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 longevity 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 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 100,000 people sign up and 400,000 more are on the wait list.
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 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.