THE VANGUARD BLOG
Physician-curated deep dives into the science of men's health optimization.
Monograph
Nattokinase is a serine protease enzyme extracted from natto, the traditional Japanese fermented soybean food. It was discovered and characterized by Sumi and colleagues in 1987 as the active fibrinolytic constituent in natto, with strong in vitro…
30 May 2026
Monograph
The DUTCH test (Dried Urine Test for Comprehensive Hormones, Precision Analytical) measures a panel of steroid hormones and their metabolites from dried urine spots collected at specified times across a 24-hour period. The test has become a popular…
30 May 2026
Monograph
Thyroid evaluation in U.S. clinical practice traditionally starts with thyroid-stimulating hormone (TSH) — the most sensitive marker of thyroid status in adults with intact hypothalamic-pituitary-thyroid axis function. Free T4, free T3, reverse T3,…
30 May 2026
Monograph
Small intestinal bacterial overgrowth (SIBO) describes an excessive concentration of bacteria in the small intestine, traditionally defined as ≥10⁵ colony-forming units per mL on small bowel aspirate. The condition has been increasingly diagnosed…
30 May 2026
Monograph
Wrist-worn and finger-worn sleep tracking has become ubiquitous in the optimization community. Two distinct categories of devices are commonly confused: FDA-cleared home sleep apnea test (HSAT) devices like WatchPAT (Itamar Medical), and consumer…
30 May 2026
Monograph
Sleep-disordered breathing — primarily obstructive sleep apnea (OSA) — is one of the most common, most underdiagnosed, and most consequential conditions in adult medicine. Untreated moderate-to-severe OSA is associated with hypertension, atrial…
30 May 2026
Monograph
Tongkat Ali (Eurycoma longifolia) and Fadogia agrestis are the two herbs that have dominated the men's testosterone-supplement conversation since approximately 2020. The pairing was popularized in optimization-medicine influencer content and has…
30 May 2026
Monograph
Modern lipid management has four major pharmacological pillars: statins (the dominant first-line therapy), PCSK9 inhibitor monoclonal antibodies (evolocumab and alirocumab, the most potent LDL-lowering option), bempedoic acid (the newer non-statin…
30 May 2026
Monograph
Rapamycin (sirolimus) and metformin are the two off-label drugs most often discussed in the longevity optimization conversation. Both have substantial preclinical evidence for healthspan or lifespan benefit, both have been the subject of ongoing…
30 May 2026
Monograph
Nicotinamide adenine dinucleotide (NAD+) is a coenzyme central to cellular energy metabolism, DNA repair, and sirtuin-mediated signaling involved in aging biology. Circulating and tissue NAD+ levels decline with age in animals and humans. Multiple…
30 May 2026
Monograph
Metformin is the most-prescribed glucose-lowering medication in the world, with over six decades of clinical use, validated efficacy in type 2 diabetes, an extensive safety database, an emerging longevity literature, and a generic cash price of…
30 May 2026
Monograph
The GLP-1 receptor agonist class has revolutionized obesity medicine over the past five years, but "GLP-1" as a single category obscures three quite different products. Semaglutide (Wegovy for obesity, Ozempic for T2D) is a single GLP-1 receptor…
30 May 2026
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