The expression “TMI” was first coined by a Wall Street Journal reporter in 1988, though it wouldn’t really enter our popular lexicon (and promptly explode!) until a decade later. The abbreviation for “too much information” refers to an overload of info, particularly anything that is personal in nature. Like, say, sharing the details of your infant’s poop composition on a triple date? Or, perhaps, sending the picture you snapped of the golf ball-size cyst your dermatologist removed from one buttock cheek to your girlfriend group chat? These are examples of my own acts of TMI (a core part of my personality that I chalk up to my reporter brain’s intense need for as many granular details as possible). This kind of behavior, once an exception, has now become the norm. We all reveal TMI, even when it comes to health care. And the growing market for comprehensive diagnostic tests and devices is just another example of information overload.
“COVID led to a thirst for knowledge,” says Richard Chang, cofounder and COO at New York’s Extension Health, the longevity-focused arm of the “integrated health ecosystem” Hudson Health, which also includes pain clinic Hudson Medical and psychiatric care Hudson Mind. That thirst for knowledge has led to a deluge of services that prominently position diagnostics—which can include anything from blood and fecal testing to full-body scans to postural alignment exams—in their approach to keeping people healthier for longer. There are at-home products too: In the past decade, technology has given us more tools to access and interface with our health data on a daily basis, like Apple watches and Oura rings.
“Wearables are giving people access to data they couldn’t easily get before,” says Mark Hyman, MD, the cofounder of health management platform Function Health, “but they can’t get under the skin.” In the past few years, though, we have seen the emergence of blood and urine home-testing brands that do, like Everlywell, and Prenuvo, a $2,500 full-body scan for the one-percenters. Now there’s a new wave of companies going deeper on diagnostics, and aiming to build long-standing relationships with the people seeking them out.
With Function Health, members get access to an extensive assessment that includes five times more lab testing than you’d receive during a typical annual physical; routine bloodwork usually includes a complete blood count, comprehensive metabolic panel, lipid panel, TSH, vitamin D, iron panel, prostate specific antigen (for men over 50), and hemoglobin A1C (for those with risk factors for diabetes). Since the company’s launch last summer, Dr. Hyman says, they’ve had more than 150,000 people sign up.
Extension Health relies on diagnostics as a baseline to inform the direction of prescribed therapeutic treatments, such as NAD IVs or peptide therapy, which are far different than what your general medicine practitioner would point you to.
Whether more information is actually better in this context is up for debate. Andrew Ahn, MD, a physician researcher at Brigham and Women’s Hospital and the Osher Center for Integrative Health at Harvard Medical School, remains relatively skeptical about the purported benefits of these comprehensive panels of biomarkers. “There are significant biological and analytical limitations to be considered,” he says, noting that biomarkers obtained in blood do not always reflect what is happening at the tissue or cellular level.
For example, serum testosterone may not accurately represent its activity in muscle or brain tissue. Taking single measurements of hormones—like cortisol, IGF-1, or leptin, which have circadian and ultradian rhythms that cause them to fluctuate throughout the day—can be misleading. Then, says Dr. Ahn, there are analytical limitations with different testing methods yielding varying results from the same biomarker. For instance, measuring testosterone by immunoassay can differ from what you get via mass-spectroscopy.
Despite skepticism from traditional health care providers, these newer businesses appeal to many types of people, not just the most woo-woo among us. Chang reports that the adopters of Extension Health thus far bridge various demographics: There are those who first came to their heritage practice to alleviate specific symptoms and are now looking for ongoing care; there are the hardcore biohackers; there are the customers who have issues (such as Lyme disease, long COVID, or autoimmune conditions) that traditional health care has overlooked or been unable to fully address.
Then there are what Chang calls “the weekend warriors,” who are newly curious about longevity and just dipping their toes in. Love.Life, the longevity center opened a few months back by Whole Foods founder John Mackey (who has shifted his focus from improving our diets to optimizing the preventative health experience), will likely see plenty of those weekend warriors, thanks to its location in a very well-trodden strip mall—a stone’s throw from a Whole Foods, fittingly—just outside LA.
I’d put myself in that last category. I’ve had Lyme disease and some health issues that my doctors haven’t been able to suss out, but they are mostly in the rearview. At the end of last year, this warrior spent a number of weekends subjecting herself to blood draws, various scans, and poking and prodding, all in the name of longevity and satiating my aforementioned biological need for details. I devoted two mornings (spaced two weeks apart to allow for a greater breadth of results) to fasting and lengthy blood draws (performed at my local Quest Diagnostics) for analysis by Function Health. My multiple vials were carted off to be tested for more than 100 biomarkers, from hormonal and metabolic to thyroid and immune regulation. An extensive and detailed assessment of my levels—conducted by Function’s clinical care team, a group of MDs—arrived in my inbox weeks later.
At Extension, I tried the 3D postural-alignment scan, which is advanced imaging technology that takes a series of pictures as you spin around on a platform to determine where the imbalances are in your body. (As a Libra, this was deeply relevant for me.) The test confirmed that my left hip is slightly off-kilter, something I’ve felt since being pregnant six years ago and carrying my daughter lopsided, and something my former pelvic floor therapist and my current trainer have repeatedly pointed out.
I also visited Remedy Place, the chic social wellness club™with locations in New York and LA, where self-care is spun as something that isn’t solely a solo affair. “Our mission is always to make people feel better, but it’s also to change the narrative of how they socialize,” explains founder and CEO Jonathan Leahy, who adds that since younger generations are drinking less, they’re more game for these alternatives. The club has cryo, bespoke vitamin IV drips, and breath work ice baths on the menu.
At the Remedy Place location in New York City’s Flatiron district, I was hoping the serene environs of the space would quell my nerves about my first cold plunge; what ended up helping more was that I didn’t plunge alone. I met Mary, who was in town from Texas, and was a regular cold plunger in Dallas. Knowing she was there in the tub near me, even though I didn’t know her at all, was weirdly reassuring. A pre-recorded track guided us through a brief breath work session, before we slid ourselves into the 39°F water (all the way up to the chest for optimal effects). The first minute or so was rough, but then I settled in, focused on my breath, and the six minutes flew by.
I toweled off and went upstairs for the next challenge, this one solo: an hour in a hyperbaric oxygen chamber, where the air pressure is increased to promote healing and boost immunity. My tolerance of small, enclosed spaces (not to mention massive crowds) has nosedived in my 40s, so the coffin-like hyperbaric chamber didn’t exactly beckon. But I took solace in the knowledge that there was a button to immediately summon a staff member should I dip into panic mode, and that I could bring a book in with me as a distraction for my overactive brain.
The information I got about myself from my visit to Remedy Place wasn’t necessarily about numbers or levels; rather, it was about how much I could push myself outside my comfort zone and what my brain and body needed to be able to go there (shout out to Mary).
Of late, my index finger has also revealed my diagnostic commitment (and made me an unwitting part of some wink-wink wellness club): Last year I betrothed myself to Oura, stacking one of their brushed-platinum rings atop my grandmother’s diamond-flecked gold band. A new accessory on my hand didn’t take any getting used to, but the sudden influx of information that it transmitted daily to my phone did. I got nudges about winding down for bed (usually while I was watching Real Housewives and scrolling Poshmark) and pop-up kudos when I met a preset activity goal.
Though I haven’t become someone who obsessively checks my Oura insights (the app does not have as much of a vise grip on my attention as Instagram), the data I’ve sorted through has been helpful in revealing—rather, confirming—areas that can use some improvement, like sleep. Specifically, I need more of it, a condition that seems like it could be solved by going to bed earlier and consuming less alcohol beforehand. My ring readout has repeatedly shown that on evenings when martinis were on the menu, my REM sleep drastically dropped.
Knowledge can be power, but can we also know too much? Is there a point when all this personal diagnostic information about health actually becomes detrimental to our health? “We are in a very exciting but also confusing place right now,” says Sofia Chernoff, PsyD, director of cognitive behavioral therapy programs at the Beck Institute, “because a lot of this technology can do so much good, but it can also be harmful depending on how we use it.” For tracking devices like the Oura ring or Apple Watch, Chernoff suggests using them only with a specific intention in mind (like, say, sleep hygiene) or on the advice of your doctor. In other words, she says, match the tech to your needs.
Allure has reported on the potential risk that trackers can perpetuate eating disorders or exercise addiction in certain people because of the focus on hitting certain numbers. Patient response is dependent on the meaning they attach to the metrics, says Allen Miller, PhD, executive director of the Beck Institute: “For an individual with health-related anxiety, anxiety may increase if they are interpreting this health information in a negative way.”
Extensive lab tests can also contribute to patient anxiety. Give almost anyone a full-body MRI like Prenuvo, says Chernoff, and it will find something wrong. It did for me when I had the scan in 2022, when the results showed something potentially problematic on my liver. I went into a panic spiral, scheduled visits with my physician and a follow-up MRI at my regular radiology center, all of which revealed that nothing was in fact wrong with my liver. “What the scan turns up might not cause a health problem,” says Chernoff, “but it can create a lot more stress and anxiety.”
In general, says Steve O’Neill, the director of behavioral and mental health at Harvard Medical School, and as studies have confirmed, people would rather know than not know. “But it can get oversaturated,” he adds. “Most patients also don’t want to be ambushed with information.”
That’s particularly true when all that knowing leads to a false alarm, as was the case for my liver and me. A recent study by the University of Michigan found that when medical test results are hard to understand, that only increases our tendency to worry. While these start-up ventures have streamlined and modernized readouts for anyone without an MD in their title, the information can still be confusing and overwhelming. I certainly felt that way.
This knowledge seeking is primarily marketed as a way to slow aging, but the onslaught of information could defeat the purpose of why we sought it out in the first place. “[Mentioning] aging is the easiest way to get people in a panic to do something,” says William Mair, PhD, a professor and director of the aging initiative at Harvard’s School of Public Health, who studies metabolism and metabolic dysfunction as the root cause of chronic disease. “There’s a good argument to be made that being anxious and having more anxiety, no matter if it helps you find something out early, will put you in such a cortisol-driven state that you’re going to age badly.”
On the other hand, if the results are in the client’s favor, they can put you in a very different state. One test that was included in my Function panel was for determining biological age. Our chronological age is the number of years lived, but our biological age, determined by looking under our proverbial hood, examines how we are aging at a cellular and molecular level. Faster biological aging is believed to increase our overall risk for diseases commonly linked with aging, such as diabetes, cardiovascular disease, kidney failure, and cognitive decline and dementia. The cellular damage that speeds up biological aging is accrued over the years by the usual culprits, including a poor diet heavy on processed and sugary foods, too much stress, and too little sleep. I’m chronologically 46, but according to my Function assessment, biologically 31. That made me feel, admittedly, bionic; I’m a mere 30-something! Thrilling! Have I happened upon some Death Becomes Her-like formula for aging in reverse like Lisle Von Rhuman?
Knowing your biological age—whether older or younger than your chronological one—is a biomarker the doctors I spoke with agree can be useful in zeroing in on (and ideally, modifying) factors that can lead to age-related diseases. It’s true that these biological age assessments can vary depending on when they are taken (some, says Mair, can be so variable that being hung over or pregnant or getting the flu will alter your readout) and the system by which your readout is being assessed. But we have, Mair says, gotten to a point in the past decade where a blood sample can provide fairly good accuracy. “[Twenty or 30 years ago], thinking about aging as a biological process we could change was still niche science, and there’s been a phenomenal shift since then,” Mair explains. As a result of this shift, more doctors are open to considering how these results could steer treatment plans.
While Mair believes that advancements in science and technology will drive groundbreaking shifts in these health diagnostics in the coming years, ones that could help doctors come up with treatment plans that would actually extend a patient’s life, we are not—despite claims by TikTok wellness gurus—there yet. “The problem is that science is a slow process and social media is a fast one,” adds Mair.
Fast and convincing, it’s easy to be swayed onto buzzy paths like rapamycin, plasma transfusions, or even intermittent fasting, all billed to unlock longevity. A study published in February that analyzed nearly a thousand social media posts about medical tests “with potential for overdiagnosis or misuse,” like full-body MRI scans and tests that analyze a patient’s gut microbiome, found that while 87% of posts mention the potential benefits of these tests, fewer than 15% mentioned potential harms; only about 6% included any scientific evidence or information about overdiagnosis. One of the study’s authors told the New York Times that Kim Kardashian’s 2023 post about getting a Prenuvo scan was what inspired her to start the research.
“People are taking five thousand things for longevity just because they saw it on Instagram,” says Jeoff Drobot, a naturopathic doctor and founder of Bio.Med, a longevity clinic in Scottsdale and Providence, which takes a root-cause medicine approach reliant on various diagnostic assessments, and offers many of the same regenerative treatments as Love.Life. “Americans have really made wellness noisy and more stressful and are completely disturbing their lifestyles to get five more years,” says Drobot, “which is the opposite of what we’re supposed to be doing.” He, like other prominent voices in the longevity space, highlights the difference between health span and lifespan: The goal of the former is to get more healthy years, not simply more calendar years.
Currently, Americans have one of the shortest lifespans when compared with similarly large, wealthy countries and, arguably, dismal health spans, with increasing rates of chronic issues like diabetes and heart disease. We also happen to spend more on health care than any other country in the world—something these modern longevity ventures don’t seem to be changing. A comprehensive diagnostic package at Extension Health is $999, a five-pack of cold plunges at Remedy Place is $250, and Oura rings start at $229. These wellness facilities, Dr. Ahn notes, are often more concentrated in communities with ample resources. Does this mythical health span then become the provenance of the one percent? Are we headed toward a world where the wealthiest people are the ones chosen to live the longest?
Dr. Ahn believes that an emerging challenge in health care will be a division between two systems of care that are increasingly disconnected. “While traditional medicine is evidence-driven and cautious, the wellness industry thrives on innovation, self-experimentation, and consumer engagement,” he explains. “Both perspectives have value, but this misalignment risks creating conflicting messages, and I worry that this may lead to further fragmentation in health care.”
On one hand, some of these spendy tests can uncover health issues that had been otherwise overlooked. This was the case with TV host Maria Menounos in 2023, when a Prenuvo appointment revealed what doctor’s visits and a CT scan previously hadn’t: a mass on her pancreas that indicated stage II pancreatic cancer, which—had it not been caught in time for treatment—could have progressed with fatal consequences. In my case, these diagnostics often underscore what I already know, like that off-kilter left hip of mine. But if there is a chance that testing could uncover a serious health issue or simply set you up for living a healthier life into your later years, and the only risk involved is wasting time and money…for some people, that may be worth it.
As technology advances, the hope among scientists who study aging, like Mair, is that these options will become more accessible, even to those who don’t make six- or seven-figure salaries. At the same time that we highlight these exciting developments in health technology and their potential for helping people avoid chronic disease and live better, we should also collectively be pushing for different kinds of advancements that would go far in lengthening everyone’s health spans. These are things like universal health care, affordable childcare, broad-scale parental-support structures, and widely available mental health resources. From a public health perspective, the interventional behaviors with the most positive studied impact on longevity remain the ones we already know: social integration, exercising, and getting plenty of sleep. I’ll admit that when I’m doing all of the above, I look and feel better…younger even. And in that case, I don’t really need a tracker or diagnostics to confirm what I already know.