Every year, around my birthday, I have blood drawn. Not the standard screen my GP might order. Something more comprehensive — a panel I’ve built up over years of thinking about what actually predicts how well a body is ageing, as opposed to simply how old it chronologically is.
I started doing this partly out of professional curiosity. I work in longevity medicine, I advise patients on ageing, I write about it. It seemed intellectually dishonest not to apply the same rigour to myself. What I didn’t expect was how much the numbers would inform my own clinical practice — not just my personal choices.
The distinction between chronological age and biological age is not abstract. It has real clinical consequences. Two women who are both 51 — which is my age — can have profoundly different biological trajectories depending on lifestyle, hormonal history, stress burden, sleep quality, and genetic predisposition. The number on the birth certificate tells you how long the calendar has run. It tells you almost nothing about where the body actually is.
What biological age means biologically
Biological age is not one thing. It is a cluster of measurements — some well-established, some emerging — that together provide a picture of cellular and systemic ageing.
The most established markers I track are: telomere length (which shortens with each cell division and with oxidative stress), inflammatory markers including high-sensitivity C-reactive protein and interleukin-6, metabolic markers including fasting insulin and HbA1c, lipid profiles that go beyond the standard screen to include ApoB and Lp(a), hormone panels including oestrogen, testosterone, DHEA-S and IGF-1, and micronutrient status covering vitamin D, magnesium, zinc, omega-3 index, and B vitamins.
More recently, I’ve added an epigenetic clock assessment — a methylation-based test that analyses DNA methylation patterns across hundreds of sites to produce a biological age estimate. These tests have become more accessible and more validated over the last few years. The one I use correlates well with clinical outcomes in longevity research [1].
In my practice at SW1 Clinic, I discuss this framework with patients who are interested in longevity medicine, not just aesthetics. The face is a reflection of systemic health. You cannot optimise the face while ignoring the body.
What I’ve found in my own testing
I’m going to be specific, because specificity is what I find most useful when I read other people’s accounts of this.
My epigenetic clock puts my biological age consistently two to four years below my chronological age. That is not extraordinary — it’s the kind of number associated with regular resistance training, adequate sleep, controlled metabolic markers, and the absence of major chronic inflammation. Nothing I would publicise as an achievement.
What has been more instructive is watching the numbers change in response to specific interventions. In a year when I was training heavily for Hyrox and sleeping poorly as a result, my hsCRP rose. My cortisol metabolites were elevated. My testosterone dropped. My biological age estimate ticked upward by approximately a year. That single data point told me something that no amount of general advice about “managing stress” could have communicated: my specific version of overtraining was biologically costly in a measurable way.
The following year, I adjusted training load, prioritised sleep aggressively, and added ashwagandha and magnesium glycinate. The numbers normalised. The biological age estimate came back down.
This is not anecdote. It is n-of-1 data with repeated measurement, which is a legitimate form of evidence for personal health optimisation even when it can’t be generalised.
The Asian-specific considerations
Asian women — and I am thinking specifically about Singaporean and Malaysian women of Chinese, Malay, and Indian heritage — face a particular set of biological age risk factors that standard Western longevity literature does not adequately address.
Metabolic syndrome risk is higher in East and Southeast Asian populations at lower BMI thresholds. The cut-off for abdominal obesity in Asian adults is a waist circumference of 80cm for women and 90cm for men — compared to 88cm and 102cm in Western guidelines [2]. This matters because visceral adiposity is a primary driver of chronic inflammation, insulin resistance, and accelerated biological ageing. A woman who appears slim by Western standards may have significant metabolic risk by Asian-appropriate metrics.
Vitamin D deficiency is paradoxically common in Singapore despite year-round sun exposure. Darker skin requires more UV exposure to generate equivalent vitamin D, and air-conditioned indoor lifestyles in Singapore mean many people — including many of my patients — have chronically low levels. Vitamin D status is increasingly recognised as a significant modulator of epigenetic ageing.
Oestrogen decline in Asian women also deserves attention. East Asian women tend to enter perimenopause slightly earlier than Western counterparts and often experience it with less institutional support — cultural silence around menopause in Chinese and Malay families means many women navigate this transition alone, without hormone optimisation, and with the attendant biological consequences.
What you can actually do
If you want to start somewhere accessible: get a comprehensive blood panel once a year. Not the basic three-item screen. At minimum: full blood count, metabolic panel, HbA1c, fasting insulin, full lipids including ApoB if your lab offers it, vitamin D, magnesium, thyroid function (TSH, Free T4), and a full hormone panel — oestrogen, progesterone, testosterone, DHEA-S.
Track these over time. A single data point is informative. A trend is actionable.
If you want to go deeper: epigenetic clock tests are available online, require a saliva or blood sample, and typically cost between SGD 300–700. They’re not necessary for a good longevity protocol, but they are compelling — particularly if you’re the kind of person who needs to see a number to stay motivated.
My book Get Your Sexy Back covers the specific testing and biohacking approach I use for women in the perimenopause and menopause transition in more detail if you want a structured framework.
Chronological age is what time has done to the calendar. Biological age is what life has done to your cells. They are related but not identical — and the gap between them is, within limits, something you can influence.
That’s what keeps me running the tests.
References
[1] Horvath, S. (2013). DNA methylation age of human tissues and cell types. Genome Biology, 14(10), R115. https://doi.org/10.1186/gb-2013-14-10-r115 [VERIFY — confirm before publishing]
[2] WHO Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet, 363(9403), 157–163. https://doi.org/10.1016/S0140-6736(03)15268-3 [VERIFY — confirm before publishing]
[3] Lu, A. T., et al. (2019). DNA methylation GrimAge strongly predicts lifespan and healthspan. Aging, 11(2), 303–327. https://doi.org/10.18632/aging.101684 [VERIFY — confirm before publishing]