Methodology
How evidence tiers and honesty flags are assigned, and why telomere length is contested.
Evidence tiers
Evidence is shown on a visible seven-tier scale (1 = healthy-aging human lifespan RCT, down to 7 = in vitro/mechanism) and is never collapsed into a single marketing score. Tier 1 is empty on this site by design: none of the studies covered here is a healthy-aging lifespan RCT. Note the deliberate distinction between tier 2 (a human clinical-outcome trial in a disease population, including single-arm danazol and randomized imetelstat trials) and a healthy-aging lifespan result — the former is real and important, but it is disease treatment, not evidence of an anti-aging effect. Tier 3 (telomere-length / telomerase-activity biomarker RCTs, e.g. TA-65) sits below that, because a biomarker change is not a clinical outcome.
Why telomere length is a contested biomarker
Telomere length is measured by several methods (qPCR, Flow-FISH, Southern/TRF) that do not always agree, varies between tissues and cell types, and associates with aging and mortality only modestly and inconsistently across cohorts. A longer measured telomere is not straightforwardly "healthier," and lengthening telomeres in a trial does not establish a slowing of human aging. Every page states this so a telomere-length result is never read as a longevity outcome.
The telomerase–cancer paradox
Telomerase expression depends on cell type and proliferation; cancer can also use telomere maintenance, so pharmacologically activating it raises an unresolved cancer-risk question. The clearest illustration is that the FDA-approved telomerase inhibitor — imetelstat (RYTELO, 2024) — inhibits telomerase to treat lower-risk MDS. TeloiX frames imetelstat as the honesty foil: it points the opposite direction from the anti-aging "activation" narrative.
Honesty flag
Each intervention carries a flag determined by its explicit status in the compiled evidence records: ○ not established means that the compiled studies do not establish a healthy-aging human lifespan benefit. Each record separately describes its population, measured endpoints and limitations. The flag comes from an explicit corpus status; wording changes cannot turn it into a positive efficacy claim.
How identifiers are confirmed
Journal, volume and DOI were confirmed via Crossref; trial design and status via the ClinicalTrials.gov v2 API where an NCT was resolvable; and PMID/PMCID against Europe PMC. Each record's citation status names which source confirmed it and on what date. An identifier that cannot be confirmed is left empty and named as unconfirmed in the record, never invented and never taken from a secondary source.
This site previously used a build-time tag to mean “confirm this later”. It was removed on 2026-08-08, because a record can sit behind such a tag indefinitely while the page reads as though someone is coming back to it. The 2025 TA-65 meta-analysis was carried that way even though its own citation status recorded a confirmed DOI; its publication identifiers are confirmed (PMID 41286474, PMCID PMC12644169), but its trial table has material discrepancies with the original cited papers; see the study record. Publication identity is not result validation. A record either names its confirmed identifiers or names what is missing and why.