Epigenetic Age Tests

Epigenetic tests estimate your biological age by reading chemical tags on your DNA. The tags are called DNA methylation patterns. Think of them as sticky notes that turn genes on or off.

What DNA methylation actually is. Methyl groups (CH3) attach to specific spots on your DNA. They never change your genetic code. They just change which genes get used.

The core finding. These tags shift in predictable ways as you age. Read hundreds of spots at once, run them through an algorithm, and you get a number: your biological age at the cellular level. Research-grade, not clinical.

The five steps from spit to result:

1. You send in a sample (blood or saliva, depending on the test)
2. The lab pulls DNA out of the sample
3. Methylation gets measured at specific CpG sites (spots where the DNA letter C sits right before a G, where methylation usually lands)
4. An algorithm compares your pattern to reference data
5. Your biological age pops out

What you get back. Most tests give you a biological age number. Many add a pace of aging score (how fast you are aging per calendar year), or break things out by system (immune, metabolic). Some throw in lifestyle suggestions on top.

Turnaround is usually two to six weeks from kit-in-mailbox to result.

Which clock should you care about? For most people it is DunedinPACE (it tracks pace of aging and responds fastest to lifestyle change) or GrimAge (the strongest mortality predictor). Several clocks exist, and each one was built to answer a different question. Here are the five names you actually need to know.

Clock	Year	What it estimates	Best for	Retest
Horvath [1]	2013	Age across many tissues, 353 CpG sites	Matching calendar age	18 to 36 months
Hannum [2]	2013	Blood age, 71 CpG sites	Cross-check	18 to 36 months
PhenoAge [3]	2018	Age anchored to clinical markers	Disease risk	18 to 36 months
GrimAge / GrimAge2 [4, 5]	2019 / 2022	Mortality-linked age	Predicting health outcomes	18 to 36 months
DunedinPACE [6]	2022	Biological years per calendar year	Tracking lifestyle change	6 to 12 months

Horvath Clock (2013). The first clock that works across many tissue types, built by Steve Horvath ^[1]. It reads methylation at 353 CpG sites. Good for a general biological age estimate.

Hannum Clock (2013). Tuned for blood. Reads 71 sites ^[2]. Often run next to Horvath as a sanity check.

PhenoAge (2018). Built by Morgan Levine ^[3]. Designed to predict healthspan and disease risk, not just match your calendar age. It's anchored to clinical markers linked to mortality.

GrimAge (2019) and GrimAge2 (2022). First-authored by Ake T. Lu with Steve Horvath as senior author. It strongly predicts mortality, heart disease, and cancer risk ^[4]. It estimates smoking history and seven blood proteins from your methylation pattern, so no extra blood test is needed ^[4]. Its successor, GrimAge2, also estimates two blood markers from your methylation pattern: CRP (an inflammation marker) and HbA1c (long-term blood sugar). It beats the original ^[5]. More providers now report GrimAge2, but many don't say which version. Check that your report says "GrimAge2", not just "GrimAge". A common pick when the goal is predicting health outcomes.

DunedinPACE (2022). Measures your pace of aging from a single test ^[6]. It estimates biological years per calendar year. A pace of 1.0 is average; lower is better.

Which one to pick? For tracking lifestyle changes, DunedinPACE responds quickest. In a two-year randomized trial of calorie restriction, DunedinPACE slowed a little while PhenoAge and GrimAge did not budge ^[11]. For a general estimate, GrimAge or PhenoAge are strong picks. Many commercial kits blend several clocks into one report.

Which clock sits inside which product (2026 matrix):

• TruDiagnostic TruAge (resellers often call it TruAge Complete): OMICmAge, SYMPHONYAge (11 organ-system ages), DunedinPACE and telomere length in one kit. Finger-prick blood-spot sample by mail. Strong current validation across the major aging-clock metrics, and the usual top pick when you want a multi-clock methylation report in one go. Pricing (September 2026): $499 one-time on TruDiagnostic's shop, a bit less at some resellers (about $449), or $998 for a 4-test annual plan.
• neotes bioAge: GrimAge method on a dried blood spot, analyzed in a German lab. Results in about 4 weeks.
• epiAge: saliva test from a German seller, built on the Horvath clock and its later refinements, read by NGS sequencing.
• MyDNAge: Horvath-style clock. Offers blood or urine sampling, which is rare.
• NOVOS Age: DunedinPACE blood-spot kit, but it ships only to the US and Canada.
• Elysium Index: PhenoAge-lineage clock on saliva (developed with Morgan Levine). Pricing varies, so check elysiumhealth.com (historical listings ran around $299 subscription or $499 one-time). Reports cumulative biological age and pace metrics. Cheaper than TruDiagnostic, but narrower analysis.
• GlycanAge: not epigenetic. It measures IgG N-glycans (sugar chains on your antibodies), a marker of inflammatory age. Treat it as complementary, not a substitute, for a methylation clock.
• Muhdo (UK-based): saliva-based multi-clock panel. Cheaper, easier to ship, but less validated in peer-reviewed literature than TruDiagnostic's tests.

How often should you actually retest?

It depends on the clock:

• DunedinPACE responds faster to lifestyle change than absolute-age clocks. Retesting every 6 to 12 months is meaningful if you're actively changing things (exercise, diet, sleep, stopping smoking).
• Horvath, Hannum, PhenoAge or GrimAge: retest every 18 to 36 months. On the older clocks, lab noise alone (how far your score jumps when the same sample is run twice) can shift a result by up to about 9 years. PhenoAge had the biggest swings, up to 8.6 years ^[9]. That is more than the change most people show in a year, so testing yearly mostly shows noise, not signal. PC-clock versions pool many sites into a few principal components, which cuts the swing to mostly within about 1.5 years ^[9]. GrimAge was the steadiest of the older clocks ^[9], but it also moves slowly, so frequent retests add little.

Most commercial epigenetic age tests cost about 200 to 500 euros for a single kit, and across Germany, Austria, and Switzerland it is all self-pay. Here is how the main providers compare. Prices are indicative and move often, so treat the table as orientation and confirm the current price on the provider's own site. Prices checked September 2026.

Test	Typical price	Sample	Clocks / output	Retest
TruDiagnostic TruAge	about 390 to 430 EUR ($449 to $499)	Blood spot	DunedinPACE, OMICmAge, SYMPHONYAge, telomere length	6 to 12 months
neotes bioAge Basic (German lab)	299 EUR (Premium 935 EUR)	Dried blood	GrimAge method	18 to 36 months
Elysium Index	about 280 EUR ($299)	Saliva	PhenoAge lineage, system ages	6 to 12 months
myDNAge	about 280 EUR ($299)	Blood or urine	Horvath	18 to 36 months
Muhdo (UK shipped, import VAT applies)	about 290 EUR (250 GBP)	Saliva	DNA methylation, several clocks	6 to 12 months
epiAge (German seller)	199.95 EUR	Saliva	Horvath-based methylation age	18 to 36 months
GlycanAge (not methylation)	about 500 EUR (850 EUR for two tests)	Blood spot	IgG glycans, inflammatory age	3 to 6 months
Face Age plus Pace of Aging (ours)	Free	Photo or quiz	Visual plus lifestyle estimate	Anytime

Two things decide your real cost. First, shipping origin. US-shipped kits add roughly 100 to 130 euros in import VAT and carrier handling in Germany or Austria. So a 500 euro kit lands closer to 600 to 630 euros (details below). Ordering from Germany or Austria? epiAge and neotes run through European labs, so there is no import surcharge. Swiss buyers still owe Swiss import VAT on parcels from the EU. Second, how often you retest: a DunedinPACE kit every 6 to 12 months is a very different annual bill from a one-off GrimAge read. None of it is reimbursed by statutory insurance in the DACH region, so the sticker price is what you pay.

The EU-shipping gotcha. On a 500 euro kit, US shipping typically adds about 100 to 130 euros in Germany or Austria, and about 50 to 60 euros in Switzerland. Here is where it comes from:

• Import VAT from the first euro. US-shipped kits (TruDiagnostic, MyDNAge, Elysium, TA Sciences) owe import VAT on the full declared value: roughly 19% in Germany and 20% in Austria. Switzerland is not in the EU and has its own rules: 8.1% Swiss import VAT. The EU killed the €22 low-value VAT exemption on 1 July 2021.
• Customs duty is a separate thing. Since 1 July 2026 the EU charges a temporary flat €3 duty per item type in parcels worth up to €150, declared and paid by the seller or importer, until mid-2028 ^[14]. A 400 to 500 euro kit is above that line anyway, so the flat duty does not apply to it.
• Carrier handling. DHL or UPS add around €6 to €20.

UK kits like Muhdo count as imports too since Brexit, so import VAT applies. GlycanAge processes samples at the Genos Glycoscience lab in Zagreb, Croatia (an EU member state), so EU customers ship within the EU and avoid UK-EU customs handling. Factor this into any price comparison.

The short answer. Pretty good for guessing calendar age, less certain for everything else. The best clocks are usually off by just a few years. Correlation with calendar age runs around r = 0.96 (1.0 would be a perfect match), which is very high ^[1]. Accuracy drops at the extremes (under 20 or over 70).

What the experts actually say.

Luigi Ferrucci, scientific director at the National Institute on Aging, told NPR in 2024: "At this point, if you want to do it, it must be based on curiosity." He also cautions that you should be ready for a result you do not like ^[12].

Steve Horvath, who built the first multi-tissue clock, put it plainly in 2022: "Epigenetic clocks will never replace clinical markers, [but] the clocks add value to them" ^[13]. So read a clock next to your blood pressure, glucose and lipids, not instead of them. The clock alone is research-grade, not clinical. Have a concrete medical question? Talk to your doctor. A methylation report does not replace a diagnosis.

Limits to keep in mind:

• A test is a snapshot, not your fate
• Results bounce around with recent life stuff (illness, stress, bad sleep)
• Different clocks often give different ages for the same person
• There is no agreed standard for what a "normal" biological age should be
• Long-term predictive power is still being worked out

How to read your result. Treat your epigenetic age as one useful number, not the final word. The real value sits in the trend over time, not in obsessing over a single result. If your biological age keeps coming in lower than your calendar age, and your pace of aging is under 1.0, you are likely on a good trajectory.

The price tag. Commercial epigenetic tests run from about 200 to 500 euros or more. Premium kits with deeper analysis and multiple clocks sit at the top end. In Germany, Austria, and Switzerland, none of this is covered by GKV in Germany, the Austrian social insurers or Swiss basic insurance (OKP). You pay out of pocket, every time. Costs add up fast if you retest several times a year.

A test makes sense when:

• You are making real lifestyle changes and want objective feedback
• You are data-driven and motivated by seeing numbers move
• You can afford regular testing without stressing your budget
• You understand the limits and won't over-read a single number
• You are working with a doctor on longevity goals

Skip it when:

• You have not yet put the basic lifestyle changes in place
• The cost would hurt your budget
• You would spiral on a bad number
• You want a single test to "diagnose" your overall health
• You expect it to tell you exactly how long you will live

No test required. You do not need a test to improve your health. The lifestyle changes linked to lower biological age are the same whether you test or not: exercise, decent food, sleep, and managing stress.

Testing is most useful for people already doing the work, who want data to confirm things are moving the right direction, or to spot the area that still needs more focus.

You do not need an expensive kit to estimate biological age or track your health.

Free tools.

Our Photo Age Test: uses AI to estimate how old you look from visible aging cues in a selfie. Not as precise as an epigenetic clock, but free, no sign-up, and done in seconds. The photo is processed on EU servers and discarded right away.

Our Pace of Aging Test: a free questionnaire that estimates your biological age from things tied to it (sleep, exercise, diet, stress, social connection, and more).

Movement tests you can run at home:

• Your resting heart rate (lower is generally better)
• How many pushups can you do?
• Can you sit down and stand up without using your hands?
• Stand on one leg with your eyes closed. How many seconds?
• How fast can you walk a set distance?
• How strong is your grip? (Compare your grip strength by age and sex)

Blood work through your doctor. Standard panels say a lot about how you are aging:

• Fasting glucose and HbA1c (metabolic health)
• Lipid panel (heart and blood vessel health)
• CRP (inflammation)
• Vitamin D
• Complete blood count

In Germany, GKV usually covers basic blood work when your GP (Hausarzt) orders it for a clinical reason. Pure wellness panels are self-pay. AT and CH systems work similarly. These routine tests give you something you can actually act on.

Bottom line. Start with free tools and standard blood markers. If you want more data and have the budget, an epigenetic test can add insight. But it is not required to make real progress.