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I am getting old! How can I fight the aging process?

I am getting old! How can I fight the aging process?

Dear Doctor,
I just turned 50 years old, and I am starting to see some changes in my look and how I feel that I don’t like.  I want to be proactive in fighting off the aging process for as long as I can.  Can you give me some ideas as to how I win this fight?

Marco Island, FL

Thank you Andrew for your question.

Patients often asked me, “What is normal for my age.”  As simple as this question sounds it is quite difficult to answer, as each person is unique and experiences life and the aging process in diverse ways.

Generally speaking, every human body undergoes many changes during the aging process.  There are several ‘normal’ age-related changes as well as ‘abnormal’ changes.  Now more than ever, with the advancements in anti-aging medicine, we are starting to be able to address some of these changes as ‘optional.’  The explosion in age-related research that has been done since the 1990’s has shown us that aging is not necessarily inevitable and is caused by accumulated damage and genetic changes.  I believe rather than fighting the individual chronic diseases associated with the aging process, addressing the root of the problem – the aging process itself, will help to answer our original question.

What is normal aging?

Signs of aging can start as young as age 30.  The process of aging includes many changes in the body and the mind.  Some of the more prominent changes that plague the human body are:

  • Stiffening of arteries and weakening of the veins which makes the heart have to work harder.  This causes physical activities such as walking long distances or walking uphill to become more difficult.
  • Bones shrink and reduce in density, making them more fragile and likely to break.  Cartilage in joints may start wearing away, which can cause pain and stiffness.
  • Muscles begin to lose strength, flexibility, and endurance over time.  Muscle mass decreases 3% to 5% every decade after 30 years of age, and that rate increases once you are over age 60.
  • The ability of the urinary bladder to stretch and contract reduces and, in men, the prostate starts to enlarge and, in women, the pelvic floor muscles weaken.
    This may cause the bladder to hold less urine and make it more difficult to maintain a urine stream, resulting in more frequent trips to the bathroom.  Similar changes in the bowel can lead to chronic constipation.
  • Skin loses elasticity and the subcutaneous fat under the skin is redistributed to other parts of the body, resulting in wrinkles where there once were none, skin thinning causing it to becomes more delicate, making it easier to get bruises and cuts.
  • Hardening of the lens in the eyes can result in far-sightedness.
  • Cataracts, a clouding of the lens in the eye that affects vision, may develop.  This can cause blurry vision and ultimately blindness if not treated.
  • The aging of the mind also takes a toll and may mean slower processing speeds and more difficulty with multi-tasking.  However, routine memory, skills, and knowledge are stable and may even improve with age.  It’s normal to occasionally forget recent events such as where the keys were last placed or the name of the person you just met.
  • This being said, aging is a process with many changes, and it may take a little getting used to.  This process itself can also affect one’s psychological status.
    Some people may become depressed or regret things in their lives while others may have a sense of fulfillment and feel happy with the lives they have led.

What is NOT normal aging?

As discussed above, there are some normal age-related changes in memory and thinking, however, confusion and memory loss that interfere with your daily life are not part of the normal aging process.  Dementia is a term for a collection of symptoms of cognitive decline including disruptions in language, memory, attention, recognition, problem solving, and decision-making that interfere with daily activities.  Even though 5.8 million people in the United States have dementia, it is the most prominent example of what is not a part of the normal aging process.  Signs of dementia include not being able to complete tasks independently, difficulty with naming items or close family members, forgetting the function of familiar items, repeating questions, taking much longer to complete customary tasks, misplacing items frequently, not being able to retrace steps and getting lost.  Unfortunately, there currently is no cure for dementia, however, there are medications to help with the symptoms.

Certain medical conditions and vitamin deficiencies, such as hypothyroidism (under active thyroid), normal pressure hydrocephalus (a neurological condition caused by the build-up of fluid in the brain), infections, and vitamin deficiency, such as B1 and B12, can mimic dementia symptoms.

Additionally, some prescription, as well as over-the-counter, medications can cause dementia-like symptoms too.

Now for the good news!

There are several simple lifestyle modifications everyone can do to slow the aging process and reduce the risk of abnormal aging.  Things like:

  • If you are a smoker, stop smoking
  • Maintain a healthy blood pressure level
  • Manage cholesterol levels with exercise and, if needed, cholesterol medications
  • Keep blood sugar within a healthy range
  • Achieve and maintain a healthy weight
  • Reduce hazards in your environment that could lead to falls or head injury
  • Eat whole foods with plenty of nutrients and vitamins
  • Exercise, including aerobic physical activity
  • Get good quality sleep
  • Keep your mind active and stimulated, with challenging tasks such as learning a new activity or playing team card games like Bridge
  • Maintain social contacts

Most of the current medical anti-aging therapies revolve around hormone replacement, antioxidant vitamins and amino acids, aesthetics, and medications such as metformin.  These treatments help to address certain ‘normal’ aging issue such as:

  • In men, testosterone replacement therapy (TRT) is a very broad and common weapon in the anti-aging arsenal.  By restoring the body’s testosterone levels to those of a young adult, you are taking one giant step away from the aging process.  Testosterone deficiency plays a key role in several of the aforementioned signs of aging and replacing it can improve muscle mass and bone density, sex drive, erectile function, mood and quality of life, verbal memory and thinking ability, and increased red blood cell production through the bone marrow.  Several small studies in the early 2000s found that men with heart disease who underwent testosterone therapy saw improvements.  They were able to increase their walking distance by an average of 33% and another study found that testosterone replacement therapy widened healthy arteries.  A more recent, larger study found that men whose testosterone was returned to younger normal levels were 24% less likely to have a heart attack and 36% less likely to experience a stroke.
  • In women, hormone replacement carries considerably more risks due to the types of hormones that need to be replaced and how they are balanced.
    Estrogen, progesterone, as well as testosterone all need to be replaced in women and in the proper proportions.  When they are dosed correctly and only administered for a short period of time, in the lowest dosage possible, they are quickly able to combat symptoms of aging and menopause.  Some of the benefits include relief from hot flashes, mood swings, vaginal dryness, irritability, insomnia, palpitations, and joint aches.  In some cases, women have reported relief from hot flashes and night sweats only three weeks after beginning treatment.  After one to three months of administration, hormone replacement can reverse changes around the vagina and vulva.  The positive side effect of easing these symptoms is that women often experience less stress and anxiety in their everyday lives.  Hormone replacement can also help women avoid osteoporosis.  Unfortunately, the risks of female hormone replacement are considerable and include higher rates of heart disease, breast cancer, strokes, blood clots, and abnormal mammograms.  The probability of experiencing such risks increases the longer a woman stays on hormone replacement.
  • Aesthetic medicine is more geared toward fighting the visible effects of aging on one’s outward appearance.  However, some treatments not only help with our appearance but also work to improve internal functions.
    • Botulinum toxin A (Xeomin or Botox) is not only used to smooth out unwanted facial lines and wrinkles, but can also be highly effective at reducing aches caused by arthritis.  Additionally, when used in the urinary bladder it can ease aches and pains caused by overactive bladder as well as expanding the size of the bladder in the process.  This means your bladder will not only hold more liquid, but it won’t hinder you as much as it normally would.
    • Platelet Rich Plasma (PRP) is another example of an aesthetic therapy that benefits far beyond skin complexion.  PRP therapy does wonders for skin rejuvenation by regenerating damaged or aging cells, as well as to stimulate the secretion of collagen and other vital components of the extracellular skin matrix, which reduce the signs of aging, lessens acne and decreases fine lines & wrinkles.  Additionally, it has shown efficacy in regenerating bone, cartilage, as well as hair.  At Optimal Male, we also utilize Platelet Rich Plasma as the PRP-Shot for male sexual enhancement.
    • Dermal Fillers are composed of different viscosities of hyaluronic acid.  As we age, crucial components of the skin like collagen, elastin, and subcutaneous fat begin to degrade and redistribute.  In turn, cheeks may become sunken and hollow looking, lips lose fullness, and deep wrinkles form.  Enter dermal fillers, which are especially designed to add fullness and plumpness to the cheeks, lips, and eliminate deep wrinkles.
  • Metformin may be the first-ever anti-aging medication.  It is current the first line drug against diabetes.  It lowers blood sugar by decreasing liver production of glucose, decreasing intestinal absorption of glucose, and increasing cellular insulin sensitivity.  Another benefit of using metformin is activating AMPK (adenosine monophosphate-activated protein), an enzyme inside cells that lowers blood sugar by promoting energy utilization.  Activating AMPK has broad-ranging effects that extend far beyond blood sugar control.  Exciting studies have found that increasing AMPK activity can prevent—and even reverse—the life-shortening effects of cardiovascular disease, diabetes, neurode generative diseases, cancer, and more.
  • Antioxidant vitamins such as vitamin C, vitamin E and the B vitamins all have strong anti-aging properties and provide energy to our cells.  Amino acids such as Alpha lipoic Acid and glutathione are very powerful universal antioxidants.  These antioxidants help to limit DNA damage done by free radicals.  They help slow aging at the cellular level by reducing the strain on the DNA repair machinery and keeping our cells healthier longer.  Intravenous supplementation of these therapies is invaluable to ensure the efficacy of the nutrients.  Oral supplementation may not be as effective due to absorption issues.

And this is just the beginning.  As the race to cure aging has gone mainstream, recent scientific discoveries have shown promise for extending life, but will take a decade or more to reach the market.  The goal is to stay alive long enough so as to take advantage of these upcoming breakthroughs!

At Optimal Male, we specialize in treatments and therapies that help our patients look good and feel great!  If you would like to meet with my medical team and I to discuss how you can slow the aging process and live a more Optimal life, call us today for your FREE Medical Exam & Consultation.  239.596.8886

Look Good, Feel Great!

Richard Freier, M.D.
Medical Director
Optimal Male Performance Center
Office: 239.596.8886

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