Our current medical care system is based on the treatment of disease. We have the knowledge, technology, and expertise to prevent or delay the onset of many of the symptoms associated with aging, and in some cases to reverse them. It is my opinion that it is important to look in areas that are often not considered by my mainstream colleagues. By doing this, I believe we can guarantee a higher quality of life as we age.

Continued specialization by physicians dealing with specific symptom complexes limited to one or two organ systems plus our country’s insurance reimbursement system based on disease codes, do not allow even the most caring physicians to work within the existing framework to help patients in their quest for optimal health. As we learn more and more about the aging process, it has become painfully obvious that traditional medicine is not equipped to realistically help the patient population interested in staying healthy.

A new specialty area has arisen called “Age Management Medicine” – managing the aging process with hormonal and metabolic therapies to keep our bodies healthy – the ultimate preventive medicine. Contrary to some who would sensationalize, aging is not a disease, but rather a process, that hopefully, we will all experience over a lengthening period of time. The diagnostic and therapeutic tools we now have to manage aging, and those that will become available in the near future, have produced a clarion call for this new specialty. Opportunities are becoming available to not only maintain, but to regain youthful vigor and to live healthier, higher quality lives. Will we live longer? Probably, but we have not proven that yet.

In Age Management Medicine we believe that we can improve the quality of life by delaying chronic disease through the use of five principles: 1) education, 2) low glycemic diet, 3) exercise, 4) pharmaceuticals when indicated, and 5) hormone modulation. The assumption that aging is normal, with the decline in hormones and other bodily functions, is wrong. Many of the aging symptoms are really a disease and should be treated. Based on valid lab findings, replacement of hormones to the mean level of a 30-year-old should be the goal.

Hormone needs will vary widely by individual patient. In the case of female hormone replacement therapy in mainstream medicine, the hormones used have been equine hormones which do not work the same in humans. Natural “bio-identical” hormones are available and are much more effective without the negative side effects. Menopause involves much more than the loss of estrogen and progesterone. Menopause is part of something much bigger involving aging of your entire being. During menopause almost all the hormones in your body become deficient and the entire endocrine system must be evaluated in order to design hormonal and metabolic therapies to help manage the aging process and restore hormonal balance, with the aim of regaining and preserving youthful vigor.

Andropause is part of the aging process sometimes called “male menopause.” Andropause involves much more than the loss of testosterone; almost all the hormone levels in your body are becoming deficient or partially deficient after the age of 35. Hormonal and metabolic therapies can: 1) increase energy level – including sexual energy, 2) reduce body fat, 3) increase lean muscle, 4) increase bone density, 5) improve cognitive function, and 6) strengthen your immune system. Perhaps more importantly, testosterone therapy has been shown to reduce heart disease.

In addition to gender specific hormones, any individual may have many other hormones that should be supplemented to reach the optimal level, including Human Growth Hormone and DHEA, among others. There is evidence that growth hormone deficiency in adults is deleterious, increasing the risk of death from cardiovascular disease. As compared with age-matched and sex-matched normal subjects, adults with growth hormone deficiency have increased fat mass, reduced muscle mass and strength, smaller hearts and lower cardiac output, lower bone density, and higher serum lipid concentrations. They also have decreased vitality, energy, and physical mobility, emotional liability, feelings of social isolation, and disturbances in sexual function, despite adequate correction of hormonal deficiencies other than growth hormone deficiency.

In 1990 it was recognized that there are benefits of using growth hormone in the treatment of normal aging. In fact, there is absolutely no difference between the clinical signs and symptoms of aging and those of adult growth hormone deficiency described in the previous paragraph. The late Dr. Daniel Rudman first described the benefits of growth hormone therapy in normal aging adults. Dr. Rudman published a landmark article in the New England Journal of Medicine on July 7, 1990. In his article, Dr. Rudman showed that by putting healthy aging men on growth hormone for six months, he was able to decrease their body fat by 14.4%, increase muscle mass by 8.8%, increase skin thickness by 7.1%, and increase lumbar bone density by 1.6%. These exciting findings clearly inaugurated the movement to supplement growth hormone in healthy aging adults, which today is becoming commonplace.

The goals of growth hormone therapy in adults are to restore normal body composition, improve muscle and cardiac function, normalize serum lipid concentrations, and improve the quality of life. Healthful living depends on balancing our hormones at the upper end of the normal range and regaining and maintaining optimal health and vigor.

Hugo Pribor, M.D., Ph.D., FCAP is the medical director of Pribor and Associates, LLC and practices anti-aging medicine in Tampa, FL and Nashville, TN. (813) 282-7173 www.hpribor.com