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likely it is that it’s going have to do with lower than desirable testosterone levels.
David: What recommendations would you make for an aging male to raise his declining testosterone levels?
Dr. Wright: That’s somewhat age-dependent, although one can run into that, certainly, as young as one’s forties. If one is in one’s forties with that, sometimes the problem can be solved by making a reformation in the diet, getting some exercise going, using nutritional supplements in addition to an excellent diet, and bringing in some botanicals. Sometimes a man can bring his own testosterone–internally produced–back up, and it’s always preferable to get our own bodies to do that. But let’s say we’ve tried that, or let’s say we are at an age where that’s not going to work, then we use testosterone as a supplement, and bring the testosterone levels back up. I call the supplement a replacement, only because we always have a little testosterone in us. But if it’s below the critical amount, we’ll bring the testosterone levels back up to–well, you’ve heard of the Jack Benny theory of medicine, have you not?
David: The Jack Benny Theory? No.
Dr. Wright: When Jack Benny was in his sixties and seventies, he used to get on TV, and he’d do a little sketch where he’d go in to see the doctor. He’d tell the doctor about his problems, and then leaning over to pat him on the back, the doctor would say, “Oh Mr. Benny, all these problems, it’s your age.” Jack would stop the doctor and say, “Doctor, that’s the problem, I’m only thirty-nine.” And the doctor would look at him and say, “Oh Mr. Benny, you don’t look thirty-nine.” And he’d say, “That’s the problem, doctor, I don’t even look thirty-nine, and I want to be treated as if I was thirty-nine.” (laughter)
So one may not want to use supplements to bring his level of testosterone back up to what one might call the raging hormones that one had between the ages of eighteen to twenty-five. But shooting for Jack Benny’s area of around thirty-nine or forty is something that a human body of either sex can tolerate quite nicely, and do better with than the levels that are happening as a matter of normal decline by age seventy or eighty.
David: What recommendations would you make for a post-menopausal woman to raise her estrogen and progesterone levels?
Dr. Wright: If she’s gone through menopause, and there are no menstrual cycles, one needs to look at all the factors and reach a decision. Now, there are those who say that menopause is natural. So what is a natural medicine physician doing interfering with a natural process such as menopause? The answer to that is, perhaps sometimes we should and sometimes we shouldn’t.
But again, to go back to the business of all the environmental changes that have put us all at a lot more risk, one of the first things we should do if we’re considering replacing hormones is to ask if there are genetic risks in the family. Have there been heart attacks, strokes, cardiovascular disease? Did someone end up with dementia or Alzheimer’s disease? Did they need care the last ten years of the lives when they couldn’t recognize all their relatives? That sort of thing.
If one does have those risk factors, then the consideration of supplementing the hormones might be a stronger one. Again, we’re not totally replacing the hormones, because women who have gone through menopause do have some hormones. If she has none of those kind of risk factors, and her mom lived to a robust eighty, ninety, maybe even a hundred, then perhaps she doesn’t have to think about it–if, of course, her diet is optimal, her exercise pattern is good, and some dietary supplements are taken.
But there’s one other reason why both men and women will sometimes choose to use bioidentical hormones and that is appearance. There’s just very little question anymore that the use of bioidentical hormones, past the age when they decline, has a beneficial effect on appearance. With bioidentical hormones over the years–not over the days and months–women maintain a slower decline in the appearance of the skin, the appearance of the muscles, and just the appearance of the entire body. Look, we’re all going to get slowly older and die someday anyway, and no one is saying that the bioidentical hormones can even come close to preventing that, but they certainly can slow the rate of decline. If we have a group of women aged seventy to eighty who’ve taken bioidentical hormones since menopause, and a group of women who’ve not, one can almost, not quite, but almost always tell the difference.
So one then needs to balance the risks and benefits, and if there’s a strong family history of any of the risk factors I mentioned, we can reduce that risk and, perhaps, give “appearance points” too. If there’s no family history of that at all, then do we really want to go into it just for the appearance and the antiaging properties? Now that’s every woman’s–and, while we’re at it, every man’s–own decision, because we need to look at risk factors regarding whether bioidentical hormones could somehow be involved in some cancers. We have to admit that even women twenty-five years old get cancer, and women in their thirties get cancer, so one can not say at all that bioidentical hormones are totally without risk.
Now there’s a lot of debate back and forth in the medical literature (and, after reading Shakespeare, one may wonder why medical writings are called literature, but that’s a parenthetical remark) about whether, for example, estrogen in itself triggers the cancer, or whether something else triggers the cancer and then estrogen makes it grow faster. The same thing goes for testosterone, although the case is a little stronger there. It appears that testosterone likely doesn’t cause cancer, but if something else triggers it, it sure as hell can make it grow. So that’s why properly done replacement by bioidentical hormones is so important. We need to as closely as we can mimic the patterns of a young healthy woman with young healthy hormones.
If I could, for a moment, mention that there are certain estrogens and estrogen metabolites that are known to be slightly pro-carcinogenic, and there are certain others that are known to be anti-carcinogenic, or at least neutral. And in a young healthy woman’s body there will be a good balance of those. There will be more of the 2-hydroxyestrogen and the 16-hydroxyestrogen, and more estriol–by far–than the combination of estrone and estradiol. And if we mimic that young healthy pattern as closely we can with the estrogens, and bring in–just as a young healthy woman’s body does–some progesterone, DHEA, testosterone, thyroid, and melatonin, we’re least likely to run into complications with hormone therapies. It’s never ever the supplementation of just one hormone; it’s always a concert of hormones working together.
This requires working with a doctor who is really skilled and knowledgeable in how to do all of them. After they’ve started on hormone therapy the physician will help the individual carefully measure what’s happening, readjust the levels if they need readjustment, and monitor from time-to-time. It’s not something where a person can start in on supplementation willy-nilly at a random dose, and hope everything comes out all right. It won’t, if we go into it that way.
David: What do you think are the primary causes of aging
Dr. Wright: I don’t think anyone has yet proven that aging isn’t something that’s supposed to happen. I know that’s a weasely sort of answer, but I think that aging is basically something that’s going to happen anyway with everyone. There are those of us who think that we can make this lifetime last forever. In addition to doing a disservice to past-life therapists–I mean, what would they do if we all lived forever? (laughter)–I just don’t think it’s part of the natural universe that anyone is going to last forever. So part of it, I think, is just programmed right into our cells and genes, but it certainly can be accelerated. Now, if we reframed the question to ask, What do I think is the primary cause of the acceleration of aging? Oh, there are many of those.
Even mainstream medicine has started in small corners to beat the drums about one of them–the consumption of refined sugar and refined carbohydrates. Scientific American and other publications have published articles written about what they call “advanced glycosylation end-products”–abbreviated cleverly as AGEs. Refined sugar and refined carbohydrates are things that have never ever been part of the human diet before. Perhaps Henry the VIII, who had his little bit of sugar, which actually was more costly than gold at the time, or the ancient Egyptians, who also used refined sugar, were among the first. But we don’t find it anywhere else for several hundred thousand years. That’s just one change, which looks likes it’s always been with us.
AGEs really stiffens tissues. They stiffen arteries and leads to a constellation of end products that are mostly stiffening. They just make everything go down hill faster. So we can improve that right way, but that’s just one island in a whole sea of things that can accelerate one’s aging. There are all the chemicals in the environment–for gosh sakes–some of which interfere with mitochondrial function. We all know that mitochondria are the so-called energy engines in cells, and if we interfere with it’s production of energy then cells are going to age more rapidly. It’s very fortunate that research scientists are putting their fingers on more and more of