Glossary

We think of it as one of the foundations of a long life.

Why it works. Purpose gets you up, out and moving, keeps you among people, and softens stress: the same trouble weighs less when it serves something you care about. In large studies of older adults, those with the strongest sense of purpose had less than half the death rate of those with the weakest over the following years.

Two teachers, two views. For Ketut Arsana, purpose is the goal of the game: you put all your attention and energy into reaching it, and every problem on the way is a lesson. Srikumar Rao puts it more sharply: each day is your life in miniature, so you should be radiantly alive in it, at least for part of it.

Finding yours. Ask what you would do if nobody paid you, who needs you, and what you want to have given when you look back. It can change with the seasons of life; what matters is having one.

“What your purpose in your life. That I call it, what the goal in your life, that purpose. And then like you’re playing football, you need to find the goal.”

Ketut Arsana · Ubud, September 2023

“Purpose is not an extra. Purpose is a main concept on how you are preparing to get old for a long time.”

Felipe Salech · Santiago, April 2024

Some come from an ordinary blood test, like blood sugar, inflammation and cholesterol; some from your body, like grip strength and walking speed; some are newer, like the epigenetic clocks. None tells the whole story, so the trend over the years says more than any single result.

A plan you can keep for forty years beats a perfect one you drop after four months. Balance is part of the protocol.

What it means. Most of longevity medicine aims to keep you healthy until the end of a normal life. Radical life extension aims to move the end itself: not 85 good years but 120, 150 or more. The oldest person on record, Jeanne Calment, lived to 122; this field asks whether that has to be the limit.

The main roads. Gene therapy, which gives cells new or better-working genes. Partial reprogramming, which turns a cell’s age back without erasing what kind of cell it is. Replacing worn parts: organs grown in the lab, printed, or taken from pigs bred for the purpose. And, as a backup plan, cryonics: keeping the body or the brain at very low temperature in the hope that future medicine can repair it.

Where it stands. None of it has been shown to lengthen a human life yet. In mice, partial reprogramming has given sight back to old animals and helped mice with a premature-ageing disease live longer. Since 2024 surgeons have transplanted pig kidneys into living patients. The furthest-out part of the field is moving from the lab towards the clinic.

“The truth is, I don’t really know what’s gonna end up working. I’d say that there is stuff that sure seems like it absolutely could extend lifespan by 10, 20-ish, 30, I don’t even know, sort of years. We really don’t know.”

Dane Gobel · Washington, June 2024

“So CRISPR technologies and really radical interventions, would they perhaps extend our lifespan, the maximum lifespan? And maybe. I feel that could very well be possible according to our studies.”

Steve Horvath · Dublin, August 2023

On the Map it is the Bridge of Prevention, the golden thread through every other level.

Why it is king. Most of what ends lives early, heart disease, many cancers, type 2 diabetes, builds up quietly for years before it hurts. Found early, much of it can be treated or turned back; found late, medicine can often only slow it down. Prevention is the cheapest and kindest medicine there is.

From sick care to healthcare. Most health systems are paid to treat illness, not to keep people well, so they act when something breaks. Longevity medicine starts earlier: it measures how you are ageing, finds risks while they are small, and acts on them while there is still time. That is the change in the system we want to help bring about.

What you can do. Know your numbers: blood pressure, blood sugar, cholesterol, and the screenings for your age and family history. Add what fits you, like a full-body scan, your genome or the newer biomarkers. Then act on what you find, with a doctor you trust.

“I’m just trying to make things more rational rather than … chasing the horses after they’ve gotten out of the barn, the diseases. Well, let’s make the barn nicer and keep the horses in there. And we don’t have to chase anything.”

Dave Gobel · Washington, June 2024

“It’s very simple. If we can prevent you dying from cancer or heart disease, the two major causes of death, you will live much longer, healthier life.”

Craig Venter · San Diego, May 2024

“To really address poor health, move the whole model towards a much more preventative health paradigm.”

Tina Woods · Okinawa, October 2023

What Live Beyond is. It began as a quest: a father and his son, a year on the road, 39 countries and states, more than 100 scientists, doctors, healers and experts. From it come a film, Live Beyond: Father and Son on a Quest for Longevity, and a book, Live Beyond: How to Win Your Longevity Game, made to inspire the first 100 million people.

How it does advocacy. Inspiration first, then a place to go: this Hub, in six languages, with the experts in their own words, the Longevity Map and this Glossary. Next comes an app, Live Beyond Journey, for one minute a day. Our double promise: we empower people to live beyond, and we empower the field to grow.

What comes next. One new film or series every year, each for different people: longevity that starts before you are born, for parents; biohacking clubs around the world, for the young; the Longevity Games, where ten very different people work with fifteen experts for six months. Each one made to reach another 100 million people.

Where you come in. Learn it, live it and talk about it, with your family, your friends and your doctor. Ask for longevity medicine where you live. And join the Founding Circle to build the movement with us.

“I think we can hit LEV, as long as people demand access, can see themselves in the future, and wanna fund the technology.”

Liz Parrish · Dublin, August 2023

“It’s funny, the longevity field, even ten years ago, people would call it a backwater. … But it’s so much better now because we have so many more people that are interested. People like you that are trying to spread the word to the public.”

Brian Kennedy · Singapore, October 2023

How it works. Normally almost all the oxygen in your blood rides on red blood cells. In the chamber the pressure is raised to about twice the normal and you breathe pure oxygen, so oxygen also dissolves into the blood plasma, the way gas stays dissolved in a closed bottle. That extra oxygen reaches places where the circulation is poor, and the brief swings in oxygen tell the body to grow new small blood vessels.

What is known. It is standard medicine for divers with the bends, carbon monoxide poisoning and diabetic wounds. Professor Shai Efrati and his team at the Sagol Center for Hyperbaric Medicine in Israel have published trials in which a course of sessions improved brain function after stroke and brain injury, and eased symptoms in veterans with PTSD whom other treatments had not helped. A small study of theirs in older adults reported longer telomeres in blood cells after 60 sessions. Shai Efrati told Marek he sees it helping with depression as well.

Before you start. A full course is usually 40 to 60 sessions, which makes it costly. Your ears must be able to equalise, and some lung conditions and medicines rule it out, so it starts with a doctor.

“The studies we are seeing, for example, from Professor Efrati from Israel, are showing great results on post-traumatic stress disorder, also athletes, also people with dementia problems.”

Evelyne Bischof · Shanghai, December 2023

How it works. Inside each mitochondrion, the cell’s power plant, an enzyme called cytochrome c oxidase absorbs red and near-infrared light. The light frees it from nitric oxide that was slowing it down, so the cell makes more ATP, its energy, and sends out signals that calm inflammation and help repair. Scientists call it photobiomodulation.

Which light for what. People often say frequency; what the device lists is the wavelength, in nanometres. Red, 630 to 670: skin tone, fine lines, wound healing, hair. Near-infrared, 810 to 880: muscle recovery, joint pain, deeper tissue. Many panels combine both. Shorter blue light is used for acne, a different job.

What is known. The best evidence is for skin, hair loss, mouth sores during cancer treatment, and some pain. Claims beyond that run ahead of the trials. A few minutes at the right distance, several times a week, with your eyes protected.

“These protein complexes, they’re light receptors. Some of them are red light receptors, some of them are infrared, near-infrared, and one of them is a UV receptor.”

Olivia Lesslar · Singapore, February 2024

How it works. The chamber holds about 25 centimetres of water with several hundred kilos of Epsom salt dissolved in it, so dense that you float with no effort. Water and air are kept at skin temperature, about 35 degrees, and the closed lid shuts out all light and sound. With almost nothing coming in through the senses, the brain gets quiet and drifts towards the state between waking and sleep.

What it does. Small trials show lower stress, anxiety and muscle tension, and better mood and sleep, after even a single hour. Meditators use it because the mind settles fast; others for the altered states that come after a while. In Stealing Fire, Kotler and Wheal describe the Navy SEALs’ Mind Gym, where float tanks help operators reach deep focus, with language courses cut from six months to six weeks.

The first time. An hour is usual. Shower before, earplugs in, and keep the salt out of your eyes. Some people need two or three sessions before the mind lets go.

“Inside the float tank there’s about 10 inches of water, 800 pounds of Epsom salts, and the idea is you’re blocking all of your senses.”

Nadeem Jiwani · Markham, Canada, July 2024

How it works. At 80 to 100 degrees your skin heats up, your heart speeds up as in moderate exercise, and your blood vessels open. Cells answer the heat by making heat shock proteins, repair crews that refold damaged proteins (see Protein folding). Done often, this trains the blood vessels, lowers blood pressure and calms inflammation: in the same Finnish men, those who went most often had the lowest CRP, a blood marker of inflammation.

The numbers. The Kuopio study followed 2,315 middle-aged Finnish men for about 20 years. Compared with once a week, four to seven sessions went with 40% fewer deaths from any cause and about half the fatal heart disease. Later analyses of the same men found lower risks of dementia and stroke too. It shows a strong link, not proof: people who can sauna every day may differ in other ways.

Safely. Fifteen to twenty minutes, water before and after, no alcohol, and a doctor’s word first if your heart is not well. Cooling down, in a cold shower or a plunge, is part of the ritual.

How it works. Cold on the skin sets off a gasp, a racing heart and a flood of noradrenaline. Within a minute or two the body takes back control: breathing slows and the mind clears. Done regularly, the shock becomes smaller, and brown fat, which burns energy to make heat, becomes more active.

The tradition. Poles call winter swimmers morsy, walruses: groups walk into the sea or a hole in a frozen lake every Sunday of winter. Finns go from the sauna straight into the ice.

Safely. The first minute is the dangerous one, because of the gasp. Go in slowly, keep your head above water, never alone in open water, and come out before you shiver hard.

How it works. A pen or roller with fine needles makes thousands of channels a fraction of a millimetre deep. The skin treats them as wounds and closes them within hours, and over the following weeks it lays down new collagen and elastin. That is why results build slowly, over two or three months.

Paired with other things. The open channels let what is put on the skin reach deeper: hyaluronic acid, your own platelet-rich plasma, or exosomes. Radiofrequency microneedling adds heat at the needle tips for deeper tightening.

How it works. A fine needle, or a device with many needles, places tiny drops just under the surface across the face, neck or hands. Hyaluronic acid pulls in water and plumps the skin from within. Polynucleotides, purified fragments of DNA, are used to calm the skin and support repair.

Why exosomes. Exosomes are tiny bubbles that cells, above all stem cells, use to send instructions to other cells: make collagen, calm inflammation, repair. For the skin they are injected, or put on straight after microneedling or a laser so they reach deeper. A recent review of the human studies found fewer wrinkles, better hydration, a more even tone and more collagen. The studies are small and short and the products differ a lot, which is why none is an approved medicine yet, and why where they come from matters.

What to expect. Usually two or three sessions a few weeks apart, then a top-up every few months. Small bumps and bruises fade in days. Go to a doctor, not a beauty salon. The older umbrella, mesotherapy, injects all sorts of mixtures and has little evidence behind it.

Many work like microneedling, through a controlled micro-injury the skin repairs.

The main kinds. Ablative lasers remove a very thin top layer so fresh skin grows back. Fractional lasers treat thousands of tiny columns and leave the skin between them untouched, so healing is faster. Pigment lasers shatter dark spots into pieces the body clears away. Vascular lasers close small red vessels.

Afterwards. Redness for a few days, and sun protection for weeks, because new skin burns and darkens easily. Darker skin types need settings chosen with care.

How it works. Inside each bubble are messenger RNA, growth factors and signalling proteins. The receiving cell takes the bubble in and changes what it does: make collagen, calm down, repair. Amy Killen calls it a new instruction manual for your cells.

Where it is used. Skin and hair after microneedling or lasers, injections into tendons and knees, and drips for the whole body. Sandy Kaufmann has them every month.

Before you try them. No exosome product is an approved medicine yet, and products differ a lot, so ask where they come from, who made them and how they were tested.

“Your cells will engulf those EVs, and then that reprograms how your cells act. So it’s basically giving a new instruction manual to your cells.”

Amy Killen · Salt Lake City, May 2024

What Liz Parrish took. In 2015 she took two genes: telomerase, which lengthens the caps at the ends of the chromosomes, and follistatin, for muscle and insulin sensitivity. The next genes she talks about are klotho, whose activity falls predictably with age, and PGC-1α, which helps the mitochondria make energy.

Where it stands. Gene therapies are approved for a handful of rare inherited diseases caused by one faulty gene. Against ageing itself, no trial has been finished yet, so it stays experimental and is the one to watch most carefully for safety.

Where it comes from. In a soil sample from Easter Island, Rapa Nui, scientists found a bacterium that makes this molecule, and named it after the island.

How it works. Every cell has a switch, mTOR, that reads the food around it. When food is plenty, it says build: grow, divide, make protein. Rapamycin turns it down, and the cell switches to clean-up, called autophagy: it wraps old and broken parts in a bubble and recycles them. That is the same thing fasting does.

Where it stands. It extended life in yeast, worms, flies and mice, even when started late in life. The Dog Aging Project is testing it in pet dogs. In people, small trials of low weekly doses are looking at immunity, muscle and wellbeing. Side effects include mouth sores and, at higher doses, a weaker immune system, so it is for a doctor to prescribe.

How it works. Metformin makes the liver release less sugar and the body respond better to insulin, and it touches several hallmarks of ageing at once. Nir Barzilai stresses one more: it lowers growth hormone, which you need while you grow, not once the body starts breaking down. About 3 to 6% of people cannot tolerate it.

TAME. About 3,000 people aged 65 to 79, to see whether metformin delays heart disease, cancer, dementia and death all together. The FDA agreed the design in 2015. It still waits for funding, because nobody profits from a generic pill that costs cents. If it works, every longevity drug after it gets a path to approval.

How it works. After a meal your gut releases GLP-1 and GIP. They tell the pancreas to release insulin only when sugar is high, slow the stomach, and tell the brain you are full. The medicines copy these signals but last a week instead of minutes. Tirzepatide (Mounjaro) copies both; semaglutide copies GLP-1 only. Newer ones add a third hormone, glucagon.

More than weight. In large trials they cut heart attacks, strokes and kidney decline, and lowered CRP, a blood marker of inflammation. Large health-record studies linked them with less dementia and Parkinson’s, but in 2025 two big trials found semaglutide did not slow early Alzheimer’s, so the brain question is still open. They are also being studied for alcohol and other addictions.

Fertility. Doctors now talk about GLP-1 babies. Women with polycystic ovaries often start ovulating again as they lose weight, and in men, weight loss raises testosterone and can improve sperm. Two things to know: tirzepatide can make the contraceptive pill less reliable in the first weeks, and these medicines are stopped well before a planned pregnancy. Talk to your doctor.

The catch. Nausea is common at first. A good part of the weight lost can be muscle unless you lift and eat enough protein, and weight tends to come back when you stop.

“The first kind of longevity drug actually is probably something like Wegovy or Mounjaro, honestly.”

Dane Gobel · Washington, June 2024

Why it matters. The ovaries age two to five times faster than the rest of the body, and when they stop at menopause, estrogen, progesterone and much of a woman’s testosterone fall at once. Amy Killen calls the ovaries the pacekeepers of the body: once they go, blood vessels, bones, muscles and the brain age faster. In men testosterone falls slowly, about 1% a year from 35 or 40, faster in some.

What it does. In women who start near menopause, Amy Killen describes 30 to 50% less cardiovascular disease, less Alzheimer’s and vascular dementia, and 40 to 50% less osteoporosis, which matters because a broken hip in older age carries a one-in-four chance of dying within the year. In men who need it: more muscle, less visceral fat, lower heart risk. In 2023 the large TRAVERSE trial found that testosterone did not raise heart attacks or strokes in men with low levels.

The old fear. In 2002 the Women’s Health Initiative linked hormones to breast cancer, heart attacks and strokes. It used synthetic hormones, in women on average more than ten years past menopause. When hormones start early the picture is different: Amy Killen points to a meta-analysis of ten studies in which women on estrogen had 22% less breast cancer. In November 2025 the FDA removed the boxed warnings from menopause hormone therapy.

How it is done. Bioidentical hormones, the same molecules the body makes, as patches, gels, pills or injections, adjusted by blood tests, including free testosterone, not only total. Once testosterone is started, your own production stops, so it is for life. Younger men can sometimes raise their own with enclomiphene or HCG instead.

“The ovaries are like the pacekeepers of your body. They age about two to five times faster than other organs.”

Amy Killen · Salt Lake City, May 2024

Why the craze. Peptides are the body’s own messengers, short proteins that tell cells to heal, grow, burn fat or sleep. Social media sells them as shortcuts for injuries, muscle, skin and longevity, often from websites that label them for research only to stay outside the law.

Which are approved. Approved peptide medicines include insulin; semaglutide and tirzepatide (Mounjaro) for diabetes and weight; teriparatide for osteoporosis; tesamorelin, which makes the body release its own growth hormone and reduces deep belly fat; bremelanotide for low desire in women; and octreotide and leuprolide for hormone disorders. Thymosin alpha-1, which strengthens the immune system, is approved in more than 30 countries, though not in the US or the EU. BPC-157 is not an approved medicine. In 2026 an FDA advisory committee narrowly recommended letting pharmacies compound it; the FDA has not yet decided.

Why the maker matters. A peptide is a big, delicate molecule. As Avi Roy explains, the right order of amino acids is not enough: they must be joined and folded correctly, or the body absorbs them differently or they become something else (see Protein folding). When he had a grey-market peptide tested, the vials held little of the real thing. Buy only what a pharmaceutical-grade manufacturer made, through a doctor, with blood tests.

How it works. For a few hours the medicine loosens the brain’s usual patterns and quiets fear. In a safe room, with a therapist beside you, painful memories can be looked at without being overwhelmed, and new connections form. The brain stays more open to change for days or weeks after, and that is when integration happens.

Where it stands. MDMA-assisted therapy for PTSD reached late-stage trials; in 2024 the FDA asked for another trial before approving it. Psilocybin is in late-stage trials for depression. Since 2023 Australia has allowed specially authorised psychiatrists to prescribe both. Esketamine, a form of ketamine, is approved for depression that resists treatment.

“These medicine psychedelics are not a silver bullet. They’re not a panacea. It’s not just take the pill and everything’s better, or eat the mushroom and everything’s better.”

Nick Brüss · Palm Springs, May 2024

A feeling is felt where it sits in the body, given a shape or a colour, and allowed to stay until it settles.

Why the body. Stress and old pain live in the body too: in held breath, tight shoulders, a clenched stomach. Talk therapy can understand them. Somatic therapy also lets the body feel them and let go, so the nervous system can settle.

How a session works. First you talk: about you, your connection with your body, and an intention for the session. Then you move to the massage table, where the conversation goes on with touch and bodywork, and Mya breathes with you until your breath slows and you go deeper into the body. At the end she leaves you to rest alone, in silent integration, so you do not have to get on a bus the moment something has opened.

Why it is amazing. It is so simple, she says: we do everything with our body, yet in healing nobody asks how it feels. She sees being in contact with your body and mind as a freeway of extra years. The research is younger than for talk therapy but growing, especially for trauma.

“During my sessions, I combine breath, touch, bodywork, and traditional talk therapy.”

Mya Thieme · Formentera, August 2024

“We can already add so many years onto our lives just by doing that, just by being in contact with ourselves, with our body, with our mind. I think it’s like a freeway of extra years to your life.”

Mya Thieme · Formentera, August 2024