Fight Aging!

It is perfectly possible to build a tremendously successful business while failing to deliver on any of the initial motivating goals and ideals. The modern "anti-aging" industry is a perfect example of this point, written thousands of times over in the careers of salespeople and founders. It began in earnest in the 1970s, a point in time when advocates for longevity science were a lot more optimistic, radically overoptimistic in fact, about what could be achieved in the near future. They built a supply pipeline for what they believed would come, but in the end, when the real thing never turned up, filled that pipeline with whatever junk happened to be available and would sell. Most of the original founders strongly believed in the declared goals of providing services that would extend healthy human life spans. Then they sold out. This is what happens when you build the supply chain in advance of the product.

Some of these folk are still very much believers, such as the principals at the Life Extension Foundation, an organization emblematic of the US supplement industry for the past four decades. They have over the years turned a portion of their profits towards real, meaningful research in cryonics and biotechnology, including SENS rejuvenation projects, far more money than I can claim to have helped raise. Nonetheless, the overwhelming majority of their activities lie in selling pills that have no real meaningful effect while loudly proclaiming the merits of those supplements - and the LEF is, I think, the best of that industry when it comes to the balance of ideals, meaningful action, and garbage. To my eyes when it comes to advocacy and obtaining support for rejuvenation research even enlightened "anti-aging" industry organizations like the LEF are probably doing more harm than good.

Yet this pipeline exists, and shows no signs of slowing down. At some point real therapies that address scientifically supported causes of aging will show up in the medical tourism pipeline, or as reapplications of existing widely available drugs, or something else that can be put out there by the existing infrastructure. These first treatments will no doubt be marginal, not very good at all in the grand scheme of things, but they will actually treat aging, and actually do some good. Think of the recent publication showing that a combination of existing drugs clears some portion of senescent cells in mice, for example. An organization outside the US could be selling that treatment today, and it is in effect a really terrible first pass at a SENS-like therapy that trims back one contributing cause of degenerative aging. But a really terrible first pass at a SENS-like therapy is already a league ahead of marginal scientific projects such as testing metformin in clinical trials and a whole different world from overhyped junk like resveratrol. It is step one on a road that actually goes somewhere.

The model for the way this will all unfold has already happened, and very recently too. If you want insight into the next fifteen years of treating aging outside the formalized mainstream of clinical trials, then look at the past fifteen years of applied stem cell research. A big melange of opportunists, entrepreneurs, rapid scientific progress, legitimate clinics, crooks, and the "anti-aging" market, all rolled into one and smeared out across half the world outside the US. At some point in the indefinite future I'm sure I'll be one of those folk out there buying treatments ahead of their availability in the US, sometime after the point at which the science, cost, and expected results make some kind of sense when balanced against the known gains of exercise and calorie restriction. We're not there yet, not by a good decade or more - probably more, frankly. But there will be a time when the "anti-aging" market stops being a bad joke and finally delivers on its original goal, set forty years back, after the good and the real chases out the bad and the fake.

Everyone makes their own calculations on these matters, of course, though I believe most of them are somewhat too eager to jump into the water now rather than supporting work on a pool that actually meets the minimal standards of usefulness. Being more skeptical than you feel you should be and more of a late adopter than you would like to be has many benefits.

Tomorrow's Anti-Aging Therapy, Available Today

For people who have a few hundred thousand dollars to spend and are willing to take on the risks of an "early adopter" and travel to South America, options are now becoming available that were inconceivable just a few years ago. This is a new vision for combining research with treatment, for treating diseases that have no proven therapies, and for aging itself.

You only have to read Time Magazine to notice that this is the year anti-aging medicine is coming of age. Promising life extension technologies are being debuted, with potential for preventing many diseases at once, adding decades to the human life span, and restoring youthful function to an aging body. These include telomerase therapies, stem cell therapies, epigenetic reprogramming, removal of senescent cells, plasma transfer, and hormonal therapies inspired by gene expression changes between young and old.

Inevitably, this has brought a surge in the number of companies eager to jump the gun and offer treatments to consumers based on early lab research, before the technology has proved safe and effective in humans. In an age of wildcat capitalism, we are well-advised to approach all claims with a skeptical eye, and assume that hucksterism is rampant. Anyone who considers signing on with a new company that is offering a promising but unproven anti-aging technology had best start with a foundation of second opinions and broad considerations of risk and rewards.

But I stop short of saying, "stay away". The field is too important, with too much at stake for us individually and as a human community, to sit on the sidelines, to wait for the research to be sorted out. Political control of medical research has protected us imperfectly, and has held back life-saving treatments, sometimes for decades. The system serves pharmaceutical profits more effectively than the public of medical consumers. Too often, the treatments that are approved are not those that offer the best risk/reward ratio, but those that are patentable and owned by someone who can afford to invest hundreds of millions of dollars in scientific advocacy.

The standard path to regulatory approval respects individual human life, and is "conservative" in the Hippocratic sense of "first do no harm". But it is far from the most effective way to move science forward, and probably is not the most efficient way to save the most lives, even in the short run. Many libertarians, anti-aging enthusiasts and ordinary citizens who find themselves with a condition for which there is currently no effective medical treatment want the freedom to participate in experimental medicine, and experimental medicine certainly wants to try to help them and to learn from successes and failures.

For people who see their options for an active and creative life being closed by age-related disabilities, for people who are willing to take personal risks to help move the science forward, for people who are bold and adventure-seeking, the choice to try experimental anti-aging technologies can be a rational decision.