Each clinic in the directory is scored 0–100 across four axes that, in our editorial view, decide whether the cheque is worth writing. The composite is a single number; the breakdown shows where it came from.
Each axis carries 25 points. The weighting is deliberate: we believe these four, in this balance, predict whether a patient is well-served better than any combination we have tried.
How comprehensive and clinically actionable is the workup? We look at: imaging (3T whole-body MRI is the bar), bloodwork (200+ markers with hormonal and inflammatory depth), functional testing (CPET-grade VO₂ max, lactate threshold, DEXA), continuous metabolic data (CGM ≥14 days), and emerging markers (epigenetic age, microbiome). Quantity matters less than the *clinical decisions the data enables*.
Is the practice MD-led? Are licensed physicians present at the workup, results review, and follow-up — or are coaches and consultants making the calls? Is there a named medical director, on-site or available, with documented training? Continuity care matters here too: the protocol the doctor designs must be the protocol the doctor reviews, not handed off to a sales-incentivised assistant.
Does the clinic profit from prescribing the treatments it diagnoses? A clinic that delivers both the problem (diagnostic findings) and the solution (in-house treatment programme) under one roof has a structural conflict of interest. The financial incentive is to find — and bill — protocol after protocol. We deduct points for this even when we like the practice. We add points for clinics that diagnose only, or that refer treatments out to clinicians they don't share revenue with.
Are treatments grounded in reasonable evidence — randomised trials, mechanistic plausibility, longitudinal observational data — or sold on storytelling? Experimental treatments are not disqualifying. Unlabelled experimental treatments are. A clinic that says "this is novel, the data is limited, here is what we know" earns full credit. A clinic that markets the same protocol as proven loses it.
A score is shorthand. The review is the work. Both should be read.
Defines the upper edge of the field on at least three axes. Recommended without qualification for the patient profile it suits.
Strong on every axis with a clear specialism. The patient knows what they're getting and gets it.
Worth considering for a specific question. Read the review for what to take and what to skip.
One or two axes drag the composite down. Often a structural conflict or thin evidence base.
We do not list clinics scoring below 55 in the directory. They are excluded, not displayed with a low score.
A floor exists before the score does. Clinics that do not meet these baseline criteria are not reviewed.
This is editorial journalism, not advisory work. We do not contact the clinics we review. We do not share scores ahead of publication. There is no right of reply. Every review is built from publicly available data, scored by algorithm against the four-axis rubric, and reviewed by an expert team — that is the only way the work stays unbiased.
Automated crawl of each clinic's public website, regulator records, professional registries, press disclosures, peer-reviewed literature and pricing pages. The full corpus underlying every score is verifiable from public sources.
A rules-based scoring engine maps the structured data onto the four axes — diagnostic depth, medical supervision, conflict freedom, evidence base — and produces a 0–25 score per axis from the underlying signal.
Physicians, longevity researchers and editors on our panel review each algorithmic score against the supporting evidence. Adjustments are documented; the final composite is published with the breakdown.
Treatments and diagnostics named on a clinic's public materials are cross-checked against peer-reviewed databases. The evidence-base score reflects what is published, not what is marketed.
Scores are not static. As clinics update their public data, as new literature emerges, as regulator records change, the scoring engine re-runs and the expert team revisits. Significant changes are dated on the profile.
We do not interview the clinics we review. We do not show them their scores before publication. Factual corrections from any reader — including the clinic itself — are accepted via the public correction channel and processed editorially.