Chapter 18

Anti-Aging

How Hormones Affect the Aging Process

• The pineal gland
• Pituitary gland
• Pancreas
• Ovaries
• Testes
• Thyroid gland

·        Parathyroid gland

·        Hypothalamus

·        Gastrointestinal tract

·        Adrenal glands

Aging Women and Testosterone

·        Women have twenty to twenty-five times lower levels of testosterone compared with men. [97]

·        As women age, the loss of testosterone causes decreased libido, lean body mass and physical function, brain function, emotions, bone loss, and frailty. [98]

·        Women in their forties will lose fifty percent of the testosterone they had in their thirties. [99]

·        In just ten years, women will have half as much testosterone as they did at age thirty. By the time women complete menopause, for most just over fifty years old, they will have just fifteen percent of the testosterone they had in their thirties. By age fifty, most women will lose eighty-five percent of the testosterone they had when they were thirty. [100] Some women will lose another sixty percent more testosterone within two to five years following menopause. Most women by age sixty to sixty-five will have just five percent of the testosterone they had in their prime. [101]

·        Women who have their ovaries removed will see a dramatic reduction in their sex hormones almost immediately, most within a few days after surgery. Even if the ovaries are preserved, most will have a decline in hormones within two years of a hysterectomy.

Aging Men and Testosterone

·        Testosterone declines at a rate of one to two percent per year in men beginning around the mid- 30s.[102] Twenty percent of men over age sixty will have testosterone that is classified as low. [103]

·        By age seventy, most men will lose ninety percent of their youthful testosterone. Almost all men seventy years old will be well below the testosterone level they were at when they were younger. These are not just theoretical considerations, but carry very serious health consequences to aging men.

·        Aging in men is associated with decreases in bone mineral density, [104] lean body and muscle mass, [105] strength, [106] capacity to exercise, [107] an increase in abdominal fat, an increase in the bad low-density lipoprotein cholesterol, an increase in the worse low-density lipoprotein, and a decrease in the good high-density lipoprotein cholesterol. [108] All of this happens in nonelderly hypogonadal men also if their testosterone is low. [109]

·        These changes in men that have declining testosterone will lead to muscular and skeletal frailty, and osteoporotic bone fractures causing major disability and limitations in elderly men. [110] It will eventually lead to cardiovascular disease. [111]

·        The most obvious clinical signs of relative deficiency in older men are a decrease in muscle mass and strength, a decrease in bone mass, and an increase in central body fat. Lowering serum testosterone concentrations in healthy volunteers decreased fat-free mass, muscle strength, and mixed muscle fractional synthetic rate, [112] but testosterone supplementation increased fractional synthetic rate in young hypogonadal men [113] and older men. [114]

·        Administration of supplemental testosterone to youthful levels increases the production of long protein chains in muscles, total body cell mass, and muscle strength. [115] As testosterone levels decline with aging, there is an increase in fat and redistributed to the abdomen in men and throughout the body to the point there are fewer areas where there is no fat. [116]

·        This decline in muscle mass and increase in fat mass obviously causes decreased muscle strength, and this leads to limitations in activity. This is seen in the elderly as loss of balance causing a higher chance of falling with serious injuries such as fracture. But other chronic conditions are seen such as type 2 diabetes mellitus, obstructive sleep apnea, obesity, liver failure, depression, chronic obstructive pulmonary disease, kidney failure, [117] decreased quality of life, and overall failure of multiple body systems and increased death rate with aging. [118]

·        The influence of testosterone on protein metabolism is well known, [119] but testosterone also is essential in proper regulation and to maintain stability of glucose and lipids, [120] and bone growth. There is an increased prevalence of osteoporosis in men over sixty years who have low total testosterone levels as well as an increased rapid bone loss at the hip, [121] followed by an increase in hip fractures and fractures in various other bones. [122]

·        Osteoporosis is thought of as a disease in postmenopausal women. There are 3 times more women with osteoporosis than men. However, there is an increased incidence of osteoporosis in men as longevity increases our life span. Because of this comes an increased rate of fractures and associated morbidity and mortality. Loss of testosterone not only causes a decrease in muscle mass in older men, but also is seen an increase of mortality in older men. [123]

In Summary

·        The effects of aging in both men and women can be slowed down...