New Body Cosmetic Surgery Center, Pasadena, CA

16 - The Brave New World of Anti-Aging

DHEA is a hormone that is the starting point for the biological manufacture of many of the hormones that regulate your body's function. Because hormones in the body decrease with age, some physicians are now supplementing their patients' diets with DHEA. It is inexpensive, taken orally, and seems to have a positive effect on overall functioning and energy levels. There is a long-acting prescription DHEA that might work best.

The female hormones estrogen and progesterone have been used routinely for over a decade for supplementation of women past menopause or the "change of life," or after a complete hysterectomy which removed the ovaries. Although this is standard medical care, only about 10 to 20 percent of women who should be supplemented are actually taking their pills or using the newer "patch" that supplies the drug through the skin. This is unfortunate because the medicines have many helpful effects including partial protection from osteoporosis and heart disease. Although estrogen alone can increase the risk of uterine cancer, when it is used in combination with progesterone the overall risk actually drops. Some studies have shown a very small increase in breast cancer rates, but these have been outweighed by many studies which show no effect. Recently, well-publicized studies were released that show a link between increased breast cancer rates and use of Premarin.® However, the studies didn't include the new types of estrogen replacement medications, such as Estrace® or the patch, which may not show these effects. Because of the uncertainty surrounding hormone therapy and cancer, female hormone supplementation is rarely recommended in those already diagnosed with breast cancer.

Testosterone is, of course, the male sexual hormone, made mainly in the testicles. Now, a new testosterone gel or patch is used on the surface of the skin, so shots are no longer needed to treat testosterone deficiency. Some doctors think that this hormone helps prevent osteoporosis and heart disease as well as aiding sexuality and having many other beneficial effects. There is a blood test to see how much the body has left, and if levels are low, some longevity doctors will use supplementation. Some specialists use it for men over 40. Testosterone is controversial because it stimulates the further growth of prostate cancer if you already have it. Whether it actually causes prostate cancer to begin with is unknown, and a different issue, of course.

The fear with some of these medicines is that their use will shut off production of normal hormones by the body. Doctors may give "drug holidays" to patients — periods in which no medicine is taken — in order to let the body recover and produce natural hormones.

What about the new diets? Although from the hype they look like fads, high protein diets seem to be based on science. Popularized "Zone" diets by Barry Sears and "Protein Power" by Michael and Mary Eades, are balanced carbohydrate-fat-protein diets that claim to regulate the production of two key body hormones, glucagon and insulin. These diets recommend more fat and protein and less carbohydrate than either the standard recommended high carbohydrate diet, the American Heart Association diet, or the American Diabetic Association diet. Supplementation with powdered whey protein may be helpful as well.

We also like "Maximum Metabolism," by Robert M. Giller, M.D., He goes into some detail about eating carbohydrates in the morning instead of the evening and how caffeine stimulates insulin (the "hunger hormone"). He points out that besides burning calories, exercise stabilizes insulin and blood sugar. It also stimulates the production of hormones that make you feel fuller by raising the blood fat level. As your muscle mass increases, you can eat more without gaining fat. His psychological suggestions for weight loss are excellent.

Another way to lose weight, if you can afford it, is to hire a service which supplies you with each meal and snacks. Several excellent organizations operate out of Los Angeles, and I'm sure they are available in other cities as well.

The idea behind the high-protein diets is that human beings aren't naturally grain eaters and that high protein sources such as animal proteins are healthier. When we stay away from dense carbohydrates like bread, rice or corn, we are less hungry and tend to lose weight naturally given a balanced fat consumption. This has been known for years. You may remember that the Atkins diet is based on the natural lack of hunger that occurs when people eat more protein and cut down on carbohydrates (the original Atkins diet — a pure protein and fat diet without carbohydrates — is pretty hard to follow, however). I think the science for these diets is pretty reasonable, and I've been recommending them to my patients. Many competitive athletes also find these diets useful.

As much as I hate to say this, all of these medical advances may soon overshadow cosmetic surgery for their anti-aging effects. They're not going to change the shape of your nose, or give you big breasts, but in the over-40 age group, a year of HGH and the other hormones might have more of an effect on your shape than liposuction.

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