Longevity medicine at NYMD Center is the practice of measuring the things that actually predict how long and how well you will live, and then acting on them. It grew out of the UroLongevity program developed by our founder, Dr. David Shusterman, and described in his book of the same name. Much of it started with questions urology patients ask: whether prostate screening still makes sense at 72, why they are up three times a night, whether the testosterone a clinic offered them is a good idea. Answering those questions well requires knowing something about a patient's expected lifespan, and that is where the program begins.
The longevity panel
We rely on four measurements that have strong, consistent associations with lifespan across large populations, and that can be improved.
Cardiorespiratory fitness, estimated as VO2max from an exercise test done in our cardiology program. Grip strength, measured with a dynamometer, as a simple and well-validated stand-in for overall muscle strength. ApoB, a blood test that counts the particles responsible for arterial plaque more directly than a standard cholesterol panel. And body composition by DEXA scan, which reports lean mass, fat mass and visceral fat separately, because two people at the same weight can be in very different condition.
We read these together and over time as inputs to an estimate of life expectancy, not as a scorecard. A single reading tells you where you stand; a trend tells you whether what you are doing is working. And we are candid about the limits. Each marker's association with mortality partly reflects underlying health rather than causing it: a person with low grip strength may be weak because of an illness that is the real driver. Improving the marker helps, but the estimate is a guide for decisions, not a prediction to be taken literally.
Screening keyed to life expectancy
The most concrete use of that estimate is deciding which screening tests still make sense. Guidelines set screening by age because age is easy to measure, but what actually matters is how many years a test has to pay off. Prostate cancer screening is the clearest example in our practice: it continues to be worthwhile while a man has about ten years of life expectancy ahead of him, and past that point treatment is more likely to harm than help. A fit 75-year-old with excellent markers and a frail 65-year-old are on opposite sides of that line. The same logic applies to colon and other cancer screenings, to how aggressively we treat blood pressure and lipids, and to whether a procedure is worth its recovery. Our heart and stroke risk screening feeds the same decisions.
Sleep, nocturia and hormones
Getting up at night to urinate is usually treated as a bladder problem. We treat it as a longevity problem as well, because fragmented sleep affects blood pressure, glucose, mood and falls, and because nocturia often has causes outside the bladder, from sleep apnea to fluid shifts to medication timing. Our nocturia and sleep program evaluates it as a whole.
Hormones are handled with the same care. When labs and symptoms support it, we offer testosterone or estradiol by injection, gel, oral routes or pellets, through our hormone replacement service. What we do not do is start a man on testosterone without telling him that it suppresses his own production and can end his fertility, or add peptides on top of it without an evaluation. That is the model of many testosterone clinics, and it is the wrong one. Where a peptide has a clear mechanism and a defined goal, our peptide therapy program prescribes it with labs and monitoring. Hydration and vitamin infusions are available through IV therapy, with the same honest framing.
Who leads it
Dr. David Shusterman, the founder of NYMD Center and author of UroLongevity, leads the program. Internal medicine, cardiology testing and our on-site lab and imaging supply the measurements, and specialists across the group act on them. The depth of the program, including the reasoning behind each marker, is at urolongevity.com.
How to get seen
Book a longevity consultation at the Manhattan office, or start with an annual physical and ask to add the panel. The first visit covers your history, an exam, baseline labs including ApoB, and grip strength, with the exercise test and DEXA scheduled around it. You leave with a picture of where you stand and a plan you can measure against at the next visit. Same-week appointments are usually available, and the underlying tests are generally covered by insurance when there is a medical indication; our staff will tell you in advance what is not.
Conditions & services
Hormone Pellet Therapy in NYC
Testosterone and estradiol pellets placed in the office every 3 to 5 months, one delivery option among injections, gels…
IV Therapy in NYC
IV hydration and vitamin infusions in NYC given in a medical office with physician oversight, labs before high-dose…
Nocturia: Waking at Night to Urinate
Nocturia evaluation in NYC that sorts bladder, kidney, sleep and medication causes with a timed bladder diary and…
Peptide Therapy in NYC
Physician-prescribed peptide therapy in NYC: ipamorelin, CJC-1295, BPC-157 and tesamorelin with labs, a defined goal…
Hormone Replacement
As men age, the unfortunate reality is that testosterone production can begin to wane as a result. Low testosterone can…
Questions patients ask
What is in the longevity panel?
Four measurements: cardiorespiratory fitness, estimated as VO2max from an exercise test; grip strength as a simple, well-studied proxy for overall muscle strength; ApoB, the blood marker that counts the particles that cause arterial plaque; and body composition by DEXA scan, which separates muscle, fat and visceral fat rather than reporting a single weight. They are read together and repeated over time, not scored once.
Can you really estimate my life expectancy?
We can estimate it, with wide error bars, and we are honest about what the estimate is for. Each marker has a well-documented association with mortality in large populations. Part of that association is cause and effect, and part is reverse causation: people with low fitness or low grip strength are often already less well for other reasons. The value of the estimate is not the number. It is in deciding which screening tests and treatments still make sense for you.
Why would life expectancy change my cancer screening?
Because screening finds cancers that take years to cause harm. Prostate cancer screening, for example, is worthwhile while a man has roughly ten years of life expectancy ahead of him; below that, treatment is more likely to hurt than help. Two men of the same age can sit on opposite sides of that line. Keying the decision to life expectancy rather than to a birthday is more accurate in both directions.
Is this a testosterone clinic?
No. We manage hormones when labs and symptoms call for it, but always after an evaluation and always with the trade-offs explained, including that testosterone therapy suppresses the body's own production and affects fertility. Clinics that start men on testosterone, and add peptides on top, without that evaluation or that conversation are the model we set out not to be.
Do I need to be an existing patient?
No. Many patients come to the longevity program from our urology, men's health and internal medicine practices, but new patients are welcome. Call the office or book online, and the first visit is a history, an exam, the baseline labs and scheduling of the fitness test and DEXA scan. Follow-up is typically every several months while a plan is being built and less often once it is stable.
Make an appointment
Manhattan (212) 991-9991 · Forest Hills (718) 360-9550 · same-week visits, most major insurance accepted.