The OS for anti‑aging medicine — for the patient asking how well they’re aging
iksa is the harness for n‑of‑1 medicine. You prescribe training like a therapy, and the harness watches labs and recovery through each block and brings your reasoning back to every re-test.
You settle which part of this patient is falling behind for their age before you write a line of the plan
You keep getting filed under aesthetics while your patients are on a treadmill, at a dynamometer and under a DEXA, and what you’re running is a trial of one, the training moving block by block and each patient read against their own last test. A percentile is only as good as the norm under it and the test behind it.
- VO2 maxMeasured and estimated tests need different norms, and weight gained as muscle can pull a per-kilo number down, so read it beside lean mass before you set how hard the plan pushes. Every six to twelve months, on the same mode.
- Grip and lean massStrength falls about three times faster than muscle in the Health ABC cohort of older adults. Reading grip and lean mass together says whether the plan starts with load, protein or both. Grip at each visit. DEXA every six to twelve months on one scanner, judged by its least significant change.
- Epigenetic pace of agingDunedinPACE’s probes repeat well on the same sample, yet in Aging Cell clocks’ reliability across draws hours to days apart, mostly in young adults, ran only about 0.4 to 0.7. No clinically important change is defined, so it reads as context, beside the function tests that decide the plan. Once a year, at one lab on one array, under the same draw conditions.
- hs‑CRP, HbA1c and cystatin CInflammation and glucose say whether the load and the diet are holding. Cystatin C reads the kidney without the muscle once added muscle pushes creatinine up, though inflammation can lift cystatin C too, so it sits beside hs‑CRP. hs‑CRP and HbA1c every three to six months, with hs‑CRP drawn away from a hard session. Cystatin C once creatinine climbs.
- Aesthetic medicineSeveral hyaluronic fillers now hold an under-eye indication. One fractional laser session cut nonmelanoma skin cancers on the treated forearm, 2 against 24 over three years, in a randomized, blinded within-person trial of 48 adults aged 60 and older (JCI 2021), now followed to five years (JAAD 2026). A neuromodulator every three to four months.
- Red light and NAD+Red light holds several 510(k) clearances and, in dry macular degeneration, a De Novo authorization that rests on 4.3 letters at two years. Oral NAD precursors raise blood NAD with function mostly unchanged, and IV or intramuscular NAD+ has no outcome trial. The dry-AMD trial ran nine sessions over three to five weeks, every four months, and no trial sets an IV series, so elsewhere the interval is one you write.
The doctor put strength first and held the biguanide the patient asked about, since it can blunt the muscle a training block builds
Clear of the sarcopenia cutoffs and still low for a man of 56, the patient’s grip and lean mass get the load first.
What does your program tell the patient who asks how old they really are, and which test does it send them back to?
Request a walkthroughRequest a walkthrough for anti‑aging medicineRe-testing one person the way a study would is a staff’s work, and your clinic runs it for every patient
A trial pays people to get each participant back on the same treadmill on time and to question a number that looks off. In your clinic the doctor who wrote the plan does the chasing and the checking too.
Follow-up windows
A patient who skips their six-month treadmill drops out of the series, and a trial has someone chasing each follow-up window, where your clinic has a nurse who knows who is due.
Source data
A treadmill report, a grip reading on a sticky note, a DEXA PDF and a methylation report arrive from four places, and only a spreadsheet puts them side by side.
Safety reporting
A shoulder that flared in the patient’s first heavy block and chest tightness in an interval session can arrive the same way, as a message, and nothing in it says which one can wait.
Measurement error
A treadmill has its test-retest error, a scanner its least significant change and a clock no agreed bar for one person, and the patient is waiting to hear whether they improved.
Six months on, when the doctor weighs the drug the patient asked about against their new DEXA, the note says why strength went first
When the patient writes in after a hard week, the harness has been watching their wearable and the labs the doctor follows, inside the protocol the Year 1 note set. The nurse or the doctor decides with that week in front of them.
At the next review, the doctor gets back the reasoning they wrote down, quoted from the note
Clinical Intelligence cites the note it sits in, so they’re weighing that decision in the words they used the day they made it.
Clinical Intelligence: clinical AI and lab trackingThe nurse clears what’s flagged on the patient’s labs, and your team has a draft when an inquiry asks for a biological age test
Agentic CRM drafts the reply from your approved answers on the assessment you run and leaves anything medical in the question to a person, and someone on your team reads, changes or approves it before it leaves.
Agentic CRM: scheduling and follow-upWhen the patient wants to know what 1.09 says about how old they really are, Patient AI starts from what the doctor wrote
It can tell the patient what the note says about their pace, their grip and why the drug waits. Chest tightness and a shoulder that won’t settle both start with safety questions, and the one that needs a person goes to the nurse or the doctor.
Patient AI: the treatment companion
Patients re-tested on one treadmill, one scanner and one norm for years are what a study of aging would start from
A result here keeps its date and report, and a plan item its note. With consent and identifiers removed, a research group could begin a first study there, on a question a Nature Medicine analysis of 51 studies (2026) left open: whether a pace of aging tracks what the treadmill and the dynamometer show. What a first study would take →
Questions from physicians who test before they treat
Can a biological age test sit beside the rest of the workup?
As one more result.The methylation report goes on file with its date, and iksa reads what your note says about it. A clock age and a pace can disagree on the same blood: in the CALERIE trial, caloric restriction slowed DunedinPACE without significantly moving PhenoAge or GrimAge.
Which norm does a percentile sit on?
The one named on it.The patient’s 35.2 is estimated from treadmill time, so it sits on the Cooper Institute’s table, built the same way, at the 38th. Measured by gas exchange it would belong on the FRIEND registry. The percentile you act on is the one your note chose.
Can I leave a therapy off the plan while the tests come back?
Recorded as a decision.A biguanide held through a strength block sits in your note with the lean mass and grip you read, and the DEXA you write there lands on the patient’s plan, still tied to that note, so at the re-test your reasoning sits beside the new report.
What does Patient AI say when a patient wants one number for how old they really are?
Your reading of it.It explains their result from their own record and from what you wrote about it, so if you treat a pace of 1.09 as context, that’s what they hear.
We began in aesthetics and still run that software. Does it have to go?
It can stay.Keep running the visits and the calendar on whatever you started with, and iksa reads your charts from your EHR, by connection or by upload. What that software was never asked to hold, the treadmill, the DEXA, the re-tests and the reasoning behind your decisions, sits with iksa.
Every OS for anti‑aging medicine I’ve been shown was aesthetics clinic software underneath. Is this?
Built around the tests.We call it the harness for n‑of‑1 medicine, because it’s organized around where one patient stands for their age on a treadmill, a dynamometer and a DEXA, and whether that moves.
What is n‑of‑1 medicine?All practicesiksa beside your EHRProtocol management softwareWhat iksa adds
Show us your performance program and the norms you read it on
Bring a protocol you run. We’ll walk one patient through it.