Dr. Michael Roizen on Longevity Medication: What He Has Said and What He Takes

Who Is Dr. Michael Roizen and Why Does His Medication List Matter?

Dr. Michael Roizen is a board-certified anesthesiologist and internist who served as Chief Wellness Officer at Cleveland Clinic from 2007 until his emeritus transition. He is the author of the RealAge book series and co-authored multiple books with Dr. Mehmet Oz. His public profile is large. When a physician of that institutional standing names specific drugs in podcasts and print, patients and clinicians pay attention.

His relevance here is not celebrity gossip. Roizen has made specific, falsifiable claims about which compounds he personally uses and why. Those claims deserve scrutiny against the published literature.

His "RealAge" Framework

The RealAge concept assigns a biological age distinct from chronological age based on lifestyle and biomarker inputs. The original RealAge book (1999) popularized the idea that modifiable factors, ranging from diet and exercise to specific medications, can shift your biological clock by years. A 2002 analysis published in the Archives of Internal Medicine supported the general principle that lifestyle factors predict mortality risk beyond chronological age, though the proprietary RealAge scoring algorithm itself has not been independently validated in a large prospective cohort [1].

Cleveland Clinic's Institutional Position on Longevity Medicine

Cleveland Clinic has invested significantly in its Center for Functional Medicine and, separately, its longevity-oriented programs. The institution does not endorse Roizen's personal supplement stack as official clinical guidance. That distinction matters when patients try to replicate his regimen.

What Dr. Roizen Has Said He Takes: The Medication Layer

Roizen has been specific about prescription medications in multiple public forums, including podcast interviews on The Dr. Oz Show archive, his own podcast appearances, and his book AgeProof (2017, co-authored with Jean Chatzky).

Metformin

In multiple interviews, Roizen has stated he takes metformin, the biguanide diabetes drug, off-label for longevity. He has cited epidemiological data showing that diabetic patients on metformin sometimes outlive matched non-diabetic controls not on metformin. The most frequently referenced study is Bannister et al. (2014, Diabetes, Obesity and Metabolism), which found that type 2 diabetic patients on metformin monotherapy had a 15% lower all-cause mortality risk compared with matched non-diabetic controls over a median follow-up of 2.8 years [2].

That finding is striking. It is also observational, subject to confounding, and has not been replicated in a large-scale RCT in non-diabetic populations. The TAME trial (Targeting Aging with Metformin), a 6-year randomized controlled trial funded in part by the American Federation for Aging Research, is designed to fill exactly that gap. TAME is enrolling approximately 3,000 adults aged 65-79 across 14 U.S. Sites and will report its primary endpoint around 2027 [3]. Until those data are available, prescribing metformin to non-diabetic adults purely for lifespan extension sits outside standard-of-care guidelines.

Roizen typically notes that metformin is generally well tolerated at 500-1,000 mg daily doses, with GI upset as the most common side effect and a small risk of lactic acidosis, particularly with renal impairment. The FDA has approved metformin only for type 2 diabetes management [4].

Low-Dose Aspirin

Roizen was an early and vocal advocate of low-dose aspirin (81 mg daily) for cardiovascular and potentially anti-cancer benefit. His books from the 2000s recommended it broadly for adults over 40. The evidence base has since shifted substantially. ASPREE (the Aspirin in Reducing Events in the Elderly trial, N=19,114) showed that aspirin 100 mg daily did not reduce all-cause mortality in healthy adults aged 70 and older over a median of 4.7 years and was associated with a statistically significant increase in major hemorrhage [5]. Roizen has acknowledged in more recent interviews that his aspirin recommendation has become more nuanced, applying now primarily to those with established cardiovascular disease or physician-assessed high risk.

Statins

Roizen has publicly stated he takes a statin, citing LDL reduction and the pleiotropic anti-inflammatory effects of the drug class. Guidelines from the American College of Cardiology and American Heart Association recommend statin therapy based on 10-year ASCVD risk, not chronological age alone [6]. Whether Roizen takes a high-intensity statin (such as atorvastatin 40-80 mg or rosuvastatin 20-40 mg) or a moderate-intensity regimen has not been specified in publicly available interviews reviewed for this article.

Vitamin D

Roizen has consistently named vitamin D as part of his daily regimen, typically citing doses in the 1,000-2,000 IU range. The VITAL trial (N=25,871) found that vitamin D3 supplementation at 2,000 IU daily did not significantly reduce the incidence of major cardiovascular events or cancer, though a pre-specified subgroup analysis suggested possible benefit in cancer mortality at 2 years of follow-up [7]. The Endocrine Society's clinical practice guideline (2024 update) recommends vitamin D supplementation for adults aged 75 and older to reduce mortality risk, while stopping short of a blanket recommendation for younger adults without documented deficiency [8].

What Dr. Roizen Has Said He Takes: The Supplement Layer

Beyond prescription medications, Roizen has named a cluster of over-the-counter compounds in books and interviews. The evidence quality for most of these is markedly lower than for the prescription drugs above.

Omega-3 Fatty Acids (Fish Oil)

Roizen has consistently cited fish oil at doses around 2-4 grams of EPA plus DHA daily. The REDUCE-IT trial (N=8,179) showed that icosapentaenoic acid (Vascepa) at 4 grams daily reduced major adverse cardiovascular events by 25% relative to placebo in patients with elevated triglycerides already on statin therapy [9]. REDUCE-IT used a mineral oil placebo, which has been criticized for potentially inflating the treatment effect. The STRENGTH trial used a corn oil placebo and found no cardiovascular benefit from 4 grams daily of EPA plus DHA combined [10]. Fish oil's benefit appears most defensible in high-triglyceride, high-cardiovascular-risk populations, not healthy adults seeking longevity.

CoQ10

Roizen has cited CoQ10 at doses around 200-400 mg daily, particularly in the context of statin use. Statins reduce endogenous CoQ10 synthesis via the mevalonate pathway. A 2015 meta-analysis in the Journal of the American Heart Association found no significant reduction in statin-associated muscle symptoms with CoQ10 supplementation [11]. The longevity-specific evidence for CoQ10 in humans is thin.

NMN and NR (NAD+ Precursors)

Roizen has referenced NAD+ precursors, specifically nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR), in podcast discussions. Both compounds raise circulating NAD+ levels. A 2023 randomized controlled trial by Yi et al. (N=66, published in GeroScience) found that NMN at 300 mg daily for 60 days significantly increased whole-blood NAD+ levels and showed modest improvement in walking speed in older adults, but the trial was small and not powered for clinical outcomes [12]. Whether raising NAD+ in humans translates to lifespan or healthspan extension has not been demonstrated in any adequately powered RCT.

Resveratrol

Roizen has named resveratrol in his supplement stack, influenced in part by the early work of David Sinclair at Harvard. Resveratrol activates sirtuin pathways in animal models. Human RCT data have been consistently disappointing. A 2014 study by Semba et al. In JAMA Internal Medicine (N=783 older Italian adults) found that urinary resveratrol metabolite levels, reflecting dietary intake, were not associated with inflammatory markers, cardiovascular disease, cancer, or all-cause mortality [13].

Magnesium

Roizen has mentioned magnesium supplementation, typically at 400 mg daily. A 2016 meta-analysis in BMC Medicine (N=1 million person-years across 40 cohorts) found that each 100 mg per day increment in dietary magnesium intake was associated with a 22% lower risk of heart failure (P<0.001) and a 19% lower risk of type 2 diabetes [14]. These are observational associations, not proof that supplementation produces the same outcome, but the signal is consistent and the safety profile of magnesium glycinate or threonate at standard doses is favorable.

What Roizen Has Said About Rapamycin

Roizen has discussed rapamycin (sirolimus), an mTOR inhibitor originally approved as an immunosuppressant, in at least one podcast interview, though he has been more cautious about it than commentators like Peter Attia or Matt Kaeberlein. His public position, as of interviews reviewed through late 2024, is that the animal data on rapamycin are compelling but that he is "not yet" taking it personally, citing the immunosuppression risk and the absence of human longevity RCT data.

The Interventions Testing Program (ITP), run across three independent U.S. Sites by the National Institute on Aging, has shown that rapamycin extends median lifespan in genetically heterogeneous mice by 23% in females and 26% in males even when started at the equivalent of middle age in humans [15]. No analogous human RCT has been completed. The PEARL trial (rapamycin for longevity in healthy older adults) was in early phases as of 2025.

A decision framework for evaluating off-label longevity drugs follows this logic: (1) Is there ITP or equivalent multi-site replication in mammals? (2) Is there a plausible human mechanism confirmed by biomarker RCT data? (3) Is the safety profile acceptable at the proposed dose in healthy individuals? Rapamycin clears hurdle one. It partially clears hurdle two. It does not clearly clear hurdle three at chronic dosing. That framework explains Roizen's stated hesitation.

How His Regimen Compares to Published Longevity Guidelines

No major medical society has issued a clinical practice guideline specifically for pharmacological longevity extension in healthy adults. The American Geriatrics Society's Beers Criteria focuses on medications to avoid in older adults, not compounds to add [16]. The Endocrine Society's 2024 vitamin D guideline is the closest thing to a longevity-adjacent recommendation backed by RCT evidence in older populations [8].

Roizen's regimen is, by design, ahead of the guideline curve. He has said so explicitly. That is not inherently wrong. Physicians have always made personal risk-benefit calculations that outpace guidelines. The problem arises when a high-profile physician's self-experimentation is read by patients as a clinical endorsement or a protocol to copy without individualized assessment.

The American College of Lifestyle Medicine has published a position statement noting that evidence-based lifestyle modification, including diet, physical activity, sleep, and stress management, produces measurable reductions in biological age markers without the risks of off-label pharmacology [17].

Inference vs. Confirmed Statement: A Transparency Note

This article distinguishes between what Roizen has confirmed in primary sources (interviews, books, podcast transcripts) and what is inferred. The following table summarizes the sourcing status:

| Compound | Source Type | Confirmed Dose | |---|---|---| | Metformin | Multiple podcast statements, AgeProof book | Not specified publicly | | Low-dose aspirin (historical) | RealAge books, multiple interviews | 81 mg daily | | Statin | Interview references | Not specified publicly | | Vitamin D | AgeProof and podcast | 1,000-2,000 IU daily | | Omega-3 (fish oil) | AgeProof and podcast | 2-4 g EPA+DHA daily | | CoQ10 | Podcast and book references | 200-400 mg daily | | NMN/NR | Podcast references | Not specified publicly | | Resveratrol | AgeProof book | Not specified publicly | | Magnesium | Multiple interviews | 400 mg daily | | Rapamycin | One podcast; stated he is NOT currently taking it | N/A |

Any compound not listed here has not appeared in primary sources reviewed for this article.

The Financial Disclosure Context

Roizen has financial interests in several wellness-related ventures, including ties to the RealAge platform, which was acquired by Sharecare. Some of the supplements he recommends are sold through channels where he has received compensation or royalties. This does not make his recommendations wrong, but it creates a conflict of interest that readers and patients should factor into their assessment.

The National Academies of Sciences, Engineering, and Medicine conflict-of-interest guidelines state that financial relationships with industry require disclosure and should be weighed when evaluating clinical recommendations [18]. Roizen has generally disclosed these relationships when asked directly.

What a Clinician Should Tell a Patient Who Asks About Roizen's Stack

A physician fielding this question can use the following approach. First, separate the compounds with meaningful RCT evidence in healthy adults from those with only observational or animal data. Only vitamin D (in adults aged 75 and older per the 2024 Endocrine Society guideline) and omega-3 at prescription doses in high-triglyceride patients meet that bar [8, 9]. Second, metformin in non-diabetic adults is a reasonable conversation for a patient already motivated and informed, with TAME trial data expected around 2027 as the next decision point. Third, compounds like resveratrol and rapamycin carry either null human data or an immunosuppression risk profile that requires individualized shared decision-making, not population-wide adoption.

The American Academy of Family Physicians supports shared decision-making for preventive medications and emphasizes that risk-benefit calculations must be individualized [19]. A 58-year-old with prediabetes has a different metformin calculus than a 58-year-old with normal glucose and CKD stage 3.