Anti-Aging
Frequently Asked Questions
What
is anti-aging medicine, and how did it come about?
Anti-aging is a new medical subspecialty in which the aging process can
be slowed, suspended and in some cases reversed. It came about as a shift
in thinking from aging as an inevitable process to aging as a series
of disease processes. Aging processes can be measured, and, as with any
disease, there are symptoms and treatments.
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How does anti-aging medicine
differ from wellness and holistic medicine?
Anti-aging medicine is a comprehensive practice of preventive medicine
that incorporates components of holistic and wellness medicine but goes
beyond them with board-certified physicians utilizing specific high-tech
testing procedures and medical treatments. Wellness and holistic medicine
don't generally deal in conventional therapies.
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Is this a "fountain of
youth?"
This is a program to extend the useful years of your life and improve
the quality of those years.
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Does Anti-Aging follow
accepted medical procedures?
Anti-aging is a new subspecialty just like emergency medicine and family
practice were 20 to 30 years ago. The first board certification exam
for anti-aging physicians took place in 1997.
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Can you reverse the aging
process? Can someone feel young again?
Many patients can feel and function young again through restoring muscle
loss, increase skin thickness, reduce total body fat and improve bone
density. Patients have seen specific improvements in skin tightness and
moisture, mental speed and clarity, enhanced sexual function, elevated
mood and energy levels, improved aerobic capacity, greater immune function,
and increased wound healing capacity.
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Who are anti-aging patients?
Is this just for seniors and retirees? Who would benefit from
this the most? When is it too late?
It’s almost never too late, however, the sooner you begin, the
more benefits you derive from an improved quality of life. The people
who benefit most are those who are motivated to stay healthy in their
later years. It's not just for seniors or retirees. Just as you save
for retirement with pensions and the like, this is preventive geriatrics.
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How do we know it's safe
medicine?
Anti-aging is a recognized medical subspecialty
and is measurable and documentable.
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How many years can you
extend a patient's life?
It depends upon the patient's motivation, how
early in life that you start treatment, and how compliant the patient
is. A reasonable expectation for someone who begins a rigorous program
in their mid 30s could be an extra 10 to 20 years or more.
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How do you measure aging?
Medical tests called Biomarkers actually indicate signs of aging at different
levels down to DNA. At the functional level, one may test such
things as visual accommodation, auditory response, and memory succession;
a skin biopsy at the cellular level; and biochemicals such as hormones
and cholesterol, and DNA is checked for damage to hereditary matter.
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What is involved in hormone
replacement therapy?
Hormones are chemical messengers that control bodily functions. Aging
depletes the body's hormonal levels. We measure a patient's level of
hormones and prescribe balanced hormone replacement to restore hormone
levels to where they were in the patient's early 30s. In many cases,
this can be done naturally with secretogogues, which release the hormones
already made by the body.
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What kind of anti-aging
supplements do you prescribe? Do you take these supplements yourself?
Yes, we should all practice what we preach and take supplements. As you
age, you develop deficiencies in vitamins and minerals. A complete, balanced
nutritional multi-vitamin, mineral and anti-oxidant complex is a major
part of the treatment regime. You should ensure the quality of the substances
you take, how much is absorbed by the body and not wasted; and whether
it is pH balanced for acidity levels.
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What are cognitive enhancers?
Techniques to improve your mental acumen. Some
involve natural herbs like ginko. Meditation is also an effective enhancer.
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Is this a lifetime program?
It's something you do for yourself the rest of your life.
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How quickly will a patient
see results?
Improvement in energy is almost immediate.
Significant differences usually take four to six months for DNA to regenerate
in the body.
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Does a patient have to
adopt a vegetarian diet to be successful?
A diet recommended is high in vegetable protein, fish and white-meat
chicken. One should tend to stay away from red meat because the liver,
for example, has to work harder to convert the red meat proteins.
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What is human Growth
Hormone (hGH)?
Growth Hormone is a protein made up of a sequence of 191 amino acids,
which is released by the pituitary gland. The pituitary produces several
hormones. Growth Hormone is the "master hormone", setting in motion several
cascades of metabolic activity. Like many hormones, hGH is released in
greater quantities when you’re young. Although the production of
hGH only drops about 25% between the ages of 20 and 65, its release may
actually drop 90%. This means that our bodies are operating in a deficiency
state even though our pituitary is capable of producing an adequate amount
as we age. By the time you are 60, you have only 15-20% of the hGH that
you had when you were in your teens.
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How does Growth Hormone
work?
HGH travels through the general circulation and binds to receptor sites
on nearly all cells of the body, though predominately in liver cells.
Once the receptor site is occupied by a molecule of hGH, the liver cell
is instructed to produce several messenger chemicals which include IGF-1,
IGF-2, and others growth factors. These messengers are responsible for
doing the work of hGH. IGF-1 level is used to monitor the hGH activity
in our bodies.
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What are the benefits
of Growth Hormone?
HGH stimulates anabolic activity in all areas of our bodies. Muscle mass
is increased, skin becomes thicker and more flexible, our immune system
is enhanced, fat is redistributed and lost more easily, increased stamina
is achieved, mental attitude is improved, the blood cholesterol balance
is shifted in a positive way, calcium is deposited in bone, and virtually
all our other glands are restored. Resistance to both disease and cancer
is increased.
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How is Growth Hormone
deficiency treated?
To maintain hGH at youthful levels requires an integrated monitored approach.
A solid nutritional platform needs to be maintained, including vitamin
and mineral supplements. An adequate amount of exercise needs to be maintained.
Blood testing is essential to insure that adequate, but not excessive
levels are achieved. Step-wise use of a secretagoge, recombinant hGH
available as a spray or sublingual tablet, and finally, injectable recombinant
hGH is utilized.
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What is a secretagogue?
Secretagogues or releasers are substances that stimulate secreting organs.
There are many substances that stimulate the release of growth
hormone from the pituitary; these include several amino acids and
drugs. Exercise is also a powerful releaser of growth hormone.
Most good secretagoges elevate the IGF-1 level about 25-40%. The
effect on individuals varies quite widely. These substances are
particularly sensitive to the condition in which they are administered.
If any other substances are taken that degrade the signal induced
by the secretagogue, a reduced response will occur. For this reason
it is important that they be taken on an empty stomach. Many authors
and researchers recommend that secretagoges be cycled (stopped
at intervals). The most common interval is the 12-week on, 2 weeks
off combination.
If target ranges cannot be reached
with secretagoges, an oral hGH spray or sublingual tablet may be
added. These approaches result in a very rapid, small, spike of hGH
in the blood. An elevation in the baseline IGF-1 occurs amounting
to about a 25-40% rise. There should be a two-minute period before
and after the spray or tablet that nothing else is put into the mouth.
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How is recombinant human
Growth Hormone given?
Our protocol uses injectable hGH at a dose of approximately 0.4IU subcutaneously
twice daily. This timing mimics the natural secretion of the hormone.
Many previous studies were done using weekly, semi-weekly, or once daily
dosing. This can cause the hGH level in the blood to rise far above the
physiologically normal ranges. Adverse effects are almost exclusively
limited to levels outside of the normal physiologic range.
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What are the side effects
of Growth Hormone therapy?
If hGH is given in excessive dosages over a long period of time, bone
growth is initiated. As the growth plates are fused in adults, this results
in a syndrome known as Achromegaly. Some of the other effects include
carpal tunnel syndrome, arthritis, vocal cord thickening, excess fluid,
osteoporosis, and heat intolerance. Again, these negative effects can
occur with supraphysiologic doses. When initiating therapy, it is best
to start with a low dose and gradually titrate it to the therapeutic
window of 350-450 ng/ml. Levels need to be monitored every month for
the first half year then every two months.
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Does treatment of Growth
Hormone deficiency increase the risk of diabetes or other diseases?
No studies have shown a statically significant increase in cancer incidence
or diabetes in humans.
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What is IGF-1?
IGF-1 is Insulin-Like Growth Factor. Liver cells form it when they are
stimulated by human Growth Hormone (hGH). It is the compound that
is responsible for many of the effects we see from hGH supplementation.
It is also known as Somatomedin-C.
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Why
don’t we just measure the hGH level?
HGH is released by the pituitary gland in a series of pulses. One series
just after falling asleep, and another about 2 hours after getting up
in the morning. The amount of hGH in the blood is very small, and varies
rapidly over time. This renders it unsuitable as a monitor of hGH activity.
IGF-1 is much more abundant, is produced in direct response to hGH, and
has a consistent diurnal pattern.
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What should the IGF-1
be?
The ideal target for IGF-1 should be 280-400 mcg/ml (slightly higher
in females). Normally this is the value for 20-25 year olds. We find
there is a wide variety of levels based on life-style and diet. Generally
the normal values drop about 10% per decade.
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How often should I check
my IGF-1?
Every 3 months while therapy is being adjusted then every 6 months.
Do I need to fast for
the test?
No, and the best time to have it drawn is in the morning. You should
always have it checked the same time of day and use the same lab for
the most consistent results.
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How high is too high?
The negative side effects are observed only when the IGF-1 remains over
500 for a period of months.
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Why should I get my level
checked?
There are no obvious indicators that correlate with IGF-1 levels. To
get the most out of treatment with any of the hGH products, it is important
to know how each impacts our bodies. To achieve IGF-1 in the ideal range
insures that the treatment will produce the results you desire and prevents
the possibility of side effects from excessive levels.
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Do I need anything else
checked?
It is advisable to have other diagnostic studies performed as part of
a complete anti-aging program.
What is Cognitive Enhancement?
Cognitive Enhancement is a multidimensional
approach to prevent and treat cognitive (mental) decline that has
been associated with aging and many degenerative diseases of aging.
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What causes cognitive decline
or memory loss?
Like many degenerative diseases
of aging, memory loss spans a spectrum of symptoms, etiologies, and
prognosis. More than 55 illnesses, some non-progressive can cause
memory loss. The causes of dementias include vascular disorders,
Parkinson’s disease, infections including HIV, depression,
hypothyroidism, vitamin B12 deficiency, malnutrition, and substance
abuse.
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What are the risk factors for
memory loss?
There are several risk factors that
interact with other biological processes to causes cognitive decline.
Some of the risk factors for memory loss are increased age, family
history, genetic factors, head injury, educational level, cardiovascular
disease, and chronic stress. The pathogenesis of cognitive decline
is multifactor, yet it is clear that the final common event is the
death of the brain cell.
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What does a program of Cognitive
Enhancement consist of?
Programs are multidimensional and
seek to improve memory and brain function utilizing integrated therapies.
The program includes nutrition enhancement through dietary modification
and nutritional supplementation with such things as anti-oxidants,
Phosphatidyl-serine, CoQ10, and Ginkgo Biloba. It also includes stress
reduction through meditation, mind/body exercises, hormone replacement
therapy, and the use of pharmaceutical agents.
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What are some of the prescription
medications that are used for cognitive enhancement?
There are new series of drugs known
as "smart drugs" as well as a category of medications known as "nootropics" that
are now available for use as part of an integrated program. Piracetam
is a drug, which mimics neuro-growth factors and can stimulate the
development of new synapses. It also helps promote interhemispheric
communication. Centrophenoxime is a chemical that helps remove intracellular
debris such as lipofuscian from nerve cells. Hydergine improves the
oxygenation of the brain and Seligiline helps maintain the balance
of neurotransmitters. Hormones such as melatonin, estrogen, DHEA,
and human growth hormone help to improve memory function.
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What are the benefits and when
should I begin a Cognitive Enhancement Program?
Memory loss is a disease that begins
to affect the brain 30 – 40 years before symptoms begin. Therefore,
it is important that everyone begin a program for the prevention
of cognitive decline. Benefits include improvements in memory, concentration,
learning ability, reduced risk of dementia, and an increase in personal
awareness that leads to feelings of connectedness, wisdom, maturity,
and greater life satisfaction.
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What kind of improvement is
possible and how long before I see results?
The human brain is akin to a muscle,
and like a muscle, it’s either "use it or lose it". In most
individuals, it is possible to increase IQ 4-5% in the first year,
and probably 2-3% per year afterwards. While this isn’t enough
to make you feel instantly smarter, testing will demonstrate a definite
improvement. You should notice better recall and clearer thinking
within 2-3 weeks, and perception will be enhanced. Most importantly
is the increased sense of being in control of your mental faculties
and self-knowledge.
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