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Aging
Anti-Aging Medicine
Functional Medicine
Preventive Cardiology
Stress
Adrenal Fatigue
Hormones and Hormone Replacement
Nutritional Supplements
1. What is the definition of aging?
Aging is a syndrome of changes that are deleterious, progressive and universal. Aging damage occurs to molecules (DNA, proteins and lipids), to cells, and to organs. Diseases that increase in frequency as we age include arthritis, osteoporosis, heart disease, cancer, and Alzheimer’s disease. The traditional definition of aging is that it is an inevitable process of becoming increasingly disabled that is evidenced by certain symptoms, such as failing memory and less energy. A more modern approach looks at the biological processes of the disabilities associated with aging and the degree to which the physiological deterioration can be prevented or altered.
2. What are the theories of aging?
There are at least a dozen theories on the causes of aging that have been proposed, but the most popular focus on the general categories of programmed aging and “wear and tear” aging. Programmed aging includes the genetic programming encoded within your DNA and free radical damage to cells as well as the disruption of cell metabolism. By contrast, aging due to wear and tear is not the result of any specific controlling program, but is the effect of many kinds of environmental insults such as radiation, chemical toxins, trauma, and metal ions on the body’s ability to repair and maintain its organs and cells. A drop in hormone production, which causes a decline in the body’s ability to repair and regulate itself, is also a critical component in aging.
3. What is the association between hormones and aging?
A “neural hormonal clock” in the brains of mammals has been suggested to influence aging through the neuro-endocrine system. Hormones alter the gene expression of DNA throughout the body and we develop symptoms of aging as hormone levels decline. The pituitary gland, the master gland under the influence of the hypothalamus in the brain, influences the physiology of all cells in the body. It has been found that when the pituitary gland of mammals is surgically removed and supplements of essential hormones are given, maximum lifespan increases by one-third to one-half.
4. What is the relationship between inflammation and aging?
Acute inflammation is a necessary response to illness and injury which turns on and off under normal circumstances. This balance can be altered when the body is subjected to too many toxins and poor lifestyle choices, and the result is chronic inflammation. Chronic inflammation is the root cause of many degenerative diseases including coronary artery disease, Type II diabetes, Alzheimer’s disease, and autoimmune diseases such as arthritis, chronic fatigue, fibromyalgia, lupus and asthma. As we age, the body’s ability to turn off the inflammatory process diminishes and the effects are exacerbated by an unhealthy lifestyle. Reducing chronic inflammation through lifestyle modifications such as stress reduction, exercise, and a balanced diet and replacing deficiencies in hormones and nutrients can dramatically alter or reverse the effects of aging.
1. What is anti-aging medicine?
Anti-aging is a clinical/medical specialty and field of scientific research that focuses on the prevention, early detection, treatment, and reversal of aging-related decline using scientifically-based medical interventions administered by highly trained anti-aging physicians or health professionals. Anti-aging medical care is a vitally important new model for health care that reaches beyond the concept of preventive care to enhance the quality of life while increasing lifespan. The American Academy of Anti-Aging Medicine was established in 1997 as a professional physician certification and review board and it currently represents over 12,000 physicians, scientists and health professionals from more than 70 countries.
2. How does anti-aging medicine differ from geriatrics?
Though both medical specialties focus on aging-related diseases, the treatment methodology is quite different. Geriatrics is a branch of internal medicine that cares for elderly patients primarily by treating the symptoms of the diseases to make the loss of function and discomfort more tolerable. The goal of anti-aging medicine is to prevent symptoms and loss of function through testing, regular monitoring, medical interventions, and lifestyle modifications.
1. What is functional medicine?
Functional medicine is a multi-specialty approach to medical care that requires an understanding of the fundamental physiologic processes, environmental inputs, and genetic predispositions that influence health and disease. It is an approach that enables interventions to be focused on treating the causes of a problem rather than masking the symptoms. The result is patient-centered care rather than disease-focused therapy. The goal is not only the absence of pain and disease, but optimal health and performance for all patients.
2. Who practices functional medicine?
Functional medicine practitioners are medical professionals trained to assess the risk factors and underlying causes of chronic diseases including diabetes, heart disease, cancer, osteoporosis, neurological disorders, such as Alzheimer’s, and autoimmune disorders, such as rheumatoid arthritis and fibromyalgia. Using integrative, science-based techniques an individual’s genetic predispositions, physiology, and lifestyle variables are analyzed. Individually tailored interventions are then designed to prevent and treat degenerative illness as well as restore the balance of internal and external factors that affect total functioning.
1. What is preventive cardiology?
Preventive cardiology is a field that has developed in recent years which utilizes advanced technology and an improved understanding of cardiovascular disease to prevent atherosclerosis. Patients with abnormal lab tests are treated before symptoms develop, and the risk factors of individuals who have experienced an event such as a heart attack, stroke, vascular or heart surgery, or angioplasty are managed and ameliorated. Using the expertise of medical professionals in multiple specialties, the goal of preventive cardiology is to halt or reverse atherosclerosis and its disabling and life threatening effects.
2. What is atherosclerosis?
Atherosclerosis is a progressive process that results in a gradual narrowing of the arteries, which can lead to stroke, heart attacks, aneurysms, and sudden death. Heart attacks and stroke are the leading cause of death in the United States and over 40% of all deaths are the result of cardiovascular disease. Every year 1.5 million people suffer a heart attack (30% of them fatal) and 4 million Americans have survived a stroke, resulting in various degrees of disability. Unfortunately, very few of these people are aware that they have atherosclerosis, or that the risk of stroke and heart attack can be identified and significantly reduced.
3. How does atherosclerosis develop?
The process begins like a cancer growing on the wall of the artery and progresses over the lifetime of the individual. Small, tumor-like structures called plaque begin growing in childhood and eventually grow together, forming thick scars and accumulating calcium. Atherosclerotic plaque growth gradually narrows the opening of the artery, diminishing blood flow when the vessel is narrowed by more than 50%. Once symptoms such as chest pain develop, there is a 90% chance that complications will occur. Asymptomatic plaques (the tiny tumor-like structures in the wall of the artery) are the most dangerous as they are prone to rupture. A clot results which cuts off the blood flow to the heart and brain causing a stroke, heart attack, or sudden cardiac death.
4. How is atherosclerosis diagnosed?
Atherosclerosis is easy to diagnose after an event such as stroke, heart attack, or an aneurysm occurs, but by that time, permanent damage is likely. Fortunately, technologically advanced CT scans can define the location and level of narrowing in the coronary arteries as well as differentiate between stable (calcified) plaque and unstable (soft) plaque. Dangerous soft plaque is detected without invasive procedures and can often be reversed by aggressive management and treatment of risk factors.
5. What are the risk factors of atherosclerosis?
The traditional risk factors which include, age (over 60), family member with early (before 60) heart disease, high cholesterol, stress, a known cholesterol or lipid disorder, diabetes, hypertension, obesity, a sedentary lifestyle, and smoking are often treated erratically. Newer diagnostic tests measure a variety of risk factors that are reversible and treatable. These include elevated homocysteine, Lipoprotein (a), fibrinogen, C - reactive protein, LDL particle density, inflammatory mediators, and hormone and antioxidant levels.
1. What is stress?
The term “stress” as it is currently used was defined by Hans Selye in 1936. At that time, Dr. Selye defined stress as “the nonspecific response of the body to any demand for change” caused by “stressors”, or the physical and psychological stimuli that trigger the stress reaction. He demonstrated that persistent stress could cause animals to develop various diseases similar to those seen in humans, such as heart attacks, stroke, kidney disease and rheumatoid arthritis. Modern scientists have clearly defined the biological mechanism of stress and the consequences of severe or chronic stress on the physiological processes of the body.
2. What is the prevalence of stress?
Twenty-five years ago, a cover story for Time Magazine titled “The Epidemic of the 80’s” referred to stress as the nation’s leading health problem. Since then, numerous surveys indicate that Americans perceive that they are under more and more stress. Currently, it is estimated that between 75 to 90 percent of all visits to primary care physicians can be attributed to stress related problems.
3. Why is stress more different and more dangerous in the 21st century?
The nature of stress for modern man is more emotional than physical and is associated with acute reactions over which we have no control that were originally designed to be beneficial. The archaic “fight or flight” response to such events as getting stuck in traffic or conflict at work can now cause tremendous physical damage over time and even be deadly. During episodes of stress, heart rate, blood pressure, and blood sugar levels increase, blood is shunted to the large muscles of the arms and legs, and there is an increase in clotting. An outpouring of adrenaline, cortisol, and other stress related hormones causes many of the effects of stress. Repeated incidents can contribute to hypertension, diabetes, ulcers, and neck and back pain and lead to an inflammatory process that causes serious physical effects throughout the body.
4. What are the physical effects of inflammation and chronic stress?
Studies have shown that tissue inflammation is an integral part of the aging process and a major cause of significant organ dysfunction. Significant damage can occur to the Central Nervous System and the cardiovascular, gastrointestinal, and neuromuscular systems. Inflammation caused by chronic stress can lead to an impaired immune system resistance as well as hormonal and metabolic imbalances. The physical effects of stress can cause such seemingly unrelated conditions as elevated glucose levels, high blood pressure, anxiety, memory loss, weight gain, muscle tension and weakness, headaches, abdominal pain, joint pain, hair loss, and even wrinkles.
5. What is the treatment for inflammation?
A treatment plan for inflammation is based on the consideration of the medical history, lifestyle, physical exam, symptoms, and testing of the individual patient. The best measurement for chronic inflammation is a blood test that detects the level of a protein that is associated with inflammation in the artery walls. The goal is to restore the physiologic balance by controlling and removing the excesses that contribute to tissue inflammation, such as high blood pressure, cholesterol, or stress and replacing deficiencies, such as nutrients, hormones, or sleep.
6. What is the effect of stress on the adrenal glands?
Acute stress increases the production of cortisol, but chronic stress can lead to a depletion of cortisol levels. This situation is known as adrenal fatigue which can lead to chronic fatigue, a condition that can be both physically and psychologically disabling. The end result of chronic stress is a depletion in the production of all major hormones, including estrogen, progesterone, testosterone, growth hormone, and thyroid hormones.
1. What is adrenal fatigue?
Adrenal fatigue occurs when the adrenal glands (situated above the kidneys) are overworked or damaged, which results in a significant reduction in the amount of adrenal hormones secreted. The adrenals mobilize the body’s response to physical and emotional stress through hormones that regulate energy production, heart rate, muscle tone, and other processes that help to cope with stress. When the major adrenal hormones, which include cortisol and adrenaline, among several others, are depleted, the body is no longer able to meet the demands of stress. This syndrome is most commonly associated with intense or prolonged stress and may also arise during or after acute or chronic infections.
2. What causes adrenal fatigue?
It is estimated that up to 80% of North Americans have adrenal fatigue at some point in their lives. Since stress causes the adrenal glands to produce large amounts of adrenal hormones, chronic stress can be a major cause of adrenal fatigue. During an illness, a life crisis, or a difficult situation, the adrenal reserves of even the healthiest person may be compromised and chronic fatigue may develop. Other causes might be cardiovascular, respiratory, liver or kidney disease, endocrine, neurologic, or metabolic disorders, fibromyalgia, rheumatoid arthritis, cancer, allergies or sinusitis, and exposure to toxins. Factors such as a poor diet, inactivity or excessive exercise, lack of sleep, certain medications such as corticosteroids, drug or alcohol abuse, or constant anger can also make an individual more prone to adrenal fatigue.
3. What are the symptoms of adrenal fatigue?
The primary symptom is fatigue that is not relieved by sleep. A person suffering from adrenal fatigue may act and look relatively normal and may not have any obvious signs of physical illness, but they live with a continual general sense of “unwellness” and complain of multiple, and often debilitating, symptoms. Some of the more common symptoms of adrenal fatigue are difficulty getting up in the morning, chronic neck or back pain, mild depression or anxiety, inability to lose weight, poor blood sugar control, frequent infections, cravings for salty, fatty, or high-protein foods, reduced memory and concentration, reduced sex drive, increased effort to do everyday tasks and increased time to recover from illness or injury, worsening of allergies, gastrointestinal problems, increased premenstrual syndrome, lack of energy, and decreased tolerance and ability to handle stress.
4. How is adrenal fatigue treated?
Treatment is based on the level of severity, as determined by the results of blood and salivary testing and the evaluation of the physician. Mild adrenal insufficiency may be treated with supplements, while moderate adrenal fatigue may involve the removal of substances that cause allergies, and treating the illness or disease processes that are associated with the adrenal fatigue. In more severe cases, an aggressive supplement program, hormone replacement, and lifestyle modifications may be necessary. Mild adrenal fatigue usually responds to treatment within days to weeks, with noticeable differences in energy levels often in the first week. In moderate adrenal fatigue, differences in energy levels are generally noted within six to eight weeks. Severe adrenal fatigue may require a treatment program of six months to two years, with symptoms usually improving in two-three months.
5. How are fibromyalgia and adrenal fatigue related?
Fibromyalgia, a disorder characterized by chronic pain and fatigue as well as sleep and memory disturbances, is aggravated by high stress levels. The adrenal glands, the “stress glands”, are directly affected by this chronic condition, and the dysfunction that occurs then further contributes to the symptoms of fibromyalgia, particularly fatigue and joint pain.
Hormones and Hormone Replacement
1. What are hormones?
Hormones are biochemical messengers that carry signals from one cell to another via the blood and transport information from the brain to the organs and from the organs back to the brain. Virtually all multi-cellular organisms have hormones, including plants, and they are essential to the biological advancement of the life cycle. If the hormones are not functioning properly, or are out of balance, the aging process and the diseases associated with aging may be exacerbated.
2. What are the functions of hormones?
Hormones rejuvenate, regenerate, and restore our bodies. They regulate the function and metabolic activity of the body’s tissue and organs and even regulate the production and release of other hormones. Tissue repair, inflammation, bone and muscle structure, brain function (mood, libido, and memory), energy levels, body weight, fertility, and immune function are all processes that are controlled by hormones.
3. What are the major hormones and where are they produced in the body?
The major hormones are cortisol, thyroid hormone, insulin, melatonin, growth hormone, adrenaline, testosterone, estrogen, and progesterone. They are produced in the pituitary and pineal glands (located in the brain), in the thyroid (neck), and adrenal (above the kidneys) glands, and in the ovaries and testicles.
4. How do hormones affect health and the aging process?
Since the hormones influence the function of organs throughout the body, too much or too little can cause imbalances that can have serious health consequences. In males and females, hormone levels begin to decline at age twenty and the gradual loss of function in the subsequent years is attributed to “getting old”. Stress, biological programming, prescription drugs, environmental inputs, and lifestyle habits can all impact the production and regulation of hormones, but hormone replacement and rebalancing can help to insure that you resist infection, prevent chronic disease, and feel (and look) your best.
5. How do hormones affect appearance?
A decline in hormones, especially estrogen in women and testosterone in men, affects all of the body’s tissue and organs. The elasticity, suppleness, and thickness of the skin and the size and tone of the muscle groups are, perhaps, the most noticeable effects of hormonal decline. Hormone replacement, along with exercise and adequate nutrients and hydration can significantly improve muscle mass and the texture and tone of the skin.
6. What is hormone replacement therapy?
Hormone replacement therapy refers to the supplementation of a hormone or a combination of hormones that the body is deficient in to control symptoms related to the deficiency and the imbalances and dysfunction that result from hormone depletion.
7. What happens when hormones are not replaced?
In males, when testosterone production drops, muscle fiber and bone density decreases, as does endurance, strength, and stamina. This syndrome, known as “andropause”, or “male menopause”, is also responsible for a drop in libido and deterioration in sexual performance. Additionally, studies clearly show that the loss of testosterone contributes to the development of atherosclerosis and the narrowing of coronary arteries, which can lead to heart attacks, stroke, and sudden death. The most commonly prescribed hormones for women are estrogen and progesterone, to control the symptoms of menopause, which is defined as the absence of menstrual periods for 12 months and the cessation of ovulation. Hormone replacement in women is also important for the prevention or treatment of cancer, osteoporosis, heart disease and other age-related diseases.
8. Doesn’t hormone replacement in females increase the risk of breast cancer and
heart disease?
In 2002, The Women’s Health Initiative Study demonstrated increased risks of breast cancer and heart disease with synthetic hormones. There is currently no evidence, however, that replacing low hormone levels with natural, or bio-identical, hormones increases the incidence of either breast cancer or heart disease. In fact, the risk of dying from breast cancer or heart disease has been shown to be significantly higher when low hormone levels are not replaced.
9. What are bio-identical hormones?
Bio-identical hormones have the same chemical structure as the hormones that are produced in the human body. They are generally derived from plant sources such as soybeans and yams and are not under the jurisdiction of the Food and Drug Administration. They are obtained by prescription from specialists referred to as “compounding pharmacists”.
1. What are nutritional supplements and why do we need them?
Nutritional supplements are micronutrients classified as vitamins and minerals, that are involved in the metabolic processes in the body responsible for energy production. The typical western diet does not contain adequate amounts of many of the vitamins and minerals that are necessary for normal metabolism. A recent study found that in order to take in the recommended amounts of nutrients, it would be necessary to consume over 5,000 calories a day.
2. Are the recommended daily allowances (RDA’s) adequate for optimal health?
The recommended daily allowances for vitamins and other supplements are determined for minimallevels of health and the prevention of major deficiencies. The RDA’s are not considered to be adequate for the prevention of the degenerative changes associated with aging. Adequate amounts and the proper balance of nutritional supplements can help control elevations of blood pressure, blood sugar, and cholesterol, strengthen the immune system, improve stamina and performance, and reduce tissue inflammation.
3. How do I know which supplements I need?
The specific supplements and the amount required by can be determined with special blood tests and the assessment of the health care professional based on an individual’s physiologic profile and description of symptoms.
4. What are the most commonly recommended supplements for optimal health and
disease prevention?
The most commonly recommended supplements can be classified as “antioxidants”, the “B” vitamins, minerals, and several other key nutrients that reduce inflammation, protect the cells, improve organ function, and balance metabolic processes. Antioxidants, substances that neutralize the effects of cancer-causing free radicals, include the vitamins C and E, Beta-Carotene, Co-enzyme Q10, selenium, melatonin, and lipoic acid. The B vitamins, which are important for proper metabolism, controlling cholesterol and homocysteine levels (a risk factor for atherosclerosis), and the production of red blood cells and adrenal hormones include thiamin, riboflavin, niacin, pantothenic acid, and folic acid. Some of the essential minerals for the prevention and reversal of chronic disease are calcium, magnesium, chromium, and iodine. Other key “anti-aging” nutrients include vitamin D, garlic, glucosamine, ginseng, green tea extract, saw palmetto, lecithin, acai berry, and omega 3 fatty acids (fish oil).