Longevity Medicine Example Patient Journeys

Longevity medicine membership – tier 3

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