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The Road "Les" Traveled
By Lester Adler, MD, MDH

Stop the Clock!
Clinical Age Management
What does it mean for YOU?
By Lester Adler, MD, MDH

Stop the Clock!
Clinical Age Management ...
What does it mean for YOU?

By Lester Adler, MD, MDH

The search for the fountain of youth, immortality, or the Methusaleh Factor has been around for eons. Traditional medicine really just extends morbidity, whereas age management extends vitality and diminishes the time of morbidity. In the past, we could only search in vain, but now we have technological means to access our body’s physiological state, as well as the effects of various substances on this state.

As I see it, many of us in the “baby boomer” generation will be the pioneers exploring these questions of aging. My own belief is that it is likely that we will improve our longevity through appropriate interventions. Certainly the quality of our lives improves as we feel more fit - - the vim and vigor remain. Will this translate into an enhanced, more vital lifestyle only, or will it also increase longevity? This is still an open question.

I am now affiliated with the Kronos Group in Phoenix. This organization, founded by Dr. John Sperling (founder of The University of Phoenix) is dedicated to the scientific study of aging. They have an impressive facility in central Phoenix equipped with their own state of the art laboratory. They offer various levels of biochemical and physiological testing. In our office here in Sedona, we are able to draw all the necessary blood for laboratory evaluation. A beautiful report is sent back to us. It is perhaps the most extensive report I have ever seen. The complete panel measures cardiovascular risk factors, all hormone levels, many antioxidants, metals, in addition to the routine blood count and chemistries. I did this and learned critical information about myself. It is a wonderful way to assess your “internal milieu” to a much greater degree than ever before. With this data, we can proceed with ways to enhance your health and reverse unhealthy trends.

Many theories are emerging as to the why’s and wherefore’s of the aging process. From my reading and understanding, it seems that we can identify some of the most important.

The Telomere Theory

Telomeres are located on the ends of chromosomes. Whenever a cell divides, a piece of the teleomere breaks off. When there is no more telomere present, the cell dies. So the questions are: A. Can we extend the life of a telomere? B. Can we shorten the amount broken off with each cell division? C. Can we prevent breaking off of the telomeres? D. If we alter the telomeres, might we be at risk of creating a higher risk of cancer? Many research scientists are looking into these questions. The answers are not yet in, so we all need to stay tuned.

The Genetic Theory

Our views of genetics have been shaped over the years by the Mendelian view- - fixed expression of genetic markers in our chromosomes. We are a 50/50 combination of the genetics of our parents and there isn’t much we can do about it. If they had “longevity genes”, then perhaps we have them. And if the opposite is the case, well, we chose the wrong parents. If there are “bad” genes present, we are stuck with them.

But, maybe not so fast. A newer modern view of genetics is emerging- - one in which genetic expression is modifiable, i.e., we are not stuck. Our genes may only reflect certain tendencies. But, these are modifiable by our life styles- - the foods we eat, the water we drink, the air we breathe, the exercise, the supplements, the way we handle stress, and many more variables. This emerging view allows us a great deal of control over the manifestations of these genetic tendencies. We are not victims of our genes, but creators of our lives using a set of modifiable blueprints.

The Antioxidant Theory

This issue of Health Security goes into this to some extent. In summary, life is a chemical balance between oxidation and reduction. Both processes go on all the time, and both are necessary. When we have oxidation within our cells, we generate substances called free radicals. If excessive, these highly reactive molecules are capable of being destructive to our cellular machinery. If they are so destructive, why do we have them at all? Well, we need them. This is one of the main mechanisms by which we handle infections. This is partly how we kill off invading organisms. The key word here is excessive. Anti-oxidants neutralize these free radicals. So, if we have oxidants and free radicals, we need to have a balance of reductants and anti-oxidants. In this way, the body maintains what is called homeostatsis or balance. Neither process, if out of balance with the other, is favorable.

The Wear and Tear Theory

Of course, as anything ages, its parts get worn. We see this with our cars, our computers, our houses, and of course, our bodies. But, if we do good preventive maintenance, they last longer and support us better. Similarly, a neglected house or car will decay more rapidly. Can we, with good preventive health maintenance, not only enhance our vitality and productivity, but also our lifespan? This is likely, but not completely proven as yet.

The Hormonal Theory

As we age, many of our hormone levels tend to change. In our teens, twenties, and early thirties, we are at our peaks. The raging hormones of youth, our sex hormones, are also at their peak, so is DHEA, growth hormone, and melatonin. Insulin levels are held in check. However, as we age, we change. Progesterone and estrogen levels decline between 35 and 50 years of age, eventually leading to menopause in women. The output of these two hormones sinks to meager levels and leads to the common complaints of hot flashes, mood swings, insomnia, and vaginal dryness. In men, testosterone levels also tend to decline, although, in a much more gradual fashion over a longer time frame. Along with this, levels of estrogen and what is known as “sex hormone binding globulin” tend to increase, further blunting testosterone’s more virilizing actions. What happens? Men get a bit more moody, flabby, fatigued, and less sexual, and possibly plagued with erectile dysfunction and thereby further plagued with psychological distress.

Similarly, in both men and women, the descending levels of DHEA and growth hormone can lead to immune dysfunction, fatigue, depression, osteoporosis, and body breakdown. When we are young, high levels of growth hormone help us grow. Later it remains a trophic hormone, basically supporting many biological functions. Its decline leads to a lack of support of these functions. A drop in melatonin levels can lead to sleep disturbances. Also, melatonin has been found to have marked antioxidant effects. Thus, low levels tend to have a negative effect on our immune and antioxidant systems.

Is the decline in our hormones a marker for diminishing health and the onset of degenerative diseases? Now, what would happen if we supplement these hormones and keep them at levels more like those in our 30’s or 40’s? If we keep our levels up, can we prevent some degenerative disease and declining health? There is some evidence that this may be the case. For example, women on estrogen have less osteoporosis, Alzheimer’s disease and, perhaps, less heart disease. Men given testosterone experience improved mood, muscle mass, sexual function, and lessened fat stores.

Just as these hormones decline, we have the reverse happening with insulin. We are all familiar with the lack of insulin in juvenile diabetes. But, as we age, particularly by eating lots of carbohydrates, insulin levels tend to rise. What results? Excess fat, hypertension, elevated cholesterol and trigyceride levels, and often a low HDL (good cholesterol). This is known as Syndrome X, or hyperinsulinism. Additionally, the increase incidence of adult onset diabetes is a direct result of this phenomenon.

It is not good to have excessive levels of insulin. Elevated insulin causes the body to retain fat and causes our vessels to become thicker and potentially blocked. Heart attacks and strokes are the result. The single most important way to deal with this phenomenon is to lower the carbohydrates in our diet. This means cutting out potatoes, bread, cakes, cookies, candies- lots of the “goodies”. Additionally, certain nutrients and medications help to keep insulin levels in check.

These are the theories. In practice, we can take all of the information and construct an individualized program based on your personal biochemistry and physiology. These could include detoxification, alterations in diet, nutritional supplements, antioxidants, hormones, medications and fitness programs.

If you have any questions, or would like to schedule your “Longevity/Clinical Age Management” evaluation, please call the office at 282-2520. We are all in this exciting new era together. For those of you interested in this exploration, I welcome you to join me.

With best wishes for your health,

Lester Adler, MD

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