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The Brave New World of Anti-Aging

My "take" on the medical literature is that this hormone may be helpful for many problems. Also, the patients' stories are remarkable. It has been claimed to restore vigor, sexuality, energy, muscles, and also to slowly get rid of fat without a change in diet or exercise patterns. All the organs of the body may grow a little in size, reversing the trend that comes with aging, and it is also a therapy for osteoporosis (thinning of the bone structure). There are even rumors that it helps reverse or stabilize farsightedness associated with aging. There are very few known side effects with it after decades of experience using it on children, and more than 10 years experience with older people. It's now manufactured to be exactly like the HGH the body produces. Unfortunately, it has to be given, like insulin, in injection form, and currently costs up to $200 a week. Prices should come down very soon.

We have to be careful about premature judgments, however. Every physician has seen drugs touted early on as the cure for everything up to and including hangovers, which later proved to have some major problem. But the early studies and stories about HGH are very encouraging. I have a 55-year-old physician friend who has been using it for six months. He says that he's lost 20 pounds, feels great, and that his sex life has improved. People over 40 should watch developments in this area carefully. I think we may be headed for significant breakthroughs with HGH, both in longevity and the quality of life.

Even if you don't have $8,000 per year to shell out for HGH, you might try melatonin. It's an over-the-counter pill (though prescription, long-acting varieties are available and probably superior), and very cheap. This hormone may be the master sleep regulator. The amount of melatonin in the body falls dramatically between 30 and 40 years old, and it is given as replacement therapy by some physicians specializing in anti-aging. It seems to really help sleep, and has been used widely to treat jet lag (taken at 8 p.m. in the time zone you're entering). Effective doses are many times the three milligram tablet that is available. Consult your doctor for advice.

"Anti-oxidant" vitamins are thought by some to "scavenge free radicals" or clean up molecular destruction in the body. I think the evidence for this is not as strong as most of the topics in this chapter, but there doesn't seem to be any harm in taking vitamins if the doses are not too high. Make your own judgments; this can get expensive and I don't have a final opinion now. I do, however, take vitamins myself. Avoid vitamin E before surgery, as it acts as a blood thinner and can make bleeding more likely and more difficult to stop.

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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