this test as a simple number to obtain — Cerasari points out — In a specialized clinic, on the other hand, VO2 max measurement is part of a cardiopulmonary exercise test (CPET) with an electrocardiogram, performed by a physician. The difference is substantial: while a simple meter tells you how much oxygen you consume, the clinical test assesses how the heart and lungs react under stress. This makes it possible to detect arrhythmias or risks of ischemia that a fitness tracker or a non-medical test would never see. Discovering a silent heart problem while being monitored in a clinic is prevention and can save a life”. Fitness to push the body to its limits must be certified by a physician, especially at a time when cardiovascular diseases are on the rise.
The same applies to body composition analysis. Tools such as bioimpedance analysis, if not interpreted by a specialist, can provide distorted data because they are affected by a great many factors — such as hydration level, the hormonal cycle, diet or previous diseases — leading to wrong advice. In this case too, technology is useful only if there is a “clinical brain” guiding it.
Therapies: why the medical history is needed
“Speaking of therapeutic interventions — Cerasari continues — the risk increases when active technologies or substances are used without knowing the person’s medical history”.
Photobiomodulation and infrared therapy, for example, are often presented in non-specialized centers as harmless beauty treatments, and are offered to anyone. In reality, given their stimulatory effect on cells, they can have contraindications in people who are pregnant, have previous dermatological diseases or a history of cancer. “Stimulating cellular activity in a person who has an oncological risk or a suspicious skin lesion without a prior dermatological assessment is a gamble — the expert stresses — Once again we are saying that the technology is valid, but it needs the filter of a physician”.
Intravenous supplementation too, for example with NAD+, is a widely used method, but it is not trivial. While oral supplements are generally safe, intravenous administration is a medical procedure in every respect: it can cause overload of the circulatory system or the production of metabolites which, in some predisposed individuals, could increase cardiovascular risk. “Tachycardia, breathlessness or malaise during the infusion are signals that must be managed by trained healthcare staff — Cerasari reiterates — The same applies to oxygen-ozone therapy and to intermittent hypoxia/hyperoxia. These are not practices ‘for everyone’. They require prior checks and monitoring during administration because they deliberately put the body under stress. And one must know how to manage emergencies, however rare”.
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The most common mistake is buying standardized “longevity packages”. True longevity medicine is precision medicine: what serves one person could be useless or harmful for another. There is no one-size-fits-all protocol. “A serious pathway always begins with an initial check-up that assesses the overall state of health to rule out unnecessary therapies and focus only on those that are necessary — Cerasari continues — One must be wary of the term “anti-aging” used as a magic slogan. The real goal is to delay the onset of chronic diseases and optimize vital functions as age advances. To do so safely, technology is a valuable ally, but only if guided by the expert hand of a physician who knows, before the ‘trend’, the person in front of them”.
At the SoLongevity Clinic, our first-contact check-up, lasting about two hours with the Longevity Doctor for the initial medical history, offers an important first projection of the person’s state of health: a highly appreciated entry point that becomes for us the starting note for planning a pathway.
