Life Extension Magazine January 2013
Conference Report: The 4th American Academy of Anti-Aging Medicine Conference
My interest in life extensionists in far-off lands was a major motivation for me to attend the American Academy of Anti-Aging Medicine conference in Thailand. Despite its name, the American Academy of Anti-Aging Medicine (A4M) has done an impressive job of organizing anti-aging conferences all over the world.
Life extension is nothing new to Asia, of course. While ancient Western alchemists were trying to turn lead into gold, Eastern alchemists were searching for the elixir of immortality. Even today, the wish for a long life is still more frequently heard in Asia than in the West.
Although a variety of topics were covered at the conference—including both cosmetic rejuvenation and health and wellness—the most notable topics that stood out were those involving the role hormones play in the aging process.
The Importance of Hormones in the Anti-Aging Equation
There is no more obvious example of the failure of conventional medicine than in the use of hormone replacement for post-menopausal women. Conventional medicine uses FDA-approved Premarin® (pregnant mare's urine) as estrogen, and Provera® (a synthetic version of progestin) as progesterone for hormone replacement therapy (HRT). But just because it's FDA approved doesn't make it safe—and the Women's Health Initiative study proved that.
The Women's Health Initiative study, which only used Premarin® and Provera® in post-menopausal women, was so devastating that it had to be halted early due to evidence of increased breast cancer, cardiovascular disease, and stroke in the Premarin®-Provera® group.1
Although many in conventional medicine regard this failure of FDA-approved drugs as proof that any hormone replacement in post-menopausal women is dangerous, that's the equivalent of throwing the proverbial baby out with the bathwater. Hormone replacement therapy can have dramatic health and life-extending benefits for women, provided the hormones used are bioidentical—or those that are chemically identical to those that naturally occur in the human body. (An important note: natural human estrogen consists of estradiol, estrone, and estriol, with estriol being a much weaker estrogen than estradiol or estrone. Bioidentical hormone replacement is often not bioidentical in the sense that a greater than natural percentage of estriol has been used to avoid the cancer-promoting effects of estradiol.)
A4M presenter Dr. Kent Holtorf wrote an extensive review in the journal Postgraduate Medicine2 demonstrating that hormones bioidentical to natural human estrogens and progesterone do not have the risks associated with their horse-urine or synthetic counterparts.
Dr. Holtorf is not surprised at all by the negative results of the Women's Health Initiative, especially given the evidence that Provera® negates the cardioprotective effects of estrogen, in contrast to progesterone, which boosts those effects.2 Estriol, on the other hand, selectively binds estrogen receptors that inhibit cell proliferation, potentially preventing breast cancer. (Ironically, the FDA opposes the use of estriol.)
Conventional medicine mistakenly equates Provera® with human progesterone and Premarin® with human estrogens on grounds that no clinical trials have directly compared bioidentical sex hormones with nonbioidentical sex hormones. Dr. Holtorf has replied that "evidence-based medicine does not mean that data should be ignored until a randomized trial of a particular size and duration is completed" ― noting that estriol has been used for decades without reported safety concerns and that Premarin® contains the non-human estrogen equilin sulfate, which promotes cancer.2
An Alternative to Bioidentical Hormones
It's possible to achieve some of the effects of bioidentical hormones without taking hormone replacement therapy, as Dr. Sandford Swartz pointed out during his talk at the A4M conference. Dr. Swartz, who has been living in Thailand for 20 years, is enthusiastic about Pueraria mirifica, a plant that grows exclusively in Thailand. Pueraria mirifica contains the plant estrogen miroestrol, which has similar effects to estriol.
Although miroestrol is not bioidentical to any human estrogen, it could still provide many beneficial effects for women. And since many women in Thailand take Pueraria mirifica daily, it could be one of the reasons why the incidence of breast cancer in Northern Thailand (particularly the Nakhon Phanom province along the Laotian border) is among the lowest in the world...less than 10% of that in the United States.3,4 Pueraria mirifica has been shown to reverse vaginal atrophy in postmenopausal women.3 The Thai equivalent of the FDA has approved Pueraria mirifica as a treatment for menopause.
Before searching for Pueraria supplements online, you should be aware that cheaper and less effective (if not harmful) variants of Pueraria (such as Pueraria candoleii) are being shipped out of Thailand and marketed as if they were Pueraria mirifica.
Hormones and Men
Hormone replacement therapy is not just for women. Holtorf also supports testosterone replacement in men, referring to evidence that testosterone has declined substantially in all American men in recent decades.6 Some would argue that supplemental testosterone increases the risk of prostate cancer, but Holtorf argued that no well-designed study has proven that the risk of prostate cancer increases with testosterone replacement.7 He suggested that testosterone receptors become less sensitive with age, and that using 50% above youthful levels of testosterone might be required in order to achieve appropriate testosterone levels.
Exercise plays an important role in hormone levels as well. Dr. Tanjung Subrata presented the results of his literature reviews and clinical practice on the effects of exercise on testosterone levels at the A4M conference. He noted that growth hormone and sex hormones decline with age, and that exercise can increase insulin sensitivity while raising levels of growth hormone and testosterone. 8,9 Six to eight weeks of acute resistance exercise increases testosterone in both men and women.9 However, more than 60 minutes of endurance (aerobic) exercise has been shown to reduce testosterone.10 In order to maximize testosterone blood levels, Subrata recommends endurance exercise duration of 30-60 minutes, with 24-48 hours between exercise sessions.
An Overlooked Cause of Hormone Deficiency
Dr. Marc Gordon said that many people suffer from hormone deficiency not only because of aging, but also as a result of a traumatic brain injury. He said that he had an "epiphany" upon reading a 2004 article associating low growth hormone with boxing.11 Because the pituitary gland in the brain is the "master gland" regulating other hormones, brain trauma has been linked to hypopituitarism (underfunctioning of the pituitary gland) which reduces the secretion of a number of hormones.12,13,14 Gordon said that head injury victims are often treated with antidepressants when what they really need is hormone replacement.15 Listing the symptoms of traumatic brain injury, he said that the most common complaint is chronic fatigue, followed by excessive sleepiness. This could be an important factor in the treatment of those with traumatic brain injuries. (Life Extension Magazine® did an extensive report on Dr. Gordon's traumatic brain injury treatment program utilizing hormones in the January 2012 issue.)
Nine Additional Anti-Aging Topics Covered at the A4m Conference
Skin Cells Promote Self-Renewal
In 2003, Dr. Christoph Ganss founded the world's first tissue bank for stem cells of the skin (called TICEBA). His motto for TICEBA is "back up your life," because of the variety of stem cells that can be found in skin.16 Ganss said that 2-5% of cells in the skin meet the criteria for mesenchymal stem cells. Mesenchymal stem cells have a great capacity for self-renewal, can differentiate into bone, cartilage, or fat ― and can be used for type II diabetes, cardiac regeneration, multiple sclerosis, and many other conditions.
Growth Factors Reverse Recent Hair Loss
The presentation by Dr. Ahmed Al-Qahtani was one of the few sessions I attended in the esthetics/cosmetics series. When he said that 50% of people experience hair loss by age 50, he was including the effects of menopause in women with male pattern baldness. In his practice, he has made use of the recent discovery of the potential for growth factors to induce hair regrowth.17 Growth factors are more effective for reversing recent hair loss (where follicles have become dormant) than for frank baldness. It's important to note that although the effects of growth factors are noticeable, they are far less dramatic than what is seen for hair transplants.
Personalized Cancer Treatment Clinic
Dr. Greg Burzynski is board certified in internal medicine, and works in a personalized cancer treatment clinic in Texas the Burzynski Clinic, founded by his father, Stanislaw Burzynski. The clinic analyzes the cancer genome of patients and currently uses "antineoplastons" (anti-cancer agents not currently approved by the FDA) that target numerous cancer genes.18 The clinic uses acupuncture for the pain, anxiety, and depression associated with cancer. The patients receive curcumin and fish oil supplements. When I asked him why he does not analyze the genome of his patients as well as their cancer cells, he told me that it is mainly a matter of keeping the cost affordable, but he acknowledged that doing so could be useful.
The World's Best Medical Spas
Eric Light was founder and first president of the International Medical Spa Association. Unlike other spas, medical spas are more concerned with health and therapy rather than beauty and pampering. He said that 72% of people surveyed would rather feel healthy on the inside than look good on the outside and this percentage increases with age. Noting that Thailand is a popular destination for "medical tourists" seeking treatments that are not available or are too expensive in their native country (Bangkok Hospital has a Japanese wing), he identified Thailand's Kamalaya (www.kamalaya.com) as one of the best medical spas anywhere.
Three Bridges to Longevity
In the spirit of the book Fantastic Voyage: Live Long Enough to Live Forever, which he co-authored with Ray Kurzweil, Dr. Terry Grossman provided an update for an article he had published in 2005,19 which identified three bridges to longevity. In Bridge One (best current medicine) he gave examples of the increasing availability of portable medical devices, noting that portable ultrasound devices (Vscan) are replacing stethoscopes. He said that Bridge Two would anticipate rather than treat disease, but he identified stem cells as the key Bridge Two technology, "bio-printing of organs" in particular. Bridge Three (nanotechnology) is more in the future, and he believes it will be possible for humans to replace and rewrite their genetic code.
Myostatin Blockers Reduce Frailty in Elderly
Dr. Richard DeAndrea said that the placenta is the most versatile of organs. His company MFIII (of which he is Medical Director) produces placenta supplements by a process that involves no heat, no drying, fat removal, and enzyme treatment. These are usually animal placentas, but human placenta products can be made available for a higher price. MFIII also sells a myostatin blocker. Myostatin is a cytokine that inhibits muscle formation and promotes fat formation. Blocking myostatin could reduce the effects of sarcopenia, a condition associated with frailty in the elderly.20 DeAndrea said myostatin blockers build muscle better than anabolic steroids and, unlike steroids, cannot be detected in athlete testing. He told me that he has moved to Thailand and is moving his family to Thailand including his parents because Thailand provides more medical freedom and has more sound monetary policies than the United States.
Flavonoids Increase Life Span
Dr. Cimen Karasu is the head of the Department of Medical Informatics in the Faculty of Medicine at Gazi University in Turkey. She has authored more than a hundred papers appearing in peer-reviewed journals. Dr. Karasu's talk was largely a review of the damaging effects of free radicals and advanced glycation end-products (AGEs). She noted that flavonoids have been shown to increase the life span of nematode worms.21 She reviewed the benefits of a number of natural polyphenols, including quercetin and pomegranate extracts.22,23 She is starting a company in Turkey which will market a formulation based on olive leaf polyphenols.24,25
Algae's Health Benefits
Doctor Randall Merchant is a Professor of Anatomy and Neurobiology in Virginia. He spoke about the benefits of Chlorella, a unicellular green algae that has the highest chlorophyll content of any known organism. Chlorella has been shown to protect against DNA damage and telomere shortening due to free radicals,26 to boost the immune system,27 and to protect against environmental dioxin toxins.28
Mushrooms Enhance Immunity
Dr. Jennifer Wan is an Associate Professor at the University of Hong Kong. She spoke of the benefits of the mushroom Phellinas spp, which can stimulate cell-mediated immunity,29,30,31 can protect against free radicals,32,33 and is effective against a number of inflammatory agents.34 She noted the long and distinguished history of the use of mushroom in traditional Chinese and Korean medicine.
Although the FDA views anti-aging medicine as an endeavor without scientific merit, the A4M conferences represent a broad tent of scientific quality. Although the Thailand A4M conference has been the largest A4M conference in Asia, the first A4M conference in Shanghai, China, scheduled for the following is expected to attract three times as many participants. The excitement that A4M is generating in Asia is very encouraging for the future of anti-aging medicine. •
If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.
1. Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321-33.
2. Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? Postgrad Med. 2009 Jan;121(1):73-85.
3. Available at: http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=73. Accessed October 10, 2012.
4. Available at: http://www.nci.go.th/File_download/Cancer%20In%20Thailand%20IV/C-II-13.PDF. Accessed October 10, 2012.
5. Manonai J, Chittacharoen A, Theppisai U, Theppisai H. Effect of Pueraria mirifica on vaginal health. Menopause. 2007 Sep-Oct;14(5):919-24.
6. Travison TG, Araujo AB, O'Donnell AB, Kupelian V, McKinlay JB. A population-level decline in serum testosterone levels in American men. J Clin Endocrinol Metab. 2007 Jan;92(1):196-202.
7. Morgentaler A. Testosterone replacement therapy and prostate cancer. Urol Clin North Am. 2007 Nov;34(4):555-63,vii.
8. Kessler HS, Sisson SB, Short KR. The potential for high-intensity interval training to reduce cardiometabolic disease risk. Sports Med. 2012 Jun 1;42(6):489-509.
9. Kraemer WJ, Staron RS, Hagerman FC,et al. The effects of short-term resistance training on endocrine function in men and women. Eur J Appl Physiol Occup Physiol. 1998 Jun;78(1):69-76.
10. Tremblay MS, Copeland JL, Van Helder W. Influence of exercise duration on post-exercise steroid hormone responses in trained males. Eur J Appl Physiol. 2005 Aug;94(5-6):505-13.
11. Kelestimur F, Tanriverdi F, Atmaca H, Unluhizarci K, Selcuklu A, Casanueva FF. Boxing as a sport activity associated with isolated GH deficiency. J Endocrinol Invest. 2004 Dec;27(11):RC28-32.
12. Bondanelli M, Ambrosio MR, Zatelli MC, De Marinis L, degli Uberti EC. Hypopituitarism after traumatic brain injury. Eur J Endocrinol. 2005 May;152(5):679-91.
13. Schneider HJ, Schneider M, Saller B, Petersenn S, Uhr M, Husemann B, von Rosen F, Stalla GK. Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol. 2006 Feb;154(2):259-65.
14. Estes SM, Urban RJ. Hormonal replacement in patients with brain injury-induced hypopituitarism: who, when and how to treat? Pituitary. 2005;8(3-4):267-70.
15. Koponen S, Taiminen T, Portin R, Himanen L, Isoniemi H, Heinonen H, Hinkka S, Tenovuo O. Axis I and II psychiatric disorders after traumatic brain injury: a 30-year follow-up study. Am J Psychiatry. 2002 Aug;159(8):1315-21.
16. Liang L, Bickenbach JR. Somatic epidermal stem cells can produce multiple cell lineages during development. Stem Cells. 2002;20(1):21-31.
17. Park BS, Kim WS, Choi JS, et al. Hair growth stimulated by conditioned medium of adipose-derived stem cells is enhanced by hypoxia: evidence of increased growth factor secretion. Biomed Res. 2010 Feb;31(1):27-34.
18. Burzynski SR. Gene silencing--a new theory of aging. Med Hypotheses. 2003 Apr;60(4):578-83.
19. Grossman T. Latest advances in antiaging medicine. Keio J Med. 2005 Jun;54(2):85-94.
20. Haidet AM, Rizo L, Handy C,et al. Long-term enhancement of skeletal muscle mass and strength by single gene administration of myostatin inhibitors. Proc Natl Acad Sci U S A. 2008 Mar 18;105(11):4318-22.
21. Grünz G, Haas K, Soukup S,et al. Structural features and bioavailability of four flavonoids and their implications for lifespan-extending and antioxidant actions in C. elegans. Mech Ageing Dev. 2012 Jan;133(1):1-10.
22. Stefek M, Karasu C. Eye lens in aging and diabetes: effect of quercetin. Rejuvenation Res. 2011 Oct;14(5):525-34.
23. Karasu C, Cumaoglu A, Gürpinar AR,et al. Aldose reductase inhibitory activity and antioxidant capacity of pomegranate extracts. Interdiscip Toxicol. 2012 Mar;5(1):15-20.
24. Cumaoglu A, Rackova L, Stefek M, Kartal M, Maechler P, Karasu C. Effects of olive leaf polyphenols against H O toxicity in insulin secreting-cells. Acta Biochim Pol. 2011;58(1):45-50.
25. Cumaoğlu A, Ari N, Kartal M, Karasu Ç. Polyphenolic extracts from Olea europea L. protect against cytokine-induced β-cell damage through maintenance of redox homeostasis. Rejuvenation Res. 2011 Jun;14(3):325-34.
26. Makpol S, Yaacob N, Zainuddin A, Yusof YA, Ngah WZ. Chlorella vulgaris modulates hydrogen peroxide-induced DNA damage and telomere shortening of human fibroblasts derived from different aged individuals. Afr J Tradit Complement Altern Med. 2009 Jul 3;6(4):560-72.
27. Kwak JH, Baek SH, Woo Y, et al. Beneficial immunostimulatory effect of short-term chlorella supplementation: enhancement of natural killer cell activity and early inflammatory response (Randomized, double-blinded, placebo-controlled trial). Nutr J. 2012 Jul 31;11(1):53.
28. Takekoshi H, Suzuki G, Chubachi H, Nakano M. Effect of Chlorella pyrenoidosa on fecal excretion and liver accumulation of polychlorinated dibenzo-p-dioxin in mice. Chemosphere. 2005 Apr;59(2):297-304.
29. Park SK, Kim GY, Lim JY, Kwak JY, Bae YS, Lee JD, Oh YH, Ahn SC, Park YM. Acidic polysaccharides isolated from Phellinus linteus induce phenotypic and functional maturation of murine dendritic cells. Biochem Biophys Res Commun. 2003 Dec 12;312(2):449-58.
30. Kim GY, Oh WK, Shin BC, Shin YI, Park YC, Ahn SC, Lee JD, Bae YS, Kwak JY, Park YM. Proteoglycan isolated from Phellinus linteus inhibits tumor growth through mechanisms leading to an activation of CD11c+CD8+ DC and type I helper T cell-dominant immune state. FEBS Lett. 2004 Oct 22;576(3):391-400.
31. Chang ZQ, Oh BC, Lee SP, Rhee MH, Park SC. Comparative immunomodulating activities of polysaccharides isolated from Phellinus spp. on cell-mediated immunity. Phytother Res. 2008 Oct;22(10):1396-9.
32. Ayala-Zavala JF, Silva-Espinoza BA, Cruz-Valenzuela MR, et al. Antioxidant and antifungal potential of methanol extracts of Phellinus spp. from Sonora, Mexico. Rev Iberoam Micol. 2012 Jul-Sep;29(3):132-8.
33. Chen W, Feng L, Huang Z, Su H. Hispidin produced from Phellinus linteus protects against peroxynitrite-mediated DNA damage and hydroxyl radical generation. Chem Biol Interact. 2012 Jul 20.
34. Huang GJ, Huang SS, Deng JS. Anti-inflammatory activities of inotilone from Phellinus linteus through the inhibition of MMP-9, NF-kB, and MAPK activation in vitro and in vivo. PLoS One. 2012;7(5):e35922.