physician-scientist, author of SUPER AGERS tinyurl.com/3w76us9a and Ground Truths: erictopol.substack.com

La Jolla, CA
A new cover for SUPER AGERS after making the NYT bestseller list. Thanks to you for making it the #1 ranked new non-fiction book on Amazon. amazon.com/gp/new-releases/b…
3
507
2,257
1,629,949
Eric Topol retweeted
Wow, this is a pretty striking result for my Strong Epigenetic Theory of Aging: transplant an old heart into a young animal and the heart is rejuvenated. But transplant a young heart into an old animal, and it quickly ages to match the recipient. This shows that biological age is not simply something an organ accumulates locally as irreversible “wear and tear.” Instead, to a large degree, it is a state imposed by the organism-wide environment. The authors saw bidirectional remodeling of both DNA methylation and gene expression, with old hearts in young hosts moving toward youthful programs and young hearts in old hosts moving toward aged ones. That is exactly what you’d expect to see if aging is a regulated, system-level state where the epigenome is acting as the writable control layer that tissues continuously adjust to the organism’s age.
TLDR of my Strong Epigenetic Theory of programmed aging: across biology, lifespan looks less like a fixed thermodynamic constraint and more like a control system with buttons: •Stop: some organisms execute a timed, endocrine-driven post-reproductive die-off •Slow: same genome but different life-history mode resulting in huge lifespan differences (e.g. caste transitions) •Pause: states where “time stands still” (developmental arrest/diapause) •Rewind: a true “Benjamin Button” mode in which organisms can reverse parts of their life history and become biologically younger My claim is that mammals run the slow version: a centrally coordinated, post-maturation retuning of maintenance setpoints. A few concrete hypotheses I argue for: 1.Aging begins at puberty (when mortality stops declining and starts rising). Puberty is the species-typical switch that flips growth/reproduction and, I think, maintenance policy. 2.The hypothalamus–pituitary axis is a plausible master tempo-setter of aging, because it already governs long-horizon state transitions (puberty, reproductive cessation, seasonal programs). 3.The epigenome is the writable operating system that turns transient endocrine signals into durable cellular state. Ultimately, the buck stops at the cell, where aging is executed as coordinated gene expression programs — and where partial reprogramming provides a real reset lever. If you disagree, what observations would falsify this model?
40
124
798
70,845
5 years ago this was the cover @Nature We've learned a lot about the power of swarms since
7
18
111
19,728
There's so much emphasis on generative AI for healthcare. But the proof points are abundant from the AI that antedated it, especially w/r to medical imaging. Recently @ScienceMagazine a model called RADAR knocked it out of the park for abdominal CT interpretation, even against the most experienced radiologists science.org/doi/10.1126/scie…
17
46
208
25,925
1
5
14
6,079
We're missing out on the value of genomics in medical practice. The cost (not charge) to do a polygenic risk score for all these diseases (Figure) and more is only $20 and they are informative for high-risk (top 5%) across ancestries A new review @NEJM nejm.org/doi/full/10.1056/NE…
26
85
360
59,944
Given the intensive research over 2+ decades and formidable progress in understanding human genomics for health and disease, it is unfathomable that we only rarely use these capabilities in patient care and prevention.
4
3
25
9,727
AI is changing medical practice, as @RBMD1982 points out @nytopinion But there are certainly concerns regarding deskilling and never-skilling among younger physicians, trainees, and students (w/@AdamRodmanMD) "Now, the chatbot in my pocket reassures me that I will always know enough, or have access to the cloud-based intelligence that generally does." nytimes.com/2026/09/25/opini…
25
40
157
28,289
The GRAIL NHS Galleri randomized trial with over 142,000 participants was published today @NEJM "In this trial, we did not observe a lower incidence rate of stage III or IV cancers [the primary endpoint] across 12 prespecified cancers after three screening rounds with multicancer early-detection testing plus usual care than with usual care alone." nejm.org/doi/full/10.1056/NE…
32
86
297
71,445
Good headline that sums it up nytimes.com/2026/09/23/well/…
2
3
7
4,497
Here come the nanoparticles to help treat cancer or get rid of senescent cells, reduce fibrosis @ScienceMagazine @ScienceVisuals science.org/doi/10.1126/scie… science.org/doi/10.1126/scie…
19
91
345
29,808
New @ScienceMagazine, a feature The obscure, unsung CD1 branch of our immune system, and how it could be exploited in the future science.org/content/article/…
4
48
210
28,639
A professor published 200+ papers and as many as 14 books this year. I'll leave it there. gift link wapo.st/4d3vD7n
99
349
1,146
208,552
Good to see the comments. Maybe he should be given a new title as the Professor of AI slop.
10
3
60
11,889
There's been steady progress using organs in a dish—organoids— for medical research. But now there's the immunoid to enhance our understanding of the complex immune system in people, and at the individual level. @CellStemCell . sciencedirect.com/science/ar…
7
42
172
26,424
In people with heart failure compared with healthy controls, the gut microbiome changes and that is linked to severity of heart dysfunction and outcomes @NatureCVR nature.com/articles/s44161-0…
2
52
181
25,768
A newly identified mechanism by which APOE4 promotes neurodegeneration, and a potential way to reverse it @CellCellPress cell.com/action/showPdf?pii=…
11
129
506
41,875
Peripheral arterial disease is the focus of a new @TheLancet series with 3 articles, open-access thelancet.com/journals/lance… thelancet.com/journals/lance…
4
97
340
30,467
The cardiovascular benefit from Ozempic in the large randomized trial was substantially not related to weight loss academic.oup.com/eurheartj/a…
30
129
642
56,268
Fat cells are a key component of our immune system but that's not generally acknowledged. An insightful review of their contributions @Cell_Metabolism sciencedirect.com/science/ar…
9
108
355
28,250