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Can our hormones make us stay young?
A fascination with long-lasting youth and the possibility of suspending, if not reversing, the natural impacts of ageing have always fascinated people, from the writers of religious texts, poetry and fiction to the modern pharmaceuticals industry to medical practitioners.
It was actually American novelist F Scott Fitzgerald in 1922 and not movie director David Fincher in 2008 who came up with Benjamin Button—the main character in The Curious Case of Benjamin Button who becomes younger as time passes. Things do not end well in either the short story or the film.
This was long after Oscar Wilde’s The Picture of Dorian Gray told of a man trading his soul for eternal youth and a life of libertine pleasures.
Some medical practitioners however stoutly claim the science of anti-ageing medicine is, by no means, either the stuff of literary fantasy or the product of divine hands.
Medical people like UK-trained internal medicine practitioner, Dr Raquel Sukhbir, are dismissive of fad diets and medications promising Dorian-like results, but stand by the role hormonal imbalances play in accelerating physical conditions typically associated with growing old.
The sceptic’s eyes scour a spotless St Clair office one sunny morning. More doctor’s offices need to be like this. As immaculate is the desk of the young preventive medicine practitioner. No manila folders. No illegible prescriptions. A tidy sheet of speaking notes.
“Through my treatment of patients with chronic diseases – diabetes, high blood pressure, heart disease and stroke, I became very interested in preventive medicine on the whole,” she explains.
This led to a curiosity with taking “a step back from before we got ill and stop that from happening. It was then I discovered anti-ageing medicine.”
Dr Sukhbir concedes that a measure of commercial “packaging” of this approach to medicine has occurred in the US context but is a branch of medicine that has long been practised in Europe. “It’s become a bit of a craze,” she suggests.
In that context, she thinks it’s necessary to “clear up” some misconceptions about anti-ageing therapies.
“There were several prominent (US) celebrity figures who started to go through menopause and started feeling unwell as a result … and they decided to treat themselves very publicly … because, on the market came this treatment called bioidentical hormones,” she says.
Bio-identical hormones, according to Harvard Health Publishing, are “identical in molecular structure to the hormones women make in their bodies” but are “synthesised from a plant chemical extracted from yams and soy.”
Use of such therapies is however not a routine part of medical teaching. “Having specialty training in chronic disease and cardio-vascular disease, I then specifically learned about anti-ageing medicine,” Dr Sukhbir said.
“I hadn’t learned those things in med school … we were never really taught properly how to assess hormones or treat them … how to really look at your nutrition; your individualised nutrition and treat that … how to look at your thyroid and treat it properly,” she added.
But how can a patient distinguish between what is purely fashionable and what is evidence-based and scientifically sound medicine?
“Because there are risks and because there are also great benefits, you really have to go to someone who knows what they are doing,” she said. “You have to have learned it to understand it … it is a tricky part of medicine to go through.”
Ageing itself is pretty daunting business biologically. People’s internal rhythms change, the efficient repair of cells slows, one’s immune system starts to decline and hormonal balance tilts negatively in the direction of disease, weakness and ensuing injury.
“From puberty to your mid-20s you start to get this peak in your sex hormones, testosterone, estrogen and progesterone … as you age, beyond the age of 40 those levels of those hormones start to decline quite rapidly until you are about 60 when they really start to tail off,” Dr Sukhbir says.
But, she warns, at the same time “because hormones live in a balance” the stress hormone, cortisol, “starts to rise to compensate for the drop in those other hormones. And that is where the real trouble starts, with all the classical symptoms of ageing.
“We used to think we just had to accept this decline...but through the practice of anti-ageing medicine, you don’t have to accept that as an inevitable progression,” she says. “You can actually halt the progression.”
“It’s not about extending someone’s age chronologically. It’s about making you have years in which you are disease-free and you are feeling optimal and energetic and you are actually able to live your life and enjoy it,” she says.
There have been concerns flagged by agencies such as the World Health Organization (WHO) and others, regarding hormone replacement therapy. Several studies are available online and resources can be tapped via the Pan American Health Organization (PAHO).
Dr Sukhbir herself recommends asking the critical questions and undergoing standard laboratory tests before venturing into this area of medical treatment and care. In the end no one is really promising Dorian, but a few years more as a healthy, active human appear to be the results on offer.
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