1. Prioritize Problem Over Intervention
Before considering any medication or supplement, define the specific problem tightly with actionable metrics, thresholds, and timelines. This prevents vague goals from leading to ineffective or harmful interventions.
2. Define Problems Actionably
Reframe vague health goals like ‘more energy’ into measurable metrics (e.g., ApoB 130 to <60 in 6 months, sleep latency 60 mins to <10 mins in 2 months). This allows for objective measurement of success or failure.
3. Assess Counterfactual Consequences
Before starting an intervention, ask what happens if you do nothing; does the problem meaningfully increase risk, reduce quality of life, or create downstream consequences? This helps distinguish real problems from those that merely feel actionable, preventing false positives.
4. Classify Intervention’s Purpose
Categorize the intervention’s ‘job’ into disease treatment, symptom relief, risk reduction, or optimization, as each requires different evidence standards and risk tolerance. Applying the wrong standard can lead to poor decisions.
5. Approach Optimization with Skepticism
For ‘optimization’ interventions, maintain high skepticism, especially regarding safety, as these often start from a healthy baseline with small expected effects and mechanistic claims. This reduces the risk of self-deception due to the lack of objective measurement.
6. Longevity Interventions are Optimization
Understand that many ’longevity interventions’ are often speculative optimizations masquerading as risk reductions, borrowing language of prevention but lacking strong evidence. This distinction should increase your skepticism and lower your risk tolerance.
7. Demand High Evidence for Disease
For disease treatment, require strong evidence like hard outcome trials or well-validated surrogate endpoints, and be willing to accept more downside. This is because the underlying problem is serious, and the counterfactual of doing nothing is strong.
8. Require High Evidence for Risk
For interventions aimed at risk reduction, demand high evidence, typically hard outcomes or very validated surrogate markers (like ApoB). This is crucial because you are treating something a person cannot feel.
9. Prioritize Lived Benefit for Symptoms
When seeking symptom relief, prioritize whether you actually feel or function better, and be willing to tolerate placebo risk if the downside is low. However, remain aware of the placebo effect and unknown safety factors.