Three principals. Six months. Three different regimens. The numbers are below.

Each subject is between 47 and 53. Each is paying out of pocket, between $38,000 and $94,000 per year. Each is sharing data with cè under the condition that they not be named.

Subject A. 47, male, 178 cm, 81 kg at start. Time-restricted feeding (8-hour window). Mediterranean-pattern diet, roughly 2,400 kcal. Resistance training four sessions weekly. Zone 2 cardio three sessions weekly. Creatine 7 g, omega-3 2 g, vitamin D 5,000 IU, ubiquinol 200 mg, methylene blue 10 mg weekly. Continuous glucose monitor since week two. Sleep tracked via Oura. Annual outlay: roughly $38,000.

Six months in. Resting heart rate 64 to 56 bpm. Sleep latency 21 to 14 minutes. HOMA-IR 1.8 to 1.4. ApoB 92 to 78 mg/dL. Bodyweight 81 to 78 kg. Body fat by DEXA 22 percent to 18 percent. Biological age (methylation panel, GrimAge 3) 49.2 to 46.8 years.

The cardiovascular markers are the reliable read. The biological-age estimate has the largest visible improvement and the largest measurement uncertainty.

Subject B. 53, female, on hormone replacement therapy since menopause. Adds rapamycin 6 mg weekly (off-label, prescribing physician based in Bangkok), metformin 500 mg twice daily, and plasma exchange every 16 weeks. The plasma exchange is the most resource-intensive intervention by some distance. Annual outlay: roughly $94,000, of which the plasma exchange accounts for $48,000.

Six months in. Rapamycin has produced no visible adverse events; the mouth ulcers most-reported in the published cohort have not appeared. Plasma exchange: subjective improvement in skin elasticity (subject’s report), fasting glucose 96 to 89 mg/dL, white-cell count stable. Biological age has not been re-measured since intake; the next panel is in week 28.

The plasma exchange interventions sit on Level 3 evidence at best, including a small recent observational study out of Stanford. Subject B is treating the protocol as an experiment and is aware of the evidence grade.

Subject C. 51, male, two prior cardiovascular events in the family line at younger ages. Conservative regimen by 2026 standards: no rapamycin, no plasma. Aggressive lipid management (PCSK9 inhibitor, high-intensity statin), strict aerobic protocol, peptide therapy via Bangkok clinic (BPC-157 for joint maintenance, no growth-hormone analogues). Annual outlay: roughly $52,000, dominated by the PCSK9 medication.

Six months in. ApoB 110 to 54 mg/dL. This is the largest single biomarker move across the three subjects. Lp(a) untreated and stable. Resting heart rate 71 to 62 bpm. Sleep largely unchanged.

Across the three. The cardiovascular markers move first and most reliably; ApoB is the cleanest single number to track. The biological-age estimates move, but at a magnitude smaller than the published longevity-clinic claims. The unconventional interventions (plasma exchange, off-label rapamycin) have produced no visible adverse events and have not yet produced data a cardiologist would change a prescription on.

cè will check in again at twelve months. Subject A is considering adding rapamycin. Subject B is considering reducing the plasma exchange cadence. Subject C plans no changes.

If you are running a similar regimen and willing to share data, please reach out.[^1]

[^1]: All three subjects gave informed consent for cè to publish their biomarker data in anonymised form. None has named the principal in this issue. The two clinicians involved (one in Singapore, one in Bangkok) have reviewed the relevant entries.