Comments for Total Health Optimization

Comment on Concerns about the legitimacy and integrity of Nucleus Genomics by totalhealth

totalhealth — Sat, 21 Feb 2026 22:12:26 +0000

In reply to MC. Perhaps Herasight

Comment on Cardiovascular disease is a solved problem by Antoine Dusséaux

Antoine Dusséaux — Sun, 15 Feb 2026 06:50:45 +0000

Associations with Parkinson’s disease are causal as confirmed by Mendelian randomization studies: https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119.314929

Comment on Cardiovascular disease is a solved problem by Tiago Vasconcelos

Tiago Vasconcelos — Thu, 05 Feb 2026 19:45:31 +0000

When taking statins — particularly potent ones like Rosuvastatin or the commonly used Rosuvastatin + Ezetimibe combo — it is advisable to monitor liver enzyme levels, especially ALT and AST.

In a small percentage of patients, these markers can become elevated.

While pravastatin may be less effective at reducing ApoB or LDL-C at equivalent doses, it can be a reasonable alternative for patients who experience liver enzyme increases on higher-potency regimens, provided lipid goals are still achievable.

Comment on Cardiovascular disease is a solved problem by A. Lincoln

A. Lincoln — Thu, 05 Feb 2026 04:13:36 +0000

This is a thoughtful post that is well-grounded in the evidence. I think the picture is changing with the pending approval of enlicitide. That promises increased LDL lowering with a better side effect profile in a pill format. There’s good evidence from the other PCSK9 treatments that suggests this will be a broadly effective strategy. We probably should be thinking about ASCVD risk in 30-year horizons (not 10) and I think things will shift in that direction as treatments get better.

Comment on Cardiovascular disease is a solved problem by JJ

JJ — Thu, 05 Feb 2026 03:52:45 +0000

It’s interesting that while PCSK9 loss-of-function drops CVD dramatically the effect on life expectancy is more muted. Seems about 1 year.

I’ll take it of course, but would have expected more from a 90% reduction of the biggest killer.

Comment on Concerns about the legitimacy and integrity of Nucleus Genomics by MC

MC — Fri, 09 Jan 2026 00:18:30 +0000

On a similar path to you (minus the IVF need), I was combing through potential DTC WGS options. Since I have a PhD in genomics, I’m able to analyze all the data myself and don’t need any flashy software gated behind a description.

Nonetheless, I was leaning toward Nucleus because of their sequencing platform (Illumina NovaSeq X vs other’s using BGI-derived tech) and local processing (versus in HK). Before reading this, I was already on edge because of how scammy their website was – but good data is all I need, right? After this debacle (and your follow-up)? Absolutely not, hard pass on Nucleus.

But now I need to find an alternative for my wife and I. Any alternative services you ended up pursuing or one that you would recommend?

Comment on Concerns about the legitimacy and integrity of Nucleus Genomics by totalhealth

totalhealth — Wed, 26 Nov 2025 08:31:07 +0000

In reply to Leo. Well, when half the article is about them plagiarizing Herasight, and when the only source of external validation of their PRSes is again Herasight, I'm not really sure how I'm supposed to avoid mentioning them.

Comment on Concerns about the legitimacy and integrity of Nucleus Genomics by Leo

Leo — Tue, 25 Nov 2025 14:33:05 +0000

Hi totalhealth! I got pulled into the blog with your intro where you say you and your husband are looking forward to having kids, and I must say this turned out to be one of the wildest, most polarizing reading experiences I’ve had in some time! This is a very capable piece of work and clearly there’s so much effort that went into this (kudos to you and your research!). However, as a layperson, this begins to feel less like a consumer warning piece and more like corporate positioning.
IVF brings a lot of hope to people in their 30s like me, and I’m tired of almost every company in this space pushing its own narrative and distorting real conversations. From my POV, this post is extremely polished, but it also feels like it’s aimed at undermining Nucleus rather than genuinely helping users. There’s such strong accusatory language throughout, incessant mention of Herasight that probably shares the competitive space, and an almost surgical compilation of points that signals broader corporate rivalry (or at least some kind of power play) rather than consumer support. It’s also very weird and non-objective + unprofessional to bring out legal claims without outlining both sides of the story or recent verdicts – that’s just sensationalizing.
I also don’t get some of the critiques you mention – like the AI testimonial headshots or whatever. Aren’t such sensitive reviews supposed to be anonymized either way? Like, I wouldn’t want my name and face plastered on a website just cause I had a baby.
I also found the multiple mentions of Scott Alexander weird when I followed one the linked blogs and noticed they had mentioned a conflict of interest for using Herasight and Orchid products.
Same for plagiarism claims – it’s hard to be convinced with the data available here, and aren’t similar technical content going to sound broadly similar?
While I only have surface-level awareness of all these companies, including Nucleus – like they’re all profit-motivated folks selling products, and I still don’t understand the hyperfocus on Nucleus because their socials look really compelling otherwise.

Comment on Concerns about the legitimacy and integrity of Nucleus Genomics by Nucleus attempts to respond, but accidentally admits its own guilt – Total Health Optimization

Mon, 24 Nov 2025 21:04:11 +0000

[…] response to my recent post, Concerns about the legitimacy and integrity of Nucleus Genomics, Stephan Cordogan, the lead author of Nucleus Origin, posted a response, entitled Setting the Record […]

Comment on Concerns about the legitimacy and integrity of Nucleus Genomics by totalhealth

totalhealth — Mon, 24 Nov 2025 02:56:16 +0000

In reply to Pulkit. Unfortunately, given the attention that this post is getting I feel that it would be inappropriate for me to express opinions on other companies for the time being. I want the criticism to stand on its own merits, rather than getting tarnished by accusations of bias in favor of other companies.