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Age and degree of GH axis decline: Patients in their late 40s and 50s typically see more dramatic early results than patients in their mid-30s starting preventively, because GH decline is more advanced and the pituitary still has enough reserve capacity to respond meaningfully to stimulation

Some of the most brilliant and prolific neuroscientists that I know who've had very long careers, Eric Kandel, Nobel Prize winner at Columbia, comes to mind for all his work on memory, used to swim a mile a day, and now I think swims half a mile a day

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Baseline labs and targeted follow-up for liver and kidney function, glucose, lipids, and relevant hormones help catch problems early