Fishtown Medicine Library
Longevity & Healthspan
Add life to your years, and years to your life.
Should You Test for APOE4? What Knowing Your Risk Gene Means
APOE4 is the strongest common gene tied to late-onset Alzheimer's, but it is a risk factor rather than a verdict. What the risk truly is, the insurance trap before you test, what you can do about it, and why status now affects treatment.
Read Full GuideThe Alzheimer's Blood Test: What It Means, Who Should Get It
The first FDA-cleared Alzheimer's blood test detects brain pathology, not dementia, and a positive result in a person without symptoms does not mean disease. Here is what p-tau217 measures and who should and should not test.
IGF-1 and Growth Hormone: Why More Is Not Younger
Longevity science points the opposite way from the anti-aging clinics: lower growth signaling tends to mean longer life, higher IGF-1 tracks with cancer, and growth hormone for aging is unproven and illegal. But lower is not the goal either.
Macular Degeneration: What Protects Your Vision, and Does AREDS2 Work?
AREDS2 does not prevent macular degeneration for everyone, despite the pharmacy shelves. A grounded, evidence-based guide to who the eye vitamins help, what truly lowers your risk, and the new treatments, from Fishtown Medicine in Philadelphia.
The New Alzheimer's Drugs: What Lecanemab and Donanemab Do
Lecanemab (Leqembi) and donanemab (Kisunla) are the first disease-modifying Alzheimer's drugs. How well they work, the ARIA brain-swelling risk, who can take them, the cost, and a balanced look at the modest benefit.
Alcohol and Longevity: What the Evidence Now Says
The "moderate drinking is healthy" story has fallen apart. What the current evidence shows about alcohol, cancer, heart, and metabolism, and how Fishtown Medicine helps you think about your own risk without judgment in Philadelphia.
Inflammaging: The Chronic Inflammation Behind Aging
Chronic, low-grade inflammation, or inflammaging, is a root driver of heart disease, diabetes, dementia, and frailty. What causes it, how to measure it, and how Fishtown Medicine helps lower it in Philadelphia.
Cold Plunge and Cold Exposure: Hype vs Evidence
Cold plunges boost mood and alertness and can ease muscle soreness, but the longevity evidence is thinner than for sauna, and timing around lifting matters. An honest look, plus how Fishtown Medicine weighs it in Philadelphia.
Hearing Loss and Dementia: The Risk Few People Treat
Hearing loss is the largest single modifiable risk factor for dementia, yet it goes untreated for years. Why the link is strong, what hearing aids can and can't do, and how Fishtown Medicine builds it into brain-health prevention.
NAD+, NMN, and NR: Do the Supplements Work?
NMN and NR supplements reliably raise NAD+ in humans, but whether that makes you healthier or longer-lived is unproven. What the evidence shows, the safety picture, and how Fishtown Medicine weighs NAD boosters in Philadelphia.
Rapamycin for Longevity: What's Proven and What Isn't
Rapamycin extends lifespan in mice and has a plausible mechanism, but no human trial has shown it extends human life. An honest look at the evidence, the risks, off-label dosing, and how Fishtown Medicine approaches it in Philadelphia.
Reading Your Family History
A family history of diabetes, dementia, cancer, or aneurysm is information, not a verdict. How to read the metabolic thread running through a family tree and the specific screening decisions it should change.
When You or a Neighbor Needs Help in Philadelphia
A Philadelphia doctor's directory of the city help that matters for health - cooling centers, Code Blue, utility assistance, home repair - with phone numbers.
Hydration and Electrolytes: Why Drinking More Water Isn't the Answer
Why plain water alone doesn't hydrate you, the role of sodium and potassium, and a practical daily protocol from a Philadelphia internal medicine physician.
What the NHS-Galleri Trial Showed (And What It Means For Your Screening)
What the 142,000-person NHS trial of the Galleri multi-cancer blood test proved over 3 years, and the honest read on what it means for cancer screening.
Microplastics in Philadelphia: What to Do
An evidence-honest playbook for reducing microplastic exposure in Philadelphia households: the 5 changes that do most of the work, and how to read the headlines.
Pollen in Philadelphia: What to Do at Each Tier
A pollen guide for Philadelphia: the tree, grass, and weed calendar, timing antihistamines and nasal steroids, and when to involve an allergist.
Air Quality in Philadelphia: What to Do at Every AQI
A Philadelphia doctor on what the Air Quality Index measures, who is at higher risk, and what to do at every tier, from normal days to wildfire smoke.
The Architecture of Facial Aging
Facial aging is more than wrinkles: fat pads deflate, bone recedes, ligaments pull. Understanding the layers explains the tired look and what you can control.
Counterfeit Skincare and Supplements
Third-party marketplaces are full of fake, diverted, and expired skincare and supplements. Why it matters for your body, and how to buy safely.
Healthy Skin Aging
Most aging skin comes from the sun rather than the calendar. Sunscreen, retinoids, glucose control - the interventions with the best evidence - and the hype worth ignoring.
Is Coffee Medicine? The Definitive Guide to Longevity.
Discover the evidence-based health benefits of coffee. From reducing Type 2 diabetes risk to neuroprotection, learn the healthiest way to brew with Dr. Ash.
Catching It Early: Advanced Screening
Early detection is the best cure. Dr. Ash integrates Liquid Biopsy (Galleri) and Whole Body MRI (Prenuvo) into a detailed cancer defense strategy.
Protect Your Brain: Neuroprotective Strategy
Alzheimer's doesnt start when you forget your keys. It starts 20 years earlier. Dr. Ash uses the Bredesen Protocol (Recode 2.0) to identify and plug the met...
Philly Living: Environmental Defense
From the Schuylkill Trail to South Street - managing air, water, noise, and urban life in Philly. Practical health strategies for thriving in the city we love.
Walk Your Way to Health in Philly
Yes, parking sucks. But Phillys walkability, Indego bikes, and SEPTA (when it shows up) are secret weapons for metabolic health. Heres how to use them.
Bone Health: Quality over Quantity
A hip fracture in your 80s can be lethal. Discover why standard DEXA scans miss bone quality issues and how much-needed resistance training builds structural...
The Clinical Toolkit: Why We Send You to Wirecutter
We dont sell gear. We curate efficacy. Here is the vetted list of tools to operationalize your health.
The Shingles Vaccine and Dementia: What the Evidence Shows
Multiple strong studies link the shingles vaccine (Shingrix) to lower dementia risk. What the Welsh natural experiment and the Shingrix data show, the leading theories, and the limits of the evidence.
Stem Cells and Exosomes: What the Evidence Shows
Clinics sell stem-cell and exosome treatments for joints, aging, and IV longevity. The biology is promising, but the products are mostly unapproved, unproven, and sometimes unsafe. An honest look at what holds up.
Sauna and Longevity: What the Evidence Shows
Frequent sauna use is linked to lower cardiovascular and all-cause mortality in large studies. What the evidence shows, how often and how hot, the cautions, and how Fishtown Medicine folds heat therapy into a longevity plan.
Severe Weather in Philadelphia: What to Do When the Alert Hits
A Philadelphia doctor on the National Weather Service alerts that matter for your health, and the moves worth taking from heat advisory to flash flood warning.
UV Index in Philadelphia Today: What to Do at Every Tier
Today's live UV index for Philadelphia, plus what it means for you: burn time by skin type, when sunscreen matters most, and the vitamin D trade-off.
Sun Protection for Shore Season
How to protect your skin through a Philadelphia summer and a long day at the Jersey Shore: cover up first, use enough sunscreen, and treat a burn right.
Sleep: The Foundation of Recovery
You cannot out-diet or out-train poor sleep. Dr. Ash uses clinical data (HRV, Oura) and CBT-I strategies to reverse insomnia and optimize recovery.
HSA/FSA Longevity Playbook
Learn how to legally use your pre-tax HSA and FSA dollars to fund your longevity medicine, supplements, and gym memberships.
Oral Health & Longevity
Why your mouth is the gateway to systemic health. Discover the heart-mouth connection, why mouthwash might be raising your blood pressure, and probiotic dent...