What to Expect From a Longevity Doctor:
Before, During and After Your First Visit

A longevity consultation is different from a typical quick appointment. It starts with data about you, focuses on a few clear priorities rather than generic advice, and continues over time rather than ending after one visit. Knowing what to expect, and preparing well, helps you get the most from it. Before your visit, it helps to complete a health questionnaire, gather previous test results, list all your medicines and supplements, note your family history and, ideally, measure your blood pressure at home. Some preparation is simpler than people think: for a routine cholesterol test, fasting is usually not required, according to a European consensus statement, although a fasting blood sugar test needs at least eight hours without food. Other details matter: biotin supplements, found in many hair, skin and nail products, can cause incorrect results in some blood tests, so tell your doctor about everything you take. During the consultation, your doctor will review your history, examine you and choose the tests that make sense for you. Afterwards, you'll agree two or three priorities with clear targets over 3, 6 and 12 months, and track progress at follow-up visits. This article walks you through each step.

Key numbers

The longevity consultation at a glance

• 1. Before: complete a questionnaire, gather information and prepare for any tests.
• 2. During: a detailed review of your health, lifestyle and goals, an examination, and a plan for tests.
• 3. After: a results discussion, a personalised plan with clear priorities, and regular follow-up.

Before your visit: how to prepare

Complete a questionnaire. A structured questionnaire covering sleep, diet, activity, stress, mood and symptoms helps your doctor see the whole picture across the domains of longevity (see The 8 Domains of Longevity).

Gather your information:

• Previous test results: blood tests, scans, ECGs and reports from the past few years. Trends are more useful than single results.
• Medicines and supplements: a complete list, with doses. The US Food and Drug Administration warns that biotin, common in hair, skin and nail supplements, "can significantly interfere with certain lab tests and cause incorrect test results which may go undetected".
• Family history: heart disease, stroke, diabetes, cancer or dementia in parents, brothers and sisters, and the ages they were diagnosed.
• Your goals and concerns: what you want to improve, such as energy, weight, sleep, fitness or peace of mind about a family history.

Measure your blood pressure at home, if you can. The American Heart Association recommends avoiding caffeine, smoking and exercise for 30 minutes beforehand, emptying your bladder, sitting quietly for about five minutes with your back supported, feet flat and arm at heart level, and placing the cuff on a bare upper arm. Measuring twice in the morning and twice in the evening for a week gives a more reliable picture than a single clinic reading. Use a validated upper-arm monitor.

Blood tests: fasting or not? For a routine cholesterol test, fasting is generally not required: a 2016 consensus from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine recommended non-fasting testing as the standard, because differences are small. A fasting blood sugar test, however, requires no calorie intake for at least eight hours. Your doctor will tell you whether to fast, depending on which tests are ordered.

During your consultation

A longevity consultation typically includes:

• A detailed history: your health, symptoms, medicines, family history, lifestyle, sleep, stress and goals.
• Measurements and examination: blood pressure, weight, waist, body composition and, where appropriate, tests of strength and fitness (see Your Key Longevity Numbers).
• Choosing the right tests: tests are selected based on your age, risks and family history rather than a one-size-fits-all panel, avoiding unnecessary tests that can lead to false alarms (see Health Screening by Age).

After: your plan and follow-up

A results discussion. Your doctor explains what your results mean, how they fit together and where your biggest risks and opportunities lie.

A personalised plan, not generic advice. Rather than a long list of changes, a good plan focuses on two or three priorities with the biggest expected benefit, with realistic targets over 3, 6 and 12 months. For example: lowering blood pressure, building strength or improving sleep.

Ongoing tracking. Longevity medicine works best over time. Regular follow-up visits review what's working, what isn't and how to adjust the plan, using repeat measurements to track progress.

Recommendations by scenario

Practical notes

The best results come from preparation, honesty and follow-through. Share everything, including habits you'd rather not mention, because accurate information leads to a better plan. Expect to focus on a few priorities at a time and to review progress regularly. If something isn't working, say so: the plan should adapt to you. To get started, take our free 40-question longevity assessment, which scores you across all eight domains and gives you a personalised 90-day plan. Our Longevity Doctors can then build on your results in a full consultation (see What Is Longevity Medicine?).