Anti-aging medicine earns converts and critics

Dee Martin of Marietta leads an active life. At 51, she hits the gym five days a week. She eats organic foods. Her weekend activities include mountain hikes and bike riding. But for some reason, no matter how much she followed the rules, she never seemed to drop the little bit of weight she wanted to lose.

After a visit to Dr. Ken Knott for a shoulder injury led to a discussion about hormone levels and testing, Martin made the connection. She had an underactive thyroid.

To improve her thyroid function, she began taking a thyroid supplement. She also took bioidentical hormones — hormones that are identical in molecular structure to hormones made in the body. She tweaked her diet, per Dr. Knott’s suggestions. In two months, Martin lost 15 pounds. Her skin, which had been dry and loose — a trait she had assumed she’d inherited from her mother — became smoother and firmer, with her wrinkles less noticeable.

Martin was hooked on a growing, if controversial, medical focus known as anti-aging medicine.

“I just want to age gracefully the way I am supposed to,” Martin said. “With Dr. Knott’s program, you don’t feel as old or look as old.”

Knott is one of more than 100 doctors in the state listed with the American Academy of Anti-Aging Medicine (A4M), an organization created in 1992 to advance technologies that prevent and treat age-related disease as well as support research on extending life. Anti-aging medicine is not recognized as a specialty by the American Board of Medical Specialties. Doctors who practice anti-aging medicine use a range of treatments and therapies, including bioidentical hormones and supplements, that continue to be the subject of debate in the medical community.

Using hormones to replace a deficiency is generally accepted by most physicians, said Dr. Lawrence Phillips, an endocrinologist at Emory University Hospital. But using hormones to battle old age or improve health in non-deficient individuals is unproven.

No research has shown that hormone therapies add years to life or prevent age-related frailty, according to the National Institute on Aging (NIA), part of the federal government’s National Institutes of Health (NIH). Some hormones may have harmful side effects, according to the NIA, and the bioidentical hormones prescribed by many anti-aging doctors have not been subjected to rigorous testing for safety and efficacy.

“It is easy to get seduced into the claim that there is something called anti-aging medicine,” said S. Jay Olshansky, a longevity specialist and professor at the School of Public Health at the University of Illinois at Chicago. “Exercise is about the only equivalent of a fountain of youth that exists today. It improves skin elasticity, muscle tone, bone density — and you can do it for free, or pretty much free.”

Anti-aging medicine has a long history, Olshansky said, with treatments such as caloric restriction and a precursor to hormone therapy surfacing in the pre-20th century. While many of today’s anti-aging practitioners have their patients’ health and best interests in mind, Olshansky said, others are not far removed from the dollar-chasing hucksters of the past. “I am optimistic that something is going to happen and happen soon that will allow us to slow the biological process,” Olshansky said. “But it is not anything that is out there today.”

Yet, with 8,000 people turning 65 each day for the next 18 years, the modern anti-aging movement gains followers daily, and many have no problem paying for the possibility of preserving their youthful qualities.

In his new book, “Use Your Brain to Change Your Age,” (Crown Archetype, $26), Dr. Daniel G. Amen details the journey of one patient from face-lift candidate to anti-aging convert. Amen, best known for his appearances on the Dr. Oz Show and his practice of using brain scan technology coupled with psychiatry to address a range of health issues, challenges readers to hold off on cosmetic surgery while spending six months to a year making life changes that ultimately will make them look younger.

“A lot of people don’t know that your skin is really an outside reflection of the health of your brain,” said Amen, who opened one of his Amen Clinics — which gross $20 million a year — in Atlanta this month. “Both your brain and your skin, their health in large part is determined by blood flow. Anything that decreases blood flow impairs the health of both organs.”

Blood flow can be reduced by everything from smoking to eating poorly to exposing your body to too many toxins, he said. “I always joke that we care more about our boobs, bellies and butts than our brains,” said Amen, referring to the “plastic society” of Newport Beach, Calif., where he resides. “There is some of that going on in Atlanta too.”

But some in Atlanta are also embracing new therapies, even as debate continues about their legitimacy.

For almost 20 years, Don Westbrook tried to outsmart his genes. He ate a low-fat diet, limited animal proteins and minimized stress. But at 50, he found himself sitting at the doctor’s office with the feeling that something wasn’t right. An electrocardiogram showed Westbrook was, in fact, having a heart attack, as had every adult male in his family.

“On the spot they gave me nitroglycerin. The next day, I had six bypasses,” said Westbrook. That was 18 years ago, and today, the spry 68-year-old says he looks and feels healthier than ever.

Westbrook has been Dr. Knott’s patient for more than a decade, and on his very first visit Knott sent him home to read a book on nutrition. Westbrook embarked on a plan of eating and exercising that he believes has helped him regain and retain his youthful qualities. Recently, that regimen began including testosterone and human growth hormone, he said. “I feel good and I have a lot of energy,” said Westbrook, who works out three times a week with a trainer.

In the early years, Knott admits he was out of his comfort zone. Though his certification is in physical medicine and rehabilitation, he began to include anti-aging medicine in his practice in the early 1990s after a 48-year-old female patient who suffered debilitating pain in her knee showed up in his office.

A colleague suggested Knott test her testosterone level. When he discovered that the test did not detect any testosterone in her system, he prescribed the hormone. Five weeks later, the patient called to say she had danced with her husband for the first time in more than two years, Knott said.

It was Knott’s initiation into the world of age management, which he believes will change the way aging is viewed and treated in this country and beyond.

“We are experts in treating illness. The focus isn’t on wellness. That is a new paradigm,” Knott said. “The body is a wonderful mechanism if you let it do its work.”

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