Dr. Nathan Curran on Making Prevention Measurable

Dr. Nathan Curran is a longevity physician at Biolite Clinic in Dubai, with nearly two decades spent closing the gap between feeling unwell and qualifying for a diagnosis. His consultations run up to an hour and a half, not out of indulgence but conviction: the quality of any intervention starts with the quality of the conversation behind it. He's spent his career proving that prevention isn't a wellness buzzword, it's a discipline, one built on data, time, and a refusal to tell patients "you're just aging" when something is clearly off.

Dr. Curran, you’ve worked across conventional medicine, functional medicine, regenerative medicine, and now longevity-focused care. But before all of that, what first drew you to medicine, and how did that early curiosity eventually lead you toward prevention?

It’s been a really long and convoluted journey over the better part of 20 years, trying to find my niche within medicine and the thing that gives me gratification, aligns with my core philosophies, and that I’m passionate about. I’ve always had an almost obsessional interest in how things work, and medicine just happened to be the field I went into. I like to deconstruct things to their foundational inputs, and the first half of medical school was basically that: learning from the cellular level up to systems, organs, symptoms, and diseases.

I was also very fortunate during my training to have the opportunity to do an intercalated research degree in human genetics, around the time the Human Genome Project was kicking off. That fed directly into my interest in cellular biology and understanding what is required to keep a human being healthy and functioning optimally. Then clinical medicine happened, and it felt almost jarring. Learning how to treat disease was a complete disconnect from all the earlier inputs, from everything that happens before disease and before decline.

For me, healthcare is ultimately disease care, and the principles of caring for disease are completely different from how you build, develop, and maintain health. I kept having conversations with patients who were experiencing decline but had not yet breached the threshold of a diagnosis, so I had to tell them, “you’re fine,” “you’re just aging,” or “it’s just menopause.” That missed opportunity for prevention became increasingly frustrating. So I eventually decided to step outside primary care and make my focus prevention: personalized prevention using precision tools to quantify current function, illustrate a trajectory of health maintenance or decline, and use precision interventions to change those trajectories.

There has never been more health data available to patients than there is today. When someone walks into your clinic, how do you decide which biomarkers actually matter and which are simply creating more noise?

It is hard to separate pure signal from noise. We’re living in an era where patients and clients are armed with data, and they don’t need permission anymore. Anyone can get blood work done, direct-to-consumer diagnostics, testing, wearables, all of it. People are awash with data. That makes my job more complicated in terms of prioritizing what is applicable and what has meaningful utility for each individual. But it has also been beneficial, because access to data has made people intellectually curious about the longevity and regenerative medicine conversation. For the most part, people want to use that data to improve function, improve disease resilience, or improve their level of vitality.

I think you have to be a practitioner who is willing to sit in the 20- to 30-year gap between research and clinical implementation. There is so much exciting research happening, but waiting 30 years misses an opportunity for someone in midlife who wants to take meaningful steps now around how they look and function in their 70s and 80s.

So it requires clinicians who are intellectually curious and brave enough to ask: for this particular individual, what does the research say, and what feels compelling enough to present as a potential diagnostic or intervention? But it also starts with time. You need to understand who is sitting in front of you, their history, the life they envision for themselves, and the risks you need to be mindful of. So how do we weed out what is important, what is applicable, and what has utility? It starts with a conversation.

I love that concept, because it really does come back to understanding the person in front of you. Do you actually have that time with your patients? Are you lucky enough to have that time?

Yes, I’m actually lucky to have that time because when I set out on this journey, longevity medicine didn’t really exist. It wasn’t a thing. In fact, I had a very hard time articulating what it is that I actually do for patients. But one thing I was very clear on is that the quality of my intervention starts with the quality of the data input, and the quality of that data input is a function of time. So when I left conventional medicine in 2015 or 2016, I knew from the outset that my consultations needed to be one hour to one and a half hours long.

Now, with the advent of AI, we may be able to replicate some of those efficiencies in half an hour or 40 minutes. But it still starts with a conversation and getting to know the person you are going on a longevity, regenerative medicine, or health optimization journey with. Because it is not a single-intervention thing. It is a journey, and the interventions and diagnostics will change as the patient’s life stage and requirements change.

I think this is such an important point, because in many healthcare systems, care is still very visit-by-visit. What you’re describing sounds much more longitudinal, almost like building the person’s health story over time.

And that is also one of the strongest values of GlycanAge: being able to test, retest, and actually see whether an intervention is moving someone in the right direction. So how did you first come across GlycanAge, and how has it helped you in your practice?

I first encountered GlycanAge in late 2022, early 2023, and I’d like to think I was one of the earliest practitioners in London incorporating it into my practice. A big lever I focus on with patients is inflammation: chronic inflammation as a modifiable risk factor for chronic disease, but also for the aging process itself.

I tell my patients all the time that silent chronic inflammation is both a characteristic and a driver of the aging process. But subclinical inflammation is not always intuitive to patients. Clinicians understand it, but finding the language to explain why someone needs to construct an anti-inflammatory lifestyle can be difficult. When I first encountered GlycanAge, the first thing that hit me was: this is going to be an incredible translational tool. It helps translate something that is not immediately intuitive, and it demonstrates the impact of intervention over time.

In functional medicine and longevity medicine, our intervention timeframes are long: quarters, six months, 12 months, and in longevity, decades. The interventions can also be costly, and it can feel like a massive leap of trust for someone to invest time, money, and effort based on the idea that the research says this might be beneficial. So to have a tool that evidences and demonstrates the impact of your intervention over a three-month timeframe is hugely valuable.

It supports sustained buy-in from the patient, but it is also an intervention refinement tool. You may start on one track and then use GlycanAge to see whether the needle has actually moved. If it hasn’t, maybe you need to focus on a different area. So for me, it has been hugely valuable as a way of illustrating the impact of inflammation on something relatable like aging, but also as a tool for refining interventions, which I think is essential for any clinician saying they are practicing precision medicine.

You’ve mentioned interventions a few times, and I think that’s important to include. In your practice, what kinds of interventions do you usually use GlycanAge to track, and how do you decide what is actually working for each patient?

This is very patient-specific and context-specific. In one person, the things that shift the needle on immune system behavior might just be lifestyle and dietary inputs: educating someone on how to lead an anti-inflammatory lifestyle, an anti-inflammatory diet, stress management, prioritizing sleep, and anti-inflammatory supplementation like vitamin D, omega-3s, or curcumin. In one individual, that might be very impactful, both in terms of how they feel and the needle shift on something like a GlycanAge test.

In the next person, those might be the foundational inputs, but you may need bigger levers to shift the needle more significantly. For me, that includes making sure someone is hormonally optimized, because the immune system is very susceptible to hormonal inputs. We have estrogen, progesterone, testosterone, and DHEA receptors on immune cells, and many of these hormones are immune modulators in their own right, especially after 40 or approaching 50, when we see significant accelerations in inflammation-driven aging.

Then there are repurposed medications like metformin, rapamycin, or naltrexone, and more recently peptides: GLP peptides, regenerative peptides, and immune-modulating peptides. At the top layer, because I tend to be very sequential with how I layer these things, there are more cutting-edge interventions like stem cells, exosomes, plasma filtration, and ozone.

We have this growing sandbox of tools, but it is really important to have a personalized framework for where you start. It is pointless starting someone on plasmapheresis if they are living a very inflammatory lifestyle and not sleeping. Foundational inputs need to be in place first before you graduate someone to those higher-tier interventions. And again, evidencing the impact of the intervention helps you decide who requires that. If we do three months of foundational lifestyle, a bit of hormone optimization, and see significant improvements in immune system behavior, we might say, “Right, that’s job done for this round.” Sometimes, if the body needs bigger tools, we might bring in something like plasmapheresis, a repurposed pharmaceutical, or a peptide.

One of the most powerful examples you've shared involved a patient whose biological age was dramatically elevated despite appearing relatively healthy on the surface. After targeted lifestyle changes and later additional interventions, his GlycanAge improved significantly.

What did that case teach you about the relationship between lifestyle, motivation, and measurable outcomes? What was the role of GlycanAge in that particular patient journey?

I think GlycanAge very powerfully tells a story to a patient. And that story is not always intuitive, and it is not something a doctor can necessarily articulate through technical jargon. In medicine, we have great tools that tell the story of disease: go for a scan, find a tumor; do this test, find that. But we do not have many good tools that tell the story of what precedes disease. That is why GlycanAge has become such a favorite tool of mine, because it makes that story real and relatable.

This case is a good example. He was a 40-something, highly successful executive and founder: frequent travel, constantly crossing time zones, very little sleep, constant stress, always running in fight-or-flight mode. He was also training hard, even overtraining, because everything was dialed up to the max, apart from recovery. He wasn’t feeling bad. He was operating at a seriously high level, having comprehensive health checks every year, and came in largely because his wife encouraged him to.

It is not unusual for someone like that to say, “I’m operating at a high level, I’m successful, I have doctors checking my health.” And I said, “No, they’re not checking your health. They’re checking to see whether you have a disease, which is a completely different thing.” Then we did the GlycanAge test, and it was sky-high. Without that result, it would have been very hard to tangibly illustrate how frequent flying, not sleeping, overtraining, late business dinners, and constant stress were causing longer-term harm.

When he saw around a 30-year difference between his inflammation-based biological age and his chronological age, the penny dropped. He immediately asked, “What do I do?” And I think he was motivated because the same tool that triggered the buy-in was going to demonstrate the impact of what he needed to do.

So it became a multi-stage process: prioritizing sleep, addressing late eating and other things promoting insulin resistance, changing his light environment, spending more time with family, disconnecting from what kept him in fight-or-flight mode, and adjusting exercise so he wasn’t pushing himself into the red every day. We also optimized hormone status and used targeted interventions to support immune modulation.

Over about six months, we saw a significant improvement. But the interesting thing was the client saying, “I didn’t realize how bad I felt.” The numbers came down, but he already knew the result was going to improve because of how much better he was feeling, functioning, recovering, and waking up restored.

Ultimately, I am treating the patient, not a number. It is great if the numbers move and validate what the patient is experiencing, but I want it to happen in that sequence: the patient feels and functions better, and the number backs that.

I love what you said about GlycanAge helping tell the story of what happens before disease, because that feels like the missing part in medicine right now.

So I’m curious, when you look at the next five to 10 years, do you think medicine will actually move more in that direction: toward measuring those early changes and helping people prevent decline? Or do you think we’ll still mostly see the system focusing on new drugs and treating problems once they appear?

I think the way things evolve all depends on incentives. This might sound cynical, but after two and a half decades in medicine, it has been consistently reinforced for me that outcomes follow incentives, and the incentives are often commercial.

But what is interesting now is that some of those incentives are starting to point us toward a deeper understanding of biology. GLP-1s are a good example. They were meant to help people lose weight, but we’ve realized that GLP receptors are found in most cell types in the body and play an important role in how those cells behave and function. So serendipitously, something targeted purely at weight loss is becoming a longevity tool and a conceptual unlock for longevity research.

I think what has happened because of peptides is going to continue. Peptides and proteomics are, for me, the next frontier of medicine, and they are going to unlock longevity-promoting and healthspan-promoting interventions. There will still be disease-focused applications, but the longevity, health-promoting, vitality-promoting applications are going to absolutely explode.

AI is also going to enable translational medicine and proteomics research, and we are going to discover a deluge of small molecules and peptides used in a very targeted manner, not exclusively for disease treatment, but also for promoting healthy, youthful, and vibrant aging. So I think the next 10 years are going to be absolutely bonkers and exciting.

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If you'd like to learn more about Dr. Nathan Curran's approach to prevention and longevity at Biolite Clinic Dubai, follow him on Instagram