by Randy Drake

hen someone mentions hormone replacement therapy, you probably think about estrogen, progesterone, menopause, osteoporosis prevention and so forth. The endogenous production of many other hormones also declines with age, however, and replacement of these declining amounts may prove as beneficial as replacement of the female sex hormones. This article will report on research being done on four hormones that hold the promise of slowing or reversing the effects of human aging.

Discovery of Circadian Rhythm

In 1729 a researcher in France studied the mimosa tree and discovered that it would open its leaves in the morning and fold its leaves at night. This piqued his interest, so he decided to move one of these trees to a place where sunlight could not reach it. To his amazement, he found that it would continue to open its leaves each morning, and close its leaves again in the evening. He is credited with discovering a persistence of what came to be known as “circadian rhythm” (circa + dies = around the day, a daily cycle) in the absence of environmental clues.

Humans also have some sort of an inner clock that regulates the circadian rhythm of all the body’s cycles. It is the focus of much current research. Researchers have found, for example, that women go into labor much more frequently between 1:30 and 2:30 a.m. than they do in midday. They have also found that you are twice as likely to have a heart attack between 8 and 10 a.m. as you are between 6 and 8 p.m. Migraine headaches, hay fever, rheumatoid arthritis, and angina are all more frequent and more severe in the morning than in the afternoon or evening. In one study, test subjects ate a single daily meal of 2000 calories. If that meal was eaten in the morning, they lost weight. If that same meal was eaten in the evening, they gained weight. The metabolism of food strongly depends upon the time of day. Aspirin stays in the body longer at 7 a.m. than it does at 7 p.m. People with allergies react with greater intensity at 11 p.m.; unfortunately, antihistamines work better in the morning.

There is a new and growing specialty called chronopharmacology that is looking into the timing of medications and how they affect the body at various times. Researchers have found that circadian variations determine how a drug is absorbed, how it is metabolized, how it is distributed throughout the body, and how it is excreted. For example, by giving an oral inhalation steroid for asthma in the afternoon instead of in the morning or evening, peak serum levels will coincide with the most vulnerable time of an asthma attack. In fact, 10 mg of steroid given at 3 p.m. has the same therapeutic effect as 40 mg of that same steroid given at 8 a.m.; however, the one quarter dose produces only one-quarter of the side effects. Oncology researchers have discovered that cancer cells lose their circadian rhythmicity. With that knowledge they can time chemotherapy treatments to coincide with the period that normal cells are the least sensitive to the toxic effects of the drugs.

What causes the circadian rhythm in our bodies? Although a large amount research has been done on circadian rhythm and its effects, only recently have the causes of the circadian rhythm been found. An overwhelming body of evidence now points to hormones as the body’s timekeeper. Hormones are pacers, so to speak, that transmit information from one part of the body to another. Rather than continuously releasing their hormones into the body, the endocrine glands emit their hormones in a burstlike fashion. A series of high- and low-emitting episodes causes peaks and nadirs in serum hormone levels in a definite circadian rhythm. Almost all of our vital biological processes have a circadian rhythm. Metabolism, body temperature, neurotransmitters, GI activity, the immune system, blood pressure, liver function—in fact, it is very difficult to find any bodily function that does not have rhythmic variations throughout the day.

Other Cycles in the Body

In medicine, as in other research, the answer to one question suggests even more questions. Once you find an answer to “What causes circadian rhythm?” other questions come to mind, such as, “Can we deliberately stop or reset our internal clock?” and “What other rhythmic cycles are at work?”

The monthly cycle in females is obvious. The menstrual cycle of about 28 days prepares the endometrial lining to receive a fertilized ovum, releases an egg from the ovary, thins the mucosal plug in the cervix, and if conception does not occur, then sheds the lining in preparation for the next cycle. Other lunar cycles that occur in the body are not as well researched and not as well understood as the menstrual cycle in women.

What about an annual cycle? Annual cycles are even less researched than the monthly and circadian cycles. For humans, in fact, most of the environmental clues that have to do with annual cycles have been circumvented by modern living. We are not greatly affected by daylight and darkness cycles now because now we simply turn on lights when it gets dark and go to bed after Jay Leno’s monologue, whether darkness comes at 6 p.m. or 9 p.m. The seasonal variations in temperature are pretty much mitigated by our controlled environment.

There is a medical condition based on an annual cycle, though, called seasonal affective disorder (SAD). It happens more in the north where the days are shorter. Scientists have found that people who do not receive enough sunlight during the day can become depressed. The cure for SAD is an artificial increase in the number of hours of light exposure during the day.

Annual sexual cycles also exist. We have all heard the old saying, “In the spring, a young man’s fancy lightly turns to thoughts of love” (Tennyson). Statistics show that nine months later, women are turning to thoughts of labor and delivery, and that, too, waxes and wanes in a definite annual cycle.

All the body’s cycles overlap. We have daily cycles. We have monthly cycles. We have annual cycles. Think of the analogy of a clock. On a clock, the second hand goes around at a certain pace, the minute hand goes around at a certain pace, the hour hand goes around at a certain pace, and all of these cycles are interrelated. So it is with the human body’s daily, monthly, and annual cycles. When physicians began doing in vitro fertilization, they knew, of course, exactly when in the monthly cycle to implant the fertilized eggs. They did not know, however, that there is a precise time of day that the eggs are more susceptible to fertilization. Of the first 79 attempts at in vitro fertilization, only four were successful. After looking at the time of day that those four were fertilized, the doctors found that 100% of the successful fertilizations happened between 10 p.m. and midnight—when women are generally inseminated naturally.

One more cycle can be demonstrated with a clock. When the clock’s battery runs down, the clock is “dead.” Similarly in the human body, there are things that happen once during a lifetime. Death is a good example—that happens only once per life—but there are other things, too. Puberty, for example. For females, puberty is marked by menarche and thelarche. For males, it is marked by facial hair and a deepening of the voice. For both sexes, there is the growth of pubic hair, axillary hair, and excess sebaceous gland activity. Once those changes have occurred, they will never happen again.

Tinkering With the Clock

Let’s return to a question posed earlier: “Can we deliberately stop or reset our internal clock?” In some cases, the answer is “Yes, we can.” Just as endogenous hormones pace the body, exogenous hormones can be administered to perform some of the same functions. Daily cycles, for example, can be disrupted by time zone changes, but administering certain hormones at specific times can actually prevent the disruptions brought about by changing time zones. (More about that below.) Monthly menstrual cycles can be regulated, even stopped, by birth control pills containing sex hormones. Thus, daily and monthly cycles can be easily altered. The big questions before the researchers are these: Can the life cycle be manipulated? Can we change things that happen only once during a lifetime? Can we alter the point in life at which certain events occur? Yes, some tinkering with the body’s “lifetime” clock has been successful. With puberty, for example, the administration of certain hormones will correct precocious puberty and slow down the point and the rate at which puberty occurs. For delayed puberty, other hormones can be given to speed up the process. So puberty—which happens only once in a lifetime—can be artificially shifted forward or backward in time.

What we are really asking by these questions is this: “Can we slow down or delay aging?” That is the pot of gold at the end of the rainbow. Longevity is a hot topic right now. The federal government, pharmaceutical manufacturers, and universities are working to identify, to understand, and to prevent or reverse the various bodily functions that we associate with aging.

Why now? The largest generation in history, the baby boom generation—fully one third of the population—will begin turning 65 in the year 2011. Another major demographic shift is the explosive growth of the “oldest old”—those who are over 85. From 1960 to 1994, the number of the oldest old grew 274%. Throughout history, not many people have lived to reach age 85. Today, however, many are living to age 85 and beyond. The Cornell Gerontology Research Institute now forecasts that we will spend one-third of our lives after retirement. By 2030, there will be more people over 65 than under 18. These statistics are not as important as the health and vitality of the individuals involved. If they are living a youthful, active life, their chronological age does not really matter. If they are productive, they are not a burden to society. As it is now, and as it has been in the past, when people reach age 85, they are typically quite frail, in poor health, and need to be taken care of. Prolonging the time that these people live healthful and productive lives would be a major boon to this baby boom generation. In the future, the question “How old are you?” will be less dependent upon the chronological age and increasingly dependent upon how we feel and how healthy we are.

Recently there has been an important paradigm shift in how the medical community looks at aging. In the past, the diseases and metabolic changes that occur in older people have been considered an inevitable consequence of increasing age. A small but growing number of physicians and researchers have begun to view aging as a “disease process” caused primarily by a decrease in immune function. Research is now being conducted into many aspects of this “aging syndrome,” with some remarkable results. The most exciting discoveries are being made in the area of hormone supplementation. Current research has found that, as with most bodily functions, the “age” of a person is determined mostly by the levels of these extremely important chemicals called hormones. These chemicals, rather than the calendar, determine the health and longevity of a person. They control how fast we “ripen.”

A Little A&P Review

Before we can discuss specific hormones, it would be good to review where the hormones come from—the endocrine system. The endocrine system is not connected together as are the cardiovascular, the digestive, the urinary, the lymphatic, and the nervous systems. It has no common thread that ties it together. Endocrine glands secrete hormones directly into the blood stream where they circulate throughout the entire body, each hormone targeting a specific organ. By analogy, when someone calls a cell phone, the transmission is broadcast over a wide area, but only one specific phone will receive it. Likewise, although a certain hormone is circulating throughout the entire blood stream, only one specific organ will respond. The word “hormone” is from the Greek word hormao (hor MAH oh), meaning to excite to activity. The more hormone there is in the blood, the more excitement and more activity the target organ exhibits.

The largest endocrine gland is the pancreas, and the smallest is the pineal gland. The pancreas weighs less than 3 ounces, and the pineal gland is about the size of a grape seed. All 11 endocrine glands together weigh only 4 to 7 ounces—less than half a pound of your body weight—but that half pound oversees all your bodily functions, your emotions, your reactions, and your life. They all work together in concert, like a grand chemical orchestra, each playing in harmony, doing its part to make sure the body functions the way it should, keeping us happy and healthy. Disease can upset this harmony, but more commonly the balance is upset by simple aging. As the players in the orchestra become old and weak, they become discordant, and the signs of aging become evident—wrinkled skin, loss of muscle, a spare tire, decreased immunity, insomnia, and loss of sexual desire.

Hormone levels can be measured as we age. That’s the easy part. What we need is more understanding of what the hormones are, how they work, what they control, and how they interact. The catch is that these chemicals are very powerful in very minute quantities. For example, the entire quantity of estrogen and progesterone that a woman will produce in her entire lifetime is less than 2 tablespoons, yet the survival of the human species depends on a precise estrogen/progesterone balance that changes throughout the month. Heavy-handed supplementation of one or two hormones without an understanding of how they interact with the other hormones can throw the entire body out of balance. The first birth control pills, for example, were 10 to 100 times more powerful than those sold today, and many can still remember the side effects that accompanied them.

Hormones are not the only factors in aging, of course. The organs and the tissues of the body will actually wear out. If you feed on a diet high in sugar long enough, eventually your pancreas will be overwhelmed and unable to keep up with the constant demand for more insulin. It is called type 2 diabetes, and it is becoming an epidemic in America. Environmental factors also cause aging. Pesticide exposure can cause premature aging. Smoking creates a personal polluted environment that accompanies a smoker wherever he goes. Heart disease and the skin’s loss of elasticity are signs of accelerated aging due to repeated exposure to smoke-polluted air, among other things. Heredity also plays a role in the aging process.

Furthermore, hormones are not in complete control of the body’s processes. The hormonal system and the nervous system interact to share control of the body. Both systems secrete chemical messengers that go to specific organs in the body. The difference is that the nerves connect directly to the target organ, whereas the hormones work circuitously through the blood stream. The nerves act instantaneously, but the effects are short-lived. The hormones work more slowly but have a much longer-lasting effect.

As an example of this dual-control system, a stressor can affect either system. It triggers the nervous system to stimulate the adrenal medulla to release epinephrine and norepinephrine to cause a “fight or flight” response. At the same time, stress stimulates the hypothalamus to produce ACTH-releasing factor which stimulates the pituitary gland to produce ACTH which stimulates the adrenal cortex to release corticoids to sustain the initial “fight or flight” response. The nerve impulses have a much shorter path and work instantly. On the other hand, the ACTH produced by the pituitary gland goes slowly through the blood stream before it stimulates the adrenal cortex. That is the difference between the immediate response to stress and the long-term response to stress.

Old Age is All in Your Head!

It is said that old age is all in your head, and that is pretty much true. Most of the hormones being investigated for anti-aging begin in your head—in the pineal, the hypothalamus, and the pituitary glands. It was once believed that the pea-sized pituitary gland was the body’s master gland. Indeed, it does send out chemical messengers that affect other glands all over the body. It controls the sex glands, the thyroid—in fact, all the endocrine glands. It is the “conductor” in our hormonal orchestra.

There is an old saying in the army, “If the bugler wakes up the camp, who wakes up the bugler?” It was discovered in the 1960s that the hypothalamus, sitting right above the pituitary, is the one that wakes up the pituitary. This grape-sized gland is the link between the thinking part of the brain and the pituitary. All hormonal responses start in the hypothalamus. It is the message center for the senses. It is the intermediary between the brain and the body. It is the center of emotion and motivation. It senses pleasure and danger. It affects health and enjoyment of life. Sleep, aggression, sexual behavior, mood, and much more begin in the hypothalamus. It also senses things that are outside of our awareness—hormone concentrations in the blood, for example, and the nutrient levels in our body. The responses to the “state-of-the-body” messages it receives are sent through a stalk that connects the hypothalamus directly to the pituitary, the only direct connection in the endocrine system.

The pituitary and hypothalamus, working together, represent a control-and-feedback system that responds to and affects all other systems in the body. Researchers now believe it is this pair of glands that hold the key to aging and longevity. As the “feedback” part of the system, the hypothalamus excretes six hormones that travel through the stalk to the pituitary gland. The pituitary, as the “control” part of this system, has a myriad of functions. Five hormones are released by the anterior pituitary and two hormones by the posterior pituitary. All 13 hormones are secreted in a burstlike fashion throughout the day, and they all decline with age, some more than others. Only the top four hormones that are the focus of current anti-aging research will be discussed here.

Human Growth Hormone (hGH)

The most exciting research is being done on growth hormone (also known as somatotropin), which comes from the pituitary gland. To back up a bit, the hypothalamus first excretes growth hormone-releasing hormone (GH-RH) and sends it down the stalk to tell the pituitary to release growth hormone. As mentioned earlier, each hormone has a target organ. The bone is the primary target organ of the growth hormone. It causes the bones to grow when necessary and to stop when appropriate. Malfunctions exist both ways, which can result in gigantism or dwarfism. In 1956 growth hormone was first isolated and used to treat short stature. Then, growth hormone was being extracted from human pituitary glands, harvested from cadavers going through autopsy, and it took 100 pituitary glands to treat one patient. Unfortunately, the extract carried with it the risk of contracting Creutzfeldt-Jakob disease (“mad cow disease”), since this slow virus of the brain can be passed on through injections of brain material.

In 1981 a synthetic growth hormone was produced that had about a tenth of the strength of the natural product. Even at its reduced potency, however, enough growth hormone was produced to treat all children with short stature, with enough extra to study the effects of growth hormone supplementation in adults. Researchers discovered that growth hormone has a profound effect on many bodily functions in adults. Instead of causing bone growth as it does in children, it controls the metabolism of sugars, fats, and proteins. It increases the activity of the sex hormones in both males and females. It increases the production of antibodies which, of course, causes a corresponding increase in the effectiveness of the immune system.

In 1996 the FDA approved Humatrope, a synthetic human growth hormone, for somatotropin deficiency syndrome (SDS) in adults. The symptoms of SDS mimic normal age-related decline. Because of this, hGH research is one of the hottest areas of anti-aging study. Can supplementation with growth hormone maintain the strength and vitality of people as they age? Studies suggest that it can. Endogenous growth hormone peaks at puberty and declines by more than 50% by age 35 to 40. By the age of 60, there is an 80% decline in growth hormone levels in the body. By supplementing growth hormone levels in the body back to the level that it was at 25 or 30 years old, the effects of aging can be reduced. What effects? Bone mass will increase. Lean muscle mass will increase. Body fat will decrease. Wrinkled skin becomes smoother. Muscles, including the heart muscle, improve in strength and endurance. Immune function is enhanced. Unfortunately, growth hormone is available only as a prescription drug, and it’s very expensive, in the range of $800 to $1500 a month. (In Mexico, however, the same FDA-approved product, Humatrope, costs about 25% of its U.S. price.)

Alternatives to hGH injections do exist. A prescription alternative is insulin-like growth factor-1 (IGF-1, now called mecasermin), which is the metabolite of growth hormone that may be the active ingredient. Over-the-counter products called growth hormone secretagogues are also available. Secretagogues contain no growth hormone but stimulate the pituitary gland to secrete more endogenous growth hormone. (Basically, they work in a similar manner as sulfonylurea oral antidiabetic drugs, which stimulate the pancreas to secrete more insulin.) Over-the-counter products cost between $50 and $200 a month—quite a savings from hGH itself. Unfortunately, there are a lot of hGH products being sold that are not the least bit effective. E-mail spam abounds from people selling “growth hormone” that is not really growth hormone. They wax eloquent about the clinically proven benefits of growth hormone supplementation, but fail to mention that the product they are selling is not the prescription injectable upon which the research is based. Because secretagogues are nonprescription “natural substances,” most lack peer-reviewed clinical testing for efficacy.

Much more research is needed on growth hormone, and it has been funded. The therapeutic dose of hGH, when it mimics the body’s own production, appears to be perfectly safe.

Melatonin

Another potential anti-aging hormone “in your head” is melatonin. Melatonin is produced by the pineal gland, which is that grape seed–sized gland in the middle of your brain. In a 1969 textbook, the author stated said that the pineal gland is a vestigial organ, like the appendix. He described it as a useless, remnant organ. Far from useless, it is now known to be the circadian pacer of the entire body. In our orchestra analogy, it would be the “metronome” that keeps the orchestra in time. The pineal gland has been called “the third eye.” It is highly sensitive to light and synchronizes the body’s circadian rhythm to the environment. Researchers are actively studying the pineal because of its sole hormone, melatonin.

Melatonin is produced only at night. It is at high levels in youth and declines with age. Serum levels are low throughout the day, rise in the early evening, peak around midnight, and then decline toward morning. This cycle continues whether you sleep or not. The duration of melatonin secretion is dependent upon the duration of darkness, with increased daily production of melatonin in the winter and decreased production in the summer. Exposure to light at night will cause melatonin production to decrease. A change in time zones, with light coming earlier or later than expected, desynchronizes melatonin production, which produces the hangover-like feeling called jet lag. In fact, jet lag can be artificially induced by taking melatonin at the wrong time and minimized or avoided when taken at the right time. Exogenous supplementation of melatonin is capable of altering sleep-wake cycles, which is especially useful for those engaged in shift work.

Melatonin production by the pineal gland is constant from about one year of age to somewhere between 8 and 15 years of age, and then declines. Because of this, melatonin is thought to delay puberty until the body is ready to bear children. In animals, melatonin triggers a seasonal breeding cycle, which is the reason it was thought to be a relic organ in humans. Interestingly, a similar correlation has also been found in the seasonal conception rates of women living in northern areas. (Northern areas have longer periods of darkness during winter months than southern areas.) Some studies suggest that a person’s average melatonin levels can affect libido and predict a tendency toward chastity or promiscuity.

Melatonin levels begin their decline at puberty, continue through middle age, until only negligible amounts are produced in old age. At 60 years, people produce about 10% to 15% of what they did in their youth. The claims of longevity for melatonin supplementation are based upon animal studies, but in those studies it has prolonged life by as much as 25%. It also caused those animals to age more slowly, probably due to melatonin’s superior antioxidant and immune-boosting properties. Several studies have demonstrated an increase of cancer-fighting NK (“natural killer”) cells brought about by increasing melatonin levels through supplementation.

DHEA

Another hormone, not secreted in the head but by the adrenals, is dihydroepiandrosterone (DHEA). The “androsterone” in its name suggests that it is a sex hormone and, indeed, it is. In fact, it is a precursor to all of the sex hormones—estrogen, progesterone, and testosterone. The discoverer created a sensation in 1995, when the cover story of a French magazine described his research and proclaimed that he had found an “anti-aging pill.” He quickly stressed that the pill would not necessarily extend life but might enable people to age better.

DHEA is the most plentiful steroid hormone in the body. Its production peaks in the mid-20s to 30, tapers off after age 30, and declines to about 20% of peak levels by age 80. The DHEA level at any age can vary dramatically from person to person. It tends to be lower in people with high blood pressure, diabetes, heart disease, cancer, Alzheimer’s disease, and impotence (which, of course, are some of the symptoms of aging). An inverse correlation seems to exist between serum DHEA levels and diseases of old age. Researchers have found that the more DHEA a person has, the better they age. DHEA supplementation research is widespread and ongoing. DHEA appears to protect against cancer in animal studies. It also tends to sharpen memory. It will reverse type 2 diabetes in animals, and it strengthens the immune system against infection. Dramatic differences can be seen in old mice with and without DHEA supplementation. With DHEA supplementation, old mice have thick, shiny coats, are much more energetic, and are much more difficult to distinguish from younger mice.

A 12-year study in humans, ages 50 to 79, at the University of California at San Diego, found that those with a DHEA level exceeding 140 µg/dL were half as likely to die of heart disease as those with lower levels. For every 100-point increase after that, there was a 48% drop in heart disease risk and a 36% drop in total mortality—just from that one hormone level! Small studies of DHEA supplementation in the elderly have shown increased mobility, sounder sleep, a decrease in body fat, and reports of generally feeling better. All this may point to increased immune function, which may be its biggest benefit. An interesting side effect is that DHEA supplementation given concurrently with vaccinations can make vaccinations more effective.

Ongoing clinical trials are testing DHEA’s effect on various cancer treatments. Interestingly, scientists have discovered that DHEA is radioprotective if given less than 16 hours before radiation treatments and radiosensitizing if given more than 20 hours before radiation. Clinical trials are also underway using DHEA for obesity, high cholesterol, Alzheimer’s disease, multiple sclerosis, AIDS, lupus, arthritis, osteoporosis, chronic fatigue syndrome, and psoriasis.

No adverse effects have been reported in moderate doses, which is defined as 20 to 100 mg per day. In fact, people have taken 6 or 8 g per day with no ill effects, but that is not a recommended dosage. The recommended dosage for DHEA supplementation is 25 to 50 mg a day, if the serum level is less than 100 µg/dL. Since DHEA is a pro hormone, it is converted to either estrogen, progesterone, or testosterone in the body. Researchers are still studying how DHEA is converted and how the body knows how to convert it. They know that it is converted more into estrogen and progesterone in women and more into testosterone in men, but they do not know why. An interesting question, still under investigation, is the effect of DHEA supplementation on hormone-sensitive tumors.

Testosterone

The final hormone in this discussion is not being used to prolong life, but rather to make aging more graceful. Gonadotropins, products of the anterior pituitary gland, are being studied to determine their effect on aging and to find out whether supplementation would be beneficial. Follicle-stimulating hormone and luteinizing hormone, two of the gonadotropins under investigation, are produced in differing amounts by both males and females. These affect the development and function of the ovaries and testes. In males, luteinizing hormone goes to the testicles to stimulate testosterone production.

Research on testosterone is about 15 years behind research on estrogen. Researchers have found, however, that testosterone deficiency in men causes the same symptoms as estrogen deficiency in women—including shortened stature due to osteoporosis. Although it does increase libido, testosterone should not to be viewed as a “passion patch.” Unfortunately, pharmaceutical company advertising is being used in this manner to sell their product to men. Once on testosterone therapy, however, no one ever wants to stop. They feel better. They have greater strength and a greater sex drive.

Testosterone levels can be measured two ways: total testosterone, which is practically useless, and free testosterone, which measures the amount of testosterone in its bioavailable form. Like estrogen, testosterone production declines with age but not as precipitously. At age 65, 60% of men have suboptimal levels, but only a small minority are below the lower limit of normal for their age. In fact, only 7% of men ages 40 to 60 have a classic testosterone deficiency. This number rises to 20% between ages 60 and 80 and 35% after age 80. To arrive at these statistics, physicians compare patients’ testosterone levels against normal levels for their age. Fortunately, there is an increasing minority of doctors who will compare their patient’s level to normal levels at their prime and prescribe testosterone replacement therapy (TRT) to restore those levels. For patients who are fortunate enough to find such a doctor, testosterone supplementation can stop muscle loss and increase bone density, as estrogen replacement does for women.

Testosterone is available by injection, as pills, and as transdermal patches. Most prefer the patch, of course, especially since long-term oral administration carries an increased risk of liver damage. Polycythemia, an excess of red blood cell production, is a serious side effect of TRT, but men typically will not stop their testosterone supplementation because of it—they just elect to donate blood more often.

Women produce about 0.2 mg/day of testosterone; 25% is produced by the ovaries, 25% by the adrenals, and 50% from pro-hormones like DHEA. At age 40, women produce about half as much as they did at age 21. Research suggests that adding testosterone to estrogen replacement therapy increases the effectiveness of the therapy. They have discovered that bone density will increase more rapidly with the combination therapy, cholesterol levels will drop, and the total body fat percentage will drop, not to mention having a better sex drive and a more pleasurable orgasm. Several oral estrogen-testosterone combination products are currently available; expect to see others released in the next few years.

There are some side effects to testosterone replacement therapy in women, however. In high doses, it can produce a deepening of the voice, acne, hair growth, and enlargement of the clitoris. Also, there is a risk of aggravating hormone-dependent tumors, such as breast, ovarian, cervical, and endometrial tumors.

Researchers at Johns Hopkins are currently studying the effects of testosterone replacement in both men and women. The current advice is that androgen supplementation is not indicated for enhancing feelings, for increasing libido, or for giving higher energy levels. It is available only by prescription, of course.

Summary

The “pot of gold” at the end of the rainbow is really the long-sought fountain of youth, and that fountain is bubbling right now in top research labs around the country. Millions of dollars are now being spent on longevity and anti-aging research. Hundreds of facilities throughout the world are participating in this research, with the United States, Italy, and Switzerland in the forefront. Dozens of substances are being studied; only four have been mentioned here.

Although research is still ongoing, practical uses are already forthcoming. A new medical specialty, Anti-Aging Medicine, has begun to appear, now concentrated primarily in Florida. An anti-aging physician will study the levels of a patient’s various hormones and nutrients and prescribe supplementation to correct deficiencies. But instead of bringing hormone levels up to normal for their age, these doctors will supplement up to the levels expected in the patient’s prime years. By helping their patients achieve the body chemistry of young adults, they have found that the increase in the immune function helps to “cure” the “disease process” known as old age.

The baby boom generation absolutely refuses to sit idly by and grow old. It is the first generation in history to take an active role in maintaining health and wellness on an individual basis. Members of this generation are the scientists and researchers who are now in the laboratories studying the effects of old age and how hormones can prevent the decay of old age. They know that the time to do this research is now, because it will soon be too late. In another 20 years, when decay sets in, the effects will be irreversible.

Overview:

• William Regelson, M.D., and Carol Colman, The Super-Hormone Promise. New York: Pocket Books, 1996. Paperback ISBN 06710 10034.
            I consider this the best “overview” book for a medically sophisticated reader—not written for research scientists, but slightly beyond the level of the average lay person. For women readers, the chapters on estrogen, progesterone, and testosterone for women (in a separate chapter from testosterone for men) are worth the price of the book. This is the definitive work on DHEA by the same author as the groundbreaking book on melatonin (below). Highly recommended reading.
  
  
• Ruth Winter, The Anti-Aging Hormones. New York: Three Rivers Press, 1997. Paperback ISBN 06098 00159.
            Ms. Winter is a prolific author in the field of alternative medicine. This book presents an overview of the “benefits and dangers” of anti-aging products, including several not mentioned here. Her book is the source of many of the statistics used in this article and the basis of the “grand chemical orchestra” analogy. It is a good introduction to the subject for readers who are not medically inclined.
  
  
• Dr. Ronald Klatz, and Dr. Robert Goldman, Stopping the Clock. New York: Bantam Books, 1996. Paperback ISBN 05535 77514.
            Not as thorough in its treatment of hormones as The Superhormone Promise (above), but what it lacks in depth, it makes up in breadth. In addition to hormones, this book also covers vitamins, minerals, and other nutrients, diet, exercise, and stress reduction as part of an anti-aging regimen. Unfortunately, some of the authors’ advice is internally contradictory, so I cannot give this book a hearty recommendation. Dr. Klatz should stick to reporting on his own research (see below), at which he excels.

Human Growth Hormone:

• Dr. Ronald Klatz, with Carol Kahn, Grow Young With HGH. New York: HarperCollins, 1997. Paperback ISBN 00609 84341.
            Dr. Klatz is president if the American Academy of Anti-Aging Medicine and is a highly respected authority in the field of human growth hormone. This book, considered the definitive work on hGH research, is highly readable and complete. Everyone interested in beginning a personal anti-aging plan should read this book.

Melatonin:

• Russel J. Reiter, Ph.D., and Jo Robinson, Melatonin. New York: Bantam Books, 1995. Paperback ISBN 05535 74841.
            This excellent book covers many aspects of current melatonin research. In addition to its promise to delay aging, its remarkable antioxidant, immune boosting, and anti-cancer properties are reported in depth. Also covered are its effects on blood pressure, cholesterol, fertility and menopause, mood, and, of course, sleep. Specific recommendations are suggested to increase melatonin levels without supplementation, and guidelines for proper supplementation are also given. This is the best book on melatonin that I’ve found, and is highly recommended reading.
  
  
• Walter Piperpaoli, M.D., Ph.D., and William Regelson, M.D., with Carol Colman, The Melatonin Miracle. New York: Pocket Books; 1995. Paperback ISBN 06715 34351.
            Dr. Piperpaoli is the head of a foundation for aging research in Ancona, Italy, and has organized several international conferences on aging. Dr. Regelson is a professor at the Medical College of Virginia and a leading researcher on the biology of aging. This book is an expansion of their search for the body’s aging clock and their groundbreaking research on melatonin. The authors strive to strike a balance between useful, easily digested information and scientifically rigorous and detailed reporting on their research, but it gets very technical in spots. Recommended.

DHEA:

• William Regelson, M.D., and Carol Colman, The Super-Hormone Promise. New York: Pocket Books, 1996. Paperback ISBN 0671010034.
            (Also annotated above in the “Overview” section.) Dr. Regelson considers DHEA to be the cornerstone of any anti-aging regimen. His extended chapter on DHEA is a better reference on the subject than the book by either Mr. Cherniske or Ms. Ley (below). This definitive work on DHEA is by the same author as the groundbreaking book on melatonin (above). Highly recommended reading.
  
  
• Stephen Cherniske, The DHEA Breakthrough. New York: Ballantine Books, 1998. Paperback ISBN 03454 26460.
            Mr. Cherniske’s book promotes increasing DHEA levels mainly through lifestyle changes—stress reduction, exercise, and proper nutrition. He covers DHEA supplementation almost as an afterthought, which is very strange, considering that he went on to head a company that sells DHEA supplements via multilevel marketing. Not recommended.
  
  
• Beth M. Ley, DHEA: Unlocking the Secrets to the Fountain of Youth. Aliso Viejo, CA: BL Publications, 1996. Paperback ISBN 09642 70331.
            Poorly written. Not recommended