Therapies & devices.Evidence in context.

Sold as an intravenous drip, an intramuscular shot, and orally

What it is

The body’s main intracellular antioxidant. Injected glutathione is cleared from plasma within minutes.

What it is sold for

Marketed for skin lightening, ‘detox’ and anti-ageing.

What the evidence shows

A 2018 dermatology review found the intravenous skin-lightening evidence rests on one study of doubtful design, with two small oral trials showing modest, reversible changes in tone. The Philippine regulator states no injectable glutathione is approved anywhere for skin lightening; India’s CDSCO issued a 2026 notice that cosmetics cannot be injected. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Approved, used off-label. Approved in a few countries for narrow hospital indications, such as an adjunct to cisplatin in the Philippines. Unapproved in the United States, where it is compounded from a Category 1 bulk substance; not approved for cosmetic use in India.

Anti-doping status, 2026 List

Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips.

What can go wrong

The Philippine advisory lists liver, kidney and nervous-system toxicity, Stevens–Johnson syndrome, and HIV and hepatitis from non-sterile injection. In 2019 the US FDA traced fever and hypotension in eight patients to glutathione compounded from supplement-grade powder.

What the practice does

The practice explains why the injected form does not reach the cells that make it. Skin questions go to a dermatologist; liver questions are read in the panel.

Sources: FDA Philippines — advisory 2019-182, unsafe use of glutathione as a skin-lightening agent · Glutathione for skin lightening: a regnant myth or evidence-based verity? (Dermatology Practical & Conceptual, 2018) · CDSCO public notice on injectable cosmetic procedures and glutathione drips (Medical Dialogues, May 2026) · US FDA — concerns with dietary-ingredient glutathione compounded into sterile injectables (2019)

Link to this entry

Sold as an intramuscular shot or intravenous additive; the studied form is oral

What it is

A fat-soluble electron carrier in the mitochondrial respiratory chain, made by the body, sold as a supplement, and now injected by some clinics as a compounded preparation.

What it is sold for

Marketed for energy, heart health, statin muscle pain and anti-ageing.

What the evidence shows

All human evidence is oral. NCCIH’s summary: heart-failure data inconclusive, evidence does not support CoQ10 for statin muscle symptoms, and a large NIH-funded trial found no benefit in early Parkinson’s disease. There is no controlled trial of an injected form for any indication. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Unapproved for the described use. US FDA compounding materials list CoQ10 as a bulk substance under evaluation. That listing is not drug approval or evidence for wellness injection.

Anti-doping status, 2026 List

Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips. CoQ10 is not on the List.

What can go wrong

Oral CoQ10 is well tolerated and may interact with warfarin and insulin. The injectable adds injection-site reactions, the emulsifier and sterility risks of compounded preparations, and no safety data.

What the practice does

Mitochondrial function is a training adaptation measured on the metabolic cart, not a molecule in a syringe. Statin symptoms and heart-failure questions go to the cardiologist.

Sources: NCCIH — coenzyme Q10 · US FDA — 503A bulk drug substances by category (May 2026) · USADA — IV infusions: explanatory note

Link to this entry

What it is

Retinyl palmitate injection is an approved medicine for vitamin A deficiency. Vitamin A is also listed in an ‘anti-ageing’ drip on an Indian menu.

What the evidence shows

The label calls it effective for vitamin A deficiency. NIH ODS states that frank vitamin A deficiency is rare in the United States. No trial of ‘anti-ageing’ use is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Approved, used off-label. Approved for treating vitamin A deficiency. Use in ‘anti-ageing’ drips is not the labelled use.

Anti-doping status, 2026 List

Not prohibited. Vitamin A is not named on the 2026 Prohibited List.

What can go wrong

The label reports anaphylactic shock and death with the intravenous route.

Sources: Aquasol A (retinyl palmitate injection), DailyMed label (Rising Pharma) · Vitamin A and carotenoids, fact sheet for health professionals (NIH Office of Dietary Supplements)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Sold as intravenous drips, single amino acids or blends

What it is

Amino acids that food supplies in grams every day, dissolved in saline. The same molecules are approved as parenteral nutrition for patients who cannot eat.

What it is sold for

Marketed for recovery, muscle, immunity, sleep and longevity.

What the evidence shows

Taurine extends lifespan in mice; a 2025 NIH study found blood taurine does not reliably fall with age in humans, monkeys or mice, and human lifespan benefit is not established. Glutamine builds muscle in burns and wasting disease and does nothing measurable for lean mass or strength in healthy trainees; the AIS places BCAAs in Group C. Arginine, glycine and lysine have no infusion trials in healthy people. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Unapproved for the described use. Clinical amino-acid products have parenteral-nutrition uses; that does not validate compounded wellness blends.

Anti-doping status, 2026 List

Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips. No amino acid is on the List.

What can go wrong

Osmotic and electrolyte errors from unlabelled mixes; raised ammonia with very high glutamine loads; the infection and endotoxin risks of compounded drips.

What the practice does

Protein is set by the day and the meal from body mass and the block; lean mass is measured on DXA. Amino acids arrive on a plate.

Sources: NIH — researchers conclude taurine unlikely to be a good ageing biomarker (2025) · Examine — glutamine · AIS Sports Supplement Framework — Group C · US FDA — compounding in medical offices and clinics under insanitary conditions (2021)

Link to this entry

Sold as a drip, as shots, and as nasal sprays

What it is

The coenzyme at the centre of energy metabolism and sirtuin signalling, which declines with age in some tissues. Oral NMN and NR are the same story by mouth.

What it is sold for

Marketed for anti-ageing, energy, cognition and ‘cellular repair’.

What the evidence shows

A 2026 narrative review found five human studies of intravenous NAD+, none placebo-controlled for efficacy; circulating NAD+ is broken down outside cells by CD38 before uptake. Oral precursors can raise blood NAD+; general longevity benefit is not established: an eight-trial meta-analysis found no effect on glucose, insulin, HbA1c or lipids. The review’s verdict: insufficient for routine clinical or wellness use. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Unapproved for the described use. The US FDA lists NAD as a compounding bulk substance under evaluation; this is not approval of a wellness infusion.

Anti-doping status, 2026 List

Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips. NAD+ is not listed; the drip as sold exceeds the M2.2 volume.

What can go wrong

Infusion reactions are the rule at faster rates: chest pressure, nausea, cramping and flushing. No long-term safety data.

What the practice does

The practice explains the difference between raising a blood marker and changing an outcome. Aerobic fitness is assessed with VO₂max, and informs individual training.

Sources: Narrative review of intravenous NAD+ and NAD+ precursors in wellness and translational medicine (Frontiers in Aging, 2026) · NMN and glucose and lipid metabolism: meta-analysis of eight RCTs (Current Diabetes Reports) · US FDA — 503A bulk drug substances by category (May 2026) · USADA — IV infusions: explanatory note

Link to this entry

Sold as an intravenous drip and oral drops

What it is

A synthetic dye and electron carrier, approved as an antidote for acquired methaemoglobinaemia, and a potent reversible inhibitor of monoamine oxidase A.

What it is sold for

Marketed for mitochondrial function, cognition, mood and anti-ageing.

What the evidence shows

For methaemoglobinaemia it is life-saving and well established. For the wellness claims there is no controlled trial of an infusion for cognition, ageing or fatigue in healthy people, and the approved label describes no such use. The mitochondrial mechanism is a laboratory finding. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Approved, used off-label. ProvayBlue was approved by the US FDA in 2016 for acquired methaemoglobinaemia; the injection is on India’s 2022 essential medicines list as a hospital antidote. Wellness use is off-label.

Anti-doping status, 2026 List

Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips. Methylene blue is not on the List.

What can go wrong

A boxed warning for serotonin syndrome, which can be fatal, with SSRIs, SNRIs, MAOIs, tricyclics, trazodone, buspirone, mirtazapine and opioids; the 2011 FDA communication asks that serotonergic drugs stop two weeks before elective use, five for fluoxetine. Contraindicated in G6PD deficiency because of haemolysis.

What the practice does

Every client is asked about antidepressants before any conversation about this molecule, because the interaction is the story. Cognitive concerns are measured and referred.

Sources: US FDA — drug safety communication: serious CNS reactions when methylene blue is given with certain psychiatric medications (2011) · US FDA label — ProvayBlue (methylene blue injection), 2024 revision · India — National List of Essential Medicines 2022 (CDSCO) · USADA — IV infusions: explanatory note

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Sold by a few clinics as an intravenous drip; the studied form is oral

What it is

A grape-skin polyphenol famous for sirtuin activation in yeast and a lifespan effect in obese mice that did not repeat in mice fed normally.

What it is sold for

Marketed for anti-ageing and heart health: ‘the red-wine effect’ without the wine.

What the evidence shows

Oral resveratrol is rapidly metabolised, reaches low blood levels, shows no clear dose–response and has improved glycaemic control only in type 2 diabetes; no anti-ageing effect has been shown in humans and no hard outcome has moved. The infusion has no human trial of any kind. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Unapproved for the described use. The US FDA lists resveratrol as a compounding bulk substance under evaluation; this is not approval of a wellness infusion.

Anti-doping status, 2026 List

Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips. Resveratrol is not on the List.

What can go wrong

Oral doses up to several grams cause mainly gastrointestinal upset. The infusion adds an undisclosed solvent or emulsifier and the sterility risks of compounded drips, with no safety data.

What the practice does

The practice explains why a marker moving in a dish is not an outcome. Cardiovascular risk is measured as ApoB, Lp(a), blood pressure, hs-CRP and VO₂max, and moved with training and composition.

Sources: Examine — resveratrol · US FDA — 503A bulk drug substances by category (May 2026) · USADA — IV infusions: explanatory note

Link to this entry

What it is

Selenium, or a zinc, copper, manganese and selenium mix, as injectable trace elements. The labelled use is parenteral nutrition; a US wellness menu lists ‘trace minerals’ as an add-on shot.

What the evidence shows

Labels name parenteral nutrition as the use. NIH ODS states that selenium deficiency is very rare in the United States and Canada, and that clinical evidence does not support selenium supplementation in replete individuals for reducing the risk of cognitive decline and dementia in older adults. No trial of wellness use is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Approved, used off-label. Labelled as a source of selenium (or of zinc, copper, manganese and selenium) for parenteral nutrition; the selenious acid label adds when oral or enteral nutrition is not possible, insufficient or contraindicated. A wellness add-on is not that use.

Anti-doping status, 2026 List

Check on Global DRO. The 2026 List volume rule (M2.2) applies to intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period. Check the product and volume of any selenium or trace-element injection on Global DRO.

What can go wrong

No adverse-effect data for wellness use of injected selenium or trace elements are cited here.

Sources: Selenious Acid Injection, DailyMed label (American Regent) · Selenium, fact sheet for health professionals (NIH Office of Dietary Supplements) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Sold as an intravenous infusion, and as joint, scalp or facial injections

What it is

Nanometre-scale vesicles shed by cells, carrying proteins and RNA between them. Commercial products are harvested from cultured donor cells and rarely characterised.

What it is sold for

Marketed for anti-ageing, hair, skin, joints and autism.

What the evidence shows

The cited FDA alerts do not support exosome products for wellness use; US approval and evidence for a specific product must be checked. The US FDA’s 2019 safety notification followed serious adverse events in Nebraska patients given unapproved exosome products, and its 2024 consumer alert repeats that none is approved. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Unapproved for the described use. Regulated in the United States as drugs and biological products requiring premarket approval, which none has. Not approved in India or Europe.

Anti-doping status, 2026 List

Check on Global DRO. USADA: mostly not prohibited, unless red cells are reinfused (M1), growth factors or hormones are added (S2.3), or the product could enhance performance. Not named on the 2026 List; M3.2 now covers cell components, and whether vesicles are caught is unsettled. Verify on Global DRO.

What can go wrong

Serious adverse events in the Nebraska cluster; infection and immune reactions from uncharacterised donor material; no data on tumour promotion. The dose of vesicles, if any, is unknown.

What the practice does

A product with no approval and no trial cannot be graded above D. Joints go to a sports physician with imaging; skin and hair to a dermatologist. A tested athlete gets the national agency’s written answer first.

Sources: US FDA — public safety notification on exosome products (2019) · US FDA — consumer alert on regenerative medicine products including stem cells and exosomes · USADA — what athletes need to know about exosomes · WADA 2026 Prohibited List (copy published by CONMEBOL)

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Given through a fibre-optic catheter placed in a vein

What it is

A low-power laser shone into flowing blood through a cannula, developed in the Soviet Union in the 1980s.

What it is sold for

Marketed for immunity, energy, chronic pain, ‘blood cleansing’ and anti-ageing.

What the evidence shows

A 2025 systematic review found studies across musculoskeletal, respiratory, cardiovascular and neurological conditions reporting benefits for pain and sleep, and summarised the field’s weakness as small samples, no large randomised trials and non-standardised dosing. No trial has tested the device in healthy people. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Device. A hardware safety mark is not evidence of clinical benefit. Regulatory clearance and the intended use require a product-specific check.

Anti-doping status, 2026 List

Check on Global DRO. Not named on the List. M1.3 prohibits any form of intravascular manipulation of the blood by physical or chemical means, and a laser fibre in a vein is a physical intervention on flowing blood; whether it is caught has not been ruled on publicly. Verify on Global DRO.

What can go wrong

A cannula in a vein for an hour brings phlebitis and infection; the laser adds eye hazard, and the risks of a procedure done outside a hospital.

What the practice does

Oxygen delivery is measured as VO₂max and haemoglobin; immune questions go to a physician and chronic pain to a sports physician. Blood is not a surface to be polished.

Sources: Clinical applications and molecular mechanisms of intravenous laser blood irradiation: a systematic review (Lasers in Medical Science, 2025) · WADA 2026 Prohibited List (copy published by CONMEBOL) · USADA — IV infusions: explanatory note

Link to this entry

Sold as intravenous infusions, joint injections and intrathecal procedures

What it is

Cells able to divide and differentiate, harvested from the client’s fat or marrow or from donor cord tissue, and injected on the promise of regeneration.

What it is sold for

Marketed for arthritis, tendon injury, anti-ageing and autism.

What the evidence shows

FDA approvals are limited to specific products and conditions; they include Ryoncil, a bone-marrow-derived cell therapy for a particular graft-versus-host disease indication. These approvals do not establish benefit for wellness, physique or longevity use. FDA product record. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Unapproved for the described use. Unapproved for every condition sold in wellness clinics. India’s 2017 ICMR–DBT guidelines permit haematopoietic transplantation for approved blood disorders and treat every other use as investigational: no administration outside a registered trial.

Anti-doping status, 2026 List

Check on Global DRO. M3.2 prohibits normal or genetically modified cells with the potential to enhance performance, and the 2026 List added cell components such as mitochondria. USADA permits an autologous, minimally manipulated, same-procedure product with nothing added. Verify with the national agency.

What can go wrong

The FDA has documented blindness after eye injections and a tumour after spinal-cord injection; bloodstream infections from contaminated products; cells migrating to unintended sites; failure at high cost.

What the practice does

The practice explains what a cell product is and what approval means, and refers joint and tendon problems to a sports physician with imaging. Strength, lean mass and asymmetry are measured and trained.

Sources: US FDA — important patient and consumer information about regenerative medicine therapies (approved products; blindness, tumour and infection reports) · USADA — what athletes need to know about stem-cell therapies · India bans commercial use of stem cells for therapy (Nature India, 2017, on the ICMR–DBT guidelines) · WADA 2026 Prohibited List (copy published by CONMEBOL)

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A cosmetic ingredient in creams and serums; also sold as a subcutaneous injection

What it is

A naturally occurring tripeptide that binds copper, found in plasma at levels that fall with age. Topical and injectable products are different propositions.

What it is sold for

Marketed topically for wrinkles and hair, and by injection for ‘whole-body regeneration’ and ‘resetting gene expression’.

What the evidence shows

Topical: several small manufacturer-linked trials (for example 71 women using a facial cream for 12 weeks) report improved skin density, elasticity and fine lines; the effect is modest and cosmetic. Injectable: the 2018 review by the peptide’s discoverer cites only animal studies for systemic use and no human data at all. The gene-expression claims come from computational profiling of gene data, not from people. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Unapproved for the described use. Permitted as a cosmetic ingredient; never approved as a medicine anywhere. The US compounding nomination for injectable GHK-Cu was withdrawn after the FDA cited immunogenicity risk and limited human safety data. Not approved as a drug in India.

Anti-doping status, 2026 List

Check on Global DRO. Not named on the 2026 List. Injectable GHK-Cu has no drug approval anywhere, so the S0 definition would cover it at all times; topical cosmetic use is a different question. No agency has published a ruling; verify on Global DRO.

What can go wrong

Topically, mild irritation; by injection, unknown systemic effects, copper load, immunogenicity and unregulated product quality.

What the practice does

Explained in two halves: a reasonable cosmetic and an unstudied injection. Skin questions go to a dermatologist. For a tested athlete the injectable subject is closed.

Sources: Pickart et al., IJMS 2018 — regenerative and protective actions of the GHK-Cu peptide (review by the discoverer’s group) · US FDA — bulk drug substances that may present significant safety risks in compounding (Category 2 and withdrawn nominations; updated 22 April 2026) · 2026 Prohibited List, full text (VADA copy of the WADA List in force from 1 January 2026)

Link to this entry

What it is

Teriparatide is a fragment of human parathyroid hormone given by injection to build bone in osteoporosis. Abaloparatide is a parathyroid-hormone-related peptide analogue for osteoporosis.

What the evidence shows

Teriparatide is an approved bone-building medicine and abaloparatide is approved for postmenopausal osteoporosis; trial details are not summarised here. No evidence for tissue-repair or anti-ageing claims in healthy people is cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. EU: Forsteo authorised 10 June 2003 for osteoporosis in postmenopausal women and in men at increased risk of fracture; Eladynos authorised 12 December 2022 for postmenopausal osteoporosis. FDA approved Tymlos on 28 April 2017.

Anti-doping status, 2026 List

Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.

What can go wrong

No safety data are cited here.

Sources: Forsteo EPAR summary, EMA · Drugs@FDA overview, NDA 208743 (Tymlos) · Eladynos EPAR summary, EMA

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A prescription GLP-1 receptor agonist used in type 2 diabetes.

Evidence and limits

Its glucose-control evidence supports a defined medical indication, not a performance or longevity claim.

Regulatory context

Byetta has a US-approved indication for adults with type 2 diabetes. Approval is product- and country-specific.

Sport status

Check the exact prescription and current anti-doping status with the appropriate authority.

Safety context

The medicine has gastrointestinal, pancreatic, kidney and other label warnings; the prescriber assesses suitability and interactions.

Coaching boundary

Explain the evidence and refer clinical questions to the physician. No prescribing, recommending or sourcing.

Sources: Current Byetta label · WADA 2026 List

Link to this entry · Research note reviewed 29 September 2026. Approval and sport status are specific to the exact substance and formulation.

A prescription once-weekly subcutaneous injection (Ozempic, Wegovy) or daily tablet (Rybelsus)

What it is

A long-acting GLP-1 receptor agonist that slows gastric emptying, reduces appetite and improves insulin secretion; the most studied of the new obesity medicines.

What it is sold for

Misused as an effortless fat-loss tool for people without obesity, and sold for ‘physique’.

What the evidence shows

In STEP 1, adults with obesity lost about 15% of body weight over 68 weeks against 2% on placebo; in SELECT, more than 17,600 adults with cardiovascular disease and overweight had fewer cardiovascular deaths, heart attacks and strokes (6.5% versus 8%). Part of the weight lost is lean mass; no trial supports use in lean people. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Approved medicine. Approved in the EU (Wegovy, January 2022), the US and India for type 2 diabetes and weight management above defined BMI thresholds, and in the US for cardiovascular risk reduction; Indian generics were approved from late 2025. Prescription-only.

Anti-doping status, 2026 List

Monitored, not prohibited. Not prohibited. Markers of semaglutide are on WADA’s Monitoring Program in and out of competition; no TUE is needed.

What can go wrong

Nausea, vomiting, diarrhoea, constipation and abdominal pain are common; pancreatitis, gallbladder disease, kidney injury, hypoglycaemia with insulin, a boxed warning for thyroid C-cell tumours, and a very rare optic-nerve condition (NAION) confirmed by the EMA in 2025; lean-mass loss.

What the practice does

A physician’s decision, never the practice’s. Where prescribed, the practice defends lean mass with resistance training and protein, reads the DXA every twelve weeks and keeps the prescriber informed.

Sources: European Medicines Agency — Wegovy (semaglutide) EPAR: indication, STEP trials, NAION update · US FDA, March 2024 — Wegovy approved to reduce cardiovascular risk (SELECT) · USADA — GLP-1 medicines are not prohibited; what WADA is monitoring · Business Standard, January 2026 — first wave of generic semaglutide approvals in India

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A prescription once-weekly subcutaneous injection (pens; single-dose vials in India)

What it is

A dual GIP and GLP-1 receptor agonist, approved as a prescription medicine for type 2 diabetes and weight management.

What it is sold for

Sold on as the ‘stronger Ozempic’ for rapid fat loss in anyone, including lean people chasing a stage look.

What the evidence shows

In SURMOUNT-1, adults with obesity lost at least 15% of body weight on average over 72 weeks against about 3% on placebo, and more than 85% lost 5% or more; the SURPASS trials cut HbA1c by two to two-and-a-half percentage points in type 2 diabetes. The weight lost includes lean mass. Nothing supports use in people who are already lean. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Approved medicine. Approved in the EU (Mounjaro, September 2022), the US (Mounjaro; Zepbound for weight management and obstructive sleep apnoea) and India, where the CDSCO approved it and Eli Lilly launched single-dose vials in March 2025. Prescription-only.

Anti-doping status, 2026 List

Monitored, not prohibited. Not prohibited. Markers of tirzepatide joined WADA’s Monitoring Program from 1 January 2026, alongside semaglutide, in and out of competition; no TUE is needed.

What can go wrong

Nausea, vomiting, diarrhoea, constipation and abdominal pain; hypoglycaemia with insulin or sulfonylureas; the GLP-1 class warnings on pancreatitis, gallbladder disease and thyroid C-cell tumours; lean-mass loss; counterfeit vials and compounded copies of unverified content.

What the practice does

A physician’s decision. Where prescribed, the practice programmes resistance training and protein to defend lean mass, reads the DXA every twelve weeks and keeps the prescriber informed with consent.

Sources: European Medicines Agency — Mounjaro (tirzepatide) EPAR: indications, SURMOUNT-1 and SURPASS results · USADA — GLP-1 medicines are not prohibited; what WADA is monitoring · NADA Germany — WADA publishes the 2026 Prohibited List (Monitoring Program note on semaglutide and tirzepatide) · Gulf News, March 2025 — Eli Lilly launches Mounjaro in India after CDSCO approval

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A prescription once-daily subcutaneous injection

What it is

The first long-acting GLP-1 receptor agonist, given daily; the older and weaker relative of semaglutide.

What it is sold for

Sold as a cheaper ‘weight-loss pen’ now that copies are appearing.

What the evidence shows

In the SCALE programme summarised by the EMA, adults on the maximum weight-management dose lost 7.5% of body weight against 2.3% on placebo, and 43% of adolescents reduced BMI by 5% or more against 19%. As Victoza it reduces cardiovascular events in type 2 diabetes at high risk. It is outperformed by semaglutide and tirzepatide in head-to-head and cross-trial terms. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Approved medicine. Approved in the EU (Saxenda since March 2015; Victoza earlier) and the US for type 2 diabetes and for weight management above defined BMI thresholds in adults and adolescents from 12 years (in the EU also children from six). Prescription-only.

Anti-doping status, 2026 List

Not prohibited. Not prohibited and not named on the 2026 Monitoring Program, which lists markers of semaglutide and tirzepatide only. No TUE is needed; declare it on the doping-control form.

What can go wrong

Nausea, vomiting, diarrhoea and constipation are very common; gallbladder disease, pancreatitis and the class warning on thyroid C-cell tumours; hypoglycaemia with insulin or sulfonylureas; lean-mass loss with the weight.

What the practice does

A physician’s decision. The practice’s job around it is lean mass, training and a DXA every twelve weeks, with the prescriber informed with consent.

Sources: European Medicines Agency — Saxenda (liraglutide) EPAR · USADA — GLP-1 medicines are not prohibited; what WADA is monitoring · Athletics Integrity Unit — understanding the Prohibited List and the 2026 Monitoring Program

Link to this entry

What it is

Dulaglutide and lixisenatide are GLP-1 receptor agonists for type 2 diabetes. Pramlintide is an amylin-analogue peptide used with insulin in diabetes.

What the evidence shows

Dulaglutide and lixisenatide were approved for type 2 diabetes, and pramlintide for types 1 and 2. Trial details are not summarised here. The EMA page for dulaglutide does not cover weight management. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. EU: dulaglutide authorised 21 November 2014 for insufficiently controlled type 2 diabetes. Lixisenatide’s EU authorisation (31 January 2013) was withdrawn on 18 December 2025 at the holder’s request for commercial reasons. FDA approved pramlintide on 16 March 2005; its formulations are listed as discontinued.

Anti-doping status, 2026 List

Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO. The 2026 Monitoring Program names semaglutide and tirzepatide markers, not these medicines.

What can go wrong

No safety data are cited here. Lixisenatide’s EU authorisation was withdrawn at the holder’s request for commercial reasons.

Sources: Trulicity EPAR summary, EMA · Lyxumia EPAR page, EMA · Drugs@FDA overview, NDA 021332 (Symlin)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

An oral GLP-1 receptor agonist (brand name Foundayo) approved for weight management. Described as a small molecule rather than a peptide.

What the evidence shows

FDA approved it on 1 April 2026 for chronic weight management in adults. That approval is the human evidence cited here; the pivotal trial data are not summarised. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Approved medicine. FDA novel drug approval on 1 April 2026 (Foundayo) to reduce excess body weight and maintain weight reduction long term in adults with obesity, or overweight with a weight-related condition.

Anti-doping status, 2026 List

Check on Global DRO. Orforglipron is not named in the 2026 Prohibited List text reviewed. The 2026 Monitoring Program names semaglutide and tirzepatide markers, not this medicine. Status can depend on route, volume or formulation, so check Global DRO.

What can go wrong

No safety data are cited here.

Sources: FDA Novel Drug Approvals for 2026 (last updated 09/28/2026) · NADA Germany: WADA publishes Prohibited List 2026

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A compound described in trial reports as a triple monoamine reuptake inhibitor, with weight-reducing effects in obese patients. Developed as a weight-loss drug; marketed online as a dietary supplement promoted for weight management and metabolic enhancement.

What the evidence shows

A phase II randomised, double-blind, placebo-controlled trial in 203 obese patients was reported in The Lancet in 2008; a 2013 Lancet expression of concern about that report is also on record. A 2022 randomised trial of tesofensine with metoprolol in 21 adults with hypothalamic obesity had safety as its primary endpoint. The weight-loss results of both trials are not cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

In trials, not approved. It is investigational, and no approval as a medicine was verified. A 2026 peer-reviewed abstract describes it as still under regulatory review and says it has been marketed online as a dietary supplement.

Anti-doping status, 2026 List

Check on Global DRO. Tesofensine is named on the 2026 Prohibited List under S6.B, specified stimulants, and is prohibited in-competition only. The exact product, route, volume or formulation must be checked on Global DRO.

What can go wrong

A small 2022 randomised trial of tesofensine with metoprolol in 21 adults with hypothalamic obesity reported mostly mild adverse events: sleep disturbances, dry mouth and headache. No longer-term safety data are cited here.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Investigations Into the Metabolism and Elimination of Tesofensine in Human Urine (Krug, Thomas and Thevis, Drug Test Anal, 2026) · Effect of tesofensine on bodyweight loss, body composition, and quality of life in obese patients (Lancet, 2008)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A cholesterol-lowering medicine; the label calls enlicitide a macrocyclic peptide that binds to PCSK9. It is indicated as an adjunct to diet and exercise to reduce LDL cholesterol in adults with hypercholesterolaemia, including heterozygous familial hypercholesterolaemia.

What the evidence shows

The US label summarises two randomised, double-blind, placebo-controlled trials: CORALreef Lipids (2,904 adults with hypercholesterolaemia) and CORALreef HeFH (303 adults with heterozygous familial hypercholesterolaemia). At week 24 the difference from placebo in mean LDL-C change was -56% and -59% respectively. The endpoint is LDL-C; cardiovascular outcome results are not cited here. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Approved medicine. The US FDA approved it on 15 July 2026 to reduce LDL cholesterol, as an adjunct to diet and exercise in adults with hypercholesterolaemia, including heterozygous familial hypercholesterolaemia. No approval outside the US was verified.

Anti-doping status, 2026 List

Not prohibited. It is not named on the 2026 Prohibited List. S0, non-approved substances, covers substances with no current approval by any governmental regulatory health authority for human therapeutic use; this medicine has US FDA approval.

What can go wrong

In the HeFH study the most common adverse reactions were diarrhoea (7% versus 2% on placebo) and dizziness (9% versus 4%). The label lists no contraindications.

Sources: FDA Novel Drug Approvals for 2026 · LIPFENDRA prescribing information (DailyMed) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A cAMP-biased, long-acting GLP-1 receptor agonist developed by Sciwind Biosciences for type 2 diabetes and long-term weight management in adults with obesity, or overweight with a weight-related comorbidity.

What the evidence shows

Phase 3 reports are published: a randomised, double-blind, placebo-controlled trial in adults with overweight or obesity, a comparison with dulaglutide in type 2 diabetes and a placebo-controlled monotherapy trial. Effect sizes are not cited here. The July 2026 approvals report says further evaluation is under way in adolescents with obesity, in obesity with obstructive sleep apnoea and in obesity with knee osteoarthritis. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Approved medicine. The NMPA in China approved it in January 2026 for glycaemic control in adults with type 2 diabetes and in March 2026 for long-term weight management, according to a peer-reviewed report. No approval outside China was verified.

Anti-doping status, 2026 List

Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.

What can go wrong

The published trial reports address efficacy and safety, but specific adverse effects are not cited here.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Efficacy and safety of a biased GLP-1 receptor agonist ecnoglutide in adults with overweight or obesity (Lancet Diabetes & Endocrinology, September 2025) · Ecnoglutide: First Approvals (Shirley, Drugs, 7 July 2026)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

A prescription subcutaneous injection where approved; sold illicitly as a ‘research chemical’

What it is

A four-amino-acid peptide that binds cardiolipin in the inner mitochondrial membrane and stabilises the electron-transport chain.

What it is sold for

Marketed as a mitochondrial ‘rejuvenator’ for energy, endurance and ageing.

What the evidence shows

FDA accelerated approval is limited to Barth syndrome. A small randomised study in older adults found a short-term mitochondrial ATP-production signal; this does not establish improved lifespan or a general longevity benefit. Older-adult trial. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. US accelerated approval (Forzinity, September 2025) for Barth syndrome only; not approved in the EU or India. Grey-market ‘SS-31’ is an unregulated copy of a prescription medicine.

Anti-doping status, 2026 List

Check on Global DRO. Not named on the 2026 List and, as an approved medicine, outside the S0 catch-all; verify on Global DRO before assuming anything, because a mitochondrial agent will attract scrutiny.

What can go wrong

Safety findings depend on the studied population and product; long-term use for healthy ageing remains unestablished. Grey-market vials have unverified contents.

What the practice does

Explained as a rare-disease medicine, not a longevity tool. Energy and endurance are measured (VO₂max, sleep, HRV, bloods) and trained; a clinical question goes to a physician.

Sources: US FDA — Forzinity (elamipretide) accelerated approval letter, 19 September 2025 · 2026 Prohibited List, full text (VADA copy of the WADA List in force from 1 January 2026)

Link to this entry

A prescription tablet or oral solution; used off-label at low doses for longevity

What it is

An mTOR inhibitor and immunosuppressant approved for kidney-transplant rejection and lymphangioleiomyomatosis; the most consistent lifespan-extending drug in mice.

What it is sold for

Marketed by longevity clinics as the one drug that slows ageing in people.

What the evidence shows

One randomised trial in healthy adults is PEARL (Aging, 2025): 114 completers, low-dose compounded rapamycin or placebo for 48 weeks. The primary outcome, visceral fat by DXA, did not change; women on the higher of two doses gained lean tissue and reported less pain; gastrointestinal symptoms were more frequent; and the compounded product reached about a third of the blood level of the commercial one. It does not establish long-term safety or a longevity benefit. Earlier older-adult trial. Grade L · Longevity shelf — human evidence thin but not absent

Regulatory status

Approved, used off-label. Approved in the EU (since 2001) and the US for transplant rejection and lymphangioleiomyomatosis; longevity use is off-label and physician-only. A prescription medicine; local rules apply.

Anti-doping status, 2026 List

Not prohibited. Not on the 2026 List; an approved medicine outside S0. Confirm on Global DRO as with any prescription.

What can go wrong

At transplant doses: infections, slow wound healing, low blood counts, raised lipids and glucose, mouth ulcers, oedema; the low-dose profile is less clear and immunosuppression matters to anyone training hard or travelling.

What the practice does

The practice discusses what it has read and will not recommend or source. It measures what the drug is supposed to move — DXA, VO₂max, fasting insulin, lipids — and refers to a physician.

Sources: PEARL trial, Aging 2025 — rapamycin and healthspan metrics after one year · European Medicines Agency — Rapamune (sirolimus) EPAR

Link to this entry

A prescription tablet or oral solution

What it is

A biguanide used for type 2 diabetes for more than 60 years; cheap, generic and among the most prescribed medicines in India.

What it is sold for

Marketed as a longevity pill for people without diabetes.

What the evidence shows

The evidence for ageing is observational and mechanistic. The trial designed to test it, TAME (more than 3,000 adults aged 65 to 79, six years, 14 US sites), has not launched and is still raising funds. In diabetes it is first-line medicine with outcome data; in healthy people no trial has shown a longevity benefit. Grade L · Longevity shelf — human evidence thin but not absent

Regulatory status

Approved, used off-label. Approved for type 2 diabetes in many countries; authorised ages and formulations vary. Longevity use is outside that indication. Prescription-only.

Anti-doping status, 2026 List

Not prohibited. Not on the 2026 List; an approved medicine outside S0. Confirm on Global DRO as with any prescription.

What can go wrong

Gastrointestinal upset; vitamin B12 depletion with long use, which the label says to monitor; a boxed warning for lactic acidosis in kidney or liver impairment and acute illness.

What the practice does

Physician territory, as the supplements page already says. The practice measures fasting insulin, HbA1c and a continuous glucose trace, which answer the question the drug is bought for, and refers.

Sources: American Federation for Aging Research — the TAME trial (design and status) · US FDA — metformin (Riomet) prescribing information: indication, lactic acidosis, B12

Link to this entry

Sold as capsules; intravenous NAD+ is covered under Injections & infusions

What it is

Oral precursors of NAD+, the coenzyme whose tissue levels fall with age.

What it is sold for

Marketed to ‘reverse cellular ageing’ and restore youthful energy.

What the evidence shows

Already graded L on the supplements page, and nothing has changed: a meta-analysis of eight randomised trials (342 people; Current Diabetes Reports, 2025) found that NMN raises blood NAD+ but does not improve fasting glucose, insulin, HbA1c or lipids, and its authors do not support use in the general population. Grade L · Longevity shelf — human evidence thin but not absent

Regulatory status

Supplement. Sold as food supplements, not medicines, in most markets. See the supplements page for the practice’s reading of the longevity shelf.

Anti-doping status, 2026 List

Not prohibited. Not prohibited. Contamination remains a risk; batch testing cannot guarantee a prohibited-substance-free product.

What can go wrong

Well tolerated in short trials, with a tendency to more adverse events at higher intakes; long-term safety unknown; unregulated products vary in content.

What the practice does

Measured, not marketed. The practice reads the trials, recommends none of them yet, and points the client to sleep, training and composition, which move the markers the capsules are sold for.

Sources: Chen et al., Current Diabetes Reports 2025 (online 2024) — NMN supplementation in humans: systematic review and meta-analysis of eight RCTs

Link to this entry

What it is

An oral diabetes drug that slows carbohydrate breakdown in the intestine and blunts post-meal glucose surges. It extended mouse lifespan in the NIA Interventions Testing Program.

What the evidence shows

No human lifespan or healthspan trial is cited. In mice, acarbose prolonged lifespan and health-span in both sexes, more in males. The ACE trial, randomised and placebo-controlled, tested cardiovascular and diabetes outcomes in people with coronary heart disease and impaired glucose tolerance; no result is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Approved, used off-label. US label (Hikma generic, February 2023): improved glycaemic control in adults with type 2 diabetes, as an adjunct to diet and exercise. No ageing or longevity indication is listed, so longevity use is off-label.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List. The List prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use; acarbose has an approved US label.

What can go wrong

No safety data are cited here.

Sources: DailyMed: acarbose tablets (Hikma) prescribing information · Nelson et al., Sex as a major determinant of pro-longevity drug efficacy: a review of two decades of the NIA Interventions Testing Program. J Gerontol A 2025;80(8):glaf138 · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Oral drugs that block renal sodium-glucose transporter 2 to lower blood glucose; labels also cover heart-failure and kidney protection. Canagliflozin was tested in the NIA mouse programme.

What the evidence shows

No lifespan or healthspan trial in healthy adults is cited. Labels cite reduced cardiovascular death, heart-failure hospitalisation and kidney outcomes in people with diabetes, heart failure or chronic kidney disease. Canagliflozin extended median survival of male but not female mice (by 14% in males). Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Approved, used off-label. US labels (Invokana, Jardiance, Farxiga) list type 2 diabetes glycaemic control plus lower cardiovascular, heart-failure and kidney-disease risk in defined patients. The labels list no ageing indication, so ageing use is off-label.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List (SGLT and gliflozin do not appear). The List prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use; these drugs have approved labels.

What can go wrong

No safety data are cited here.

Sources: DailyMed: INVOKANA (canagliflozin) label, Janssen, rev. June 2026 · Miller et al., JCI Insight 2020: Canagliflozin extends life span in genetically heterogeneous male but not female mice · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

An over-the-counter pain and antiplatelet medicine; low dose is used for cardiovascular prevention. Tested for ageing in mice and in the ASPREE trial of healthy older adults.

What the evidence shows

In ASPREE (19,114 older adults aged 70 and over, about 4.7 years), disability-free survival was 90.3% on aspirin and 90.5% on placebo, showing no benefit on that measure. In mice, aspirin increased lifespan in males but not females. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Approved, used off-label. Over-the-counter low-dose label: temporary relief of minor aches and pains or as recommended by a doctor; no ageing indication. The April 2022 USPSTF position is against initiating low-dose aspirin for primary prevention of cardiovascular disease in adults 60 or older.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List (aspirin does not appear). The List prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use; aspirin has an approved over-the-counter label.

What can go wrong

In ASPREE, bleeding occurred in 3.8% on aspirin versus 2.7% on placebo, and deaths were 5.9% versus 5.2%.

Sources: NIH news release on the ASPREE trial (published NEJM 16 Sept 2018) · USPSTF: Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication (April 2022) · DailyMed: aspirin low-dose OTC label (Meijer), rev. Jan 2025

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A prescription ACE inhibitor for high blood pressure and heart failure. Tested in the NIA mouse programme, with a small female lifespan gain and a male result complicated by short-lived controls.

What the evidence shows

No human lifespan or healthspan trial is cited. In mice, captopril led to a significant but small (4% or 5%) increase in female lifespan. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Approved, used off-label. US label (Hikma, December 2024): hypertension, heart failure, improved survival after myocardial infarction with left-ventricular dysfunction, and diabetic nephropathy. The label lists no ageing indication, so ageing use is off-label.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List (captopril and ACE inhibitors do not appear). The List prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use; captopril has an approved US label.

What can go wrong

No safety data are cited here.

Sources: DailyMed: captopril tablets (Hikma) prescribing information · Strong et al., Aging Cell 2022: Lifespan benefits for the combination of rapamycin plus acarbose and for captopril in genetically heterogeneous mice · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Cholesterol-lowering prescription drugs, not ageing drugs as such. Two large trials in older adults, STAREE and PREVENTABLE, test cardiovascular and healthy-ageing outcomes.

What the evidence shows

STAREE (9,971 adults aged 70 and over, median 5.9 years) found fewer major cardiovascular events (HR 0.70) but no longer disability-free survival. PREVENTABLE, in adults aged 75 and over, has no results cited. A mouse study of atorvastatin with telmisartan found no lifespan increase. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. Lipitor label (April 2024): lowers LDL-C and reduces the risk of heart attack, stroke, revascularisation procedures and angina in adults with multiple risk factors for coronary heart disease. No healthy-ageing or dementia-prevention indication is listed.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List (statins do not appear). The List prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use; statins have approved labels.

What can go wrong

In STAREE, deaths were 637 versus 676 (HR 0.94, not significant). No adverse-effect data are cited here.

Sources: Zoungas et al., NEJM 2026: Atorvastatin, Cardiovascular Events, and Disability-free Survival in Older Adults (STAREE) · DailyMed: LIPITOR (atorvastatin) label, Viatris, rev. April 2024 · PREVENTABLE trial website

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Everolimus is a rapamycin analogue approved for transplant and cancer. Low-dose everolimus and the related TORC1 inhibitor RTB101 were tested in older adults for immune function.

What the evidence shows

Trials in older adults used immune endpoints. RAD001 raised the influenza-vaccine response by about 20% (2014); a TORC1 inhibitor lowered reported infections for a year (2018); the RTB101 phase 3 trial showed no reduction (26% versus 25%, p=0.65). Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved, used off-label. Zortress label (September 2026): kidney and liver transplant. A 2023 review states rapalogs are approved for transplantation and cancer, not for ageing. RTB101 is investigational.

Anti-doping status, 2026 List

Check on Global DRO. Everolimus is not named on the 2026 Prohibited List. RTB101 is investigational and would fall under S0, which prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use. Check Global DRO for the exact product.

What can go wrong

Trial abstracts describe RAD001 as relatively well tolerated in older adults and low-dose RTB101 as well tolerated. No other safety data are cited.

Sources: Mannick and Lamming, Nature Aging 2023: Targeting the biology of aging with mTOR inhibitors · Mannick et al., Sci Transl Med 2014: mTOR inhibition improves immune function in the elderly · Mannick et al., Lancet Healthy Longevity 2021: phase 2b and phase 3 randomised trials of RTB101

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Prescription JAK-pathway inhibitors for blood cancers and graft-versus-host disease. In mice they dampen the inflammatory secretions of senescent cells, termed a ‘senomorphic’ effect.

What the evidence shows

No human ageing or healthspan trial is cited. In aged mice, a JAK inhibitor given for 10 weeks alleviated adipose tissue systemic inflammation and enhanced physical function. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Approved, used off-label. Jakafi label (July 2026): myelofibrosis, polycythaemia vera and graft-versus-host disease. No ageing indication appears on the label, so ageing use is off-label.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List (ruxolitinib and JAK do not appear). The List prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use; ruxolitinib has an approved label.

What can go wrong

No safety data are cited here.

Sources: Xu et al., PNAS 2015: JAK inhibition alleviates the cellular senescence-associated secretory phenotype and frailty in old age · DailyMed: JAKAFI (ruxolitinib) label, Incyte, rev. July 2026 · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A stereoisomer of oestradiol. Sold as a topical hair-loss treatment in a few countries; given in food to mice it extended male lifespan in the NIA programme.

What the evidence shows

No human lifespan or healthspan trial is cited; human use is topical, for hair loss. In mice, lifespan was longer in males but not females. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Unapproved for the described use. Marketed as a topical treatment of androgenetic alopecia in Germany, and in Argentina, Mexico and others per a secondary source. No approval for ageing or systemic use was found.

Anti-doping status, 2026 List

Check on Global DRO. Not named on the 2026 Prohibited List (oestradiol and alfatradiol are absent). The List’s S0 class prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use, so the product, route and country of approval must be checked on Global DRO.

What can go wrong

No safety data are cited here.

Sources: NIA Interventions Testing Program overview · Drugs.com international: alfatradiol (secondary source) · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

An over-the-counter antihistamine for motion sickness. It extended male mouse lifespan in an early NIA Interventions Testing Program test.

What the evidence shows

No human lifespan or healthspan trial is cited. A later mouse test with a later start found no benefit, and a 2026 report found no significant lifespan increase in male or female mice. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Approved, used off-label. US over-the-counter label (2017): prevention and treatment of nausea, vomiting and dizziness of motion sickness. The label gives no ageing indication, so ageing use is off-label.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List (meclizine and antihistamines do not appear). The List prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use; meclizine has an approved over-the-counter label.

What can go wrong

No safety data are cited here.

Sources: DailyMed: meclizine tablets (The Generic Pharmaceutical Company) label · Korstanje et al., GeroScience 2026: Astaxanthin, meclizine, mitoglitazone, pioglitazone, alpha-ketoglutarate, mifepristone, methotrexate, and atorvastatin-telmisartan do not increase lifespan in UM-HET3 mice · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A prescription MAO-B inhibitor for Parkinson’s disease (and, as a patch, depression), studied since the 1980s as a possible anti-ageing drug in rats.

What the evidence shows

No trial of selegiline for healthy ageing or lifespan is cited. Human data are in Parkinson’s disease, and the theorised anti-ageing effects have not been clearly demonstrated in humans. Rat longevity studies are cited from 1988 and 2005. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Approved, used off-label. US label (Apotex capsules, June 2014): adjunct in the management of Parkinsonian patients being treated with levodopa/carbidopa. The US label lists no ageing indication, so ageing use is off-label.

Anti-doping status, 2026 List

Check on Global DRO. Named on the 2026 Prohibited List under S6.B, specified stimulants, and prohibited in-competition only. Check Global DRO for the exact product and route.

What can go wrong

It is partly metabolised to amphetamine-type compounds. No other adverse-effect data are cited here.

Sources: DailyMed: selegiline hydrochloride capsules (Apotex) label, rev. June 2014 · WADA International Standard Prohibited List 2026 (effective 1 January 2026; copy hosted on CONMEBOL CDN) - S6.B specified stimulants

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A combination of the leukaemia drug dasatinib and the plant flavonoid quercetin, studied as a ‘senolytic’ to clear senescent cells.

What the evidence shows

Open-label pilots only: in idiopathic pulmonary fibrosis (n=14) walking and chair-stand measures improved; in diabetic kidney disease (n=9) senescent-cell markers fell; in mild Alzheimer’s disease (n=5, a phase 1 feasibility trial) the approach was feasible and safe. No placebo-controlled efficacy trial is cited. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Unapproved for the described use. Dasatinib is FDA-approved for Philadelphia-chromosome-positive leukaemias; the label lists no ageing use. The combination for senescence is investigational.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List (dasatinib and quercetin do not appear). The List prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use; dasatinib has an approved label.

What can go wrong

In the mild Alzheimer’s disease feasibility trial (n=5) the approach was reported as feasible and safe. Safety in larger or longer studies is not cited.

Sources: Justice et al., EBioMedicine 2019: Senolytics in idiopathic pulmonary fibrosis · Gonzales et al., Nature Medicine 2023: Senolytic therapy in mild Alzheimer's disease: a phase 1 feasibility trial · DailyMed: SPRYCEL (dasatinib) label, rev. Aug 2026

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A circulating protein called a ‘longevity factor’, studied for brain and kidney effects. Recombinant klotho and klotho gene therapy are experimental, not approved products.

What the evidence shows

No human trial is cited. In aged nonhuman primates, low-dose, but not high-dose, klotho enhanced memory. The study authors say systemic low-dose klotho treatment may prove therapeutic in ageing humans. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Unapproved for the described use. No klotho therapy is approved. A secondary source reports that the US Food and Drug Administration did not authorise a company chief executive’s self-administration experiments, because the requirements to progress to human trials had not started.

Anti-doping status, 2026 List

Check on Global DRO. Klotho is not named in the 2026 Prohibited List text reviewed. M3.1 covers nucleic acids that may alter genome sequences or gene expression by any mechanism, relevant if delivered as gene therapy; a non-approved protein drug could fall under S0. Check Global DRO.

What can go wrong

No human trial is cited, so human safety data are lacking here. Klotho gene therapy is reported, by a secondary source only, to be among genes a company chief executive self-administered.

Sources: Castner et al., Nature Aging 2023: Longevity factor klotho enhances cognition in aged nonhuman primates · WADA International Standard Prohibited List 2026 (effective 1 January 2026; copy hosted on CONMEBOL CDN)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A diol (organic alcohol) used in food flavouring and sausage-casing manufacture; its fatty-acid esters have been studied for inducing ketosis. It was tested in the NIA mouse programme.

What the evidence shows

No human lifespan or healthspan trial is cited. In the NIA mouse programme it significantly extended lifespan in the primary analysis, but the median increase was just 1%. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Unapproved for the described use. 21 CFR 172.712 lists 1,3-butylene glycol as a food additive used in the manufacture of sausage casings as a formulation aid. No drug or supplement approval was found.

Anti-doping status, 2026 List

Check on Global DRO. 1,3-Butanediol, hydroxybutyrate and ketone are not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.

What can go wrong

No safety data are cited here.

Sources: Nelson et al., Sex as a major determinant of pro-longevity drug efficacy: a review of two decades of the NIA Interventions Testing Program. J Gerontol A 2025;80(8):glaf138 · eCFR: 21 CFR 172.712, 1,3-Butylene glycol · Wikipedia: 1,3-Butanediol (secondary source)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A lignan from the creosote bush (Larrea tridentata), once a food preservative. It extended male mouse lifespan in the NIA programme but is reported to cause liver and kidney toxicity.

What the evidence shows

No human lifespan or healthspan trial is cited. In the NIA mouse programme it increased mean lifespan in males but not females. Renal toxicity and hepatotoxicity are reported for chronic internal use of creosote bush and NDGA. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Unapproved for the described use. No approval for ageing was found, and no regulator page is cited. A secondary source says it was widely used as a food preservative in the 1950s and later banned after reports of toxicity in the early 1960s.

Anti-doping status, 2026 List

Check on Global DRO. NDGA is not named in the 2026 Prohibited List text reviewed. S0 prohibits at all times substances with no current approval by any governmental regulatory health authority for human therapeutic use and may apply. Check Global DRO.

What can go wrong

Liver and kidney toxicity are reported with chronic internal use of creosote bush and NDGA. It was later banned as a food preservative after reports of toxicity.

Sources: NIA Interventions Testing Program overview · Wikipedia: Nordihydroguaiaretic acid (secondary source)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A branded herbal dietary supplement blend (milk thistle, bacopa, ashwagandha, green tea, turmeric) sold with unsupported health claims. It extended male mouse lifespan in the NIA programme.

What the evidence shows

No human lifespan or healthspan trial is cited. In the NIA mouse programme it increased lifespan in males but not females. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Unapproved for the described use. A herbal dietary supplement; no approval as a medicine was verified. A secondary source reports a 2017 FDA warning letter to its seller over illegal advertising claims about curing disease.

Anti-doping status, 2026 List

Check on Global DRO. The blend is not named in the 2026 Prohibited List text reviewed. Status can depend on formulation, and ingredient-level and contamination risk need a product-specific check on Global DRO.

What can go wrong

A 2017 FDA warning letter to the seller concerned illegal claims about curing disease. No adverse-effect data are cited here.

Sources: NIA Interventions Testing Program overview · Nelson et al., Sex as a major determinant of pro-longevity drug efficacy: a review of two decades of the NIA Interventions Testing Program. J Gerontol A 2025;80(8):glaf138 (sex pattern) · Wikipedia: Protandim (secondary source)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Sildenafil and tadalafil are phosphodiesterase-5 (PDE5) inhibitors, marketed for erectile dysfunction, benign prostatic hyperplasia (tadalafil) and pulmonary arterial hypertension (sildenafil). Their use in ageing is a research idea, not an approved use.

What the evidence shows

No randomised trial of an ageing or lifespan outcome is cited here. The main human signal is observational: a 2021 analysis of insurance claims for 7.23 million people linked sildenafil use to a 69% lower Alzheimer’s risk, with supporting neuron-model work. Its authors state that this does not establish causality. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Approved, used off-label. FDA-approved for erectile dysfunction (sildenafil as Viagra, tadalafil as Cialis), benign prostatic hyperplasia (tadalafil) and pulmonary arterial hypertension (sildenafil as Revatio). Ageing, lifespan and dementia are not indications on the FDA labels; any such use is off-label.

Anti-doping status, 2026 List

Not prohibited. Sildenafil and tadalafil are not named on the 2026 Prohibited List.

What can go wrong

FDA labels contraindicate concomitant use with organic nitrates in any form, because of the greater risk of hypotension.

Sources: DailyMed: VIAGRA (sildenafil citrate) label · DailyMed: REVATIO (sildenafil) label · Sildenafil as a candidate drug for Alzheimer's disease: claims-data study (Fang et al., Nature Aging, 2021)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

TAME is a planned multicentre trial of metformin, an approved diabetes medicine, in older adults. It is designed to test metformin against age-related disease; it is not a product or a service.

What the evidence shows

No TAME results are cited here, so there are no human efficacy data from the trial. Its 2016 design paper plans about 3,000 participants aged 65–79 at about 14 US centres, with a composite outcome of cardiovascular events, cancer, dementia and mortality, and functional and geriatric end points. The absence of results is not a negative finding. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

TAME is a research design and changes no approval. Metformin, the medicine it studies, is FDA-approved for type 2 diabetes; healthy ageing is not an approved indication. No approval as a medicine was verified for this use.

Anti-doping status, 2026 List

Check on Global DRO. TAME is a trial, not a substance. Check Global DRO for the anti-doping status of metformin, the medicine it studies.

What can go wrong

No TAME results are cited here, so there are no safety findings from the trial to report.

Sources: DailyMed: metformin hydrochloride tablets labels · Metformin as a Tool to Target Aging (Barzilai et al., Cell Metabolism, 2016)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A nonapeptide hormone produced by thymic epithelial cells; its activity depends on zinc. A 2026 paper describes it as a thymus-derived peptide that declines with age; papers frame it as a potential anti-inflammatory and immune-ageing peptide.

What the evidence shows

Evidence is preclinical. A 2026 Nature Communications paper reports that, in its experimental models, thymulin suppresses pro-inflammatory cytokine production by inhibiting NF-κB signalling and enhances antitumour T-cell immunity. Other papers use mouse and rat models. The only human data are thymulin concentrations in children, not treatment. No controlled human trial of thymulin is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Unapproved for the described use. No approval as a medicine was verified for this use, and no approved medicine containing thymulin is cited here. A 2026 paper calls it only a ‘potential strategy’ to improve cancer immunotherapy in older individuals.

Anti-doping status, 2026 List

Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; check Global DRO for the exact product. S0 prohibits non-approved substances at all times, and would apply to thymulin only if no government has approved it.

What can go wrong

No human safety data are cited here. The laboratory and animal work cited cannot show safety in people; the only human data are thymulin concentrations measured in children.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Thymulin restrains age-associated myeloid inflammation and enhances cancer immunotherapy (Nature Communications, 2026) · Thymulin concentrations in children in rural Nepal (J Dev Orig Health Dis, 2019)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

A prescription intravenous or intramuscular injection where registered

What it is

A mixture of low-molecular-weight peptides and amino acids extracted from pig brain, made by EVER Neuro Pharma of Austria. It is a drug mixture, not a single peptide.

What it is sold for

Marketed for stroke recovery, dementia, brain injury and ‘neuro-regeneration’.

What the evidence shows

The Cochrane review (2023 update; seven trials, 1,773 participants) found that in acute ischaemic stroke it probably makes little or no difference to death and probably increases non-fatal serious adverse events, on moderate-certainty evidence. It is registered in Russia (April 2025, prescription) for Alzheimer’s disease, dementia, stroke, brain injury and other indications; it has no FDA or EMA approval. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Approved medicine. National approvals include India: CDSCO lists an injection approval for specified neurological indications. This does not establish benefit for healthy ageing; current use and labelling are physician decisions. CDSCO approval record.

Anti-doping status, 2026 List

Check on Global DRO. Not named on the 2026 List and, as a nationally registered medicine, outside S0; verify on Global DRO for the athlete’s country before any use.

What can go wrong

The Cochrane review’s signal of more non-fatal serious adverse events; the label lists agitation, confusion, insomnia and, rarely, allergic reactions and arrhythmias; an animal-tissue injectable of variable composition.

What the practice does

Explained with the Cochrane result. Cognitive complaints are referred to a neurologist or GP; sleep and training load provide coaching context, while clinical interpretation of blood results stays with the physician.

Sources: Cochrane review 2023 (Ziganshina et al.) — Cerebrolysin for acute ischaemic stroke (PubMed record) · Vidal (Russia) — Cerebrolysin: registration, holder, indications

Link to this entry

Sold as capsules, sublingual drops and injections

What it is

A family of two- to four-amino-acid synthetic ‘cytogens’ and organ-extract ‘cytomaxes’ from the St Petersburg Institute of Bioregulation and Gerontology, each claimed to target one organ; Pinealon is the brain one.

What it is sold for

Marketed as organ-specific rejuvenators that lengthen telomeres, restore function and reduce mortality.

What the evidence shows

The evidence base is one group’s own publications: rodent lifespan gains of 20–40%, cell-culture telomere work, and human follow-up series without placebo control, summarised in the group’s own reviews and a 2026 book chapter that states no limitations. There is no independent replication and no registered trial outside Russia. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Supplement. Pinealon and the other short synthetic cytogens are sold as dietary supplements, not medicines. Some organ extracts from the same school (thymalin, see Immune) are registered Russian medicines; none of the family is approved in the EU, US or India.

Anti-doping status, 2026 List

Check on Global DRO. Not named on the 2026 List. Synthetic pharmacological peptides without therapeutic approval are the definition of S0, so an athlete should assume they are prohibited at all times and verify on Global DRO.

What can go wrong

Unknown in independent hands; unregulated products whose content cannot be verified.

What the practice does

Explained as a closed literature. Cognitive and sleep complaints are measured and, where persistent, referred to a neurologist or GP. For a tested athlete the subject is closed.

Sources: Springer, 2026 — Medicinal peptide drugs and Khavinson Peptides (book chapter) · Khavinson & Anisimov, Biogerontology 2010 — peptide bioregulation of ageing (review) · Korkushko, Khavinson et al., 2011 — epithalamin in elderly coronary patients, 15-year follow-up

Link to this entry

A prescription subcutaneous injection where licensed; compounded in the US without approval

What it is

A 28-amino-acid thymic peptide that primes T-cell and dendritic-cell responses: a genuine, regionally licensed immunomodulator.

What it is sold for

Marketed as an immune booster for infections, long COVID, cancer and ‘immune ageing’.

What the evidence shows

Licensed in Italy (Zadaxin) as an adjuvant to influenza vaccination in immunocompromised people, and, according to its US nominators, in more than 30 countries for uses including chronic hepatitis B. The largest test, the double-blind TESTS trial in sepsis (about 1,100 patients, 2025), found no reduction in mortality; a 2025 meta-analysis of 11 trials shows a pooled benefit that disappears in the high-quality and multicentre subgroups. No trial in healthy adults. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. Approved for specified medical indications in some countries, including India. CDSCO records an additional Indian indication; that is not an approval for general wellness or longevity. CDSCO approval record.

Anti-doping status, 2026 List

Check on Global DRO. Not named on the 2026 List and, as an approved medicine, outside S0; the S2.3 entry covers thymosin beta-4, not alpha-1. Verify on Global DRO before any use.

What can go wrong

Trial safety data are in patients, not healthy people; immunogenicity is the FDA’s concern for compounded product; imported vials are unregulated.

What the practice does

Illness days are logged alongside load, sleep and travel to give the clinician context; recurrent infection is referred to a GP or immunologist. The practice does not suggest immune peptides.

Sources: Torrinomedica — Zadaxin (timalfasina): Italian authorisation, holder and indication · Frontiers in Cellular and Infection Microbiology 2025 — thymosin alpha 1 for sepsis: systematic review and meta-analysis (with the TESTS trial) · US bulk drug substance nomination for thymosin alpha-1 acetate (regulations.gov) · US FDA — bulk drug substances that may present significant safety risks in compounding (Category 2 and withdrawn nominations; updated 22 April 2026)

Link to this entry

A prescription intramuscular injection in Russia (thymalin); sold abroad as ‘research chemicals’

What it is

Thymalin is a polypeptide extract of calf thymus registered in Russia since the Soviet era; thymogen is a synthetic dipeptide from the same school of ‘bioregulators’.

What it is sold for

Marketed as immune restoration and anti-ageing, with a claimed reduction in mortality in the elderly.

What the evidence shows

Thymalin is a registered prescription medicine in Russia (re-registered June 2024) for immunodeficiency states, infections and post-chemotherapy suppression, on the strength of Russian studies. The longevity claims come from the Khavinson group’s own follow-up series without placebo control; there is no independent trial and none outside Russia and Ukraine. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Approved medicine. Approved in Russia only (Samson-Med; prescription). Thymogen is likewise a Russian product. Neither is approved in the EU, US or India; neither is on the US compounding lists.

Anti-doping status, 2026 List

Check on Global DRO. Not named on the 2026 List. As a medicine registered in Russia, thymalin falls outside the S0 definition, but no agency has published a ruling; verify on Global DRO. Thymogen and unregistered copies sold online have no such approval.

What can go wrong

Allergic reactions are the labelled effect; it is an animal-tissue extract of variable composition; product sold outside Russia is unregulated.

What the practice does

Explained as a closed literature. Immune complaints are measured against load and sleep and referred to a GP or immunologist. For a tested athlete the subject is closed.

Sources: Vidal (Russia) — Thymalin: registration, holder, indications, prescription status · Khavinson & Anisimov, Biogerontology 2010 — peptide bioregulation of ageing (review) · 2026 Prohibited List, full text (VADA copy of the WADA List in force from 1 January 2026)

Link to this entry

Prescription patches, gels, sprays, tablets and pessaries

What it is

Oestradiol, with progesterone to protect the womb, for menopausal symptoms.

What it is sold for

Sold as anti-ageing ‘bioidentical’ pellets and compounded creams.

What the evidence shows

Effective for hot flushes, night sweats, sleep and vaginal symptoms and protective for bone; under 60 without high breast-cancer or clot risk the benefits usually outweigh the risks. Patches and gels do not raise clot risk. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Approved medicine. Approved for menopausal symptoms; compounded pellets are unapproved products.

Anti-doping status, 2026 List

Not prohibited. Oestradiol and progesterone for menopause are not prohibited; formulations containing prohibited androgens have different rules. Formulation-specific warnings are on the clean-sport page.

What can go wrong

About five extra breast cancers per 1,000 women on five years of combined HRT; clots and stroke with oral oestrogen.

What the practice does

A gynaecologist’s or GP’s decision; the practice coaches bone, muscle and sleep. See peptides and hormones.

Sources: NHS — benefits and risks of hormone replacement therapy · USADA — bioidentical hormones and pellet therapy in sport · Sport Integrity Australia — female health and anti-doping

Link to this entry

Prescription prolonged-release tablets in the EU; an over-the-counter supplement in the US

What it is

The pineal hormone that signals darkness and times the circadian system.

What it is sold for

Sold as a sleep cure, antioxidant and anti-ageing hormone.

What the evidence shows

Approved in the EU (Circadin, 2007) for short-term primary insomnia over 55, where 32% improved against 19% on placebo. USADA’s summary: it may help people fall asleep faster. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. A medicine in the EU and UK; a supplement in the US; not approved for ageing anywhere.

Anti-doping status, 2026 List

Not prohibited. Not prohibited; no TUE needed. Supplement content has been measured from 83% below to 400% above the label.

What can go wrong

Headache, dizziness, nausea, drowsiness; long-term daily use is under-studied.

What the practice does

The practice tracks sleep and coaches light exposure, timing and training load; persistent insomnia goes to a physician. See peptides and hormones.

Sources: European Medicines Agency — Circadin (melatonin) EPAR · USADA — what athletes need to know about melatonin

Link to this entry

What it is

Custom-compounded oestrogen, progesterone, testosterone, DHEA or pregnenolone preparations, including estriol, estrone, Bi-est, Tri-est and pellets, marketed as ‘bioidentical’ or ‘natural’ alternatives to approved hormone products.

What the evidence shows

The National Academies committee found insufficient evidence for the overall clinical utility of compounded bioidentical hormone therapy for menopause and male hypogonadism symptoms. It found some evidence that estriol may help vasomotor symptoms and vaginal atrophy. No human lifespan or healthspan trial of estriol is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Unapproved for the described use. The National Academies describes compounded preparations as custom-formulated alternatives to FDA-approved hormone products, and names compounded pellet products as candidates for FDA’s Difficult to Compound List. No approval as a medicine was verified for estriol for this use.

Anti-doping status, 2026 List

Check on Global DRO. S1.1 covers testosterone- and DHEA-containing preparations; prasterone (DHEA) is named on the 2026 List. Estriol and oestradiol were not found by name in the 2026 text reviewed. Check the exact product on Global DRO.

What can go wrong

No adverse-effect data for these preparations are cited here.

Sources: National Academies: clinical utility of compounded bioidentical hormone therapy (conclusion) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Calcitonin is a human hormone that is also found in salmon. Calcitonin salmon injection is used for postmenopausal osteoporosis, Paget’s disease of bone and high blood calcium.

What the evidence shows

MedlinePlus lists postmenopausal osteoporosis and Paget’s disease of bone among the approved uses of calcitonin salmon injection. No trial data are cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. Approved medicine. MedlinePlus lists postmenopausal osteoporosis, Paget’s disease of bone and quickly lowering blood calcium as uses of the injection.

Anti-doping status, 2026 List

Check on Global DRO. Calcitonin salmon is not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.

What can go wrong

No adverse-effect data are cited here.

Sources: MedlinePlus: calcitonin salmon injection

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A steroid-hormone precursor. The National Academies lists it among the hormones in compounded ‘bioidentical’ preparations.

What the evidence shows

No pregnenolone-specific trial is cited here. The National Academies committee found insufficient evidence for the overall clinical utility of compounded ‘bioidentical’ hormone therapy as treatment for menopause. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

The National Academies treats it as an ingredient of compounded preparations. No approval as a medicine was verified for pregnenolone.

Anti-doping status, 2026 List

Check on Global DRO. Pregnenolone is not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.

What can go wrong

No adverse-effect data are cited here.

Sources: National Academies: clinical utility of compounded bioidentical hormone therapy (chapter 2)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Synthetic progestogens (progestins) used alone or with oestrogen. Medroxyprogesterone acetate is a derivative of progesterone; drospirenone is a spironolactone analogue with anti-mineralocorticoid activity. Prescription uses include secondary amenorrhoea, menopausal vasomotor symptoms with oestrogen, and contraception.

What the evidence shows

Approved medicines for narrow clinical uses; the evidence cited is label wording. For dydrogesterone the only study cited is a 2026 retrospective cohort of 150 perimenopausal women. Anti-ageing or performance use is not described, and no controlled human trial of it is cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. Approved prescription medicines with FDA labels: Provera (medroxyprogesterone acetate, label revised March 2024), Slynd (drospirenone, label revised 6/2025) and an oestradiol and norethindrone acetate medicine (label revised 6/2026). No approval as a medicine was verified for dydrogesterone.

Anti-doping status, 2026 List

Not prohibited. Medroxyprogesterone, norethisterone and dydrogesterone are not named on the 2026 Prohibited List. Drospirenone appears in S5, diuretics and masking agents, only as an exception.

What can go wrong

The Provera boxed warning covers cardiovascular disorders, breast cancer and probable dementia with oestrogen-plus-progestin therapy, and says that therapy should not be used to prevent cardiovascular disease or dementia. The oestradiol and norethindrone acetate label adds endometrial cancer. The Slynd label notes potential hyperkalaemia in high-risk females.

Sources: DailyMed: Provera (medroxyprogesterone acetate) tablets label · DailyMed: Slynd (drospirenone) label · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Oestrogens in approved prescription products. Estetrol is a synthetic version of an oestrogen naturally present during pregnancy, combined with drospirenone in contraceptives. Conjugated oestrogens are purified from pregnant mares’ urine and used in menopausal hormone therapy.

What the evidence shows

Evidence cited is limited to contraceptive trial figures for estetrol with drospirenone from the Nextstellis label: a Pearl Index of 2.65 per 100 woman-years of use, with 26 on-treatment pregnancies among 1,524 females. No trial data for conjugated oestrogens are cited here. Wellness or anti-ageing marketing is not described. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Approved medicine. EU: Drovelis (estetrol with drospirenone) is shown by EMA as authorised, marketing authorisation 19 May 2021. US: Nextstellis label revised 2/2023 and Premarin label revised 4/2025. No approval as a medicine was verified for estetrol on its own or in menopause.

Anti-doping status, 2026 List

Not prohibited. Estetrol, conjugated oestrogens and oestradiol are not named on the 2026 Prohibited List. S4.2, anti-oestrogenic substances, lists other substances, among them clomifene and tamoxifen.

What can go wrong

EMA says Drovelis should not be used by women with a history of blood clots in the veins or arteries. The Nextstellis boxed warning concerns cigarette smoking and serious cardiovascular events. The Premarin boxed warning covers endometrial cancer, cardiovascular disorders, breast cancer and probable dementia.

Sources: EMA: Drovelis EPAR overview, estetrol · DailyMed: Nextstellis (drospirenone and estetrol) label · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Touchscreen or web tasks measuring memory, attention and executive function

What it is

A validated research instrument, developed at Cambridge and used in clinical trials, measuring performance on standardised cognitive tasks on the day, adjusted for age, sex and education.

What it is sold for

Marketed by clinics as a ‘brain age’ or a diagnosis.

What the evidence shows

The battery is sensitive, precise and language-independent, and the maker publishes normative data, most recently from 728 adults aged 18–75, so a score can be placed against people like the client. It returns a measurement, not a diagnosis: sleep loss, anxiety, caffeine and practice all move the scores. Before-and-after use without a control shows practice effects, which is how clinics produce ‘improvement’. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Test. Validated as a measurement instrument and used in regulated trials; not a diagnostic test for dementia, ADHD or anything else. The maker is ISO 13485-certified; no product-specific CE mark or FDA listing is stated on its site. The norms are largely the company’s own.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

Misread scores: a ‘brain age’ announced from one sitting, or a course of treatment sold on a practice effect.

What the practice does

A validated computerised battery is used for a baseline and a trend, always with sleep and HRV beside it, never as a verdict. A score that falls and stays down is referred to a neurologist or psychiatrist.

Sources: Cambridge Cognition — CANTAB · Cambridge Cognition — regulatory compliance (ISO 13485, notified body, 21 CFR Part 11) · Generating normative data from web-based CANTAB using a Bayesian framework (Frontiers in Digital Health, 2024)

Link to this entry

One testing day at partner laboratories and performance facilities, repeated at twelve weeks

What it is

The measurements the practice starts from, chosen because they move with training.

What it is sold for

What is measured can be changed, and what is changed is measured again.

What the evidence shows

In a cohort of 122,007 adults referred for exercise testing, higher cardiorespiratory fitness was associated with lower mortality. This observational result does not establish the accuracy of an individual risk prediction. Other measurements add context to coaching and physician-led care. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Test. Blood chemistry at accredited laboratories, where the accreditation that matters is ISO 15189; VO₂max on a calibrated metabolic cart; body composition on DXA.

Anti-doping status, 2026 List

Not prohibited. Not applicable. A blood draw for a medical test is excluded from the 2026 M1 blood-withdrawal rule.

What can go wrong

Risks depend on the test and the person; strenuous exercise testing needs appropriate screening and supervision. Results also need context, rather than being read in isolation.

What the practice does

See What we measure and the Biomarker index. The findings report at week three and week twelve is the record the next block is written from.

Sources: Mandsager et al., 2018 — cardiorespiratory fitness and long-term mortality (JAMA Network Open) · ISO 15189:2022 — medical laboratories: requirements for quality and competence · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry

What it is

MRI of most of the body, searched for tumours and other abnormalities in people with no symptoms. Marketed as radiation-free, non-invasive full-body scans for preventative health.

What the evidence shows

The American College of Radiology (2023) states there is no documented evidence that total-body screening is cost-efficient or effective in prolonging life. A 2026 radiology review cites low diagnostic yield, false positives, overdiagnosis and no survival outcome data, with reportable findings in 78% to 97% of people. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Test. Prenuvo’s release of 13 Feb 2025 cites FDA clearance for its AI body-composition report only. No clearance of the MRI screening service itself was verified.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

False positives and overdiagnosis are among the concerns cited. Incidental findings are very common, and 10% to 25% of findings are clinically significant or need further evaluation.

Sources: ACR Statement on Screening Total Body MRI (American College of Radiology, 17 Apr 2023) · How to implement a radiologist led whole-body MRI screening program (Kierans et al., Radiology Advances, 2026) · Prenuvo announces it had raised $120M to advance preventative health, launches novel FDA-cleared AI-powered products (BusinessWire press release, 13 Feb 2025)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A blood test that screens for signals of multiple cancer types and predicts where in the body a signal originates. Prescription-only; intended for screening for early detection of multiple cancers in adults aged 50 or older.

What the evidence shows

In the NHS-Galleri trial (142,250 people aged 50 to 77) the test did not meet its primary endpoint of reducing the combined number of stage III and IV cancers. Fewer stage IV cancers and more earlier-stage diagnoses were seen among people offered the test. Longer follow-up will be crucial to understand what this means for cancer outcomes. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. Prescription-only. An FDA advisory committee voted 7 to 2 (one abstention) that benefits outweigh risks and 6 to 4 in support of effectiveness; as of 28 Sep 2026 the final FDA decision on the pre-market approval application was still pending, expected in the coming months.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No false-positive or false-negative rates, and no harms from investigating a signal, are cited here. Whether earlier diagnosis improves cancer outcomes is not yet established.

Sources: FDA advisory committee votes in favor of approval of multi-cancer early detection test (The ASCO Post, posted 24 Sep 2026, updated 28 Sep 2026) · Major NHS trial provides new evidence on multi-cancer blood test (Queen Mary University of London, 23 Sep 2026)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

DNA-methylation patterns in blood used to estimate biological age or pace of ageing, for example GrimAge, PhenoAge and DunedinPACE. Sold as a ‘biological age’ readout to track the effect of lifestyle or longevity interventions.

What the evidence shows

Research clocks predict outcomes in cohorts: DunedinPACE was associated with morbidity, disability and mortality, and PhenoAge outperformed earlier measures for mortality and other outcomes. No consensus exists on how such biomarkers should be validated before clinical use (Nature Medicine, 2024). Responsiveness to interventions that target ageing must be tested before use as surrogate endpoints (Nature Medicine, 2026). Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Test. No FDA status for consumer clock tests was verified. For context, a court vacated FDA’s rule on laboratory-developed tests on 31 Mar 2025.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No harm from the test itself is cited here. Validation standards and responsiveness to interventions remain unsettled, so a change in score is not an established measure of an intervention’s effect.

Sources: Validation of biomarkers of aging (Moqri et al., Nature Medicine, 2024) · Responsiveness of epigenetic aging biomarkers to longevity interventions in humans (Sehgal et al., Nature Medicine, 2026) · DunedinPACE, a DNA methylation biomarker of the pace of aging (Belsky et al., eLife, 2022)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Tests of the patterns of sugar chains (glycans) on IgG antibodies in blood, used to estimate biological age. Offered as a biological-age estimate.

What the evidence shows

A 2014 study analysed IgG glycosylation in 5,117 individuals from four European populations and reported that a combination of three glycans can explain up to 58% of variance in chronological age. No performance data for commercial glycan-age tests are cited here. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Test. Offered as a consumer or wellness test. No regulatory approval or clearance of commercial glycan-age tests was verified.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No adverse effects, and no false-result rates for commercial tests, are cited here. Because the published accuracy concerns chronological age, not health outcomes, a ‘glycan age’ is not shown to predict health.

Sources: Glycans are a novel biomarker of chronological and biological age (Kristic et al., J Gerontol A Biol Sci Med Sci, 2014; Penn State record)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Average length of telomeres (chromosome end caps) in blood cells, offered as an ageing-related score. Consumer kits are sold as a measure of biological age; clinical flow-FISH is used for short-telomere conditions.

What the evidence shows

Johns Hopkins Medicine says that within the normal telomere length range it is not possible to determine a person’s exact biological age. ADLM describes flow-FISH as clinically validated for screening patients with suboptimal telomere length, and quotes an expert who sees no clinical relevance yet for risk of more common diseases such as cancer or cardiovascular disease. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Test. ADLM describes clinical flow-FISH telomere testing as standardised, clinically validated and commercially available. No FDA status for consumer telomere kits was verified.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No harm from the test itself is cited here. The cited limit is interpretive: within the normal range a result cannot give an exact biological age, and no clinical relevance is yet seen for risk of common diseases.

Sources: Accurate telomere length test influences treatment decisions for certain diseases (Johns Hopkins Medicine, 26 Feb 2018) · On the trail of telomeres (ADLM Clinical Laboratory News, Dec 2019)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

An algorithm’s estimate of maximal oxygen uptake (VO₂max) from resting data or from exercise data recorded by a wearable. Marketed as a cardiorespiratory-fitness or fitness-score readout on consumer watches and bands.

What the evidence shows

A systematic review of 14 validation studies (403 participants) found that resting-based wearable estimates significantly overestimated VO₂max (bias 2.17 ml/kg/min). Exercise-based estimates had lower bias (−0.09) but wide limits of agreement (−9.92 to 9.74). The authors say individual-level error is large. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Device. Sold as consumer fitness readouts. No regulatory clearance or approval for wearable VO₂max features was verified.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No adverse effects are cited here. The risk is a misleading figure: resting-based estimates significantly overestimated VO₂max, and the authors say these methods still need improvement for sport or clinical purposes.

Sources: Validity of estimating the maximal oxygen consumption by consumer wearables: a systematic review with meta-analysis and expert statement of the INTERLIVE Network (Molina-Garcia et al., Sports Medicine, 2022)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Amount of calcium in the heart’s artery walls on a non-contrast CT scan, used to refine heart-attack risk estimates when risk is uncertain. Offered to check for early or subclinical calcium and plaque in the heart’s arteries.

What the evidence shows

In the 2026 ACC/AHA guideline, selective use of a non-contrast CAC scan is recommended in men over 40 and women over 45 with borderline or intermediate 10-year risk, when knowing CAC will help the statin decision. USPSTF (2018) found the evidence insufficient to assess the balance of benefits and harms of adding CAC, ABI or hsCRP to traditional risk assessment in asymptomatic adults. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. An imaging test. No regulatory approval or clearance was verified for the scan itself.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No harm from the test itself is cited here. USPSTF could not assess the balance of benefits and harms of adding CAC in symptom-free adults, and guideline use is limited to borderline or intermediate risk.

Sources: ACC/AHA issue updated guideline for managing lipids and cholesterol (American Heart Association newsroom, 13 Mar 2026) · Cardiovascular Disease: Risk Assessment With Nontraditional Risk Factors (USPSTF, 10 Jul 2018, grade I)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A blood marker of low-grade inflammation, measured at high sensitivity. Offered as an inflammation marker in wellness panels and discussed as an add-on to cardiovascular risk assessment.

What the evidence shows

In 2018 the USPSTF concluded that current evidence is insufficient to assess the balance of benefits and harms of adding the ankle-brachial index (ABI), hsCRP or CAC score to traditional risk assessment for cardiovascular disease in asymptomatic adults. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. Used in standard clinical care and offered in wellness panels. No regulatory approval or clearance was verified for the test.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No specific adverse effects or false-result rates are cited here. The USPSTF could not assess the balance of benefits and harms of adding hsCRP to cardiovascular risk assessment in asymptomatic adults.

Sources: Cardiovascular Disease: Risk Assessment With Nontraditional Risk Factors (USPSTF, 10 Jul 2018, grade I)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Blood level of homocysteine, used to look for B-vitamin deficiency and discussed as a cardiovascular risk marker. Offered in wellness panels for both purposes.

What the evidence shows

ADLM’s testing guide says homocysteine testing is appropriate when vitamin B6, B12 or folate deficiency is suspected. It calls homocysteine a weak indicator of cardiovascular risk and states the test is not recommended in routine cardiovascular screening. Its clinical utility for cardiovascular risk is described as uncertain and controversial in folic acid-fortified populations. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Test. No regulatory status was verified for the homocysteine test.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No harm from the test itself is cited here. Its use as a cardiovascular risk indicator is described as weak and uncertain.

Sources: Optimal testing guide to lab test utilization: Homocysteine (ADLM)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A blood protein used, alone or with creatinine, to estimate kidney filtration (eGFR) when creatinine may mislead. Used to check kidney function when creatinine-based eGFR may be unreliable, for example with higher muscle mass.

What the evidence shows

KDIGO 2024 states that eGFRcr-cys, the estimate using cystatin C, has been established as a better approximation of measured GFR than creatinine-based eGFR alone. NICE NG203 notes creatinine-based eGFR may be less reliable with higher muscle mass or protein-supplement use but does not mention cystatin C. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Test. Used in standard clinical care and described in the KDIGO 2024 guideline. No regulatory approval or clearance of cystatin C testing was verified.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

KDIGO notes that creatinine-based eGFR overestimates GFR in the elderly and others with sarcopenia, leading to drug overdosing; cystatin C is used where creatinine may mislead. No harms specific to cystatin C testing are cited here.

Sources: KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease · Chronic kidney disease: assessment and management, NICE guideline NG203, Recommendations

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Liver stiffness measured with a special type of ultrasound. Used to help determine whether a person has advanced liver fibrosis.

What the evidence shows

NIDDK describes elastography as a newer imaging test that can help determine whether advanced liver fibrosis is present, and says increased liver stiffness may be a sign of fibrosis. It notes that liver biopsy can show fibrosis at earlier stages than elastography can. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. No regulatory status was verified for liver elastography.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No harm from the test itself is cited here. Liver biopsy can show fibrosis at earlier stages than elastography can, so earlier-stage fibrosis may not be detected.

Sources: NIDDK liver disease information: diagnosis page (nafld-nash/diagnosis)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Blood tests that combine pTau217 and amyloid 1-42 as a ratio to indicate whether amyloid plaques are present in the brain. One such test is FDA-cleared for adults aged 55 and older with signs and symptoms of Alzheimer’s disease.

What the evidence shows

No accuracy figures are cited here. The FDA clearance covers adults with signs and symptoms of Alzheimer’s disease, and the agency states the test is not intended as a screening or stand-alone diagnostic test. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Test. FDA announced on 16 May 2025 that it cleared the Lumipulse G pTau217/Amyloid 1-42 Plasma Ratio for adult patients aged 55 and older who show signs and symptoms of Alzheimer’s disease.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

A result in a person without symptoms falls outside the cleared use, and a result is not intended to stand alone as a diagnosis. No false-positive or false-negative rates, or harms from a wrong result, are cited here.

Sources: FDA clears first blood test used in diagnosing Alzheimer's disease (FDA press announcement, 16 May 2025)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Glucose levels recorded continuously by a skin-worn sensor, showing how diet and exercise may affect blood sugar. Intended for people without diabetes who want to understand those effects.

What the evidence shows

The FDA announcement presents it for people without diabetes who want to better understand how diet and exercise may affect blood sugar levels. No controlled human trial of health benefit in people without diabetes is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Device. FDA cleared the first over-the-counter CGM on 5 Mar 2024, intended for anyone 18 years and older who does not use insulin.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

FDA states the system is not for people with problematic hypoglycaemia (low blood sugar). It cautions that users should not make medical decisions based on the device’s output without talking to a healthcare provider.

Sources: FDA clears first over-the-counter continuous glucose monitor (FDA press announcement, 5 Mar 2024)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

EPA plus DHA in red-blood-cell membranes, expressed as a percentage of total red-cell fatty acids. Offered as a measure of a person’s omega-3 status.

What the evidence shows

NIH ODS says most clinicians do not currently assess omega-3 status. Its statement that experts have not established normal ranges is made about serum or plasma phospholipid EPA plus DHA. No controlled human trial of the index as a guide to health is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Test. No regulatory status was verified for the Omega-3 Index.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No harm from the test itself is cited here. Routine clinical assessment of omega-3 status is uncommon, and the sources cited give no agreed normal ranges for the related serum or plasma measures.

Sources: Omega-3 fatty acids: fact sheet for health professionals (NIH Office of Dietary Supplements)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Tests of selected genetic variants linked to risk of certain conditions, for example late-onset Alzheimer’s disease or Parkinson’s disease. Offered to tell consumers their genetic risk without a clinician ordering the test.

What the evidence shows

The tests report risk variants, not diagnoses. FDA states that a positive result does not indicate that an individual will develop a given disease or condition, and that results from direct-to-consumer tests should always be discussed with a health care provider. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. FDA states that some direct-to-consumer tests are reviewed by FDA while others are not. It lists authorised examples, including 23andMe genetic health risk tests.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

A negative result means a person may still be at risk for a particular disease or condition. Some direct-to-consumer tests are not reviewed by FDA.

Sources: Direct-to-consumer tests (FDA)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A test of which APOE gene variants a person carries, discussed in relation to the risk of late-onset Alzheimer’s disease. Offered to estimate Alzheimer’s risk; in clinical care it matters for treatment with antiamyloid therapies.

What the evidence shows

Mayo Clinic says routine genetic testing for late-onset Alzheimer’s is not recommended by most experts, and that results cannot fully predict who will get the disease. It adds that for treatment with certain medicines called antiamyloid therapies, testing for APOE genes is important. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. No regulatory approval or clearance was verified for APOE testing offered to estimate Alzheimer’s risk.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

Mayo Clinic states the results cannot fully predict who will get Alzheimer’s disease. No adverse effects or error rates for the test are cited here.

Sources: Alzheimer's genes (Mayo Clinic in-depth article)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Maximal force of a hand squeeze, used as a simple measure of muscle strength. Used in clinical assessment to find sarcopenia (low muscle strength).

What the evidence shows

The EWGSOP2 consensus (Age and Ageing, 2019) says low grip strength is a powerful predictor of poor patient outcomes such as longer hospital stays, increased functional limitations, poor health-related quality of life and death. It gives cut-offs of below 27 kg for men and below 16 kg for women. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Test. No regulatory status was verified for the handgrip test.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No harm from the test itself is cited here. The cut-offs come from a sarcopenia consensus; the sources cited do not address their use in young athletes.

Sources: Sarcopenia: revised European consensus on definition and diagnosis, EWGSOP2 (Cruz-Jentoft et al., Age and Ageing, 2019)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Quick physical-performance tests: the time to walk a set distance and the time to rise five times from a chair without using the arms. Used in clinical sarcopenia assessment.

What the evidence shows

The revised European consensus on sarcopenia (EWGSOP2) says gait speed is considered a quick, safe and highly reliable test for sarcopenia and is widely used in practice. The guidance describes use for sarcopenia assessment in patients and does not address healthy athletes. No performance figures for the chair stand test are cited here. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Test. A physical-performance test used in standard clinical care. No regulatory approval or clearance was verified for these tests.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

EWGSOP2 describes gait speed as a safe test. No harms from false results are cited here.

Sources: Sarcopenia: revised European consensus on definition and diagnosis, EWGSOP2 (Cruz-Jentoft et al., Age and Ageing, 2019)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A test that records brain waves, blood oxygen level, heart rate, breathing, and eye and leg movements during sleep. Used to diagnose sleep disorders such as sleep apnoea.

What the evidence shows

Mayo Clinic describes polysomnography as a test used to diagnose sleep disorders. It records brain waves, blood oxygen level, heart rate and breathing during sleep, and can identify if or when sleep patterns are disrupted and why. No comparison with consumer sleep trackers is cited here. Grade A · Consistent human trials support the claimed use, in the people it is claimed for

Regulatory status

Test. No regulatory status was verified for polysomnography.

Anti-doping status, 2026 List

Not prohibited. Not applicable; a test is neither a substance nor a method.

What can go wrong

No harm from the test itself is cited here.

Sources: Polysomnography (sleep study) (Mayo Clinic)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Consumer wearables, rings, bedside devices and apps that estimate sleep time and sleep stages from motion and heart-rate sensors. Sold to track sleep, give sleep scores and encourage better sleep habits.

What the evidence shows

The American Academy of Sleep Medicine (AASM) 2018 position statement says consumer sleep technologies cannot be used to diagnose or treat sleep disorders at this time. They may enhance the patient–clinician interaction within an appropriate clinical evaluation; future validation, access to raw data and algorithms, and FDA oversight are needed. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Device. FDA’s general wellness policy states it does not intend to examine low-risk general wellness products to determine whether they are devices. The AASM statement notes these products lack FDA clearance.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List. Sleep trackers are measurement tools rather than treatments.

What can go wrong

No adverse effects are cited here. The AASM says device data should be considered within a comprehensive sleep evaluation and should not replace validated diagnostic testing.

Sources: Consumer sleep technology: an American Academy of Sleep Medicine position statement (Khosla et al., J Clin Sleep Med, May 2018; Johns Hopkins repository record) · General Wellness: Policy for Low Risk Devices (FDA guidance, 6 January 2026) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A CT scan covering much of the body, offered as a screening check for people with no symptoms rather than to investigate a complaint. The FDA calls this ‘whole-body scanning of individuals without symptoms’.

What the evidence shows

The scan produces X-ray images of internal structures. The FDA says it ‘knows of no scientific evidence demonstrating that whole-body scanning of individuals without symptoms provides more benefit than harm to people being screened’, and on its CT page that it ‘does not see a benefit’ to it. No randomised trial of whole-body CT screening is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Test. Imaging test. The FDA says it prohibits manufacturers of CT systems from promoting their use for whole-body screening of asymptomatic people; the FDA does not regulate practitioners, who may use a device for any use they deem appropriate.

Anti-doping status, 2026 List

Not prohibited. The scan is not named on the 2026 Prohibited List. A test is not a substance; it carries no anti-doping status.

What can go wrong

Radiation: the FDA says a 10 mSv scan ‘may be associated with an increase in the possibility of fatal cancer of approximately 1 chance in 2000’. An abnormal finding may not be serious, a normal finding may be inaccurate, and false leads can prompt unnecessary testing.

Sources: Full-Body CT Scans - What You Need to Know (FDA) · Computed Tomography (CT) (FDA) · What are the Radiation Risks from CT? (FDA)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A published formula combining chronological age with nine routine blood-chemistry results into an ‘expected age’ matching a person’s estimated mortality risk. The aim is to estimate ‘biological age’ or speed of ageing from a standard blood panel.

What the evidence shows

In US adults (NHANES IV), Phenotypic Age was associated with mortality after adjusting for chronological age, and the association was robust across strata of age, disease count, health behaviours and cause of death. These are observational cohort associations; no trial showing that changing the score improves outcomes is cited here, nor any data on individual-level accuracy, repeat-test variability or responsiveness to interventions. Grade C · Mechanistic, animal or small uncontrolled human data only

Regulatory status

Test. No regulator clearance or approval was verified for the calculation, which has been used in research (NHANES IV). No consensus exists on how biomarkers of ageing should be validated before their translation to the clinic (Nature Medicine, 2024).

Anti-doping status, 2026 List

Not prohibited. The calculation is not named on the 2026 Prohibited List. The List’s wording on withdrawal of blood or blood components carries an exception for withdrawal performed for analytical purposes, including medical tests.

What can go wrong

No adverse effects or regulator warnings are cited for the calculation, which uses results from a routine blood sample.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study (Liu et al., PLOS Medicine, 2018) · Validation of biomarkers of aging (Moqri et al., Nature Medicine, 2024)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A bundle of blood tests and body measurements run together in people without symptoms, to find risk factors or early disease; private services offer it under ‘executive’ and ‘longevity’ labels. The NHS Health Check is a public example.

What the evidence shows

A Cochrane review of general health checks (BMJ, 2012) found no reduction in morbidity or mortality, overall or for cardiovascular or cancer causes, although new diagnoses increased. A 2021 ESC guideline says systematic cardiovascular risk assessment in the general population with no known risk factors appears not cost-effective in reducing events and death in short follow-up. No trial of ‘longevity’ or ‘executive’ panels is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for

Regulatory status

Test. No regulator position on ‘longevity’ or ‘executive’ panels as a product was verified. The NHS runs a defined public Health Check, a free check of heart and blood-vessel health for adults aged 40–74.

Anti-doping status, 2026 List

Not prohibited. The panels are not named on the 2026 Prohibited List. The List’s wording on withdrawal of blood or blood components carries an exception for withdrawal performed for analytical purposes, including medical tests.

What can go wrong

General health checks increased the number of new diagnoses without reducing deaths, and false-positive and overdiagnosis rates for commercial panels are not cited.

Sources: NHS Health Check (NHS, page last reviewed 14 August 2023) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis (Krogsbøll et al., BMJ, 2012)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

A body-composition device that estimates fat mass and fat-free mass by air displacement, marketed for use in athletes, clinics and research.

What the evidence shows

Body composition (fat mass and fat-free mass) is estimated by whole-body air displacement. A 2021 narrative review of body-composition methods in athletes (Nutrients) says hydrostatic weighing and air plethysmography are considered the gold standard for assessing fat mass. No error ranges, athlete-specific accuracy figures or comparison with DXA are cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. FDA’s 510(k) record for the Bod Pod (K060848, 2006) shows a Substantially Equivalent (SESE) decision under the classification name ‘Plethysmograph, Air Displacement For Body Composition Analysis’ (Class 2 per openFDA). The status of the current-generation product was not verified.

Anti-doping status, 2026 List

Not prohibited. The Bod Pod is not named on the WADA 2026 List.

What can go wrong

No adverse effects or regulator warnings are cited here, and neither is accuracy in specific groups such as very lean or heavily hydrated athletes.

Sources: FDA 510(k) database record K060848, BOD POD · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Assessment of Body Composition in Athletes: A Narrative Review (Campa et al., Nutrients, 2021)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Devices that estimate total body water, fat-free mass and fat mass from the body’s bioelectrical impedance, marketed for estimating body composition and, in athletes, monitoring nutritional status and seasonal changes in body composition.

What the evidence shows

A 2021 narrative review in Nutrients says that, up until 2020, BIA and BIVA in athletes failed to provide accurate results because equations and references were unspecific, and that athlete-specific equations have only recently been proposed. The authors say BIA and especially BIVA can now be used to monitor nutritional status and seasonal changes in body composition. Comparison with DXA is not cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. FDA’s 510(k) database lists a body-composition analyser device type (Class 2 per openFDA); example record K140045 shows a Substantially Equivalent (SESE) decision. The FDA entry names no measurement principle, and the status of consumer smart scales was not verified.

Anti-doping status, 2026 List

Not prohibited. Body-composition scales are not named on the WADA 2026 List.

What can go wrong

Accuracy depends on the equation used: unspecific equations gave inaccurate findings in athletes, and the quantitative estimate rests on assuming constant soft-tissue hydration; no adverse effects or regulator warnings are cited here.

Sources: FDA 510(k) database record K140045 · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Assessment of Body Composition in Athletes: A Narrative Review (Campa et al., Nutrients, 2021)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

What it is

Non-invasive tests used to estimate arterial stiffness and, with some devices, central aortic pressure. Pulse-wave velocity (PWV) is described in the 2018 ESC/ESH guideline as ‘an index of aortic stiffness and underlying arteriosclerosis’.

What the evidence shows

The evidence cited is limited: the 2018 ESC/ESH hypertension guideline lists carotid–femoral PWV above 10 m/s among factors influencing cardiovascular risk in hypertensive patients. No trial showing that acting on PWV improves outcomes is cited here, and no figures are cited for individual-level accuracy or for use in people without symptoms. Grade B · Some human trials — limited, mixed, or in a narrow clinical population

Regulatory status

Test. A test. The FDA cleared one cuff-based system (510(k) K122129, Class II) as a noninvasive blood pressure measurement system; its PWV option is intended to obtain PWV measurements. No position on other PWV devices is cited here.

Anti-doping status, 2026 List

Not prohibited. Not named on the 2026 Prohibited List. A test is not a substance; it carries no anti-doping status.

What can go wrong

No adverse effects are cited here. Reliability and individual-level accuracy figures are not cited either; the FDA summary states a measurement purpose for the PWV option.

Sources: FDA 510(k) summary K122129, SphygmoCor XCEL System (PWV option) · 2018 ESC/ESH Guidelines for the management of arterial hypertension (Table 4)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.