What we measured in 240 executive assessments.

Two hundred and forty data points.

Every January, our clinical team sits down with a year of executive assessments and asks a simple question: what did we actually see? Not what we expected to see, and not what would make a good headline — what the biomarkers, taken together across the full 2025 cohort, actually showed. This essay is that exercise, made public for the first time.

Two hundred and forty comprehensive executive assessments were completed at Clinic82 in 2025. This is not a formal study. There was no control group, no randomisation, and no pre-registered hypothesis. It is a retrospective — an internal audit we run annually because a clinic that measures hundreds of high-performing adults every year and never looks at the aggregate pattern is leaving information on the table.

What follows is what we found, organised by physiological domain, with the numbers as we recorded them.

Who we were looking at.

The 240 assessments in this retrospective were drawn from Clinic82's principal-client population — a wealth-adjacent, high-performing cohort, mostly founders, executives, and professionals in demanding roles. Mean age was 52. The split was roughly 60% male, 40% female. The majority were Cyprus-based, with a substantial international component travelling in specifically for assessment.

This matters for how the findings should be read. A cohort that self-selects into a comprehensive executive assessment is not a random population sample. People who book this kind of assessment tend to already suspect something is off, or want reassurance that nothing is. Both motivations bias the sample in ways we cannot fully correct for. We flag this now because it applies to every number that follows.

Drift, not disease.

The first domain we look at every year is the hormone axis, because it is where high-performing adults most often show drift without symptoms severe enough to prompt them to seek care on their own.

An elevated evening cortisol pattern — consistent with HPA axis drift under chronic load — was present in 34% of the cohort. Sub-clinical hypothyroidism, meaning a TSH outside optimal range with normal free T4, appeared in 18%. Among men over 50, 41% had total testosterone at least 25% below the age-adjusted median — a figure high enough that we now manage it as close to expected rather than exceptional in this age band.

Inflammation markers told a related story. hs-CRP above 2 mg/L, our threshold for clinically meaningful low-grade inflammation, was present in 28% of the cohort. IL-6 was elevated in 22%. GlycA, a composite inflammatory glycoprotein marker we have increasingly relied on for its stability, was raised in 31%.

None of these figures describe disease. They describe drift — physiological signals moving in a direction that, left alone, tends toward disease over years rather than months. That distinction is the entire premise of assessment-led medicine.

The compounding pattern.

Metabolic markers showed a pattern consistent with sedentary time layered on high cognitive load. Fasting insulin above our optimal threshold was present in 44% of the cohort — nearly half. HOMA-IR above 1.5, indicating meaningful insulin resistance rather than borderline drift, was present in 38%.

The biological age composite — a multi-clock model combining epigenetic and blood-chemistry inputs — is where these individual signals tend to converge. 12% of the cohort had a biological age more than five years above chronological age. A further 34% sat two to five years above. Taken together, nearly half the cohort was ageing, by this composite measure, faster than their calendar age would suggest.

Micronutrient status added a further layer. Vitamin D below 30 ng/mL was present in 47% of the cohort — a figure we return to below, because Cyprus's climate makes it the most counter-intuitive finding in this retrospective. B12 in the low-normal range appeared in 22%. Magnesium RBC, a more sensitive intracellular measure than serum magnesium, was low in 39%.

Sunshine is not enough.

Three findings did not match our priors going into the year.

The first was vitamin D. Cyprus has among the highest annual sunshine hours in the Mediterranean, and we expected deficiency rates closer to those reported in northern-European executive cohorts to be the exception here, not the rule. Instead, nearly half the cohort was frankly deficient. The explanation, once we looked at lifestyle data alongside the labs, was straightforward: an indoor, climate-controlled, high-cognitive-load lifestyle produces the same sun-exposure deficit in Limassol as it does in London. Climate does not protect you if you never leave the building.

The second was the frequency of sub-clinical thyroid drift. 18% is a higher figure than we would have predicted from general population data, and it reinforced a practice we had already been moving toward — managing TSH within the "normal" reference range as a number worth interrogating rather than dismissing, particularly alongside fatigue or cognitive complaints.

The third was the extent of HPA rhythm disruption in a cohort that, by most external measures, is performing exceptionally well. High performance and a well-regulated stress axis are not the same thing, and a third of this cohort showing a disrupted evening cortisol pattern suggests the two can diverge for years before anything becomes clinically obvious.

What did not surprise us was the metabolic picture. Fasting insulin and HOMA-IR elevated in a cohort that spends most working hours seated and most cognitive hours under sustained load is close to the pattern the wider literature on executive and knowledge-work populations would predict.

The honest retrospective.

A retrospective is only useful if it changes what we do next. Three adjustments we are making for 2026:

• Structured re-measurement at a fixed interval. 2025 assessments were largely one-off events for first-time clients. We are moving toward quarterly re-measurement as the default for anyone with a flagged marker, so that 2026 becomes the first year we can report genuine within-patient trajectories rather than a single cross-sectional snapshot.
• Earlier sun-exposure and lifestyle screening. Given how much the vitamin D finding surprised us, we are adding a structured sun-exposure and time-outdoors question to intake, rather than relying on climate as a proxy for adequacy.
• A standing cortisol-rhythm protocol. HPA drift at this frequency in a high-performing cohort deserves a default intervention pathway, not a case-by-case response. We are building one for 2026.

None of these changes would have altered what we found in 2025. They should change what we find, and how quickly we act on it, in 2026.

What this is not.

This is not a controlled study. The cohort is self-selecting, drawn entirely from clients who chose to book a comprehensive assessment, and it carries no denominator from a general population for comparison. We have no long-term outcome tracking yet — 2025 was a baseline year, and 2026 will be the first year we can report genuine year-over-year change within the same patients rather than a fresh cross-section.

What we do with these findings, in practice, is build personalised intervention plans around whichever domains flagged for each client, and bring them back for quarterly re-measurement so drift is caught while it is still drift rather than diagnosis. That loop — measure, intervene, re-measure — is the actual clinical product. The retrospective you have just read is the by-product.

We intend to publish this retrospective annually, as an internal-facing account of what we are seeing across the client base. We are also weighing whether a version of this dataset, with appropriate methodological additions, is worth preparing for peer publication. That decision has not been made. For now, this is what we saw, in the numbers we recorded, in one year.