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VitalDecades Guides & Explainers

Weight and metabolism 10 min

Does Medicare cover GLP-1 weight loss drugs? The 2026 rules

Part D still cannot pay for a drug prescribed for weight loss, and that has not changed. What changed on July 1, 2026 is that a separate program, the Medicare GLP-1 Bridge, began offering three specific products for a $50 monthly copay outside the Part D benefit. The list is narrower than it sounds, and the $50 does not count toward your out-of-pocket cap.

Weight and metabolism 8 min

GLP-1 friendly foods: what to eat when the drug has taken your appetite

On a GLP-1 the binding constraint is not which foods you choose, it is how little food you can face. Semaglutide's own label reports nausea in 44 percent of people and constipation in 24 percent, and the drug delays gastric emptying. Eat protein first, keep fat modest at any single sitting, and treat fluid and fiber as scheduled, not incidental.

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Labs and biomarkers 7 min

What your A1C means, and the conditions that make it wrong

An A1C below 5.7 percent is normal, 5.7 to 6.4 is prediabetes and 6.5 or above is diabetes. The test measures glucose stuck to hemoglobin over about three months, which means anything that changes the life of a red blood cell changes the result, and several common conditions do.

Labs and biomarkers 6 min

Vitamin B12 levels: the gray zone between 200 and 400, and how to settle it

The NIH Office of Dietary Supplements treats serum B12 below 200 or 250 pg/mL as subnormal, and names methylmalonic acid as the most sensitive marker, able to confirm deficiency when serum B12 sits anywhere between 150 and 399 pg/mL. That range is wide, it covers many results reported as normal, and it is the whole reason B12 testing confuses people.

Labs and biomarkers 7 min

Normal hemoglobin levels: the cutoff is a percentile, not a verdict

WHO's 2024 guideline defines anemia at a hemoglobin below 130 g/L in men and below 120 g/L in non-pregnant women aged 15 to 65. Those cutoffs are the 5th percentile of a healthy population, which means one healthy adult in twenty sits below the line by construction, and WHO itself treats anemia as a sign of something else rather than a diagnosis.

Hormones 10 min

Menopause weight gain: the scale is the wrong instrument

The best longitudinal data says the menopause transition does not accelerate weight gain. Weight climbs through the forties on an unchanged slope and keeps climbing at the same rate through the transition. What changes is composition: fat gain roughly doubles while lean mass starts falling, and visceral fat begins rising at over 6 percent a year.

Strength, mobility and aging 11 min

How to reduce dementia risk: what WHO rates strong, and what the trials actually found

WHO's second-edition dementia risk guideline, published in July 2026, makes exactly one strong recommendation on moderate-certainty evidence for people with normal cognition: physical activity. It also recommends against vitamin B, vitamin E, omega-3 and multivitamin supplements for this purpose, and records insufficient evidence for depression, stroke, brain injury, vision and sleep interventions.

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Labs and biomarkers 7 min

High uric acid without gout: what the rheumatology guideline says to do

The American College of Rheumatology defines asymptomatic hyperuricemia as a serum urate of 6.8 mg/dL or above with no prior gout flare and no tophi, and conditionally recommends against starting any urate-lowering drug for it. That recommendation rests on high certainty evidence, which is rare in this guideline.

Hormones 8 min

High TSH with a normal free T4: what subclinical hypothyroidism does and does not mean

A raised TSH with a normal free T4 is called subclinical hypothyroidism, and the largest randomized trial in older adults found levothyroxine produced no improvement in hypothyroid symptoms or tiredness at one year. The AACE and ATA position is that treatment below a TSH of 10 should be tailored to the individual, not automatic.

Labs and biomarkers 10 min

High ALT on a blood test: what the number means and what to do next

The American College of Gastroenterology puts the true healthy upper limit for ALT at 29 to 33 IU/L for men and 19 to 25 IU/L for women, below what many laboratories flag. The commonest cause of a mildly high result is fat in the liver, and the question that actually matters is not the enzyme, it is whether the liver has scarred.

Heart health 9 min

Does walking lower blood pressure? A Cochrane review of 73 trials has the number

Pooling 73 randomized trials and 5,060 participants, a Cochrane review found walking reduced systolic blood pressure by 4.11 mmHg, on moderate-certainty evidence. Diastolic fell less, on weaker evidence, and the effect was similar whether participants started with normal or high blood pressure.

Heart health 7 min

Blood pressure ranges: the 2025 categories and what each one actually triggers

The 2025 AHA and ACC guideline kept the four categories introduced in 2017 and changed what happens inside them. Stage 1 hypertension now triggers medication for anyone with cardiovascular disease, kidney disease, diabetes, or a PREVENT 10-year risk of 7.5 percent or more, and the overarching treatment goal is below 130 over 80 for all adults.

Strength, mobility and aging 10 min

The best exercise to prevent osteoporosis depends on which bone, and which outcome

The exercise that builds bone and the exercise that stops you falling on it are not the same exercise. Cochrane rates the fall-prevention evidence high certainty for balance and functional work, and says the effect of resistance training alone, and of walking, on falls is uncertain. Bone density answers differ by skeletal site.

Labs and biomarkers 5 min

TSH normal range: 0.45 to 4.12, and why that is too tight after 70

The standard adult TSH interval is 0.45 to 4.12 mIU/L. But the 97.5th centile rises from 3.56 in your twenties to 7.49 after 80, and 70 percent of older people flagged with a TSH above 4.5 are inside their own age group's range.

Preventive care and screenings 9 min

Normal PSA levels by age: what the guidelines actually say

No body publishes a normal PSA by age. The decade-by-decade cutoffs you have seen are in the AUA guideline's background text, citing a 1993 paper, not in any numbered recommendation. Here is what age does decide, with the grades attached.

Labs and biomarkers 6 min

eGFR by age: what is normal, and why 60 is not age-adjusted

The National Kidney Foundation publishes an average eGFR for every age band, and it falls from 116 in your 20s to 75 after 70. The threshold that defines kidney disease does not move with it. Both facts are true, and the gap between them is an open argument in nephrology.

Heart health 8 min

Cholesterol levels by age: chart for men and women

No guideline publishes cholesterol targets by decade of age. What sets your target is your calculated 10-year cardiovascular risk. Here are the real LDL, HDL, total cholesterol and triglyceride categories from NCEP ATP III, the 2018 AHA/ACC guideline, the 2019 ESC/EAS guideline and MedlinePlus, with the one age boundary that sets a treatment threshold (40 to 75), and the one place these guidelines split by sex (HDL).

Strength, mobility and aging 13 min

Protein after 40: how much you actually need, and what the trials show

The RDA is 0.8 g/kg/day and the 2026 Dietary Guidelines say 1.2 to 1.6. Nitrogen-balance work re-run in 2025 found no age effect. Protein without resistance training did nothing in a controlled-feeding trial. Even meal distribution failed in the one conflict-free trial in older adults.

Supplements 15 min

Does magnesium help you sleep? What the trials show

Magnesium has high-certainty null evidence for leg cramps, no current guideline grade for migraine, the lowest possible grade for depression, and an explicit ADA recommendation against it for glycaemic benefit. The clearest effect is as an osmotic laxative at about 2.6 times the upper limit.