Silicon Valley startup gives ‘cellular ages’ based on a blood test

Shutterstock

• A Silicon Valley blood-testing startup called Telomere
  Diagnostics sells a $99 kit that tells customers the average
  length of their telomeres.
• Telomeres are seen by some researchers as a holy grail
  of aging. Unlike other factors, such as your genetics or
  upbringing, telomere length appears to change in response to
  behaviors like diet and exercise.
  
• But two of Telomere Diagnostics’ original founders,
  along with a NASA researcher who specializes in telomeres,
  raised doubts about the efficacy of the test.
• A former Telomere Diagnostics employee also alleged
  that the company’s lab was “filthy” and said she didn’t
  “believe in the science” behind the test.

Age is just a number, unless you’re talking about your “cellular
age.”

Cellular age, according to a Silicon Valley company called
Telomere Diagnostics, reveals more about your health than a birth
date ever could.

Telomere Diagnostics sells a $99 at-home blood-testing kit that
tells customers the average length of their telomeres, the tiny
protective caps on our DNA believed to protect us from aging’s
steady wear and tear.

Then the company offers health advice based on the test results.

Telomeres are seen by some researchers as a holy grail of aging.
That’s because unlike other factors such as your genes or
upbringing, telomere length appears to change in response to a
variety of activities. Commit to regular exercise and your
telomeres will grow, Telomere Diagnostics claims. Start binging
on fast food and they’ll shrink.

“It’s like a fitness tracker for your DNA,” Jason Shelton, the
CEO of Telomere Diagnostics, told Business Insider. “It can
change based on actions you take, and you can see the results
immediately.”

But two of Telomere Diagnostics’ three original founders, along
with a NASA researcher who specializes in telomeres, aren’t so
sure.

Elizabeth Blackburn, a biologist at the University of California
at San Francisco, who won the Nobel Prize for her work on
telomeres, in 2009, cofounded Telomere Diagnostics in 2010. The
company still shows images of a Nobel Prize on its website, but
Blackburn left the company more than five years ago because of
concerns she had about its products.

Elissa Epel, another UCSF researcher who cofounded the company
with Blackburn, left at the same time for the same reasons.

Both researchers told Business Insider that they questioned the
efficacy of Telomere Diagnostics’ test. And a former Telomere
Diagnostics employee said she witnessed practices that raised
doubts about the company’s cleanliness, commitment to scientific
accuracy, and handling of private health information.

The emerging science of telomeres

Telomeres,
in white, are structures at the tips of chromosomes, in
blue.
NIH

In 2009, Blackburn
shared the Nobel Prize in medicine for her work demonstrating
that our cells’ chromosomes — the wishbone-shaped structures that
contain our DNA — are capped with delicate structures, or
telomeres, that help shield our genetic material from wear and
tear.

It gave rise to a fervor of telomere research. Nearly 1,300
papers containing the word “telomeres” came out in 2017 — a
nearly fourteenfold increase from 1991, when there were fewer
than 100 such papers.

But the links between telomere length, health, and aging are not
yet clear cut.

Shorter telomeres have been tied to higher
rates of disease, faster
tumor growth, and overall
age-related degeneration. But longer telomeres have not been
tied to the opposite outcomes; several recent studies have failed
to find any link between
long telomeres and positive health effects, and
longer-than-normal telomeres have also been tied to an increased risk of
cancer.

Many activities appear to have the power to grow or blunt
telomeres, from exercise to smoking, but scientists have not yet
been able to prove that this relationship is causal. That means
that we still do not fully understand telomeres or their role in
aging and disease. So trying to lengthen or shorten your
telomeres as a health intervention is arguably premature and, at
worst, harmful, some experts say.

And there is no recognized optimal telomere length for health.
According to Blackburn, that makes the idea of telling someone
their cellular age based on the length of their telomeres
problematic — at least for now.

Still another hurdle is that measurements of telomere length vary
depending on the method used to test them. Some testing
procedures look at the length of all the telomeres in a given
blood sample and give you the average — the method that Telomere
Diagnostics uses — while other tests focus exclusively on the
shortest telomeres in a sample.

But telomere science is a highly promising area for future
studies, many researchers say. When looking across large
populations, telomeres hold intriguing clues about how everything
from diet to smoking affects our cells and their ability to
self-repair and replenish.

“The research uses of telomere analyses, done with high quality
controls and on sufficiently large and carefully done cohort
studies, are scientifically valuable,” Blackburn said. “It is
just the value right now of commercial testing of individuals
without clearly telling those tested the whole story that I find
questionable.”

A NASA scientist says astronaut Scott Kelly ‘threw a wrench’ into
one hypothesis about telomeres

Twin
astronauts Scott Kelly, right, and Mark Kelly are helping NASA
explore what life in space does to the human
body.

NASA

Because of their potential connection to aging, stress, and
disease, telomeres are of particular interest to researchers at
NASA.

As part of its
NASA Twin Study, researchers are using Scott Kelly and his
identical twin brother, Mark, to explore how the intense stress
of spaceflight spurs changes inside the body. Scott lived in
space for a year while his Mark stayed on Earth, and scientists
examined Scott’s genes after he returned.

They found evidence of a body trying to protect itself from
strain. But his telomeres did not respond the way scientists had
expected. Instead of shrinking, as telomeres are believed to do
in response to stress or negativity, they grew longer.

Susan Bailey, a professor of radiation-cancer biology and one
of the lead NASA researchers studying the Kelly twins, told
Business Insider that the discovery “threw a wrench into the
hypothesis” that healthy behaviors lengthen telomeres while
unhealthy ones shorten them.

It was a reminder, she said, of how much we still don’t know
about the links between telomeres, health, and aging.

“There’s a lot of good research that shows shorter telomeres are
linked with heart disease, whereas longer ones are associated
with an increased risk of things like cancer,” Bailey added. “I
think you have to balance those things. It’s not just, ‘Oh, I
have longer telomeres, so I’m going to live longer and be
healthier.’ You may live longer, but you may get cancer, too.”

From Nobel Prize to brazen startup

Elizabeth Blackburn,
right, celebrates her Nobel Prize in medicine.
Getty Images / Justin Sullivan

After she discovered telomeres, Blackburn believed that measuring
them could give doctors and patients a way to spot signs of poor
health early. So in 2010 she founded Telome Health along with
Epel and another UCSF researcher, Jue Lin, who still serves on
the company’s scientific advisory board but told Business Insider
she was “not very” involved with them. The startup aimed to help
accelerate the pace of telomere research.

“Our vision was to enroll people in research [with a consent
form], tell them their results in a responsible way, and learn
more about the effects of testing,” Epel said.

Blackburn served as a cofounder, board member, and chair of the
company’s scientific advisory committee.

Several of Blackburn’s colleagues in the field expressed doubts
about the usefulness of the blood test between 2010 and 2013, but
she called the test’s utility “a no-brainer” in 2013 interview
with
The New York Times.

A few months after that interview, Blackburn left Telome Health.
The decision, she told Business Insider, was the result of an
internal conflict. A board member wanted to team up with a
supplement company called TA Sciences, which was making a
plant-extract pill that it claimed could lengthen telomeres and
fight aging and disease.

Blackburn said she had concerns that the supplement, known as
TA-65, “carried a very scientifically plausible risk of being
cancer-causing.” The board out-voted Blackburn.

“This was sufficient for me … to sever [my] relationship with
the company,” she said.

TA-65 is made with telomerase, an enzyme that appears to spur
telomeres to elongate. But that growth may also
seed the germination of cancer cells by making it easier for
them to proliferate, according to research from several
biologists, including Blackburn.

Jim Cich, the president of TA Sciences, told Business Insider
that he believed Blackburn’s doubts “revolved around a worry a
few people had in the early days of telomere biology,” adding
that those concerns were “currently out of date with the thinking
of most telomere biologists.”

But a study published
in the journal Genome Medicine in 2016 suggested that
deactivating telomerase — as opposed to reactivating it, as TA-65
claims to do — could be a promising anticancer treatment.

Cich, however, said TA-65 was safe and effective.

“TA Sciences has spent several million dollars on product testing
including double-blind, placebo-controlled clinical trials that
demonstrate the effectiveness and safety of TA-65,” he said.

Within a year of leaving the company, Blackburn had stepped down
from all leadership roles and donated all of her equity to a
nonprofit. Epel and Lin Blackburn’s cofounders, also left at that
time for the same reason.

“The company’s direction was drifting away from the scientific
basis underpinning its formation,” Blackburn thought.

But the work continued. The company changed its name to Telomere
Diagnostics and began selling its telomere testing kits, called
TeloYears, for $99. Lin, the third cofounder, rejoined the
company’s scientific advisory board at this time.

When asked about the test’s accuracy, Jason Shelton, Telomere
Diagnostics’ CEO, said that since he took on a leadership role at
the company, in 2014, “We have remained strongly committed to
advancing telomere science.” To that end, the company published
an
article in a peer-reviewed journal last year that said the
company’s telomere-measuring techniques were scientifically
valid.

Shelton said the company’s relationship with TA Sciences “was
terminated” when he took over in 2014.

Today, Telomere Diagnostics sells a different supplement that it
says is based on scientific research that has found links between
various vitamins — including vitamins D and E — and longer
telomeres.

Telomere Diagnostics is now doing well financially, according to
Alexandre Levert, a board member who represents a French
shareholder in the company. Levert told Business Insider that
2017 was one of the “strongest years so far” in terms of revenue.

How Telomere Diagnostics determines cellular age

The process of getting your cellular age from the TeloYears test
is somewhat similar to the one that genetics and ancestry-testing
companies use. Customers get a box in the mail, which contains a
kit for providing biological samples (TeloYears uses blood; other
companies use saliva). Customers follow the instructions, then
ship their blood sample back to the company for processing.

Once a doctor signs off on the order, customers receive a report
in the mail that purports to tell them whether the age of their
cells “in TeloYears” is older or younger than their actual age.
This result is an indicator of “how well a person is aging,”
Shelton said.

“You can use your results to improve your overall health by
finding … the motivation to take steps to slow down the clock on
the aging process,” the Telomere Diagnostics website reads.

Those steps, according to the company, involve more exercise,
sleep, and healthier eating.

“Your TeloYears results can also be used, through repeat testing,
to track how your choices are affecting your aging,” the
description says.

All those recommendations are “common sense,” Lin, the third
cofounder, told Business Insider. Despite this, she said the test
would be helpful to many people who “don’t have the motivation to
improve or maintain their health.”

“If knowing your telomere length is the thing that allows them to
have that motivation, that could be a potential use,” Lin said.

‘I didn’t believe in the science’

Shutterstock

A former Telomere Diagnostics employee, who worked for the
company as a supervisor on a contract basis in 2017, spoke with
Business Insider anonymously about her experience out of fear of
retribution.

Several events made her uneasy about the work she was doing, she
said. On one occasion, the employee said, a Telomere Diagnostics
customer complained that their TeloYears results were inaccurate.
The customer said that because they regularly exercised and ate
healthy, they must have a younger “cellular age” than the one the
test yielded. According to the employee, Telomere Diagnostics
responded by sending the customer a new kit, then returned
results showing a new “cellular age” that was decades younger.

“The test is garbage,” she said, adding, “I didn’t believe in the
science.”

Shelton denied that the company had ever fudged the numbers on a
report and said such behavior would be grounds for firing an
employee.

The former employee also alleged that she observed several
organizational errors in the lab that jeopardized patient
privacy. She twice saw staff members accidentally mix up
customers’ test results, she said, which led them to mail one
customer’s health information to the wrong person. In one of
those cases, a customer sent back a report that belonged to
another patient, she alleged.

Shelton said those two errors did occur, but said “both were
promptly rectified.”

Finally, the employee alleged that Telomere Diagnostics’ lab was
once infested by mice. She said she raised the issue “over and
over again” in meetings with management, but “people wouldn’t
listen.” She quit.

“That lab is the filthiest, most screwed-up lab I’ve ever seen in
my life,” she said, adding, “I’m honestly stunned that they’re
still in existence.”

The former employee also worked in the lab of Silicon Valley
blood-testing startup Theranos, which was plagued by scandal and

announced plans to formally dissolve in September.

Shelton did not deny the allegation about a mouse infestation but
said “any traces of pests would be addressed according to
accepted pest-control procedures.”

Levert, the Telomere Diagnostics board member, agreed with
Shelton, telling Business Insider that during his “regular”
visits to the company’s lab he never saw any evidence supporting
the former employee’s claims.

“We’re putting all of our efforts into a really high-quality lab
where we’re upgrading regularly,” Levert said. “Any inspections
we’ve had have been very positive.”

2 founders raise questions over accuracy

Some researchers who specialize in telomeres — including
Blackburn and Epel — said the science wasn’t yet advanced enough
for any company to offer health advice based on measurements of
telomere length.

“Telomere length is another risk factor, just like cholesterol,”
Epel told Business Insider. “But the current tests for it are
probably not accurate for widespread use, or for single use for
individuals.”

Bailey, the NASA scientist, said a few crucial steps were
necessary before such tests could be considered trustworthy.

“At the most basic level, one of the first things we need to do
is standardize how telomere length is being measured and make
sure we’re measuring what we think we’re measuring in the first
place,” Bailey said.

But Shelton, Telomere Diagnostics’ CEO, said telomeres’
malleability is precisely what makes them useful.

“If you do an ancestry test, there’s no amount of push-ups you
can do that can change what percent Irish you are,” Shelton said.
“But your telomere length is one of those unique parts of DNA
that’s been shown in clinical studies to change based on a
variety of lifestyle modifications.”

Shelton encouraged customers to take the test several times so
that they could track how their telomere length shifts based on,
say, eating healthier or working out more regularly.

“We can help inspire people to improve their overall lifestyle
and engage on their own personal journey through what is perhaps
the oldest and most important problem shared by all mankind,” he
said. “How do you put more years in your life, and how do you put
more life in your years?”

But of course the more times a person takes the TeloYears test,
the more money Shelton’s company makes.