DISEASE STARTS DECADES BEFORE DIAGNOSIS
ARE YOU LOOKING FOR IT?
Decades before a disease
is diagnosed, your labs are normal
but your body is sending out subtle SOS signals
that are ignored or dismissed by doctors - not because doctors don't care, but because they don't have the the system to listen.
--So Dr. Alexis Anvekar built one---
THE SCIENCE IS CLEAR
The SILENT GAP™
IS A 10–25 YEAR WINDOW
of pre-disease
that no one talks about.
The best time to treat was 10 years ago. The second best time is now.
Age 25–35
THE SILENT GAP™ WINDOW IS WIDE OPEN
SIGNAL ONSET
Insulin sensitivity, mitochondrial efficiency, and inflammatory tone begin to drift. Nothing hurts. Everything looks normal. This is the easiest decade to act in — and almost nobody does.
Age 35–50
THE SILENT GAP™ WINDOW IS STILL OPEN
THE CRITICAL WINDOW
The first felt symptoms: the afternoon crash, the recovery that takes three days, the word that won't come, the sleep that stopped working. Dismissed as stress, parenting, or a busy season. Conventional medicine has no reason to act.
Age 50–65
THE SILENT GAP™ WINDOW IS CLOSING
MEASURABLE CHANGES
Now it shows up: on a lipid panel, an A1c, a DEXA scan, an MRI. What was a modifiable pattern becomes a named condition — and treatment shifts from prevention to management.
Age 65+
THE SILENT GAP™ WINDOW IS CLOSING
DIAGNOSIS
By the time many conditions are diagnosed, substantial irreversible change has already occurred. With dementia specifically, 30–60% of neurons may already be lost.
Dementia is the starkest example: 30–60% of neurons may already be lost at
diagnosis. The same shape shows up in heart disease, type 2 diabetes,
osteoporosis, and the slow muscle loss that decides how you move at 70.
"Normal" is a population average. It was never built for you.
30-60%
Dr. Anvekar talks about THE SILENT GAP™
and how she built a program to detect it.
Is your body sending SOS Signals now?
The Wall
The energy crash that never used to happen. You used to power through. Now you're managing around it.
Something Feels Off
Same diet. Same training. Different outcome. Something changed metabolically and no one can tell you what happened.
Slower Recall
Names and words take half a second longer than they should. You catch yourself searching for language that used to arrive on its own.
Nothing Left
Your family is right there — and you have nothing left to give them. Fatigue doesn't clock out at 5 pm.
The Silent Gap™ doesn't announce itself. It shows up like this.
If two of these are yours, you're likely in The Gap.
Could this be you?
NHANES 2011–2018: 22.2% of adults aged 20–39, rising to 25.3% in the most recent cycle.
ONE IN FOUR
adults aged 20–39 already meet criteria for metabolic syndrome — the quiet
engine behind heart disease, diabetes, and cognitive decline. Most have no idea.
ONE IN NINE
Americans aged 65+ is living with Alzheimer's — roughly 7.4 million people.
The biology behind it begins decades before the diagnosis.
Alzheimer's Association, 2026 Alzheimer's Disease Facts and Figures.
Traditional medicine needs a diagnosis before it can act.We built a way to act before there is one.
Scores generated by
reveal a pattern in one or more of
The Ten Living Domains that
guide our treatment.
This is how we do it--find The SILENT GAP™ despite, in our decades of prior experience, is invisible to traditional medicine.
-- THE COGSPAN™ SYSTEM --
Ten systems. One pattern. We score every one of them, because the thing limiting you at 35 is rarely the thing you'd have guessed.
Brain Performance & Cognitive Aging
Mitochondrial Energy & Oxidative Stress
Cardiovascular & Vascular Aging
Risk Behaviors, Environment & Health Engagement
Metabolic & Glycemic Stability
Sleep, Circadian Rhythm & Recovery
Physical Function, Strength & Mobility
Inflammation & Immune Aging
Hormonal & Neuroendocrine Balance
Lifestyle, Purpose & Cognitive Reserve
52
YEAR OLD MAN
Brain Performance & Cognitive Aging ▓▓▓▓▓▓▓░░░ 71
Inflammation & Immune Aging ▓▓▓▓▓▓░░░░ 64
Sleep, Circadian Rhythm & Recovery ▓▓▓▓▓▓▓░░░ 68
Cardiovascular & Vascular Aging ▓▓▓▓▓▓▓▓░░ 77
Lifestyle, Purpose & Cognitive Reserve ▓▓▓▓▓▓▓░░░ 70
Metabolic & Glycemic Stability ▓▓▓▓▓░░░░░ 58 ← target domain
Mitochondrial Energy & Oxidative Stress ▓▓▓▓░░░░░░ 42 ←target domain
Hormonal & Neuroendocrine Balance ▓▓▓▓▓▓░░░░ 63
Physical Function, Strength & Mobility ▓▓▓▓▓▓▓░░░ 69
Risk Behaviors, Environment & Health ▓▓▓▓▓▓▓▓░░ 74
38
YEAR OLD MAN
Brain Performance & Cognitive Aging ▓▓▓▓▓▓▓░░░ 71 ← target domain
Inflammation & Immune Aging ▓▓▓▓▓▓▓▓░░ 86
Sleep, Circadian Rhythm & Recovery ▓▓▓▓▓▓▓▓░░ 82
Cardiovascular & Vascular Aging ▓▓▓▓▓▓▓▓░░ 82
Lifestyle, Purpose & Cognitive Reserve ▓▓▓▓▓▓░░░ 99
Metabolic & Glycemic Stability ▓▓▓▓▓░░░░░ 86
Mitochondrial Energy & Oxidative Stress ▓▓▓▓░░░░░░ 78 ← target domain
Hormonal & Neuroendocrine Balance ▓▓▓▓▓▓░░░░ 86
Physical Function, Strength & Mobility ▓▓▓▓▓▓▓░░░ 89
Risk Behaviors, Environment & Health ▓▓▓▓▓▓░░░ 96
A Case Study: 38 year old Larry complained of difficulty finding names at work and felt that his gut was inflammed.
He completed the Tier 3 COGSPAN™ System and his neurocognitive testing showed a related deficit in his immediate recall and delayed recall and his advanced neuroinflammation markers were abnormal. Additionally, he was found to have mold toxicity with a particular mold known to cause brain symptoms. He hired a mold expert who found mold in his refrigerator line. The refrigerator was replaced, Larry underwent a Living Method detox protocol with prescription medications, IV detox therapy, NAD+ therapy and oral supplements and he reported improvement in just two months.
A Case Study: 49 year old Alejandra complained of difficulty focusing, hot flashes, weight gain, gut issues and fatigue. Her doctor checked her hormones and labs and told her that everything was normal.
She completed the Tier 2 COGSPAN™ System and found that she had elevated phthalates in her body which are environmental toxins that are powerful endocrine and hormone disruptors. She also was found to have continued neuroinflammation likely from a remote concussion. After removing phalates from her environment, she went through a treatment protocol. In regards to her remote concussion, she returned to her neurologist, and started a peptide shown in clinical studies to increase brain growth factor, and a second product to assist with gut inflammation in addition to dietary changes. After 4 months, her hot flashes, gut issues and fatigue improved by 75%+ and her difficulty focusing improved by 50%.
49
YEAR OLD WOMAN
Brain Performance & Cognitive Aging ▓▓▓▓░░░░░ 60 ← target domain
Inflammation & Immune Aging ▓▓▓▓▓░░░░░ 61← target domain
Sleep, Circadian Rhythm & Recovery ▓▓▓▓▓▓▓░░░ 82
Cardiovascular & Vascular Aging ▓▓▓▓▓▓▓▓░░ 86
Lifestyle, Purpose & Cognitive Reserve ▓▓▓▓▓▓░░░░░ 92
Metabolic & Glycemic Stability ▓▓▓▓▓▓▓░░░ 72
Mitochondrial Energy & Oxidative Stress ▓▓▓▓▓▓▓░░░ 68
Hormonal & Neuroendocrine Balance ▓▓▓▓░░░░░ 64
Physical Function, Strength & Mobility ▓▓▓▓▓░░░░░ 89
Risk Behaviors, Environment & Health ▓▓▓▓░░░░░ 54← target domain
A Case Study: 52 year old Mark complained of brain fog and had normal labs from his doctor.
He completed the Tier 1 COGSPAN™ System and was surprised to learn that his Living Domain pattern revealed a need for focus in the Mitochondrial Energy & Oxidative Stress Domain. After treatment, Mark's symptoms improved and his CogSpan score shot up by over 10 points.
Living Method Executive Physicals
Normal isn't good enough when we're looking decades ahead.
One day to measure what matters. Ten scores to guide what comes next.
Concrete numbers to follow over a lifetime to stop the guesswork.
Every Living Method Executive Physical begins with one coordinated day of advanced testing. Rather than presenting you with pages of disconnected laboratory results, we evaluate and organize hundreds of individual data points into your proprietary 10 Living Method Domain Scores. Each data point is measured against optimal ranges, not normal ranges.
These scores reveal patterns across brain health, metabolism, sleep, cardiovascular health, physical function, inflammation, hormonal health, cellular energy, resilience and environmental risk—providing a clearer picture of where your health stands today.
OPTIMAL
HIGH NORMAL
LOW NORMAL
-- THE COGSPAN™ SYSTEM --
Our patent-pending Operating System connects the dots of hundreds of biomarkers that can be treated now when the window to treat is wide open.
Small changes now may amount to massive changes in the future.
Tier 1
Living Method
Essentials
COGSPAN™
Physical
$1,495 for the:
-
Proactive
-
Under age 50
-
No symptoms
-
Looking for a baseline health assessment with concrete numbers to follow over time
Tier 1 is our foundational whole-health assessment for proactive adults who want to measure their health while it is still theirs to shape.
In one coordinated visit, we collect advanced laboratory results, cognitive data, medical and family history, lifestyle information, vital signs and physical-performance measurements. Our patent-pending COGSPAN™ System then weighs and organizes approximately 160 biomarkers and health measurements into your 10 Living Method Domain Scores.
Instead of asking only whether each result is “normal,” we look for small shifts, developing patterns and areas beginning to move away from optimal health.
You receive:
-
One coordinated day of medical and performance testing
-
Advanced fasting laboratory testing
-
BrainCheck neurocognitive assessment
-
Strength, balance, gait and mobility testing
-
Comprehensive medical, family-history and lifestyle assessment
-
Physician examination and preventive-health review
-
10 proprietary Living Method Domain Scores
-
Identification of the one to three health domains that may deserve the most attention
-
may include a one year subscription to My Living Eats prescribed diet app
Best for:
Healthy, proactive adults who want a comprehensive baseline, clearer priorities and a more meaningful annual physical—even when they have no significant symptoms.
One visit. Approximately 160 measurements. Ten scores that show you where to focus next.
Tier 2
Living Method Advanced
COGSPAN™
Physical
$3,495 for the:
-
Proactive
-
Over age 45
-
Might be in The Silent Gap™
-
Family History of Dementia
-
Increased risk of dementia
-
Includes 20+ page Blueprint with detailed plan of prescribed treatment
Go beyond your scores to investigate what may be driving them.
Tier 2 includes everything in the Essentials Physical and adds more than 100 advanced biomarkers, imaging and performance assessments designed to investigate the patterns that a traditional physical can miss.
This is our most comprehensive assessment for adults who may be entering the Silent Gap™—the years when changes are developing beneath the surface but may not yet meet the criteria for a diagnosis.
Tier 2 looks more deeply at cognitive risk, neuroinflammation, environmental exposures, body composition, cardiovascular fitness and early cancer signals. The purpose is not simply to collect more data. It is to help explain why a domain is underperforming and determine what additional medical attention may be appropriate.
Includes everything in Tier 1, plus:
-
More than 100 additional advanced environmental testing biomarkers-molds, metals, chemicals, plastics, forever chemicals included
-
OAT testing mitochondrial and cellular nutrition assessment included
-
Advanced neuroinflammation and cognitive-risk testing billed to insurance
-
DEXA total-body muscle, fat and bone assessment
-
VO₂ max cardiovascular-fitness testing
-
MRI of brain billed to insurance
-
Additional physician-selected testing based on medical history and findings may include oral microbiome testing, sleep study, CGM, or additional imaging/labs
-
A 20+ page Blueprint summarizing all findings, scores and maps out a detailed plan for treatment.
Best for:
Adults over 45, people with persistent but unexplained symptoms, family history of dementia or chronic disease, and anyone who wants a deeper evaluation
Tier 1 shows where your health needs attention. Tier 2 helps determine why.
Tier 3
Living Method Premier
COGSPAN™
Physical
$ varies for the:
-
Proactive, or
-
Over age 50, or
-
Chronic disease, or
-
In The Silent Gap™
Our deepest assessment—with treatment incorporated into the experience and a full repeat of Tier 1 testing.
Tier 3 includes everything in the Advanced COGSPAN™ Physical and adds physician-selected longevity or regenerative treatment when medically appropriate.
This tier is designed for people who do not want to stop at measurement. After completing the most advanced assessment we offer, Dr. Alexis Anvekar reviews the findings, identifies the domains requiring priority attention and selects an appropriate treatment experience based on the patient’s medical history, goals and results.
Potential options may include additional MD, NP, fitness and nutrition consultations, frequent neuropsych testing to follow up on therapy measures, NAD+ therapy, targeted peptide therapy, IV therapy, exosome-based products or other regenerative approaches. Treatment is never selected simply because it is included in the tier. Every option is subject to medical evaluation, candidacy and informed consent.
Includes everything in Tiers 1 and 2, plus:
-
Our most comprehensive physician review
-
VIP coordinator
-
Enhanced MD support during the treatment period
-
Repeat Tier 1 testing included
-
A physician-selected longevity or regenerative treatment
-
A multi-month treatment regiment supervised by MD
Best for:
Adults who want Living Method’s deepest one-day assessment and are ready to move from measuring their health to taking medically guided action.
Measure what is changing. Understand what may be driving it. Begin addressing what matters most in a multi-month program guided by Dr. Anvekar.
Patients, in their own words about how the
COGSPAN™ System and recommended treatments made a big impact in their lives
Why Dr. Anvekar built this
My patients don't come to me with a diagnosis. They come to me with a feeling that "something is off" or they "feel inflamed" or have "brain fog" and they look to me for a diagnosis so they can get some needed relief from their symptoms.
However, traditional medicine doesn't have a system to address these vague symptoms because the SOS signals the body sends out in this very early state of pre-disease are too soft to hear. We have to wait for the signals to shout out before a diagnosis can be made.
This doesn't work in dementia.
My mother was diagnosed with mild cognitive impairment and she forgot my name just a few years later then passed.
When I sat down and scrutinized decades of my mother's medical records scattered across many different doctors offices, I found that my mother had dozens of subtle SOS signals and that she had been on a slow train to dementia for decades.
But her doctor couldn't see it, and I couldn't see it because we didn't have a system to detect it.
So I built one:
I built The COGSPAN™ SYSTEM for my patients. I built it for my children. I built it for both you and me so we can do everything possible now to have the healthiest body and brain later.
-- THE COGSPAN™ SYSTEM --
Who The Living Method is For
The Early Mover
Thirty-something, healthy on paper, and unwilling to find out at 55 what could have been found at 35.
The High Performer
Leads high-stakes work and has started noticing the first tax on energy, focus, and recovery.
The Woman in Transition
Perimenopause, postpartum, or somewhere in between — where the standard reference ranges fit worst and the dismissal comes fastest.
The Adult Child
Experienced with the devastation of a parent with dementia and fearing a repeated genetic cycle.