Longevity Protocol • ICD-10 Z71.89
Cellular Longevity & mTOR/AMPK Optimization
Preventive geroscience protocols targeting nutrient-sensing pathways, autophagic proteostasis, mitochondrial biogenesis, and inflammaging suppression.
Medically Reviewed by Dr. Devon Caldwell, DO, MPH (NPI #1568063758)
Cellular Longevity & mTOR/AMPK Optimization Optimal Biomarker & Diagnostic Fact Matrix
| Metric | Verified Benchmark | Source |
|---|---|---|
| ICD-10-CM Diagnostic Classification | Z71.89 | WHO / CMS ICD-10-CM Clinical Modification |
| Biomarker: hs-CRP | < 0.7 mg/L | DotMD Preventive Optimal Target Range |
| Biomarker: ApoB | < 70 mg/dL | DotMD Preventive Optimal Target Range |
| Biomarker: IGF-1 | 110 – 175 ng/mL | DotMD Preventive Optimal Target Range |
| Biomarker: Cystatin C eGFR | > 95 mL/min/1.73m2 | DotMD Preventive Optimal Target Range |
Pathophysiology & Clinical Presentation
Age-associated hyperactivation of mTORC1, NAD+ depletion via CD38 upregulation, and accumulation of senescent SASP-secreting cells impair mitophagy and accelerate epigenetic clock drift.
Hallmark Clinical Signs & Biomarker Triggers
- Declining VO2 max and slower post-exercise recovery
- Rising high-sensitivity CRP without acute infection
- Sarcopenic lean mass loss despite resistance training
- Impaired metabolic flexibility between lipid and glucose oxidation
Evidence-Based Medications & Cash Arbitrage for Cellular Longevity & mTOR/AMPK Optimization
| Medication | Mechanism Class | Worth-It Score | Retail Avg | Lowest Cash |
|---|---|---|---|---|
| Tadalafil Cialis, Adcirca | Long-Half-Life Selective Phosphodiesterase-5 (PDE5) Inhibitor | 96.10% (64) | $165.00 | $5.90/mo |
| Ezetimibe Zetia | Intestinal NPC1L1 Sterol Transporter Inhibitor | 94.60% (36) | $98.00 | $6.60/mo |
| Telmisartan Micardis | Long-Half-Life AT1 Receptor Blocker & Partial PPAR-Gamma Agonist | 94.10% (31) | $76.00 | $7.80/mo |
| Rosuvastatin Calcium Crestor | Hydrophilic High-Potency HMG-CoA Reductase Inhibitor | 92.40% (44) | $86.00 | $5.70/mo |
| Sirolimus (Intermittent Longevity Protocol) Rapamune | Allosteric mTORC1 Kinase Inhibitor / Geroprotector | 91.60% (34) | $168.00 | $24.80/mo |
| Ergocalciferol / High-Dose Prescription Calciferol 50,000 IU Drisdol | Secosteroid Nuclear Vitamin D Receptor (VDR) Prohormone Repletion | 91.50% (33) | $22.00 | $4.90/mo |
| Low-Dose Colchicine (0.5–0.6 mg Vascular Anti-Inflammatory) Lodoco, Colcrys | Beta-Tubulin Polymerization & NLRP3 Inflammasome Inhibitor | 89.90% (22) | $118.00 | $9.20/mo |
| Methylcobalamin (Active Vitamin B12 Injection) Methyl-B12 Sterile | Methionine Synthase One-Carbon Methylation Cofactor | 89.00% (22) | $48.00 | $25.00/mo |
| Low-Dose Naltrexone (LDN 1.5–4.5 mg) Compounded LDN | Microglial TLR4 Antagonist & Endogenous Opioid Rebound Modulator | 88.70% (29) | $75.00 | $35.00/mo |
| Metformin Hydrochloride Glucophage, Glucophage XR, Fortamet | Biguanide AMPK & Mitochondrial Complex I Modulator | 88.10% (51) | $24.00 | $5.40/mo |
| Selegiline Hydrochloride (Low-Dose Selective MAO-B Protocol) Eldepryl, Emsam | Selective Propargylamine Monoamine Oxidase-B (MAO-B) & Striatal SOD Enhancer | 87.50% (19) | $132.00 | $19.40/mo |
| Acarbose Precose | Intestinal Alpha-Glucosidase & Pancreatic Alpha-Amylase Inhibitor | 83.40% (21) | $64.00 | $11.80/mo |
| Memantine Hydrochloride Namenda | Uncompetitive Fast-Off-Rate Voltage-Dependent NMDA Receptor Antagonist | 82.90% (15) | $78.00 | $6.80/mo |
| Nicotinamide Adenine Dinucleotide (NAD+ Sterile) Compounded Subcutaneous NAD+ | Sirtuin (SIRT1–7) & PARP Coenzyme Redox Substrate | 82.10% (19) | $240.00 | $145.00/mo |
| Pentoxifylline Controlled-Release Trental | Hemorheologic Methylxanthine Erythrocyte Deformability & TNF-Alpha Inhibitor | 81.70% (14) | $56.00 | $9.40/mo |
| Canagliflozin Invokana | Dual Renal SGLT2 & Low-Potency Intestinal SGLT1 Inhibitor | 81.00% (11) | $628.00 | $142.00/mo |
| Reduced L-Glutathione (GSH Parenteral) Compounded GSH | Endogenous Tripeptide Thiol Antioxidant & Phase II Conjugant | 80.40% (14) | $165.00 | $99.00/mo |
| Donepezil Hydrochloride Aricept | Piperidine Reversible Central Acetylcholinesterase Inhibitor | 79.60% (14) | $44.00 | $5.30/mo |
INSTANT PRESCRIPTION & CASH ROUTING
DotMD Club Members get $29 flat-rate script renewals →
Verified Online Prescribers & Wholesale Pharmacies for Cellular Longevity & mTOR/AMPK Optimization
Mark Cuban Cost Plus Drugs (Wholesale Pharmacy)
Requires an existing doctor prescription. Need a script? Pair with a $29 DotMD Club TeleMed consult.
$5.90/mo
Wholesale Cash Price
AgelessRx Geroprotective Telehealth (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~3 days
• Rx included in monthly tier
$
65.00
All-In Monthly
Hone Health Hormone & At-Home Biomarker Lab (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~3 days
$
65.00
Consult / Starting Tier