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According to Microsoft, I’m either 46-years-old, 37-years-old, or 29-years-old. As a 31-year-old woman, that’s, ahem, less than ideal.
Microsoft offers a free application called How-Old.net that uses machine learning to analyze an uploaded photo with a face on it. The application then guesses how old the user is based on their uploaded face. Pulling my long hair up into a ponytail ages me by over a decade, and standing in natural lighting makes me appear younger than I actually am. This is all to say that even our smartest computers can’t tell how old we are based on our looks alone.
And also to say that if I’m serious about anti-aging, I need to wear my hair down and more makeup if I’m going to make it to 80.
The thing is, my chronological age, or how old I am based on the day I was born, isn’t something I have much control over. I—like many other spanners—am far more concerned with biological aging (sometimes called phenotypic aging). Human life extension is fundamentally concerned with how old we are on a molecular level—and how quickly we are aging and, consequentially, how long we might live.
The question is: how do we quantify our biological age? The answer is in our aging biomarkers. The top biological age tests specifically look at our DNA.
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How do the best biological age tests work?
Knowing your own genetic makeup is critical for longevity—after all, your DNA could reveal that you’re at a heightened risk for age-related diseases like Alzheimer’s or Parkinson’s. But your DNA can also expose the rate at which you’re aging through small attachments known as epigenetic markers.
Your DNA can’t change—think of it like the script of King Lear. No matter which playhouse you might watch the drama, the lines all remain uniform. However, the director, the actors, the stagehands—your epigenetics, to continue the metaphor—might change. If you eat poorly and exercise irregularly, your DNA’s performance might seem more akin to a high school production than a masterpiece produced by London’s Royal Shakespeare Company.
In other words, your surroundings and lifestyle choices—like whether you regularly get enough Vitamin D, eat a nutrient-rich diet, and get enough sleep and exercise—can influence your risk of developing diseases like Type II diabetes, heart disease, and cancer, depending on your genetic predisposition to the ailments. Your epigenetics alter your gene activity to be more or less susceptible to these aging factors based on your environment.
Unfortunately, every person is marching to an eventual encounter with an age-related disease should they not already have one yet. As you age, epigenetic changes accumulate throughout your body. Instead of celebrating annual birthdays as you chronologically age, your epigenetics produce markers, like rings on a tree, that inscribe your age on your DNA.
In 2011, Dr. Steve Horvath published his analysis of hundreds of these epigenetic markers (or “DNA methylation and demethylation”). He found enough patterns to develop an epigenetic “clock,” or an estimate of someone’s age solely based on epigenetic patterns. That number may be older or younger than your chronological age. If you’re 50 and your biological age test says you’re 55, you are aging quicker than other 50-year-olds. If your test says that you’re, instead, 45, you are aging slower than other 50-year-olds.
In a 2019 interview with Rhonda Patrick, Horvath notes that while some tissue, like a cancerous organ, may age faster than others, there’s a general consistency throughout the body for one’s biological age. At the time of that interview, he had not recorded anyone whose biological age is off by more than eight years relative to their chronological age.
There are several consumer-grade DNA-methylation clocks. There are also proteomic clocks that look at the protein composition in their subjects’ blood samples instead of epigenetic indicators. Other clocks, like glycomic clocks, aren’t widely available.
Why do biological age tests matter? What are their limitations?
A lifetime is far too long to learn about whether a lifespan intervention is actually working. Biological age tests provide benchmarks to inform individuals whether they should continue their current lifestyle or tweak it to decelerate aging.
Unfortunately, the clocks themselves have a built-in problem. The better they’re able to accurately detect chronological age—certainly a requirement for the clock to have any meaning—the less valuable they are for predicting biological age. Dr. Mitteldorf explains,
The biostatisticians who create these clocks are optimizing them to predict chronological age with higher and higher correlation coefficient r. But if they achieve a perfect score of r=1.00, the clock becomes useless. It cannot be used to tell a 60-year-old with the metabolism of a 70-year-old from another 60-year-old with the metabolism of a 50-year-old, because both will register 60 years on this ‘perfect’ clock.
In other words, the biological aging tests are not and can never be perfect. And until we know the exact causes of aging (a step beyond the hallmarks of aging), a clock is only as good as our own understanding of why we age and how we record that process. Scientists and consumer-focused companies are iteratively improving their biological age tests, but it’s worth noting that not all are peer-reviewed or independently evaluated. There are also significant differences in findings by gender, race, and ethnicity—for example, women tend to develop more diseases later in life than men, but they nevertheless tend to die later.
These nuanced differences from individual-to-individual highlight another problem with biological age tests: they’re great for looking at population-level trends, but they really aren’t able to tell how many years you have left to live. Your DNA methylation level might be similar to a group that statistically lives 3.5 years longer than others, but, as Dr. Horvath tells Wired, “It’s not the case we could nail down the date of death of an individual within plus or minus one year.”
What makes any of these tests valuable, as of today, is what the spanner does with the number.
How can a spanner make the most of a biological age test?
A biological age test is really only valuable if it’s measuring an intervention.
Or a new prescription for Metformin over the course of six months?
Or going from a vegan diet for longevity to a keto diet for the same, or switching from traditional weight training to HIIT workouts?
There’s no way to benchmark these interventions without some kind of standardized way of doing so.
So are paid biological age tests worth anything?
With all this in mind, I set out to find what the market had to offer directly to consumers. Which biological age tests are worth the time and the couple hundred dollars? Which tests don’t hold up?
Unfortunately… there isn’t much to fairly compare them by. Few companies offer an impressive security level for your health data (which we all may want, seeing as life insurance companies may start taking an interest in the results of these tests). Pricing—if available on their website—tends to vary more on what additional services the company offers, like coaching, than the raw epigenetic information these companies return to the user. The methylation analysis procedure for each business certainly differs, but not in a way that can be evaluated based on their marketing material.
In other words, each of these companies offer a whole lot of the same. And their advice hinges on the obvious: if you’re aging quicker than what you’d like, prioritize sleep, water, and a healthy diet, work out a heck of a lot more, don’t smoke, and stress a little bit less. Remember, the FDA has not approved any direct-to-consumer tests like biological age tests, so the findings can’t formally diagnose you with anything. Technically, the most medical advice these companies can give you is, “Go see a doctor.”
I won’t go as far to say that paid epigenetic tests are worthless—DNA methylation analysis is considered far more accurate for estimating one’s biological age than a blood test, and you can only get that kind of analysis with a lab.
The best biological age tests
Let’s take a brief look at what some of the leading top biological age test companies actually have to offer. All of these services suggest retesting every six months. Seeing as the companies are difficult to formally compare, I arranged them alphabetically and omitted tests that cost more than $500. (DoNotAge and BioViva would have otherwise made the list.)
2. EpiAging USA
EpiAging USA was founded by Dr. Moshe Szyf, who is most famous for his research on the effects of epigenetics on aging. The biological age test uses a saliva sample to evaluate its users’ cellular DNA. At $169, EpiAging’s kits are relatively inexpensive, and unlike other tests on this list, it’s HIPAA verified. Users get access to EpiAging’s Android and iOS apps, which provide little lifestyle nudges based on the results of the test.
Muhdo is based out of the UK but ships internationally. Their biological age test, DNA Transform, costs $249.99. The kit includes a comprehensive action plan based on your DNA results, including meal guides, supplement suggestions, and scores for eye, hearing, and memory ages. As a UK company, they offer a more comprehensive data retention policy that adheres to GDPR.
For $299, users can submit either a blood or urine sample for epigenetic feedback. myDNAge uses SWARM™ technology (Simplified Whole-panel Amplification Reaction Method) to evaluate the samples, a proprietary analysis method. Users get a single-page report back with their biological age, biological age relative to others their age, and biological age relative to the rest of the population. While myDNAge claims that they won’t give away information about your results, they do reserve the right to sell your personal identifying information to third parties.
For just $99, TruMe offers a zero bells-and-whistles DNA methylation test. The test was founded by Dr. Yelena Budovskaya. While the website claims that users will “receive personalized recommendations on how to improve or maintain your health,” there are no screenshots or examples of them doing so. There is no information available on your health data privacy. TruMe is the test that Ponce de Leon Health used to document the anti-aging effects of their supplement, Rejuvant Lifetabs.
What about blood-based biological tests?
DIY tests like Young.AI, ageless RX, and Michael Lustgarten’s spreadsheet (based on Morgan Levine’s phenotypic age calculator) might be more worth your while. That said, using these tools does ask a lot of a user. For example, my blood tests (CBC with differential, comprehensive metabolic panel, lipid panel, A1C, and vitamin B12 and folate) didn’t cover everything needed for Aging.Ai, which left me guessing on the remaining blank inputs (everything needed to be filled out to hit “enter”). Those guesses likely interfered with the final output—and wouldn’t be a good benchmark for future biological age tests.
Spanners without a PhD in biostatistics will have to rely on the functions built into the DIY biological age spreadsheets. Ultimately that’s not so different than sending your spit off to a company, but the scientific teams behind the lab work are likely more dedicated to keeping their algorithms up to date.
There are paid blood test services which we’ll dive into next week, like InsideTracker (used by and invested in by longevity expert David Sinclair) or LifeExtension.com’s blood tests, that do analyze your blood work for aging markers. I personally question whether their analyses are more thorough and insightful than getting blood work done through a doctor (and, with insurance, at a substantially reduced price). Users are paying for convenience above all else with these services.
Do you invest in biological age tests?
Tracking your epigenetic age isn’t cheap, but it may be well worth the insights if you’re actively engaging in anti-aging interventions. Have you tried any of the companies I listed above? Are you manually tracking your blood work—or paying a third party to do so? Why or why not?
Let us know in the comments!