However much we might tell ourselves that ageing is a natural process and we should ‘embrace our age’, if someone told us there was a sure-fire way to avoid the undesirable effects of ageing – wrinkles, saggy skin, weight gain and impaired energy levels – we’re not exactly going to say no, right? Well, many experts believe that such a fountain of youth is already within our reach. And unlike Botox or a facelift, it is completely natural and non-invasive. Dr Thierry Hertoghe, president of The World Society of Anti-Aging Medicine, explains: “Hormone deficiencies are the biggest reason we age. By treating these deficiencies we can not only slow down, but reverse the ageing process, by as many as five to 15 years. Within 20 to 30 years, we should have the ability – using hormones and stem cells as well as lifestyle changes – to reverse the age of a 70-year-old to the physical age of a 30-year-old.”
Grand claims, indeed! While hormone therapy has been around for a long time, the new paradigm in hormone science is the use of bioidentical hormones. We ask local and international anti-ageing experts for the low-down on the rather wordy but fascinating new world of bioidentical hormone replacement (BHR) therapy...
What is BHRT?
“Our hormones are chemical messengers that keep your body functioning,” says Dr Jen Landa, a US-based obstetrician/gynaecologist and international hormone specialist, who spoke at the third American Anti-Aging Conference held in Dubai last year. “From regulating metabolism and growth to controlling immune function and reproduction, hormones are major players in all that you do and all that you are – physically, at least.”
Our hormones are at their optimal level when we are between 18 and 25, and then start to decline from our mid-20s onwards. This results in imbalances, which throw off the harmony of the body and can lead to the undesirable effects that we associate with ageing – from weight gain to mood issues and lines on our skin.
Bioidentical hormone replacement therapy simply involves testing for those hormone deficiencies and then replacing the declining hormones, so that we are restored to our peak levels again. “The deterioration of the human body that results from ageing can be optimised through preventive treatments in which bioidentical hormones can play a pivotal role,” says Dr Thomas Redner of Eternity Medicine Institute in Dubai Marina. “By balancing our body’s hormone level, bringing it back to its optimal level, we can significantly increase our well-being and achieve a more youthful skin appearance. Hormone balance is absolutely essential to maintain healthy tissues in the skin, because they serve to optimise the water content and proportions of elastin and collagen in the tendons and muscles.”
Dr Landa agrees: “When we lose the influence of certain hormones in our body, we start to look and feel older. “Lack of oestrogen causes loss of elasticity in the skin and skin dryness, which increases the likelihood of wrinkles and sagging skin. Lack of progesterone causes poor sleep and higher stress levels. High stress and poor sleep also take their toll on our skin. Testosterone, in addition to helping with sex drive, also helps both men and women with energy, moods, memory, bone strength, muscle strength.”
The interesting thing about bioidentical hormones is that they have an identical molecular structure to the hormones that we have in our bodies naturally. They’re not found in this form in nature but are synthesised from a plant chemical extracted from yams and soy. Although bioidentical hormones are sometimes referred to as ‘natural’ hormones, this confuses things – one of the conventional sources of oestrogen that is still often prescribed is manufactured from a pregnant mare’s urine, which is also a natural source, but is not bioidentical to human oestrogen.
Is it safe?
Hormones don’t have the greatest reputation. This is partly because of the way they can be abused – think bodybuilders pumping themselves full of human growth hormone – and because of the link that was found (most notably the Women’s Health Initiative [WHI] trial that was brought to a premature end in 2002) between conventional hormone replacement therapy (HRT) and an increased risk of life-threatening conditions such as cancer and blood clots. But, many experts say, bioidentical hormones are different. “Bioidentical hormones are safer than non-bioidentical hormones,” explains Dr Landa. “They have the same exact chemical structure as the hormones that we have in our bodies naturally, which makes them safer for two main reasons. “Firstly, for hormones to have an action in our bodies, they have to bind to a receptor. These two structures bind together like a key fits into a lock. The hormone has a shape and structure that is exactly complementary to the receptor. Altered versions of hormones or non-bioidentical hormones, do not have the same chemical structure as the hormones in our bodies so they don’t interact properly with our receptors and that results in undesirable effects from non-bio identical hormones.
“Secondly, our bodies know how to break down hormones that are bioidentical. We have been doing it our whole lives. When hormones are broken down in the body, the process can follow different pathways, depending on our genetics and environment. Some non-bio identical hormones have a tendency to break down in ways that are less safe for us than bioidentical hormones. This altered detoxification process can lead to increased risks of cancer. We have many scientific studies that prove when you use bioidentical hormones there do not seem to be increased risks of cancer or heart disease – the main two worries when non-bio identical, traditional hormone replacement is used.”
Nevertheless, hormones have a very powerful effect in our bodies, and any supplements must always be prescribed and taken under close medical supervision. Mainstream institutions like the Harvard Medical School caution that bioidentical hormones are still a new science and have not yet been studied in large, long-term trials, and not all of them are FDA-approved.
When should you have BHRT?
Although hormone replacement therapy is traditionally associated with menopause, when oestrogen levels in particular decrease, our levels of other hormones naturally decline well before we reach menopausal age, according to Dr Landa. She points out that our progesterone levels start to decline from around age 30, and that women’s testosterone levels are highest between 18 and 34, after which they also decline. She says that in an ideal scenario we’d all have our hormone levels measured at 18, to get a sense of our natural optimal hormone profile, and then have our levels continually tweaked back to this optimal level as we get older.
Dr Redner agrees that hormone therapy can begin at a much younger age than traditionally done. “Most people assume that the anti-ageing fight begins when we reach our late forties,” he says.
“However, nowadays we are witnessing an accelerated decay of hormone levels in women as well as in men. Hormone deficiency is also affecting a much younger demographic. Toxic and stressful lifestyles also play a critical role. The daily ingestion of small amounts of artificial and unnatural oestrogens called xenoestrogens [endocrine-disrupting compounds that pass into our environment through foods, plastics and other chemicals that we interact with], as well as food items called phytoestrogens [plant-derived compounds notably found in soy] are other important factors that are challenging the balance of hormones in women today, and a factor in testosterone decrease in men.”
How BHRT fits in the fight against age
BHRT is just one strand in the fast-growing world of anti-ageing science, which puts an emphasis on preventive medicine rather than the so-called traditional ‘sick’ medicine. “More than 90 per cent of doctor visits can be traced back to stress, yet we learn almost nothing about stress in medical school,” says Dr Landa.
Markus Giebel, CEO of Eternity Medicine in Dubai, agrees, “Instead of ‘disease management’ we should focus our efforts on wellness and health creation,” he says. This includes everything from maintaining a healthy lifestyle incorporating the right food, exercise, stress management and adequate sleep, to other newfangled anti-ageing sciences including nutrigenomics (using your DNA profile to identify the sort of foods you should and shouldn’t eat); antioxidant testing (identifying your skin carotenoid status, which is supposed to help in the fight against cancer) and molecular biology.
“There are many factors that contribute to ageing in addition to declining hormones,” says Dr Landa. “These include many environmental factors – things we eat, environmental pollutants and how these factors interact with our bodies including increased inflammation, more free radical damage and shortened telomeres. The good news is that hormones can help reduce inflammation, fight free radical damage and reduce our risk of many chronic diseases including diabetes, heart disease, cancer and dementia.”
Dr Landa continues, “I don’t believe there is a ‘cure’ for ageing, after all ageing is a natural process. I do believe that we want to look and feel our best and have the best quality of life we can. Hormones can help us age more gracefully. Hormones may also extend our years, but they also extend the quality of life. There’s no point in having more quantity without the quality. I don’t think of using hormones or other anti-ageing techniques as a war on ageing, but I practise anti-ageing medicine as a way of improving how we look and feel as we age so that our age is just a number – it doesn’t have to define us.”
A cure for ageing?
Dr Bill Andrews is an American molecular biologist and gerontologist who believes that ageing is a disease that can be cured. Speaking at the third American Anti-Aging Conference in Dubai last year, he outlined his belief that we age because there is a ‘clock’ ticking inside every cell in our body that limits how long we can live.
He explains: “We are born with long, repetitive sequences of DNA, called telomeres, at the end of each of our chromosomes. Each time our cells divide and our chromosomes replicate, our telomeres gradually become shorter.” He likens telomeres to the caps on a shoe lace; every time the cell divides, the shoelace cap begins to fray, until they break completely and we die of old age.
“But our reproductive cells do not exhibit telomere shortening, and show no signs of ageing. This is because they produce an enzyme called telomerase, which adds nucleotides to the ends of our chromosomes, thus lengthening our telomeres.”
Dr Andrews explains that because the DNA in every cell of our body is identical, every cell in our body contains the telomerase gene, although it is suppressed. “It is possible to release that gene with drugs, although the perfect drug has not been found yet. However, using this technology, researchers at Harvard University have already been able to turn an old mouse into a young mouse. We believe that we are approximately three years away from being able to test on humans. Eventually there’s no reason why the expectancy of good-quality life for a human couldn’t go up from the current maximum of 125 years, to 500 or even 1,000 years.”
For more information see www.sierrasci.com/documents/bill_andrews_on_telomere_basics_curing_aging.pdf
Anti-ageing medicine in the UAE For more info on locations in the UAE offering tests related to anti-ageing see www.dnahealthcorp.com, www.eternitymedicine.com and www.oplifestyle.com.