What is anti-ageing medicine?
Medicine is continually changing as we learn more about the body and its processes. How medicine was practiced 100 years ago is clearly different compared with 1000 years ago, and with now. Even medicine of 20 years ago is vastly different. Science continues to update us on the pros and cons of various medications and therapies. One thing is for certain, and that is that medicine of today will not be that of tomorrow. For some medical practitioners the ongoing task of relearning their medicine seems extreme and pointless since current therapies seem to work okay for most. This attitude is supported by rich and powerful pharmaceutical companies, which would be disadvantaged by returning to basic concepts of physiology to correct illness through nutrition and lifestyle changes. For other doctors not to relearn their medicine is a failure of the science of medicine and a betrayal of the oath “to do no harm”.
Consequently, anti-ageing doctors (or functional medicine practitioners) worldwide are dedicating themselves to finding the most up to date, scientifically backed medicine to help their patients. They are all fully qualified doctors in conventional medicine and use the knowledge to provide the most complete and safest of medical care, often choosing proven natural medicines over conventional.
Why natural? Not just because our bodies were genetically designed over thousands of years to function in the environment but also because these medicines have advantages with better side-effect profiles than their conventional counterparts. For example, did you know that your anti-cholesterol drug may lower your cholesterol but at the expense of the energy and muscle systems of the body leading to muscle cramps and fatigue.
Anti-ageing doctors strive constantly to learn more, and if they don’t have the answers, will look to find them. Anti-ageing uses advanced testing to accurately diagnose and adjust treatments. The body with it’s thousands of processes is the most complex piece of machinery on earth. As one system alters, it can affect another.
To have the body functioning perfectly, it often takes many visits. The amount depends upon the state that the body originally presents in. After all “Rome wasn’t built in a day”, and certainly regaining balance can take months to years. Fortunately you will continually feel better along the way.
This is different to conventional medicine, which aims to patch symptoms rather than resolve the actual underlying problem and restore health, balance and well-being.
Consequently many basic physiological and biochemical concepts are used, lending to corrections in nutrition, hormones and lifestyle and ultimately to better health. Once again, doctors dedicated to anti-ageing will always use a scientific basis for doing so. If ever in doubt, just ask them for the scientific evidence. But be prepared if they present you with a long list of scientific references to read.
The only down side to anti-ageing medicine at this point is the fact that there are so few properly trained anti-ageing practitioners (although many will claim to be so), and that at this stage the government does not provide rebates for such care. In addition the cost of natural medicines is similarly not subsidized (despite in many cases being safer and more effective than conventional medicine).
I use the term ‘at this stage’ because the medicine of tomorrow will eventually see the virtue in functional medicine and all medical students will one day be taught it in schools around the world. This image of medical UTOPIA is some time away and will first require regaining the financial power held by governments and drug companies.
Functional medicine also puts the onus back on the patient to take charge of their health. To ‘repair’ rather than ‘patch’, patients must make lifestyle changes. They must choose to eat better, to increase sleep, to exercise and to attempt stress reduction by re-ordering their lives. I emphasize this because most illnesses of today could be prevented completely be such changes. No health practitioner can offer true wellness without first addressing these issues, so beware of false promises. The trained anti-ageing doctor is then able to fine tune and restore balance and hence wellness.
How does anti-ageing medicine work?
Anti-Ageing Medicine (or Functional Medicine) is the cutting edge of medical science. It focuses on the latest research to improve and maintain our standard of living, as we grow older by prevention and repair of disease processes that are occurring in the body. Everyone can benefit from Anti-Ageing Medicine no matter how old they are. The aim is not only to live longer but also to remain active into our later years. As more of society lives into the hundreds, Anti-Ageing Medicine allows people to maintain their mental, physical and sexual function. It makes it possible for a 70 year old to feel like a 30 year old.
How is this done?
Science knows that ageing is due to 3 factors:
Insulin resistance. Normally the body produces insulin in response to the food we consume, which tells the cells to use the glucose to make energy. Glucose that is not converted into energy is stored as fat. In insulin resistance, the cells no longer recognise the insulin and consequently blood sugar rises and more glucose is stored. The body tries to make more insulin in response to the high blood sugars. The process continues to repeat itself, eventual resulting in diabetes with all of its complications.
Insulin resistance is the result of poor nutrition i.e. too much refined carbohydrate, skipping meals and large portion sizes.
Our decline in hormones.
Inadequate minerals/nutrients in foods due to toxins and pollutants in the environment. This prevents our body systems from running efficiently.
So how can we fix it?
Firstly, we need to assess and improve nutrition with the aim to correct insulin resistance and prevent diabetes. A great secondary effect from this is weight loss. To do so we need to eat small meals regularly throughout the day, rich in protein and low in fat and refined carbohydrates. We need to exercise cardio-vascularly and with resistance training for at least 20 - 40 minutes 3 to 5 times per week.
Secondly, we correct hormonal imbalances. The body functions due to its ability to send signals between cells. It does this with small molecules called hormones. These include sex hormones such as oestrogen, testosterone, progesterone, DHEA and pregnenalone, and the thyroid hormones, cortisol from the adrenal gland, melatonin, and human growth hormone.
If hormones are in excess or deficient they will cause a variety of symptoms as tabled below.
ESTROGEN DEFICIENCY (FEMALES)
- Vaginal dryness
- Painful intercourse
- Bladder infections
- Hot flushes
- Night sweats
- Decreased sexual response
- Foggy thinking
- Low bone density
- Heart palpitations
- Puffiness and bloating
- Weight gain in hips
- Mood swings
- Anxiety and irritability
- Frequent thrush
- Carbohydrate craving (sugar/bread)
- Diminishes sex drive
- Breast tenderness
- Foggy thinking
- Fibrocystic breasts
- Premenstrual headaches and migraines
- Heavy bleeding
- Hair loss
- Breast enlargement
- Weight gain
PROGESTERONE DEFICIENCY (FEMALES)
- Irregular periods
- Night sweats
- Low bone density
- Early miscarriage
- Sore or swollen breasts
- Headaches associated with your period
EXCESS TESTOSTERONE (Females)
- Excessive hair on face and arms
- Thinning hair on head
- Ovarian cysts
- Pain when ovulating
- Unstable blood sugar
- Polycystic ovary syndrome (PCOS)
- Deepened voice
- Elevated cholesterol
- High blood pressure
TESTOSTERONE DEFICENCY (Males)
- Weight loss
- Muscle loss
- Decreased sex drive
- Enlarged breasts
- Lower stamina
- Weaker erections
- Gall bladder problems
- Stiff muscles and joints
- Decreased motivation
Thyroxine is produced by the thyroid gland and is responsible for metabolism.
THYROID DEFICIENCY (FEMALES AND MALES)
- Fatigue, lack of energy
- Weight gain or difficulty losing weight
- Low body temperature
- Fluid retention
- Pale, dry skin
- Puffiness in face, hands and feet
- Depression, anxiety
- Intolerance to cold or heat
- Stiffness of the joints
Melatonin is often a forgotten hormone that is essential for sleeping. It is released around midnight in response to the lack of stimuli from lights. When we turn the light on to go to the toilet in the middle of the night, melatonin production is switched off. Consequently, we may feel unrested in the morning. Melatonin is always reduced in shift workers and in jet lag.
Probably the most important hormone the body produces is Human Growth Hormone (HGH). When we are young growth hormone causes a child to develop into an adult. At the age of 25 to 30 growth hormone has peaked, after this age it starts to decline and, as it does, so our bodies begin to age more rapidly. Low growth hormone results in a large range of symptoms and I encourage you to read the separate information on HGH, as you might be well surprised.
Cortisol, the body’s stress hormone, is produce by the adrenal gland. It can cause people to loose and gain weight. When people have been stressed for a long period of time the adrenal gland can begin to fail and we see a condition known as Adrenal Fatigue Syndrome. This may result in chronic fatigue syndrome.
CORTISOL DEFICIENCY (FEMALES & MALES)
- Difficulty getting up in the morning
- Fatigue not relieved by sleep
- Craving for salty foods
- Decreased sex drive
- Decreased ability to handle stress
- Increased time to recover from illness,
- Stress or trauma
- Light headed if standing quickly
- Mild depression
- Less enjoyment of life
- Loss of memory
- Symptoms worse if tired
An anti-ageing doctor will assess a patient’s symptoms and organize specialized laboratory testing. Once they have this information they are able to recommend and prescribe hormone replacement that is derived from a natural source. This is known as “Bio-identical Hormone Replacement”, that is, it has the same molecular structure as the body itself makes. Conventional hormone replacement is synthetic with a similar chemical structure but not exact. This has lead to the theory that conventional hormone replacement may be linked with cancers when used over a long period of time. There has not been substantial evidence to date that natural hormone replacement has the same risks as conventional. It is important to note that we are talking about replacement of hormones not giving excess hormone to the body. The aim is to put a person’s hormones into a range of a younger age group suitable to the individual. In other words the therapy is tailored to suit the patient. A compounding chemist especially trained in this area usually makes up the hormone replacement. By monitoring the patient’s symptoms and further testing an anti-aging doctor is able to perfect the formula for the patient to function at their peak.
So, if natural HRT is so good why don’t all GPs prescribe it? Basically because it is not taught at medical school, as it combines some of the theories of naturopathy as well as scientific data, Medicare does not subsidize it or the testing for it. But just ask anyone on natural HRT how they feel and I guarantee that most will give you a positive response.
Finally, the third factor to correct is vitamin and mineral imbalances resulting from inappropriate diet and poor nutrients in soils, pesticides and from over-harvesting. For example a healthy individual requires 5 grams of omega 3 fish oil per day, which may prevent heart disease and the need for cholesterol lowering medication. Unfortunately even health stores may not stock the most pure and efficient health supplements available on the market.
WHAT’S IN FOOD?
Internal wellness begins with what we put into our bodies to fuel them. It is essential to have an understanding of what our food consists of and why certain foods are better than others.
Consider our food as grouped into carbohydrates, fats and protein, vitamins, minerals, fibre and water (all classified due to their molecular structures), and what these do in the body.
Carbohydrates are essential to provide glucose to the brain and nervous system. The body will convert protein to carbohydrates when carb stores are low (i.e. when less that 100 to 150 g/day is consumed. This is known as ketosis. Carbohydrates are also used as the primary fuel for muscles in the first 20 minutes of exercise and to maintain metabolic processes including the breakdown of free fatty acids. They have 2 basic forms:
- Complex (such as fruits, vegetables and whole grains). They have slower and longer effects on blood sugar levels to allow the body to use them for energy for longer periods. They are great sources of fibre, minerals and vitamins.
- Refined (such as soft drinks, lollies, chocolate and white bread). They have many calories with minimal nutritional value. They raise the blood sugar quickly making you feel great but then drop quickly to provide a hypoglycaemic effect of tiredness, dizziness, irritability and deflated mood. It is refined carbs that create carb addictions with withdrawal symptoms leading to cravings for more refined carbs. It’s also these that lead to insulin resistance.
Carbohydrates are rated on the way they raise blood glucose levels in the body. This is known as the glycaemic index.
Fats are energy storage molecules and contain vitamin A, D, E and K. They are used in exercise of longer than 20 minute duration at medium intensity. There are 3 basic forms:
- Simple fats (triglycerides) have 2 groups:
- Saturated fatty acids (from animal fats such as meat, egg yolks, dairy and shell fish) and
- Unsaturated (from plants such as corn, olive, sunflower and peanuts).
- Compound fats are simple fats combined with other chemicals such as phospholipids (seen in cell membranes) and lipoproteins (transport molecules in the blood). The lipoproteins are important and are commonly tested in lipid/cholesterol tests that GPs perform. Lipoproteins are of 3 classes: high density (HDL), low density (LDL) and very low density (VLDL). The HDLs are the good lipoproteins that take cholesterol away from blood vessel walls to the liver where they are broken down by bile and excreted into the intestines. Exercise can increase HDL’s. LDL’s are ‘bad’ lipoproteins as they carry cholesterol through the body allowing it to deposit in arteries.
- Derived fats are combinations of simple and compound fats e.g. Cholesterol. Not all cholesterol is bad, as the body does need some cholesterol to make sex hormones and vitamin D. It’s having too much that makes it dangerous.
Proteins are the third nutrient and are arguably the most important. They comprise of amino acids (i.e. the building blocks of nature) and are used to make hormones and enzymes, maintain water and acid balance, carry oxygen in the blood, maintain growth and repair cells/tissue, and provide 10 to 15% of the total energy during prolonged exercise. Proteins constitute 50% of the dry body weight. There are 2 types – essential and non-essential. Essential amino acids cannot be made by the body and must be ingested while non-essential ones can be synthesized from essential amino acids. They must be in correct amounts in the body to allow the body to function properly. They are derived from animal products. Some grains and beans have proteins but usually lack one or more essential amino acids.
Vitamins allow fats, carbohydrates and proteins to release energy essential for the formation of red blood cells, connective tissue and DNA production. Deficiencies cause the body's biochemical processes to fail resulting in disease. Some vitamins are strong anti-oxidants that bind dangerous free radicals that move around the body damaging tissues. There are 2 types of vitamins:
- Water-soluble include vitamins C, B1, B2, B6, B12, folic acid, panthanoic acid and biotin. Deficiencies can occur within only 2 – 4 weeks, but excesses are eliminated in urine.
- Fat-soluble include vitamins A, D, E and K. Deficiencies are rare but becoming more common while excesses of A and D can be toxic to the body.
Minerals are enzymes or co-enzymes aiding in cellular and energy metabolism, allow muscle and nerve conduction and act to maintain the acid/base balance in body fluids. They are also used in teeth, bone, haemoglobin, and protein and hormone synthesis. There are 6 major minerals: calcium, phosphorous, magnesium, potassium, sodium and chloride. The body requires in excess of 100mg of these minerals per day. Trace minerals need less than 100mg per day. There are 14 of these in the body: chromium, cobalt, copper, fluoride, iodine, iron, manganese, molybdenum, nickel, selenium, silicon, tin, vanadium and zinc.
Fibre provides bulk to the stools, which help remove toxins, soak up fats, reduce appetite, and reduce the risk of colon cancers. There are two types of fibre. Water-soluble fibre (beans and oats) act to bind fats to reduce cholesterol, while water insoluble fibre (wheat) adds bulk. The body needs 25 to 40 grams of insoluble/soluble fibre every day.
Water is essential for life. Two-thirds of the body's composition is water as is 85% of the brain. Water is essential for digestion, absorption, circulation and excretion. It regulates body temperature, lubricates joints, moisturises skin and maintains muscle. The body requires 8 to 10 glasses daily.
Just a note on vitamin and mineral supplementation
There is much controversy in regards to supplementation being a waste of money. This would be true if we ate fresh food from the garden that had no pesticide exposure and a high soil nutrient content. Nowadays, this is an unlikely situation and so for efficient body functions to occur supplementation is essential. However, many of the over the counter preparations consist of low doses with low-grade ingredients. The result is that you need more to get the desired effect. So when choosing supplements select only high grade, concentrated products. These will be cost effective. Your anti-ageing doctor should be aware of these and can make recommendations. Ask what they use for themselves and their families!
The glycaemic index (GI) is a rating of carbohydrate foods from 0 to 100 indicating how these foods raise blood glucose levels in the body when eaten. This is important when dealing with insulin resistance and diabetes as those foods with lower GI require less insulin to control blood glucose rises.
The GI rating is not the only factor in choosing suitable carbohydrates in a diet. Generally the slower the digestion the better the glycaemic control as well as appetite control. Factors that slow digestion of carbohydrates include:
- The type of starch
- Increasing particle size
- Choosing less ripe fruit
- Less cooking and processing of food
- Water soluble fibre
- The type of sugar chosen, e.g. fruit sugars digest slower than sucrose
- Adding fat and protein
- Increasing the acidity e.g. adding lemon or vinegar
The amount of carbohydrate is equally as important as the type. This is indicated by the glycaemic load, calculated as:
Glycaemic load = ( GI of food * amount of carb in a normal serving ) / 100
In this case:
- > 20 = high
- 11 - 19 = medium
- < 10 = low
The ideal GI food is high in fibre and low in fat.
A point of importance in reference to diets is the use of the word ‘diet’ itself. To many this word implies temporary eating changes to produce a desired effect, usually weight loss. I prefer to use the word ‘lifestyle eating plans’, as it is only long term changes that will provide satisfactorily lasting results. The word diet in this context simply means an eating plan.
All anti-ageing diets, i.e. lifestyle eating plans, should be tailored to the individual. However some basic rules can be applied.
They should be balanced with:
|Complex carbs||50 to 60%|
|Fats||20 to 30%|
|Protein||15 to 20%|
Calorie intake should be around 1800/day for the average 70kg moderately active person.
This balance will change depending upon exercise, insulin resistance and maximizing the use of growth hormone
What does the future hold?
As medicine advances it has become able to tell a patient of their genetic predisposition to certain diseases and how to avoid them, if they have had exposure to various infections, such as Herpes or other STDs previously not able to be tested, and even what skin care is most suited to that individual based on their genetics. In the future we will even be able to vaccinate to stop the diseased genes from switching on, thus preventing some of the terrible debilitating and life threatening diseases that affect so many people every day.
How to choose anti ageing specialist?
The following information is from “Grow Young With HGH”, written by Dr. Ronald Klatz, President of the American Academy of Anti-Aging Medicine and world expert in this field.
When seeking an anti-ageing physician one should ask the following questions:
Do you think we can delay ageing or the diseases associated with ageing?
While there is some dispute about what ageing actually is, a physician who practices anti-ageing medicine believes that we can postpone or reverse many of the biochemical changes associated with later life disease, such as heart disease, cancer, stroke and diabetes. Beware if your physician says something like:
‘Well, you’re just getting old, what can you expect?
People at your age get aches and pains, start slowing down, have trouble getting it up, etc.
I know a lot of people who are sixty and can’t get out of the bed in the morning.’
My advice, get out of that person’s office while you’re still able to move.
What do you do for your own health?
Physicians who have an anti-ageing orientation practice what they preach; exercising regularly, taking high quality multivitamin and mineral formulas along with supplements of antioxidants and other compounds that reflect their own research and that of others. It is interesting to note that every doctor who prescribes human growth hormone replacement uses either HGH or GH-releasers on himself or herself if the IGF-1 levels indicate a deficiency. Look for a doctor who spends money and time on a personal anti-ageing program and is proud of the fact.
How many patients are you actively treating in anti-ageing regimens?
You don’t want someone who sees anti-ageing medicine as a passing fad but someone who is actively practising it. While a doctor’s practice is made up mostly of people who come in when they’re in extreme discomfort, a physician who does anti-ageing medicine should have at least 30 or 40 patients who are committed to a program of optimal health.
How do you keep up with latest advances?
Medical knowledge increases exponentially, doubling every 3.5 years. Nowhere is this truer than in the high-technology arena of anti-ageing medicine, where there have been tens of thousands of scientific articles on growth hormone, melatonin and DHEA just in the past few years. Doctors should subscribe to periodicals that inform them of the latest advancements in anti-ageing.
Do you see your patient as an active partner or a passive recipient?
Your role in anti-ageing medicine does not stop with having a prescription filled or taking a drug. As you become more involved in your personal life extension program, you will find that you will want to read everything on the subject, subscribe to magazines yourself. Sometimes it can be the patient who brings findings to the doctors’ attention.
Do you believe in regular follow-ups?
It is essential that you see your doctor every 3 to 6 months to make sure that there are no adverse side effects, to adjust your dosage if needed and to determine if the treatment is working. Your IGF-1 levels should be tested to see if they are at youthful levels. You don’t want to go to a growth hormone mill where the doctor hands you some medications and says ‘good luck.’
Remember it is your job to interview your doctor and evaluate their qualifications to see if they are the best choice as your personal anti-ageing physician!
More more information on anti-aging doctors check out The Australian Academy of Anti-aging at www.a5m.net
- Grow Young with HGH, Dr Ronald Klatz, 1997 Harper Collins, ISBN 0060186828
- Adrenal Fatigue: The 21st Century Stress Syndrome, Dr James Wilson, Smart Publications 2006, ISBN 1890572152
- HRT: The Answers, Dr Pamela W Smith, Healthy Living Books 2003, ISBN 0972976736
- Your Hidden Food Allergies Are Making You Fat, Rudy Rivera Three Rivers Press 2002, ISBN 0761537600