The exact system.
Everything you need to run it.

The biomarker panel

The exact 56 markers you order for every client. Why each one matters, what range you're aiming for, and what abnormal values tell you about the body's aging trajectory.

Group 1 — Metabolic & Glucose Regulation

These markers reveal how the body handles glucose and energy — the foundation of metabolic aging. Insulin resistance typically develops 10–15 years before a diabetes diagnosis appears.

Group 2 — Lipids & Cardiovascular Risk

Standard lipid panels miss the most important markers. ApoB and Lp(a) are the actual atherogenic particles — LDL-C alone gives incomplete information. Peter Attia's framework: ApoB is the metric that drives cardiovascular disease, not LDL cholesterol.

Group 3 — Inflammation Markers

Chronic low-grade inflammation is the primary driver of biological aging. This is why Peter Attia calls inflammation "the engine of chronic disease." These markers detect it before symptoms emerge.

Group 4 — Organ Function (Kidney & Liver)

Organ function markers are essential for safe supplementation, protein targets, and understanding detoxification capacity. They're also PhenoAge inputs.

Group 5 — Hormones

Hormonal status dictates energy, body composition, cognitive function, and motivation. Indian urban professionals are often deficient in testosterone (men) or dealing with thyroid disruption, driven by chronic stress, poor sleep, and refined-carb diets.

Group 6 — Micronutrients

Deficiencies in these four nutrients are endemic in urban India and drive fatigue, depression, cognitive decline, and poor recovery. Supplementing without testing is guesswork.

Group 7 — Blood Count & Haematology

Group 8 — Cardiac-Specific

Group 9 — Optional Advanced (Year 1: add for Pro/Continuum)

How to get it done

Exactly which labs to use, what to order, how to arrange home collection, what to tell clients, and what to do when results arrive.

Lab partners in Hyderabad (Ranked by recommendation)

Exact panel to order — by tier

The blood draw process — step by step

Calculating biological age

The PhenoAge algorithm — exactly how it works, the inputs, the formula, how to calculate it in a spreadsheet, and how to interpret the result for your client.

What is PhenoAge?

PhenoAge was developed by Dr. Morgan Levine (then at Yale, now at Altos Labs) and published in 2018 in Aging journal. It uses 9 standard blood markers to calculate a biological age. The model was trained on a US cohort (NHANES III) and validated for predicting all-cause mortality, with strong correlation across ethnicities.

It is freely usable, scientifically peer-reviewed, and based entirely on markers available from standard Indian labs. This is your headline metric.

The 9 inputs required

The formula — step by step

This looks complex. In practice, you put this into a Google Sheet once and it auto-calculates when you input the 9 values. I'll provide the exact Google Sheet formula strings below.

Google Sheet implementation

In your client tracking sheet, create columns A through I for the 9 inputs (with client values). Then in column J, paste this formula (assuming A2=Albumin, B2=Creatinine, C2=Glucose, D2=hsCRP, E2=Lymphocyte%, F2=MCV, G2=RDW, H2=ALP, I2=WBC):

Interpreting the result for the client

The lifestyle questionnaire

Every question you need to ask, organized by category, with why each question matters and what the answer tells you about the protocol design. The intake is done as a 45-minute video conversation, not a form. Forms give you data. Conversations give you context.

Section A — Demographics & Medical History

Section B — Nutrition

Section C — Exercise & Movement

Section D — Sleep

Section E — Stress & Psychology

Section F — Current Supplements & Past Protocols

Section G — Goals & Motivation

Reading the biomarkers

How to take a full results report and systematically identify problems, rank them by priority, and map each problem to a specific intervention. This is the core intellectual skill of the program.

The interpretation framework — 4 priority tiers

When you receive results, you are looking for findings at four levels of urgency. Always work top to bottom before writing any protocol.

The metabolic problem map

Every abnormal marker pattern corresponds to a likely root cause and a specific intervention pathway. Here are the most common patterns you'll see in your target demographic:

AI + doctor workflow

Exactly how you use AI tools and your medical advisor together to generate, validate, and personalize every protocol. AI speeds up the first 80%. Your knowledge does the next 15%. The doctor handles the final 5% that requires clinical judgment.

The protocol generation workflow

AI tools and how to use each

Nutrition protocol

How to design a nutrition protocol from biomarkers. Not a generic diet plan — a specific, evidence-based prescription calibrated to each client's results.

The 5 nutrition levers and when to use each

Protein targets — the most important variable

Protein is the highest-leverage nutrition intervention for most clients. It's also the one most commonly underdone in India (especially in vegetarians). The anabolic resistance of aging means that older clients need more protein, not less.

Carbohydrate protocol — calibrated to insulin status

• Normal insulin sensitivity (HOMA-IR <1.5): No restriction needed. Focus on quality — whole grains (brown rice, millets, oats), fruits, legumes. Avoid ultra-processed carbs and sugar-sweetened beverages.
• Mild IR (HOMA-IR 1.5–2.5, HbA1c 5.2–5.5): Time carbohydrates around exercise. Reduce total carb load by 30–40% from baseline. Replace refined with complex. Target: 130–160g carbs/day.
• Significant IR (HOMA-IR >2.5, HbA1c >5.5): Consider low-carb protocol: 50–100g/day. Eliminate all added sugar, refined flour, sugary beverages, white rice as primary starch. Switch to millets, oats, lentils. Reassess at Day 30.
• South Indian diet specific: Rice is the cultural core. Don't remove it entirely — reduce quantity, replace some meals with millets (ragi, jowar), add dal protein and vegetable fiber to slow glucose absorption. Idli/dosa are fermented — better than bread on glycemic terms.

Dietary fat protocol — calibrated to lipid panel

• High ApoB (>90): Reduce saturated fat to <10% of total calories. Reduce red meat to 1–2x/week. Replace with monounsaturated fats (olive oil, avocado) and omega-3 rich sources (fatty fish 3x/week). Add 10g soluble fiber (psyllium husk is excellent and cheap).
• Low Omega-3 Index (<6%): Supplement is the fastest fix (see Chapter 10). Dietary: sardines, mackerel, salmon 3–4x/week. Switch cooking oil from refined vegetable/sunflower to cold-pressed groundnut oil, ghee, or coconut oil.
• Elevated hsCRP (>1.5): Anti-inflammatory eating pattern. Increase: extra-virgin olive oil, turmeric (with black pepper for bioavailability), ginger, dark leafy greens, berries. Reduce: fried food, ultra-processed food, trans fats, refined seed oils.

Eating window (time-restricted eating)

TRE works by aligning eating with circadian biology and reducing total insulin exposure per day. Evidence supports 12:12 as a minimum, 16:8 as the primary target for metabolic benefit.

• 12:12 window (minimum): Stop eating by 8pm, breakfast no earlier than 8am. Suitable for clients who are metabolically normal and are new to eating window protocols.
• 16:8 window (primary target): Eat between 10am–6pm or 12pm–8pm. First meal contains protein + fat, no refined carbs. Suitable for IR clients. Expect adjustment period of 1–2 weeks.
• 18:6 or 20:4 (advanced): Only for clients who are metabolically adapted, genuinely not hungry in the morning, and whose training schedule accommodates it. Not suitable for hard training days (post-workout nutrition matters more than window length).
• Important caveat for women: Aggressive TRE (18:6+) can disrupt LH/FSH axis in some women. Start with 12:12. Assess hormonal symptoms before extending. Avoid aggressive fasting in luteal phase.

Training protocol

How to prescribe exercise from biomarkers and wearable data. The four training modalities and what each does to the aging body. How to build a weekly structure for any client, any fitness level.

The four modalities of longevity training

Zone 2 — the most important modality

Zone 2 is low-intensity, aerobic-dominant exercise at roughly 60–70% of maximum heart rate. It's the zone where you can hold a conversation with effort. It's the primary driver of mitochondrial health — which is the primary driver of metabolic aging.

How to find Zone 2 heart rate

Zone 2 weekly prescription

VO₂ Max training — the intervals

VO₂ max is measured in mL of oxygen per kg of bodyweight per minute. It declines 10% per decade after 30 unless trained. Each 1 MET increase in VO₂ max = 13% reduction in all-cause mortality (Peter Attia's data from Cooper Clinic).

Standard VO₂ max interval protocol

• 4×4 Norwegian Protocol: 4 intervals of 4 minutes each at 90–95% max HR. 3 minutes active recovery between each. 10 min warm-up, 10 min cool-down. Once or twice per week maximum.
• Shorter option (beginners): 8 × 1 minute at 90%+ HR with 2 minutes easy recovery. Same physiological target, less psychological barrier.
• When NOT to prescribe VO₂ work: NT-proBNP elevated, client is currently sick or recovering, HRV is significantly below their baseline, first 3 weeks of program (adaptation period).

Resistance training — the weekly structure

Muscle is the longevity organ. Every kg of muscle gained is protection against metabolic disease, frailty, and aging. The goal is to build and maintain muscle mass and strength, with particular emphasis on compound movements and progressive overload.

Weekly resistance training frameworks (choose by availability)

Key principles for all resistance programs

• Progressive overload is everything. Each session should be slightly harder than the last — more weight, more reps, less rest, or better form. Track it. Without overload, the stimulus is maintenance, not growth.
• Compound first. Squat, deadlift, bench press, row, overhead press. These give the most stimulus per unit of time and produce the strongest hormonal response.
• Train close to failure. Research (Schoenfeld, 2020s) shows that proximity to failure, not heavy weight per se, drives hypertrophy. Leave 1–3 reps in reserve per set.
• Minimum effective dose for beginners: 3 sets per muscle group per week is enough to produce measurable gains. Don't programme complexity they can't follow.
• Indian gym context: Most commercial gyms in Hyderabad have adequate free weights and machines. If client has no gym access, dumbbell home program or bodyweight works fine — frame expectations accordingly.

Recovery & sleep protocol

Sleep is the most potent recovery and longevity intervention available. HRV is the daily readiness signal. Here is the exact system for optimizing both.

Sleep protocol — by problem type

Using HRV to guide training decisions

HRV is the daily readiness signal. Give every client this decision framework based on their morning HRV reading (use Oura or Whoop app — they normalize HRV to their own baseline, which is more useful than absolute numbers):

Stress management protocols

• Physiological sigh (immediate cortisol reset): Double inhale through nose (two quick inhales), then long exhale through mouth. Repeat 3–5 times. Works in 30 seconds. Andrew Huberman's most evidence-backed acute stress tool.
• 5–5–5 box breathing (pre-sleep / pre-stressor): In for 5, hold for 5, out for 5, hold for 5. 5 minutes daily. Activates parasympathetic system.
• NSDR (Non-Sleep Deep Rest): 10–20 minute yoga nidra or guided body scan. Particularly useful for clients who can't nap but need midday recovery. YouTube: "NSDR Andrew Huberman" — free, evidence-backed.
• Morning sunlight: 10–30 minutes of natural outdoor light within 30–60 minutes of waking. Resets cortisol and melatonin rhythm. No sunglasses. Sunscreen on face is fine. This single habit improves sleep onset time significantly.

Supplement protocol

The exact supplements, doses, forms, timing, and brands for every scenario. The philosophy: fix deficiencies first, then consider evidence-based optimization. Never start supplements without bloodwork. Always start by removing supplements with poor evidence.

Tier 1 — Deficiency correction

Tier 2 — Evidence-based optimization

Supplements to typically STOP or reduce

Most clients arrive taking multiple supplements with poor evidence or poor form selection. Start by auditing and removing these before adding anything new.

• Multi-vitamins (most brands): Inadequate doses of most things, wrong forms of several things (D2 not D3, cyanocobalamin not methylcobalamin, oxide forms). Stop and replace with targeted singles based on bloodwork.
• Generic fish oil (1g capsules): Most provide only 300mg EPA+DHA per capsule. Client is taking 3g fish oil thinking they're getting 3g omega-3. They're getting 900mg. Switch to concentrated fish oil with dose by EPA+DHA content.
• Iron supplements without confirmed deficiency: Excess iron is pro-oxidative and harmful. Only supplement if ferritin is genuinely low (serum iron <60, ferritin <30).
• Fat burners, testosterone boosters, proprietary blends: Remove entirely. Most are ineffective, some are harmful, all are overpriced.
• High-dose single antioxidants (Vit C >1g, Vit E supplements): Evidence suggests high-dose antioxidants blunt the beneficial adaptations from exercise. Remove if client is training seriously.

Mind & mindfulness protocol

The cognitive and psychological practices that directly affect biomarkers. Not philosophy — measurable physiology.

Evidence-based practices (with biomarker impact)

Call & check-in system

The exact structure of every touchpoint over the 90-day program — what happens when, what you cover, how long it runs, and what happens after each call.

The 90-day touchpoint calendar

Call structure — the Intake Call (Day 1)

• Open (5 min): Build rapport. "Before we dive in — what made you decide to do this now?" This is not small talk; it's anchoring motivation that you'll reference throughout the 90 days.
• Questionnaire (30 min): Work through Sections A–G from Chapter 4. Take notes. Probe when something is interesting or vague.
• Wearable data review (5 min): Ask them to share their screen or send screenshots. What does their HRV trend look like? Sleep duration? Resting HR? Note the baselines.
• Set expectations (5 min): "Results arrive in 3–5 days. I'll book our next call once I have them. You'll have the protocol within 7 days. Between now and then, the one thing I'd ask you to do is: [one simple habit — e.g., get morning sunlight, drink 2L of water daily]. Just one thing."

Call structure — Protocol Delivery Call (Day 5–7)

• The number (10 min): Lead with biological age. "Before I show you the results — what would you expect your biological age to be, given how you feel?" Then reveal it. Let the number land. If PhenoAge is higher than chronological, this is your most powerful motivational moment.
• Marker tour (20 min): Walk through Tier 1 and Tier 2 findings. Explain each in plain language. Use analogies. "Your HOMA-IR of 2.8 means your cells are about 40% less sensitive to insulin than optimal. Think of insulin as a key — yours is a slightly bent key." Avoid overwhelming with every marker. Focus on the 5–8 most actionable.
• Protocol walkthrough (20 min): Go through each lever. Nutrition first, then training, then recovery, then supplements. For each: what to do, why (connected to their specific biomarker), and how to start this week.
• Question and resistance handling (10 min): "What feels hard? What do you already do?" Acknowledge what's already good. Make the protocol feel achievable.
• Week 1 commitments (5 min): "This week, just these 3 things: [habit 1], [habit 2], [habit 3]. Send me a WhatsApp at the end of each day with a thumbs up or down on each."

WhatsApp daily accountability system

Daily WhatsApp check-in is the highest-leverage retention tool. Do not skip it. Compliance drops dramatically without daily light accountability.

• The daily message (their side): Client sends: "✅ ✅ ❌" against their 3 weekly habits. Takes 10 seconds. You respond within 2–4 hours.
• Your response: Emoji acknowledgment + one sentence of encouragement or a specific protocol note if they missed something. Never shame. Always coach.
• Weekly summary (your side, Sundays): Send: "Week [X] summary: You hit [N] out of [X] habits. HRV trend this week: [up/stable/down]. One thing to focus on this week: [specific]."
• At scale: This daily system is manageable for up to 15 clients manually. At 30+ clients, hire a health coach who handles all check-ins within 4-hour response windows.

Tools & templates

Every tool, template, and document you need to run the system. What to set up before your first client arrives.

Essential setup checklist

• Google Sheets Master Tracker: One sheet per client. Tab 1: Demographics. Tab 2: All biomarker values (Day 1 and Day 90 side by side). Tab 3: Calculated values (HOMA-IR, TG:HDL, PhenoAge). Tab 4: Protocol summary. Tab 5: Check-in log.
• Airtable Client Database: One record per client. Fields: Name, age, program tier, start date, Day 90 date, lab order status, protocol delivery status, next call date. Use Airtable to trigger reminders to yourself.
• Calendly (or Cal.com): Two event types: "Initial consultation (free, 30 min)" and "Client check-in call (30 min)" and "Outcome review (60 min)." Connect to Google Calendar. Send reminders automatically.
• WhatsApp Business: Create a WhatsApp Business account. Set an automatic greeting. Create "Quick Replies" for common check-in messages. Keep client contacts organized in labeled groups.
• Lab ordering accounts: Create B2B/partner accounts with Thyrocare and Redcliffe. These give you: preferred pricing, home collection coordination, direct digital results, and the ability to order on behalf of clients easily.
• Razorpay: Payment links for each tier. Set up automatic payment reminders. Issue receipts automatically.
• Google Drive: One shared folder per client. Contains: their signed agreement, bloodwork PDFs, protocol document, check-in summaries, outcome report.
• DocuSign or Zoho Sign (free tier): Digital signing for the client agreement. This agreement should specify: scope of service, limitation of liability (not medical treatment), data handling, and refund policy.

Documents to create before your first client

What to study

The exact curriculum to become deeply knowledgeable. Prioritized by what you need to learn first. With 6–8 hours per week, you can be fluent in this domain within 6 months.

Tier 1 — Read/listen to these first (Months 1–2)

Tier 2 — Build deeper expertise (Months 3–6)

Tier 3 — Scientific literacy (Ongoing)

Certifications to consider (not mandatory but useful)

End of Tessera Operational Rulebook v1.0 · April 2026 · Confidential