Protocol

At a glance

Philosophy

I treat health optimization as a portfolio problem under uncertainty. Each intervention has an expected benefit (measured in QALYs), a cost, and uncertainty about whether the observed effect is causal or confounded.

The framework: estimate each intervention's hazard ratio from literature, shrink it toward null by a tiered publication-bias correction (10% for preregistered RCTs with hard endpoints, 20–30% for standard RCTs and cohorts, 50% for supplement-industry RCTs, 70% for animal-only evidence), apply a Bayesian causal-fraction prior calibrated against observed RCT-vs-observational discrepancies, simulate 50,000 Monte Carlo samples through CDC life tables, and report the posterior hazard ratio the simulator actually applies — not the publication-bias-only HR.

Mechanism-cluster diminishing returns prevent correlated supplements from stacking additively. Anti-inflammatory polyphenols (curcumin, quercetin, apigenin, EGCG, luteolin, cocoa flavanols) share a cluster with within-cluster retention dropping fast past the first item; NAD+ precursors (NR, NMN) are tightened further; antioxidants, mitochondrial-support, and senolytics each have their own steep retention schedules. A portfolio-level QALY ceiling of 3 applies a concave saturation to the raw additive total so the stack can't claim multi-QALY gains that exceed primary-prevention CEA literature.

Key parameters: willingness-to-pay of $200K per QALY (with a sensitivity panel at $50K/$100K/$150K below), 40-year horizon, 3% cost discount, 3% QALY discount. Bundled products (Blueprint Essentials, Advanced Antioxidants, Longevity Mix) now carry an allocated per-ingredient cost so bundled items no longer free-ride on $/QALY.

I am not a doctor. I have no medical training. This is expected value reasoning applied to personal health decisions, not clinical guidance. Most of these effect sizes are small, uncertain, and could be entirely confounded.

Reference-case ground-up audit

This newer audit uses the US Second Panel-style 3% health and cost discounting path and item-by-item assumptions from the live protocol inventory. It is not yet a formal reference-case CUA: All 86 items now have explicit utility lineage or no direct-QOL overlay; 52 items still use disability-weight fallback lineage.

Ground-up full-state total: 0.1326 QALY (48.4 days). Additive standalone value 0.2465 QALY, shared stack adjustment -0.1139 QALY. Alignment: reference case discounting with fallback utility lineage.

Willingness-to-pay sensitivity

The same item simulations rerun at four cost-effectiveness thresholds. At $50K/QALY — the bar common in public healthcare systems — only the highest-conviction items survive. My personal WTP is $200K, higher than standard clinical CEA because the marginal dollar on health beats the marginal dollar on most other spending for me; but the frontier is what to look at for the robust core.

Core stack

The top 15 highest-conviction items I take daily, ranked by expected value. The posterior HR column is what the simulator actually applies after publication-bias and Bayesian confounding shrinkage — much weaker than the raw literature HR and the right column for comparing items.

Supplement schedule

Dose timing for supplements, prescriptions, and services. Food recipes are separated below so the stack stays distinct from meal prep.

Meal recipes

Food prep kept separate from the supplement stack. Nutty pudding amounts use the toggle for one serving, one 4-serving blender batch, or the 14-serving powder jar.

Exercise

Daily morning workout, typically strength and cardio combined, following Bryan Johnson's workout protocol. Consistency matters more than intensity — the goal is a sustainable daily habit, not periodic heroic sessions.

Full catalog

All 86 items evaluated, organized by category. Items marked "bundled" are included in Blueprint products below.

Blueprint bundles

I use Blueprint products for items where bundling is cheaper than buying individually. Each bundle contains multiple catalog items.

Portfolio optimization

The optimizer greedily adds items by marginal net value (QALY gain × $200K − cost), applying diminishing returns and a complexity penalty. It stops when the next item would have negative marginal value.

Result: 24 items selected, +439 expected days (1.2 years), $1,346/yr.

Sleep optimization

Sleep is the highest-leverage health behavior. I track it obsessively with two devices and have made several environmental interventions.

Devices

• Eight Sleep Pod 5 — bed temperature control, sleep scoring, HRV, respiratory rate, snoring detection, sleep stages
• Whoop MG — recovery score, strain, HRV, RHR, SPO2, sleep performance

Environmental interventions

• Hamvay-Lang PureDelight 800fp winter duvet ($885) — Bayesian analysis showed bed temperature has a +3.0 score/°C causal effect on Eight Sleep sleep score. The duvet raises bed temperature, improving sleep quality. Estimated 165-day payback period.
• Bed incline — Eight Sleep adjustable base, slight incline for reflux and breathing
• Nasal strips + Nasacort — first night with this combination: zero snoring (vs. 13.2 min/night average). The clearest win in the protocol.

Medications

• Trazodone 50mg — sleep maintenance. Whoop data confirms it wears off at 4-5 hours, leading to second-half fragmentation.
• Melatonin 300mcg — low-dose for sleep onset. Higher doses are not more effective.

Key findings

• Sleep duration is the #1 lever: +8.6 Whoop recovery points per hour
• Bedtime before 11pm yields a 13-point recovery advantage
• SPO2 drops below 95% on 36% of nights (flagged for apnea investigation)
• Disturbances trending up (+0.009/day, p<0.0001)

Tracking

I maintain a SQLite database of nightly health data with 12+ tables, synced from Eight Sleep and Whoop APIs. Metrics that actually influence decisions:

• Sleep score (Eight Sleep) — primary outcome for environmental experiments
• Recovery (Whoop) — composite of HRV, RHR, sleep quality; guides training intensity
• HRV — parasympathetic tone; trending metric for stress and recovery
• Snoring duration (Eight Sleep) — proxy for airway obstruction; guides nasal interventions
• SPO2 (Whoop) — blood oxygen; apnea screening metric

Most other metrics (strain, respiratory rate, sleep stages) I log but rarely act on directly.

What I'm investigating

• Sleep apnea — Bayesian estimate: 66% probability based on SPO2 patterns, snoring, and family history. Pending home sleep study. Treatment options: CPAP, Inspire nerve stimulator, Dayvigo (lemborexant).
• Rapamycin — strongest longevity candidate in the Rx list (ITP mice +26% lifespan). Requires physician willing to prescribe off-label. Immunosuppression concern.
• Semaglutide — SELECT trial HR 0.80 for MACE. High cost ($6K/yr) but enormous effect size. Watching for generic timeline.
• Lion's mane, cistanche — recently added to stack. Low evidence confidence but low cost.
• Trazodone alternatives — wears off at 4-5h. Evaluating lemborexant (Dayvigo) for better second-half sleep maintenance.

Methodology

This page is generated from the Optiqal Python package. The data pipeline:

1. Literature hazard ratios are entered into a structured catalog with uncertainty estimates, study-quality tiers, and confounding priors
2. Each HR is shrunk toward null by a tiered publication-bias correction: 10% for preregistered RCTs with hard endpoints, 20–30% for standard RCTs and cohorts, 50% for supplement-industry RCTs, 70% for animal-only evidence
3. A Beta-distributed confounding prior discounts the causal fraction (e.g., Beta(2.5, 4) means ~38% of the observed effect is believed causal for medical interventions, calibrated against observed RCT-vs-observational gaps)
4. 50,000 Monte Carlo simulations propagate uncertainty through CDC life tables for a 39-year-old male. The resulting posterior hazard ratio (what the simulator actually applies) is reported alongside the literature HR so readers can see the shrinkage that matters
5. Mechanism clusters (anti-inflammatory polyphenols, NAD+ precursors, antioxidants, mitochondrial-support, senolytics, neurotrophics, methylation-donors) apply within-cluster diminishing-returns schedules so correlated supplements don't stack additively
6. Expected days gained = mean QALY gain × 365.25
7. Greedy portfolio optimizer selects items by marginal net value; a portfolio-level QALY ceiling (3) applies a concave saturation to the additive total, bounded by primary-prevention CEA literature
8. Bundled products carry an allocated per-ingredient cost share so bundled items contribute to $/QALY accounting

Evidence confidence labels: high = strong causal prior + tight uncertainty; medium = moderate evidence or wider uncertainty; low = weak causal evidence, speculative.

Profile: 39yo male, BMI normal, never smoker. WTP $200,000/QALY, 40-year horizon, 3% QALY discount, 3% cost discount, 50,000 simulations. Saturated QALY total: 1.2016 (raw additive: 1.5352). Ground-up audit total: 0.1326 QALY (48.4 days).