Reflections on aging and turning 40

Coming up on 40: how do we face ageing?

I’ve been trying to put my finger on why I’m sceptical of some “anti-ageing” strategies while happily taking part in others. I haven’t usually thought of those things as anti-ageing but I exercise, pay attention to what I eat and want to stay strong.

What I tend to bristle at are protein shakes, creatine, testosterone injections, Botox and an endless selection of supplements. My instinct is sometimes to dismiss the whole lot. But that isn’t a particularly thoughtful position. These are different choices, with different evidence, benefits and risks.

I want to steelman these approaches—to understand the strongest case for them before deciding what I think. I’ve tried to read about them and reflect critically on there uses.

Ive just turned 40 and I’ve stayed fairly healthy. I still feel strong, and I still look a certain way. It’s easier for me to say I’m comfortable with ageing while I’m fairly comfortable with where I am. Will that change as I start to feel and see the effects of aging? Will I start to be tempted?

What are we trying to preserve?

Wanting to keep your strength, independence or ability to play a sport makes sense to me. So does wanting to feel good about your appearance. I don’t think every choice needs to pass some test of whether it’s medically necessary before we’re allowed to make it.

But I’m starting to see why some approaches sit better with me than others. I want to know what a choice actually offers, what it costs—in money, time, risk and attention—and whether it supports the life I want to live.

Calling something “natural” doesn’t answer those questions. Neither does calling it “optimisation.” Exercise can become excessive or joyless, just as a supplement can be a useful, uncomplicated choice. The label alone doesn’t tell me much.

For me, health matters because it allows us to do more, see more and enjoy a full life. I want to keep that purpose in view when I’m deciding what to add to my routine.

Giving supplements a fair hearing

Nick Tiller and Alex Hutchinson have both shaped the way I think about these topics. They also give me reasons to examine my own assumptions.

Hutchinson’s “Maybe Endurance Athletes Should Take Creatine After All” is a good example. He considers possible benefits for endurance athletes while questioning broader claims and discussing trade-offs such as added water weight. He also reflects on whether ageing might give him reason to reconsider his own reluctance to take supplements. That willingness to reconsider is something I appreciate.

Creatine has evidence behind it for strength and repeated high-intensity efforts. It deserves to be considered on those merits. The NIH overview of sports supplements makes clear that effects depend on the activity and the individual. Evidence for one benefit doesn’t establish every other claim attached to a product.

Protein deserves the same approach. A shake can be a convenient way to meet a need. My preference for cooking doesn’t make someone else’s shake a bad choice. Hutchinson’s guide to protein for athletes explores the subject with more care than the usual argument over whether we’re all eating too much or too little.

I can accept that something may help without feeling obliged to take it. I can also change my mind later.

Testosterone: treatment and enhancement need separating

My concern about testosterone needs to be more precise than “it has loads of bad side effects.” That phrasing overlooks people who benefit from appropriate treatment.

For men being assessed for testosterone deficiency, the Endocrine Society guidelines require compatible symptoms or signs alongside consistently low testosterone levels, confirmed with repeat morning testing. The cause also needs investigating. Treatment can be appropriate for confirmed hypogonadism, with follow-up to assess benefits and adverse effects. Older age alone doesn’t establish a need for treatment, but it doesn’t automatically rule treatment out either.

That is a different decision from taking testosterone to chase higher numbers, a more muscular body or the promise of feeling young again without an established deficiency. Prescription testosterone, over-the-counter “testosterone boosters” and creatine are also different products; they shouldn’t be bundled together.

Tiller’s “Testosterone Supplements: Summoning the Specter of Tucker Carlson” examines how testosterone-boosting products are marketed through concerns about strength, sex and masculinity. His piece helps explain part of my discomfort: being encouraged to interpret dissatisfaction with ourselves as evidence that we need to buy something.

What about the risks?

Testosterone treatment needs monitoring. Fertility plans matter, and elevated haematocrit—the proportion of blood made up of red blood cells—is among the concerns addressed in the Endocrine Society’s guidance.

The cardiovascular story also needs updating. In 2025, the FDA removed the boxed-warning language about increased adverse cardiovascular outcomes, following the TRAVERSE trial in men with hypogonadism. It also required warnings about increased blood pressure. Those findings don’t establish that taking testosterone for general anti-ageing or at performance-enhancing doses is safe.

With nonmedical anabolic-steroid use, including testosterone misuse, the National Institute on Drug Abuse describes potentially serious harms: cardiovascular damage, disrupted hormone production, reduced sperm production and psychiatric effects, among others. Some effects can persist. This evidence concerns misuse of testosterone and related steroids; it shouldn’t be presented as the expected outcome of properly supervised replacement therapy.

There isn’t a single dose I can point to here as the boundary between safe and dangerous. The formulation, resulting hormone levels, duration, other drugs and the person’s health all matter. “More” needs a much better justification than wanting to turn back the clock.

I’ve collected additional reading in my earlier post, “Testosterone and Creatine: my trusted sources of information.”

I’ve been here before

I tried creatine in high school because someone older than me was taking it. I remember keeping it in my bedroom and taking it secretly. After a few goes, I stopped.

At the time, it felt less accepted, and hiding it made me feel as though I was doing something wrong. That feeling wasn’t evidence about creatine. It was part of being young, comparing myself with someone older and not quite knowing what to make of it all.

I’m still not particularly keen to take it. But I can recognise that some of my reaction comes from that experience. My preference isn’t a scientific verdict.

Can I chase goals and still be content?

I’m not immune to wanting to be faster or stronger. I’m training for a half marathon and checking my kilometre splits. I clearly enjoy improvement.

But the races and tournaments have never brought me quite the same joy as learning and training. I like having something to work on. I like noticing that something difficult has become a little easier.

If I took a supplement and beat a personal record, I’d probably enjoy it. Would everything suddenly fall into place? I doubt it. There would still be another time to chase.

There will always be someone younger, stronger or more athletic than me. There will always be someone with more money or more time. If feeling good about myself depends on catching up with all of them, I’m setting myself an impossible task.

I think I can pursue a goal and still be content if I’m willing to let the result be information rather than a judgment on my worth. I can care about a race, be disappointed if it goes badly, and still value the months spent preparing for it.

That is what I want to practise as I get older.

Knowing when enough is enough

The question I’m left with is practical: is this choice helping me live more fully, or is it adding another demand I feel I can never quite meet?

I want to cook food that is healthy, fun to make and enjoyable to eat. I want to train, play with the kids, spend time with friends and try new things. Some of that takes discipline. Every worthwhile habit doesn’t have to feel enjoyable every minute. But the overall direction should be towards a life I like living.

For me, warning signs would be feeling guilty whenever I miss a routine, avoiding things I enjoy to protect a number, or repeatedly buying something new because the last improvement didn’t make me feel good enough.

I can’t speak for someone experiencing anxiety, depression or a painful struggle with self-worth. Those experiences deserve care, and I don’t want to suggest that contentment is simply a choice. My concern is with marketing that offers a product as the answer to feelings it may have helped stir up.

I don’t need to reject every supplement or treatment to make peace with ageing. I want to make informed choices, leave room to change my mind and remember what I’m trying to preserve.

I’ll still have goals—I’d like to be able to pursue them while still appreciating the body and the life I have now.

Dave