Anti-aging medicine is a type of preventive medicine, which aims to provide people with a better quality of life by delaying the signs and symptoms equated with aging.
Anti-aging medicine is not the elixir of youth, nor does it intend to add years to life expectancy. Our goal is to improve quality of life given the years one has to live. Prolonging life, often means extending the suffering that comes with illness so common as we age, and that is not our objective in the least.
HOW THEN CAN WE DELAY THE TICKING OF OUR BIOLOGICAL CLOCK?
Anti-aging medicine is based on five pillars: Diet, physical exercise, supplements, and hormonal supplements, which are fundamental but the one I am most adamant about is changing unhealthy lifestyle habits. Only a synergy of all these elements will allow us to increase vitality and eventually extend our longevity.
Dietary supplementation and physical exercise have been known to be important for some time.
In my childhood, as in many of yours I suppose, we were encouraged to take hefty doses of cod live oil. Today, the proliferation of vitamin shops ang gyms clearly indicate that these points have become a priority. Yet, it is not enough. According to a report presented last year by the Calouste Gulbenkian Foundation, while the average life expectancy for Portugal and Scandinavian countries is 80 years old, once the average Portuguese person reaches age 65, they only have about 6 years of good quality of life while Scandinavians enjoy an average of 15 years with the same quality of life.
This occurs because Scandinavian countries also practice preventive medicine and frequently use hormonal modulation.
The hormone levels in our body decrease by 1-3% per year starting between the ages of 30 to 35
By the time we reach 40, we start to manifest clinical hormonal deficits, and by ages 60 and 70 very high deficits.
Hormone replacement should be done whenever necessary, as the entire endocrine system takes part in the aging process.
A decrease in libido, less energy, an increase in body fat, more fragile bones, more flaccid skin and other tissues, osteoporosis, and a change in sleep patterns among many other symptoms, become more evident.
As a result of the changes to our organism, our self-confidence is deeply affected due to the inevitable changes our body and image undergo.
Today we know that the decrease in hormone levels, and the imbalance between them is most probably at the origin of innumerous diseases.
HOW THEN IS THE DIAGNOSIS CARRIED OUT?
Age alone is not the sole form of diagnosing hormone deficiencies.
There are 30 year old women, for example, who need it more than some 50 year-olds.
Through the patient’s clinical history, his exams, clinical analyses, ultrasounds, and eventually other exams, we can detect eventual deficiencies and treat them so that our organism does not work itself into exhaustion. Our body is designed to “auto-adjust” as much as possible but within reason. When the body is unable to supply what is necessary, it becomes exhausted and consequently “sick”.
In my first consultation with the patient I try to do a general overview by conducting a global health exam, and afterwards I listen to the patient’s greatest concerns. All my consultations last at least an hour. We need this time to better understand the patient we have before us, and sometimes during the first consultation the patient does not completely open up as they are also observing the doctor and trying to decide if they should put themselves in our hands.
The patient needs to be seen as a whole. We need to be aware that by altering one hormone in the body, we are indirectly altering all others. We need to basically think on a cellular level.
Hormonal balance is fundamental to maintaining a robust state of health.
If the patient needs any particular hormone, I only use bioidentical hormones.
WHAT ARE BIOIDENTICAL HORMONES?
These are hormones which structurally are identical to ours.
This has many advantages since the receptors upon which bioidentical hormones act are totally adapted to them and recognize them as if they were the body’s own; in addition to this, as the liver does not perceive them as foreign, and is prepared to metabolize them, their accumulation in the liver is avoided.
Non-bioidentical hormones, which are chemically and structurally different from ours, may accumulate in the liver because it is not enzymatically prepared to metabolize them meaning there is the possibility that they may turn into metabolites that are harmful to our organism. Furthermore, their structural difference will not allow them to fit perfectly into the hormonal receptors resulting in a process that is not identical to the one that takes place when using bioidentical hormones, which mimic exactly those produced by our body.
CONCRETE CASES DURING THE CONSULTATION
1- The woman in perimenopause/ menopause.
Many times women do not realize that their complaints may be a consequence of a decrease in their hormone levels. Their menstrual cycles may still be regular, or they may be experiencing some irregularity, and the only sign may be increased irritability and difficulty sleeping, problems most women would consider “run-of-the-mill”. Some may experience a decrease in libido, vaginal dryness, urinary incontinence, lack of sleep, a tendency to gain weight, greater flaccidity and disturbances in the musculoskeletal system, and in the near future, osteoporosis. Feeling like a total “air-head”, “difficulty concentrating and memory loss”, “hot-flashes” which may cause some women distress and great inconvenience, a tendency towards depression and aggressive behavior are frequent symptoms.
The woman is not yet in menopause, she does not pay attention to the symptoms and starts taking anxiety medication and anti-depressants in order to solve a problem which could be easily corrected, and is in the interest of every woman’s health to correct. About 60% of the women who come see me take anxiety medication or anti-depressants as that is the easiest way “to treat” the immediate problem.
Normally, I would not have an objection to this course of action, were it not for the problems which later follow as a result of this, such as memory loss, an increased rate of neurological and degenerative disease and a substantial decrease in quality of life in the future.
Because of this, I strongly advocate starting hormonal modulation therapy before menopause. Years earlier actually, while we still have “active” receptors.
Around the time of menopause the woman’s libido starts to decrease. Many couples experience problems at this time because the woman, due to an untreated hormone deficiency, does not have an appetite for sex, and men around this age are more excitable, although they may be experiencing less frequent and prolonged erections as estradiol (a hormone believed to be female but super important to men) increases and makes them more excitable.
I often say, jokingly, although there is some truth behind it, that many divorces could be avoided if couples were more hormonally balanced.
2- Men, frequently come for a consultation because they feel tired, with lack of vitality, energy and dissatisfaction in regard to their sexual performance.
PORTUGAL IN COMPARISON WITH THE REST OF EUROPE
The situation in Portugal must be reversed. Last year, the Calouste Gulbenkian Foundation presented a report entitled “A Future for Health”. In fact, the prognosis for health is for great change over the next 25 years, and this treatment starts outside the hospital, more precisely in the home. This is the only way to reduce and prevent many chronic and degenerative diseases that appear as we age. In Portugal, the prognosis is for a mere “healthy” six years after most of us reach age 65, while in Norway, for example, the elderly experience on average 15 years without any serious problems because preventive medicine is practiced in their country.
Urgent action is needed. What anti-aging medicine does is prevent or delay the appearance of diseases associated with age through five basic pillars.
1. Nutrition. Fundamental. We are what we eat. The best treatment is a healthy diet as the wise men of antiquity used to say. And it is true.
Some basic advice: abolish cow’s milk and derivatives. Cows today are pumped full of hormones, and as a result, we end up doing cow hormone compensation therapy and not bioidentical.
Much could be said about the food we eat but the truth is the food is not what it once was.
2. This is why we need food supplements, the second pillar of anti-aging medicine. Very few though, as eating well is what really matters.
Food supplements: In my opinion: VERY LITTLE and vary your supplements year round. What we need is to eat well.
3. In regard to physical exercise, it is obviously fundamental and affects the internal production of hormones and metabolisms which improve our health. Advice: exercise with moderate intensity over a longer period of time. Yoga is excellent. Dance, for example, releases oxytocin, a hormone fundamental to our health which gives us a sense of pleasure, often addictive. Running is excellent if well executed and adapted to the patient’s physical condition. Swimming is excellent for men. Especially those who sit for long periods of time as it strengthens the lumbar musculature.
4. Hormonal supplementation to balance our physical and mental health and well-being.
5. Changing lifestyle habits is essential in order for everything that we have discussed to result: coffee, tabaco, drugs and alcohol ZERO!, the early bird catches the worm, as the saying goes, so go to sleep at a reasonable hour and rise early. Our hormones have what is known as a circadian rhythm. Most are released by natural light, therefore “living in reverse” is not healthy at all. There are only two hormones that peak at night: growth hormones and melatonin. All others are fundamentally secreted during the morning with the help of daylight!