How much should you spend on your health?
My framework for deciding when and how to spend money on your health
Top of the morning, sapien. Welcome to Common Sense Medicine, where I try and keep you up to date on the latest and greatest in longevity science.
This week was kind of a mess because between studying and work, it was really hard to fit in all the workouts. I was able to get 1 walk on Tuesday, and then a workout on Tuesday, Wednesday, and Friday. Less than ideal, I know. However, we’re still trucking and time still moves on. I’m having a lot of fun doing these weekly posts, and I think it helps operationalize what I’m talking about on a week to week basis. I’m not perfect at executing, but I think it’s all about a give and take.
This week’s post is a fun one. It’s about how we can deal with the ultimate game, one which everyone is playing every second of every day — don’t die. I’m discussing a recent health app which I downloaded and it’s sneaky ability to gamify wellness, in an attempt to talk about a broader way on how I analyze how to spend on my wellness.
Other items on the differential:
Following up on last week’s issue, I found a great article around how alcohol affects our health, focusing mostly on a review of the research out there. I think it provides some good practical takeaways at the end of the article on how to engage with alcohol in moderation, if that’s something that you choose to do.
I have often mentioned how dietary and observational research is pretty bogus, because you can find out multiple effects if you wrangle the data enough times. With multiple tests, you can find correlations between things which aren’t remotely affecting each other, due to investigators not correcting the statistical significance values for multiple tests. Recall bias is also a huge problem, with people under-eating or underreporting things that they’ve eaten. At the end of the day, if it’s garbage in, garbage out for these nutritional epidemiology studies (see the PREDIMED study in last week’s issue for an example), then it’s very hard to find truth in which diet is beneficial in the long term. This article dives deeper into that problem and how the future of dietary research will evolve.
I’ve realized how important grip strength is really important in the gym. Without the requisite grip strength, it’s hard to lift the weight for the reps called for in that workout. I’ve been trying to use this grip and testing out new ways to lift weight for deadlifts. I’m also going to dedicate some time on it and see if it’s worth another issue.
For a more poetic view of how food is inherently political, check out this piece here or this piece about Red Dye 3. I think it’s interesting that there is more discussion around how to eat better in 2024 and 2025 to live better, as we have seen rates of obesity decline using GLP-1 agonists. It’s a double-punch against chronic diseases (i.e., diabetes, CVD) when we have both the “Chad” health (i.e., healthy eating) and the “Trad” health (GLP-1 agonists) uniting against one goal. Rather than moving to a more reactionary tone, as the writer suggests, we need to focus on how we can use food as a tool to reach a state of a better diet.
THE WEEKLY DOSE
How much should you spend on your health?

This week, I was scrolling on X and saw a tweet (is it called a “X-eet” now?) which piqued my interest — it was an advertisement on how a wellness app called “Death Clock” became one of the most downloaded wellness apps in the United States. While the name sounds morbid, it’s an app to help with prioritizing wellness, specifically by showing you how much time you have to live based on the habits you do day-to-day, your prior health history, and the supplements and medications you take. When you open the app, the branding and the UX are very slick. Then, you answer a couple of questions similar to the ones your physician would ask you on a first-time visit, and it spits out a “death age” and some recommendations on what you should buy. For example, when I finished my onboarding, it told me to buy NAD+ supplements, Curcurmin, and a sleep tracker.
This app isn’t anything that hasn’t been done before — people have used shock to change people’s behaviors and used gamification to keep people engaged in healthy habits. In fact, it’s what I use to keep exercising: I like to see the weekly streak go up and the daily streak go up on my workout and diet tracker. On the last screen, however, it asked me to pay $40 for yearly access to this app, with a free 3-day trial. The first thought that I had was — who is paying for this app? It’s useful, but not knowledge that you can’t get for free. Secondly, how are they even calculating your death age? Most of the clocks which are generated aren’t that useful, apart from just having a good basis for your biomarker levels.
For today’s newsletter, therefore, I’m going to try and focus on the framework that I use to decide if something is worth it to spend money on for my own health, and what I currently spend my money on. I think this app in particular isn’t malignant, I just think that I’m part of the churn which would happen anyway as my trial runs out in 3 days.
Longevity as a Service (LaaS)
Longevity has been making the rounds as a way to “optimize” your preventative health that the current health system is not prioritizing — finding the best foods, supplements that [insert guru here] is taking, your fitness trackers, your gym, and even trying not to die — has now become a competition for awareness, for clicks, and standing up new business ventures. I don’t fault anyone for doing this, because I think it’s helpful to get more people interested in their health — it would make me a hypocrite too, as I’m trying to do the same.
It becomes hard to differentiate the core advice, though, from the fads that gurus espouse (like eating better vs. shilling AG1). For example, should I be taking Vitamin D or Curcurmin? Should I ask my doctor about an optimal exercise routine? In my experience, these aren’t topics that primary care physicians (PCPs) obsess about — and they aren’t usually trained in talking about ultra-preventative care in medical school. The average American is unhealthy, and by the time they show up in the hospital or the clinic, people are more on the defensive and physicians need to be taught about how to manage chronic sickness rather than just focus on preventative care (although there’s tons of stuff in medical school which should be updated).
A Framework for Health Spending
One effect of the LaaS free market is that there are many companies (all associated with different influencers) which have been stood up in order to take your money to help you navigate how to take care of your health.1 I think the framework to evaluate whether you should use these LaaS apps like Death Clock comes down to a few things:
Trust: There has to be some level of trust to the advice that the “influencer” you follow is giving you. For me, this usually comes down to looking at how rooted in science the influencer is — for example, I’m a fan of Dr. Attia & Derek from More Plates More Dates both because they reference the primary sources which you can read through the articles. This doesn’t mean that I do everything that they say, but rather I can pare down my information diet knowing that the information is coming from a more credible source. I then engage with some research tools like OpenEvidence, Claude, Pubmed to do a quick literature review about what’s happening, maybe write a newsletter about it, and define my own parameters for the intervention / service.
Setting a budget for health: While we cannot predict what is going to happen 12 months from now, we can focus on how much we want to spend on our health and try to stick to it. This is coupled with the return on your investment, where you continually analyze whether you’re getting enough for what you’re paying for. For me, this exercise looks like fixed spend (i.e., gym, food) which I know I’m going to spend on and then variable spend (i.e., physician’s visits, supplements, skincare, etc.) which is first spent from FSA money (if possible) and then from regular spend.
How to split up your spend: Depending on your insurance and PCP, you might find that your PCP is more amenable to ordering some of the labs which you want to get (i.e., lipid panel, apoB, etc.) with a conversation around your health and fitness goals. Further, if they don’t want to, then you could split up the spend and use tax-advantaged accounts like an HSA / FSA to buy supplements through TrueMed or through other companies if you decide that (a) it’s in your budget and (b) it provides the ROI you’re looking for.
Return on investment: Your health is a big experiment. When playing the game of “Don’t Die,” it’s mostly about experimentation — there are both quantitative (like biomarkers), and qualitative (how you feel) metrics. I think that continually coming back to this to prevent buyer’s remorse is important, because you should always be focusing on whether you have the right information to proceed.
Practical Takeaways
Physician’s are taught to “do no harm” and as such, I would suggest this framework to critically evaluate both your financial health and the non-negotiables which need to be bought for your health. Evaluating the Death Clock app for me, came down to not only my budget for my health, but also around the trust that I felt towards the app. I wasn’t going to spend $40 / year to essentially get an app to tell me what I had been reading online for years now, and I didn’t think that it was that trustworthy to improve my health compared to other purchases that I could make (i.e., a nice dinner for my partner and I, deadlift straps to progress in the gym, or saving towards a nice bike)
Maybe this attitude will shift as I become an attending physician and might have more discretionary spend available for my health budget, but I think defining a system to decide whether you’d like a health purchase is integral based on your own health, your propensity for spend, and the overall trust you feel that the app or service will provide a net benefit to your health goals. For me, as of right now, my health goals focus on gaining weight and muscle and running a half marathon, and I’m not sure that an NAD+ supplement and curcurmin, along with a personal health evaluation is going to change that — even if it is done by AI.
THE PRESCRIPTION
Q1 2025: Hypertrophy Cycle Progress
The upshot: We’re moving! I’m getting in the swing of things. Unfortunately, I’m going to be traveling next week so this might be changing in the next few days, but I’m going to try and keep going and gaining weight. I’ve lowered the rate that I’m gaining, keeping it less than 0.5 lbs per week but I think after I come back from traveling I’m going to increase that to 0.5 - 1 lb. / week.
REMEMBER, IT’S JUST COMMON SENSE.
Thanks so much for reading! Let me know what you thought by replying to this email.
See you next week,
Shree (@shree_nadkarni)
The information provided here is not medical advice. This does not constitute a doctor patient relationship and this content is intended for entertainment, informational, and educational purposes only. Always consult with a doctor before starting new supplementation protocols.
Not saying that they’re all bad (“taking your money”) but I think there are some perverse incentives when it comes to marketing longevity startups