Annual programme membership

A head-to-toe examination including heart sounds, lungs, abdomen, lymph nodes, thyroid, skin and neurological function.
A considerable number of conditions produce a physical sign before they produce an abnormal result, and no panel of tests replaces a clinician examining you without hurry.

Fat mass, lean mass and — most importantly — visceral fat, which surrounds the organs and is a stronger predictor of cardiovascular disease and diabetes than weight or body mass index. Two people of identical weight can carry entirely different risk, and only measurement distinguishes them.

A recording of the heart’s electrical activity, detecting rhythm disturbance, conduction abnormality and evidence of previous damage. Atrial fibrillation affects well over a million people in the United Kingdom, substantially raises stroke risk, and frequently produces no symptoms at all.

Lung capacity and the rate at which air can be moved. Obstructive and restrictive lung disease develops silently over years and is frequently well established before breathlessness is noticed. Detected early, the trajectory can be altered; detected late, the damage is fixed.

Up to two hundred parameters across blood count, renal and hepatic function, lipids, glucose and insulin, thyroid, inflammation, iron, vitamins, minerals and hormones. Together they describe metabolic health as a system rather than as a series of isolated readings, and they identify anaemia, renal impairment, hepatic disease, diabetes risk and thyroid dysfunction years before symptoms.
Two elements deserve particular mention. Apolipoprotein B counts the particles that cause arterial disease rather than the cholesterol they carry, and diverges from a standard cholesterol result in roughly one person in five. Lipoprotein(a) is inherited, unmodifiable by diet or by statin therapy, raised in a further fifth of the population, and measured once in a lifetime — most people have never had it measured at all.

Glucose and insulin measured together across two hours. Insulin resistance develops a decade or more before blood sugar rises, because the pancreas compensates by producing progressively more insulin. Throughout that period a standard glucose or HbA1c result reads as normal. This is the only routine test that finds it.

The full thyroid panel including antibodies, which can predict autoimmune thyroid disease years in advance, alongside a complete hormone profile measured by mass spectrometry. Immunoassay — the method used almost everywhere — is unreliable at low concentrations, which is precisely where accuracy determines the diagnosis.

Autoimmune conditions cluster, and antibodies frequently appear years before the condition they signal. A full panel identifies that tendency at a stage when it can be monitored rather than treated. Immune profiling assesses how the immune system has aged, which is measurable and is not the same as chronological age.

Used as part of a picture rather than in isolation, since no marker is diagnostic alone. In women the composite ovarian index combines two markers and is more accurate than either separately. In men prostate-specific antigen is interpreted alongside imaging rather than as a number.

Renal function and early kidney damage, which appears in urine long before it appears in blood. Intestinal inflammation, permeability, exocrine function and occult bleeding. The diurnal rhythm of cortisol, which a single blood test cannot show. These are the analyses most frequently omitted, and they cover territory nothing else reaches.

Imaging of the brain, the arteries within the head and neck, the whole spine, and the organs of the chest, abdomen and pelvis. The angiographic sequences identify aneurysm and vascular disease that a torso-only protocol leaves out. No radiation, and reported by a consultant radiologist.

The finest available assessment of the coronary arteries and the lung, and the only investigation here that carries a radiation dose. Calcium scoring quantifies established disease; angiography identifies the softer plaque that scoring does not detect, which is the plaque that ruptures. Performed on risk, justified individually, and repeated at intervals of years.

Without radiation, and repeatable. The carotid arteries, where arterial disease appears earlier than in the heart. The abdominal organs and the aorta. The thyroid, for nodules. The pelvis, and in men the testes, ultrasound being the reference investigation for testicular malignancy.

Bone mineral density at spine and hip. Bone loss is entirely silent until fracture, and osteoporosis causes several hundred thousand fractures a year in the United Kingdom. Identified at fifty, the trajectory can be changed; identified at seventy after a wrist fracture, it cannot.

Liver stiffness and fat content, measured by ultrasound in ten minutes. Fatty liver disease is now the commonest liver condition, is silent until advanced, and produces a normal blood panel in a substantial proportion of those affected.

Maximal oxygen uptake, measured directly under load rather than estimated at rest. It is the single measure most strongly associated with how long and how well people live, the association is graded with no upper limit of benefit, and it responds to training at any age. A resting estimate is not the same measurement and should not be described as one.

Hearing because its loss is the largest single modifiable contributor to dementia risk in current modelling, and is corrected straightforwardly. Vision because the retina is central nervous tissue and its blood vessels are the only part of the circulation that can be photographed directly. Cognition because decline is detected against your own prior performance and cannot be assessed without a baseline.

Photography of the entire skin surface with magnified imaging of individual lesions, held against your previous mapping. The value is created at the second assessment rather than the first: a single examination identifies lesions that already look abnormal, whereas comparison identifies those that have changed — which is how melanoma is caught early and how unnecessary excision is avoided.

Undertaken once. Inherited cancer risk, cardiac predisposition, carrier status, and the enzymes that determine how you metabolise medicines — so that anything prescribed to you is something you can process. Your genome does not change; what is known about it does, which is why the analysis is revisited rather than repeated.

Given weekly, and at higher dose once a month. It replaces what is measurably depleted, not what is fashionable: fluid and electrolytes, the B vitamins in the forms the body uses directly, amino
acids, vitamin C and glutathione. Minerals and trace elements accumulate in the body, so they are given monthly and dosed against measurement. The evidence for NAD in humans is still early, and it is given at a conservative weekly dose for that reason.

Oxygen breathed at more than twice atmospheric pressure, in a hard-shell chamber. Its use in wound healing and decompression illness is long established. The studies suggesting an effect on cellular ageing are small, short and not yet replicated. We offer it because it is safe and the reasoning is sound, and we say plainly that the longevity evidence is
preliminary.

Blood is drawn from one arm, passed through a filter where it is exposed to oxygen and ozone, and returned to the other over forty-five minutes. It is offered on indication, not by routine, and only
after your doctor has explained what is known and what is not.

Alternating intervals of reduced and elevated oxygen, delivered by mask while you sit. The trials are small but consistent in showing improvements in exercise capacity and vascular function in older
adults. It asks nothing of you, carries no recovery, and is given during the monthly infusion for that reason.

Plasma is separated from the blood, removed, and replaced with albumin, over two to three hours. It is established treatment in neurology and haematology, where it removes the antibodies causing
disease. Its use in ageing rests on a smaller body of work suggesting that removing circulating inflammatory and age-associated proteins has measurable effects. It is offered where your doctor
judges it warranted, and not otherwise.

The same platform, with a column that binds lipoprotein(a) and removes it from the circulation. Lipoprotein(a) is inherited, raised in roughly one person in five, and unmoved by diet or by statins. Where it is high and arterial disease is progressing despite everything else, apheresis is the only treatment that lowers it. The criteria are strict and few members will meet them.

Prescribed where measurement shows deficiency, and monitored by measurement thereafter. It is given to restore a physiological range, not to exceed it. Doses are adjusted against results rather than at a scheduled review, which is why hormones are measured by mass spectrometry at every assessment and monitored again each month.

Platelet-rich plasma prepared from your own blood, drawn at the start of the visit and concentrated on site. The evidence is strongest in hair restoration and in skin quality, where the effect is real but modest and depends on repetition. It is one part of hair restoration rather than the whole of it, which is why medical therapy is reviewed at the same attendance.

Given at the assessment, last in the day, because four hours upright afterwards precludes every supine investigation. They are aesthetic rather than medical, and they are recorded, dosed and reviewed in the same way as everything else.

Periodontal inflammation is a measurable contributor to inflammatory burden elsewhere in the body, and it is increasingly linked to disease of the arteries and the brain: people with gum disease carry a higher cardiovascular risk, and the bacterium behind it has been found in the brains of people with Alzheimer’s disease. Professional cleaning uses air polishing rather than scraping, and whitening is provided at the quarterly assessment, alongside other treatment, at an interval that protects the enamel.

Wax is removed under a binocular microscope rather than by syringing: the canal is visible throughout, nothing touches it but the instrument, and there is no water and no discomfort. Where the sinuses are the problem rather than the ears, powered irrigation reaches surfaces that rinsing at home does not. Both are examined monthly and treated where needed.

The weekly HydraFacial addresses tone, congestion and hydration, and is the part of the programme whose effect is visible within the week. The monthly treatment alternates between radiofrequency microneedling with your own plasma and the laser protocol your skin requires. They are never combined, since both act on the same layer of the skin.

Three clinical wavelengths delivered simultaneously, each reaching a different depth: blue at the surface, red within the dermis, near-infrared below it. Twenty minutes, nothing felt beyond a mild warmth and given after the facial because light reaches freshly exfoliated skin more effectively.

A single blood sample analysed for the DNA signature of more than fifty cancers, most of which have no other screening test. It finds some cancers early and misses others, and it is offered with those limits explained rather than assumed, as one part of a screening programme built around your risk.

Some things cannot be measured in a clinic at all. A patch worn for up to fourteen days records the rhythm disturbance that appears once a fortnight; twenty-four-hour blood pressure monitoring records the overnight pattern that carries the greatest prognostic weight; and a home sleep study identifies obstructive sleep apnoea, which is common, largely undiagnosed, and treatable.