May
20
2017

Prevention Of Telomere Shortening

Dr. Mark Rosenberg gave a talk on prevention of telomere shortening. This was presented at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The detailed title was: “The Clinical Value of Telomere Testing”.

What are telomeres?

Telomeres are the caps at the end of chromosomes. They are very important in the aging process. Prematurely shortened telomeres are linked closely to all major diseases like cardiovascular disease, cancer, diabetes and more. Telomeres are also a measure of the aging process. Aging occurs due to a decrease of the number of cells in organs and/or because of a lack of functioning of these organs. Telomeres get shortened every time a cell divides. But when the telomeres are used up, there comes a time when cells can no longer divide. These cells become senescent cells or they enter apoptosis (programmed cell death).

The senescent cells can become a problem when they get transformed into cancer cells and their telomeres lengthen again. These cancer cells divide rapidly and this can become the reason why cancer patients to die.

What is the significance of telomeres?

Telomere dysfunction is the first sign that the telomeres are getting shorter in a person compared to the average telomere length in a comparable age group. This is not only important for aging, but also has clinical implications. The shorter telomeres are, the higher the risk for cardiovascular disease. Telomere length also provides prognostic information about the mortality risk (risk of dying) with type 2 diabetes and for many cancers. Many physicians incorporate a telomere blood test into periodic health checks, if the patient can afford it.

Interventions that help telomere length

Here are a number of things we can do to lengthen our telomeres.

  1. Rosenberg mentioned that the strongest effect on telomere lengthening comes from caloric restriction and weight loss. 80 years ago they showed at the Cornell University that rats put on calorie restriction had a 30% increase in their mean and maximum lifespan. Many research papers have confirmed that the same is true in man and that the common denominator is telomere lengthening.
  2. Next are regular physical activity, meditation, reduction of alcohol consumption and stopping to smoke.
  3. Taking antioxidants and omega-3 fatty acids regularly will also lengthen telomeres.
  4. Improving one’s dietary pattern by adopting a Mediterranean type diet that contains cold-pressed, virgin olive oil.
  5. Telomerase activators. Here is some background on the TA-65 telomerase activator, which is based on Chinese medicine. A one year trial was completed with 250 units and 1000 units of TA-65 per day. The lower dose (250 units) showed effective telomere lengthening, while the placebo dose did not. The 1000 unit dose did not show statistical significance.

Should you wish to take TA-65, only take 250 units per day, not more.

Cancer and telomeres

There is a strong correlation between cancer and telomere shortening. When cells are at the brink of dying toward the end of their life cycle the telomeres get shorter and shorter. This is the point where the cells can turn malignant. Certain genetic abnormalities help the malignant transformation, like 11q or 17q deletions or a p53-dependent apoptosis response. Once cancer cells have established themselves they activate telomerase in 85% of cases. In the remaining 15% of cancer cases telomeres are activated through telomerase-independent mechanisms. Here are a few examples.

CLL

CLL stands for chronic lymphocytic leukemia. It is a disease of the aging population. At age 90 people’s bone marrow cells have a telomere length of only 50% of the length at birth. This is the reason that in older age CLL is more common. Researchers observed a population segment and found that the shorter telomeres were, the poorer the overall prognosis and overall survival for CLL was.

Lung cancer

Researchers examined the telomerase activity in patients with non-small cell lung cancer. When telomerase activity was present, the 5-year survival was only 55%. When telomerase activity was absent, the prognosis was 90% survival after 5 years.

Prostate cancer

  1. Prostate cancer risk correlated with telomere shortening in stromal cells. Men with shorter telomere length in stromal cells had a 266% higher risk of death compared to men with normal telomere length.
  2. Another study took blood samples and determined the telomere length in lymphocytes (the immune cells). Those men who came down with prostate cancer within a year after they had their blood sample, had short telomeres. The risk for prostate cancer in these patients was 355% higher than in the prostate cancer negative controls.

Yet another study looked at surgical tissue samples from 596 men that

Underwent surgery for clinically localized prostate cancer. Patients whose samples showed variable telomere lengths in prostate cancer cells and shorter telomeres compared to prostate samples with less variable telomere length and longer telomeres had a much poorer prognosis. They had 8-times the risk to progress to lethal prostate cancer. And they had 14-times the risk of dying from their prostate cancer.

Breast cancer

Breast cancer is diverse and consists of cases whose origins are genetic (BRCA1 and BRCA2), but there are also cases where the cancer is local or has a higher stage. In families with mutated BRCA1 and BRCA2 telomeres are significantly shorter than in spontaneous breast cancer. Increased telomerase activity in breast cancer cases is directly related to how invasive and aggressive the breast cancer is.

  1. In one study researchers analyzed blood leukocytes in 52 patients with breast cancer for telomere length  versus 47 control patients. Average telomere length was significantly shorter in patients with a more advanced stage of breast cancer than in early breast cancer. Mutated HER patients had the shortest telomeres. It follows from this that checking for the HER status and blood telomere testing adds to the knowledge of potential cancer development and prognosis.
  2. In patients with with larger breast tumors, more lymph node metastases and more vascular invasion the researchers found short telomere length of the cancer cells.
  3. More aggressive breast cancer cells have higher telomerase activity. More than 90% of triple negative breast cancers have short telomeres.

CNS disorders and telomeres

Dr. Rosenberg presented evidence for a correlation between shorter telomeres and the development of dementia. But dementias with Lewy bodies and Alzheimer’s disease are also linked to short leukocyte telomeres. The length of blood telomeres predicts how well stroke patients will do and how people with depression will respond to antidepressants.

Cardiovascular disease and telomeres

The renin-angiotensin-aldosterone system controls our blood pressure and keeps it constant. When this system is not stable, our blood pressure shoots up and causes cardiovascular disease. This is tough for the heart, as it has to pump harder against a higher-pressure gradient. A study of 1203 individuals was examining the connection between leukocyte telomere length and renin, aldosterone and angiotensin II activity. It concluded that oxidative stress and inflammatory responses affect the telomere length of leukocytes and that the more stress there is in the renin-angiotensin-aldosterone system, the more cardiovascular disease develops. The conclusion of the study was that the overall cardiovascular stress leads to shortening of leukocyte telomeres.

Prevention Of Telomere Shortening

Prevention Of Telomere Shortening

Conclusion

Telomere length testing from a simple blood test will become a more important test in the future as hopefully the cost comes down (currently about 300$). It can predict the general aging status by comparing a single case to the general telomere length of the public. But it can also predict the cancer risk, risk for mental disease and cognitive deficits (Alzheimer’s disease). In addition your cardiovascular status correlated globally with this test. What are the options for the patient, if the test comes back with short telomeres?

It allows you to change your lifestyle and adopt a healthy diet. You can exercise regularly, take antioxidants and meditate. There are even telomerase activators that are gradually becoming more known. They lengthen the telomeres. The cost of telomerase activators will likely still be a problem for some time. All in all telomere length tests are here to stay, but healthy lifestyle choices are the only tool for effective intervention at this point. This is good news: healthy lifestyle choices like non-smoking, exercise and avoiding non-processed foods are either free or have a reasonable price tag. Telomerase activators are big business and at this point not really affordable!

May
13
2017

Results Of Insomnia Studies

Results of insomnia studies are focusing on all angles of insomnia. We know for some time that the circadian rhythm is linked to deep REM sleep, which we only reach about 2 hours into our nightly sleep. There are several reasons why our normal sleep pattern can get disrupted.

1. Night owls have a CRY1 mutation

A recent publication on March 27, 2017 has detected a mutation of the human circadian clock called CRY1. This is a dominant gene that is responsible for delayed sleep phase disorder (DSPD). People with this genetic feature tend to go to sleep 2 hours later than the average person every day.

It occurs between 0.2% and 10% in the general population and is inherited by the autosomal dominant mode.

This gene is responsible for the phenomenon of persons being “night owls”.

2. Sleep deprivation in nursing homes

Another publication has zeroed in to what happens in the frail elderly who live in nursing homes.

Here is what sleep researchers have found out about nursing homes.

  • Older people also need 7 to 8 hours of sleep per night, not less as previously thought.
  • Let people sleep at night, and give them undisturbed sleep. The practice of waking them up every 2 hours is unnecessary and undermines a restful sleep with normal amounts of REM sleep.
  • The color of light matters: Blue/purple light coming from TVs, iPod’s, laptops or cell phones stimulates serotonin production that wakes you up. In contrast to this orange/red light stimulates melatonin production that facilitates sleep. A nursing home owner, Guildermann said: “We have made it darker at night, and what light they do have is orange/amber/red light, and we are having phenomenal results.”
  • Sleep, exercise and nutrition are the biggest components of health.

3. Night workers

One of the news stories in 2016 was about health risks of night shifts. The Bureau of Labor Statistics reported in 2000 that 15 million workers (16.8 % of the working population) were doing alternative shifts (night shift work mixed with daytime shifts). In 2016 they reported 14.8% were working alternate shifts. Among blacks, Asians and Latino Americans the percentage of working alternative shifts was higher, namely 20.8%, 15.7% and 16%, respectively.

Effect of shift work on your diurnal hormone rhythm

Shift work is more common in certain industries, such as protective services like the police force, food services, health services and transportation.

Your body rewards you, when you sleep 7 to 8 hours during the night, but it will penalize you severely, if you turn it upside down. The reason is the diurnal hormone rhythm that we all have built in. Sleep is regulated by melatonin during the night, which is released by the pineal gland (on the base of the skull). Daytime wakefulness is regulated by the stress hormone cortisol from the adrenal glands. These two hormones inhibit each other, cortisol inhibits melatonin and melatonin inhibits cortisol. All the other hormones are also regulated according to the diurnal rhythm: testosterone, for instance is highest in the morning, human growth hormone is highest between midnight and 3 AM.

Studies about the effects of shift work

There are examples of what happens when you do shift work for several years:

  1. A) A Swedish study found that white-collar shift workers had a 260% higher mortality compared to a control group of daytime white collar workers: Shift work and mortality.
  2. B) A study compared night workers in the age group of 45 to 54 with daytime workers and found a 147% higher mortality rate in the night shift workers: Shift Workers’ Mortality Scrutinized. Shift workers work at night and sleep during the day. This can be done, but it is against the physiology of your body, as I explained above. Remember that melatonin does not only regulate your sleep, it also is one of the main stimulant hormones of the immune system. If you manipulate your diurnal hormone rhythm by staying awake during the night and sleeping during the day, you pay the price by an increased risk of mortality (increased risk of death). I think this is not worth it!

4. What to do when you cannot sleep?

The first step is to take 3mg to 5mg of melatonin at bedtime. It should be taken between 10PM and 11PM. It takes 20 to 30 minutes for melatonin to take effect. If you do not fall asleep within that time frame you are likely thinking too much! Relaxation before going to sleep should be part of your evening ritual. It can happen that we experience demanding, stressful days, and despite all better effort, it is difficult to be entirely relaxed. After demanding days like that I would recommend taking 1 or 2 capsules of valerian (500 mg strength) from the health food store. This combined with the melatonin should help in more than 80%-90% of insomnia cases.

Medical tests and sleep studies

If you cannot sleep, see your physician. Sleep studies may be required or you may have problems of the thyroid (hypo- or hyperthyroidism), which may need to be checked. Other medical problems including depression have to be checked out as well. Melatonin and valerian are safe. Other sleeping pills have multiple side effects including memory problems the next day or the feeling of a mild hangover.

5. Telomeres and insomnia

Some people have no problem disciplining themselves to go to sleep between 10PM and 11 PM, which seems to be the window of opportunity to catch a good night’s sleep. Others are so used to do their late night activities (reading, watching TV, being online, going to the pub etc.) that they finally drop into bed at 1 or 2 AM. People need 7 to 8 hours of good sleep; even hard-core party goers need to get that much sleep. Nature does not make exceptions! When you go to bed only at 1AM or 2AM, it is difficult to get enough sleep.

Healthy telomeres with healthy sleep pattern

It is true that you can suffer multiple health problems, as all of your hormones depend on the resetting during your deepest sleep between 2AM and 4AM triggered by the nighttime melatonin response. Even your telomeres, the caps of chromosomes in every cell get shortened from too much stress and too little sleep. Shortened telomeres mean a shortened life span. The reason for this is that people with shortened telomeres develop heart attacks, strokes and cancer. This is what shortens the life span. How do we avoid this risk? Go back to healthy sleep habits. As mentioned above it is best to start going to sleep between 10 PM and 11 PM and sleep for 7 to 8 hours.

6. Electronics in the bedroom

There is new research showing that electronics in the bedroom can interfere with a normal sleep pattern. Dr. Ben Carter is the lead author and a senior lecturer in biostatistics at King’s College London. He completed a study involving 125,198 children with an average age of 14½ years. There were about equal amounts of males and females. Both sexes had the same problem. Allowing the use of electronic media interfered with their sleep time. What electronic devices are we talking about? Watching TV, using the computer, the cell phone, tablets and computer games. The study was originally published at JAMA Pediatrics.

The blue/purple light of the TV screen or a computer screen stimulates the brain to produce serotonin. This undermines the melatonin production and as a result the person finds it extremely difficult to fall asleep.

What contributes to better sleep habits

Here is a list that contributes to better sleep habits and better sleep quality:

Sleep friendly environment in the bedroom

Ensure that the bedroom is dark, soundproof, and comfortable with the room temperature being not too warm. It is important to develop a “sleep hygiene”. This means going to sleep around the same time each night, to have some down time of 1 hour or so before going to bed and getting up after the average time of sleep (for most people between 7 to 9 hours). Sleeping in is not a solution, and an alarm clock will also help to develop a sleep routine.

Avoid stimulating drinks, drugs and nicotine

You need to avoid caffeine drinks, alcohol, nicotine and recreational drugs. Smokers should butt out no later than 7PM, as nicotine is a stimulant.

Adopt a regular exercise program

Getting into a regular exercise program, either at home or at a gym is beneficial.

No heavy meal at night

Avoid a heavy meal late at night. A light snack including some warm milk would be OK.

No computer in the bedroom

It is not a sensible idea to use the bedroom as an office, reading place or media center. It stimulates by cortisol production, which keeps us awake. The bedroom is a place of rest and should be comfortable and relaxing.

What to do when waking up at night

Some sleepers wake up at night, and they are wide-awake! Leaving the bedroom and relaxing in the living room for a while can help. It goes without saying that playing video games will not help! An alternative is to take 3 mg of melatonin, which will helps to fall asleep faster, but melatonin will wear off after about 4 hours.

Self-hypnosis recording

A self-hypnosis recording is a useful adjunct to a sleep routine. Listening to it before going to sleep helps to focus on relaxation and to stop ruminating about the day and its events. Keep the volume low.

Results Of Insomnia Studies

Results Of Insomnia Studies

Conclusion

Recent results of insomnia studies have reconfirmed that we need our regular sleep to maintain our health. We have seen that some nursing homes have a practice of waking the client up every 2 hours. Nursing homes must abandoned this as it interferes with the restorative deep REM sleep. In turn this will interfere with hormone restoration overnight.

Children and adolescents must limit their time in front of the TV, iPhones and computer screens. The blue light has the frequency that over stimulates the brain and interferes with melatonin production. Some people work overnight as shift workers or party until the wee hours in the morning. This causes your telomeres in your body cells to shorten. As people restore their sleeping pattern to normal, the telomeres length will remain stable.

Important to restore normal sleep pattern

Even people who are night owls due to an inborn CRY1 gene that is responsible for delayed sleep phase disorder can normalize their sleep pattern by following a strict sleep hygiene. As people get older they lose the ability to make melatonin, but they can counter this by taking melatonin tablets at bedtime.

Remember what I said earlier: Sleep, regular exercise and good nutrition are the biggest components of health.

Apr
16
2016

Sleeping Habits

When you are a child or a youngster sleeping habits are rarely a problem. But as people age, they tend to have problems falling asleep and sleeping through the night. Older people may also have certain hormone deficiencies, which can contribute to a change in sleeping habits.

Some basics regarding sleeping habits

There are a couple of facts that everybody should know about sleep, so you work with nature, not against it.

Need of 7 to 8 hours of sleep

The way our bodies are hardwired, we need 7 to 8 hours of sleep and we need to fall asleep between 10PM and 11PM.

Diurnal hormone rhythm

The reason for the relative rigid sleeping schedule time wise is the diurnal hormone rhythm. This is also known as the circadian clock that is dictated by the light of the sun (24 hour cycle). Light going into our eyes in the morning inactivates melatonin. But in the evening the pineal gland releases melatonin after sunset. This is what keeps the internal clock on time. We all know how we derail when we fly east or west. There are differences. I find that I am more affected when I fly west than east. The readjustment for me often takes one or two weeks for a 9-hour time zone difference.

Melatonin production is age-sensitive

Melatonin is gradually produced less as we age. The highest melatonin production occurs around 10 years of age. From then on melatonin production declines. This likely is the reason why older people more often have insomnia problems.

Melatonin rules at night, cortisol rules during the day

There is interplay between melatonin and cortisol. These two hormones complement each other. When you sleep melatonin governs and resets the hormones to be ready in the morning. This involves an early testosterone peak for the male and cortisol, which has to be ready the moment you wake up. It is cortisol coming from the adrenal glands that rules during the day and is giving us energy. Thyroid hormones also gives you energy during the day. As I will explain below, human growth hormone is an energy-giving hormone as well that also clears your mind.

Human growth hormone

What is not as much known is that human growth hormone (GH) provides energy for us. Growth hormone is released as a spurt between midnight and 3 AM, when you’re deep asleep. The purpose of that is to get you ready with regard to energy for the next day. If you drink alcohol after 5PM the afternoon before, you will miss most of that GH spurt during the night and have a hangover (lack of energy the following day).  At the 23 rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about GH and said that even one drink during the evening before you go to sleep will cancel 75% of the GH spurt causing a lack of energy the following day.

Regular alcoholic drinks can interfere with growth hormone production

When you have alcoholic drinks evening after evening as many people do, you interfere with your deepest sleep, creating a fitful sleep and you can develop GH deficiency, which can be measured with blood and urine tests. GH deficiency leads to premature signs of aging, such as wrinkles, musculoskeletal problems, muscle weakness and dementia. Many people in their 80’s look “old”. In fact they may be growth hormone deficient and could be treated with human GH, if GH deficiency were confirmed by tests. Part of the aged appearance is reversible in cases of growth hormone deficiency by treating with daily GH injections.

Less melatonin as we age

As we age, we produce less melatonin and less growth hormone. All of these hormone levels can be determined. If they are low, they should be replaced with small amounts of whatever hormone is missing.

Other hormones that are important

There are other hormones that are important for energy: cortisol from the adrenal glands, thyroid hormones and DHEA from the adrenal glands. When people get older there is a problem with melatonin production and an evening dose of melatonin supplement of 3mg is advisable. People beyond the age of menopause (females) and andropause (males) need bioidentical sex hormone replacement. Once they have sufficient hormone levels, they will also have more energy. It is advisable to get all of these hormones tested using a saliva hormone test.

How to assess growth hormone deficiency

Growth hormone is a bit more difficult to assess, but IGF-1 levels give a first indication what your growth hormone levels are doing. The newest test is a 24-hour urine collection or an overnight urine sample looking for growth hormone metabolites. If levels are found to be low, daily replacement of growth hormone using a pen similar to insulin injections in diabetics can be given, using pure human growth hormone. You would need to seek the advice of a knowledgeable naturopath.

What does insomnia do to you?

From a psychological point of view performance is slower, there is a slower reaction time and there is a risk of developing anxiety or depression. The immune system gets weakened, high blood pressure can develop and there is a risk of developing heart disease, diabetes and cancer. It is common to gain weight becoming overweight or obese. Even your telomeres, the caps of chromosomes in every cell get shortened from too much stress and too little sleep. Shortened telomeres mean a shortened life span.

How to improve sleeping habits

Set your alarm clock for 8 hours later when you go to sleep. Make sure your bedroom is dark, but wake up to the alarm clock after 7 to 8 hours of sleep. Don’t sleep longer than 8 hours per night. Your internal diurnal hormone rhythm will thank you for regulating your sleep/wake rhythm by giving you the energy you want. I enjoy mine.

Sleeping habits include problems falling asleep or sleeping through

Falling asleep: As we mostly have a lack of melatonin, the first step is to take 3mg to 5mg of melatonin at bedtime. But it should be taken during the window of opportunity fitting into the diurnal hormone rhythm as mentioned above: between 10PM and 11PM. It takes 20 to 30 minutes for melatonin to take effect. If you do not fall asleep within that time frame, you are likely thinking too much. If that were the case, I would recommend taking 1 or 2 capsules of valerian (500 mg strength) from the health food store. This combined with melatonin should help in more than 80%-90% of insomnia cases.

Not sleeping through: Some of you, particularly if you are elderly, may wake up at 3 or 4 AM and have a hard time falling asleep again. At that time it would be safe to take another 3mg of melatonin and if this does not work within 20 minutes add another 500mg valerian capsule.

If you continue to have insomnia problems, see your physician. You may need sleep studies done or you may have problems with your thyroid gland (hypo- or hyperthyroidism), which needs to be checked. The doctor needs to be aware of other medical problems including depression. Melatonin and valerian are safe. Other sleeping pills have multiple side effects including memory problems.

Part of good sleeping habits is to provide a quiet, comfortable bedroom

The following points are good checklist for a comfortable sleep environment (Ref.1).

  • Ensure your bedroom is dark, soundproof, and comfortable with the room temperature being not too warm, and you develop a “sleep hygiene”. This means you get to sleep around the same time each night, have some down time 1 hour or so before going to bed and get up after your average time of sleep (for most people between 7 to 9 hours). Do not sleep in, but use an alarm clock to help you get into your sleep routine.
  • Avoid caffeine drinks, alcohol, nicotine and recreational drugs. If you must smoke, don’t smoke later than 7PM.
  • Get into a regular exercise program, either at home or at a gym.
  • Avoid a heavy meal late at night. A light snack including some warm milk would be OK.
  • Do not use your bedroom as an office, reading place or media center. This would condition you to be awake.  Reserve your bedroom use only for intimacy and sleeping.
  • If you wake up at night and you are wide awake, leave the bedroom and sit in the living room doing something until you feel tired and then return to bed.
  • A self-hypnosis recording is a useful adjunct to a sleep routine. Listen to it when you go to bed to give you something to focus on (low volume) and you will find it easier to stop thinking.
Sleeping Habits

Sleeping Habits

Conclusion

We need to be aware how important a proper hormone balance is when it comes to a healthy sleep pattern. Thyroid hormones and sex hormones are easy to measure. Bioidentical hormone replacement is necessary, if one of the hormones is low. To check GH levels, the doctor orders an IGF-1 level and/or metabolites of GH in a 24-hour urine sample as explained above. Older people need to replace melatonin deficiency the way I summarized above. With these measures sleeping habits improve, and you will get your 7 to 8 hours of restoring sleep. Forget the notion of the past that older people would not need as much sleep. Especially for an aging individual it is important to have a good night’s sleep in order to feel well and energized every day.

References

Ref.1: Jean Gray, editor: “Therapeutic choices”, 5th edition, Chapter 8 by Jonathan A.E. Fleming, MB, FRCPC: Insomnia, © 2008, Canadian Pharmacists Association.

Apr
02
2016

Women Win Turning Older

Supercentenarians may teach us something about the question “Why do women win turning older”? Supercentenarians are people who are 110 years or older. Presently there are 53 of them distributed over the world, 51 are females and two are males. According to Ben Dulken and Anne Brunet this is not by chance: in other mammal species females often live longer than their male counterparts. They theorize that stem cells live longer under the influence of estrogen and this may be the explanation for the difference. They wanted to answer the burning question: “Is life expectancy linked to gender and stem cells”?

Observations regarding why women win turning older

Ben Dulken and Anne Brunet describe that several pieces of evidence are important to note.

Human eunuchs live longer than average males

Castrated males, called eunuchs, live on average 14 years longer than the average male.

Treatment of male mice with estrogen caused longevity

Experiments with male mice treated with estrogen increased their lifespan compared to untreated male controls.

Estrogen receptors on some stem cells in women

Neural stem cells (NSCs) and hematopoietic stem cells (HSCs) have estrogen receptors in females. This leads to extra stimuli during pregnancy, but also during the menstrual cycle in women or the estrus cycle in female mammals.

Faster wound healing in women may be from extra X-chromosome

It gets more complicated: There are non-estrogen regulated stem cell niches in the liver, skin and subcutaneous tissue (important for wound healing and resident muscle stem cells, called satellite cells (SCs). For some reason liver regeneration and wound healing, but also healing of muscle injuries in women and female mammals occurs at a faster pace. Scientists still do not have an answer for this. Theories are that perhaps women with their two X-chromosomes are at an advantage in comparison to males (only one X-chromosome) with respect to certain wound repair mechanisms.

Longevity and self-repair capacity may be related

There is the question whether longevity and self-repair capacity would be related, either through stem cell populations (NSCs, HSCs, SCs), other repair mechanisms or tissue proliferation.

Telomere length in older persons longer in females than in males

There are gender differences in aging patterns of stem cells. For instance studies in dizygotic twins showed that telomere length of blood cells in the female twin was much longer than in the male twin. Genetic factors appear to be the dominant factor to explain this phenomenon rather than hormones. But again this was favoring the female.

Comparison between muscles in older men and younger men

A study in males showed that there is an accumulation of damaged DNA in SC’s of muscle tissue with older age that leads to muscle senescence. In older men there is a delayed response to a specific exercise stimulus with regard to the satellite cell division (SC) when compared to the response in young men.

Women’s telomeres in stem cells grow longer

In females estrogen stimulates telomere growth of stem cells (NSCs and HSCs), which prevents premature stem cell exhaustion.

Effects of diet and exercise on life expectancy

The Potsdam study analyzed 4 healthy behaviors in 23,153 German participants aged 35 to 65 years over 7.8 years. They looked for the development of cancer, heart attacks, strokes and cancer as end points. The 4 healthy behaviors were: to be a lifelong non-smoker , having a body mass index lower than 30, performing 3.5 h/week or more of physical activity, and adhering to healthy dietary principles (high intake of fruits, vegetables, whole-grain bread and low meat consumption).

Those who had adopted all 4 healthy lifestyles reduced the development of serious disease by up to 80%. Dr. David Katz delivered a keynote address at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014 entitled “Integrative Medicine: A Bridge Over Healthcare’s Troubled Waters”. He mentioned the Potsdam study. And he mentioned what the new logic of a healthy lifestyle is: a healthy lifestyle causes healthy telomeres of somatic cells and of stem cells; this causes health until a ripe old age.

Life Expectancy Linked To Gender And Stem Cells

Life Expectancy Linked To Gender And Stem Cells

Conclusion why women win turning older

It seems that women and female mammals are more protected by nature than males. The previously called ”weak sex” is in fact a lot stronger! This may be the reason that among supercentenarians there are only a few males remaining. But we don’t know how many males take the lifestyle factors of the Potsdam study serious. Males who want to age gracefully have to pay more attention to healthy lifestyles. This leads to longer telomeres and this allows for stem cell and somatic cell renewal. There are still many unanswered questions, but life expectancy is definitely related to how well we preserve stem cells throughout our body. This in turn depends very much on our lifestyle patterns.

Mar
19
2016

Book Review: “Healing Gone Wrong – Healing Done Right”, By Ray Schilling, MD

This book entitled “Healing Gone Wrong – Healing Done Right” (Amazon, March 18, 2016) is dealing with the practice of medicine then and now. Medical errors, false diagnoses and wrong treatments are nothing new in the history of medicine. It happened in the past, and it is happening now. My first book was about anti-aging. The title was “A Survivor’s Guide to Successful Aging” (Amazon 2014).

Book overview

Chapter 1

Here I describe describe that famous people like President Kennedy, Elvis Presley, Churchill, Beethoven or more recently Michael Jackson have something in common: all of them suffered the consequences of blatant medical mistakes. In Beethoven’s time lead containing salves to plug the drainage holes from removing fluid from his abdomen caused lead poisoning. In this chapter I review also how doctors treated the illnesses of the above-mentioned celebrities, but then ask the question: “What better treatments have offered to prevent some of the disastrous treatment outcomes?”

Chapter 2

Modern drugs seem to come and go. We learn that twenty-first century medications that are supposed to be the latest therapeutic agents are having their potentially deadly consequences too: COX-2 inhibitors, the second generation arthritis drugs cause strokes and heart attacks! Your doctor may still prescribe some of these dangerous drugs for arthritis now.

Chapter 3

This chapter deals with the fact that medical treatments for people’s diseases may be inappropriate when the doctor treats only symptoms, but the doctor does nothing about the causes of their illnesses. This is a scary thought.

Chapter 4

What does it take to prevent these poor health outcomes, so that we will be able to prevent any disastrous outcomes pertaining to our own health care in the present and future? As we will see, the problem today is still the same as it was in the past, namely that many physicians still like to treat symptoms instead of the underlying cause of an illness. Big Pharma has the seducing concept of a pill for every ill, but it is not always in your best interest, when these medications have a slew of side effects. “Gastric reflux” means a mouthful of stomach acid. Big Pharma simply offers the patient with the symptom of gastric reflux a multitude of medications to suppress this symptom. But it is more important to dig deeper to find the reason for the illness and treat the underlying cause.

Chapter 5

We all need our brain to function. This chapter concentrates on the brain and how we can keep our brains functioning optimally until a ripe old age. This review spans from prevention of head concussions to avoiding type 3 diabetes (insulin sensitivity from overconsumption of sugar). It manifests itself in Alzheimer’s disease. It is a form of diabetes of the brain that leads to deposits of a gooey substance. Prevention of this condition is also reviewed .

Chapter 6

This chapter reviews what we now know about how to keep a healthy heart. Certain ingredients are necessary such as regular exercise, a healthy Mediterranean diet, supplements etc. The good part is that what is good for the heart is also good for the brain. You are preventing two problems (brain and heart disease) at the same time.

Chapter 7

What should we eat? And why does healthy food intake matter? Without the right ingredients of our body fuel, the body machinery will not work properly. The Mediterranean diet is an anti-inflammatory diet that is particularly useful.

Chapter 8

We need healthy limbs, bones and joints. We are meant to stay active in our eighties and nineties and beyond. No osteoporosis, no joint replacements, no balance problems that result in falls! Learn about how to deal with problems like these in this chapter.

Chapter 9

This chapter deals with detoxification. What do we do as we are confronted with pollution, with radiation in the environment and poisons in our daily food? A combination of organic foods, intravenous chelation treatments and taking supplements can help us in that regard.

Chapter 10

I am dealing here about reducing the impact of cancer in our lives. A lot of facts have come out in the past 10 years telling us that reduction of sugar and starchy food intake reduces cancer. Curcumin, resveratrol and vitamin D3 supplements also reduce cancer rates as does exercise and stress management. All of this is reviewed here.

Chapter 11

This chapter tells you all you need to know about your hormone status. Women need to avoid estrogen dominance; both sexes need to replace the hormones that are missing. By paying attention to your hormonal status and replacing the missing natural hormones with bioidentical ones, most people can add 10 to 15 years of useful, active life!

Chapter 12

Here you will learn more about anti-aging. You will learn about the importance to keep your mitochondrial DNA healthy. Apart from that there are ways how to keep your telomeres longer; certain supplements that are reviewed will help. Also your lifestyle does make a big difference in how old you can turn.

Chapter 13

This chapter investigates the limits of supplements. Many supplements are useful, but you do not want to overdo it and get into toxic levels. More is not necessarily better!

Chapter 14

Here is a review of an alternative approach to treating ADHD. Attention deficit and hyperactivity disorder has been over diagnosed, has been neglected and has been over treated with dangerous drugs. An alternative treatment plan is discussed, which includes a combination of therapeutic steps.

Chapter 15

This gives you a brief summary of the book.

Kirkus Review

Kirkus Reviews reviewed the book on March 17, 2016: “A retired physician details how various preventative measures can fend off disease and disability in this consumer health guide. Schilling (A Survivor’s Guide to Successful Aging, 2014) had a family medicine practice in Canada for many years before retiring. Although Schilling ventures into some controversial territory in his latest book, it’s generally an engaging, helpful synthesis of ideas that draws on reputable research from the Mayo Clinic and other sources. Overall, it serves as an intensely detailed wake-up call to the importance of preventative health. He largely brings an accessible and even-tempered tone to his narrative, warning readers, for example, that preventative health measures can only aid in “a delay of aging, not ‘eternal living.’ ” A thought-provoking, impassioned plea to be proactive about one’s health.”

Healing Gone Wrong – Healing Done Right

Healing Gone Wrong – Healing Done Right

Conclusion

In this book it becomes evident that it is better to prevent an illness whenever possible rather than to wait for illness to set in and cause disabilities or death. You heard this before: “Prevention is better than a cure” or “an ounce of prevention is better than a pound of cure”. I will give an explanation, based on scientific data that there is indeed evidence to support these notions on a cellular level.

Mitochondria, the energy packages within our cells

The mitochondria, the energy packages within our cells, are the driving force that keep people vibrantly healthy well into their nineties. All this can only happen when the mitochondria function properly. If toxins poison the mitochondria and as a result they malfunction, we are not looking at a person with vibrant health. Instead sixty or seventy year-olds may use a wheelchair. If you want a life without disabilities, a life without major illnesses and enjoy good health to a ripe old age, you are reading the right book.

The book is written in American English.

Available in the US: http://www.amazon.com/gp/product/1523700904

In Canada: https://www.amazon.ca/Healing-Gone-Wrong-Done-Right/dp/1523700904/  

In other countries the book is available through the local Amazon websites.

Oct
03
2015

What Stress Does

I like to discuss what stress does. We all are stressed out at times. Some people are stressed all the time and this is called chronic stress.

Acute stress

Let’s say you were in a minor rear-ender accident. It is annoying, but at least you had no injury. But you have to deal with the insurance company, get the repair done and maybe get a car rental during the time of repair. Yes, you may have a few days where you feel that your hands are shaky and your heart pounds, or your sleep may not be restful. But when everything is done things are back to normal. This is an example of acute stress with a shorter running time. It has a limited severity, is an inconvenience, but it does not really affect your body on the long-term.

Chronic stress

Let’s assume the car accident was more severe and you received a personal injury with a broken leg. You end up in hospital and the orthopedic surgeon fixes the fracture with a surgical plate. The leg has to be in a cast for several weeks, and you have to use crutches. Every day you feel reminded of the car accident, because it is awkward to walk with crutches. After weeks you notice that you have gained weight. Your doctor is also worried about you because your blood pressure showed higher readings. You do not sleep as well, waking up frequently and having nightmares about another fictitious accident. On top of that you came down with the flu. What happened here? The stress reaction released cortisol, which weakened your immune system and may be responsible for catching the flu.

High blood pressure and increased alcohol consumption

On the long-term cortisol can also contribute to high blood pressure, but so can alcohol consumption. You may have increased your alcohol intake in the evening to relax more, but with the chronic stress and the cortisol increase this can cause high blood pressure. The weight gain that you noticed has to do with the fact that you cannot work out any more because of your healing leg fracture and you having to use crutches. Inadvertently you may also eat a bit more rich food; a lot of people do that as food can be used as comfort food.

Disbalance of melatonin and cortisol with stress

And why do you sleep less well? Chronic cortisol elevation leads to lower melatonin levels, as these two hormones are natural opponents. A high melatonin level leads to a low cortisol level and vice versa. With relaxation methods you can lower cortisol and the melatonin level increases normalizing your sleep. Chronically elevated cortisol can also lead to weight gain as sugar is converted into fatty acids that are stored as subcutaneous fat. Muscles can melt down when cortisol is high giving the appearance of spindly arms and legs.

Causes of chronic stress

Holmes and Rahe tested a stress scale in 1970, which has become the standard ever since. You get a certain amount of points for a stressful event, e.g. 100 for the death of a spouse; 45 point for retirement; 23 for trouble with the boss etc. Add up all of the points that are affect you right now; if the total score is less than 150 points there is only a minor risk of getting medical problems from the chronic stress; for 150 to 299 points the risk of illness is moderate and for 300 and more points you are at a significant risk for illness.

Physical illness and mental illness from stress

There is physical illness and mental illness that chronic stress can cause. Physical illness can be high blood pressure, hardening of the arteries. The long-term risks from this are possible heart attacks and strokes. But chronic adrenalin and noradrenalin elevation associated with chronic stress can burn part of your brain cells in the hippocampus and medial prefrontal cortex. This can lead to memory loss, spatial memory loss and aggression. Mental illness caused by chronic stress can be anxiety, depression, social isolation, panic attacks and panic disorder. Psychosomatic symptoms can include headaches, back pain, abdominal pain and difficulties concentrating.

Job stress and cancer

Perhaps one of the best examples of job stress and cancer is a study where the amount of breast cancer was correlated to the amount of stress. I discussed this in another blog. Briefly, women with a less responsibility had the lowest rate of breast cancer, but they too had some stress as there was a higher breast cancer risk after 15 years on the job versus only 5 years on the job. The same study showed that women with high responsibility had the highest breast cancer rates.

How stress leads to higher breast cancer rates

A hormone disbalance can explain this based on high cortisol levels associated with chronic stress. If cortisol is high, the cortisol binding globulin (CBG) increases; this in turn also binds more circulating progesterone, as progesterone attaches to CBG. CBG is a transport protein for both cortisol and progesterone. The end result is that estrogenic compounds get the upper hand, a condition called estrogen dominance. I have explained under the above link that this was the real reason for the increase in breast cancer in the stressed women. Similar mechanisms are causing other cancers to occur more frequently with chronic stress.

Chronic stress and cardiovascular disease

High stress jobs were found to cause a 2.2 to 2.4-fold increase of strokes and heart attacks due to cardiovascular disease when compared to low stress jobs. This was based on a British Medical Journal study in October 2002. As I discussed above under a brief description of chronic stress cardiovascular disease is often what develops as part of chronic stress. People who are under chronic stress feel that they do not have enough time to prepare good, healthy food at home. They tend to eat out more often. Even well educated people just swallow a quick hamburger and other processed foods.

Bad fats lead to heart attacks and stroke

This increases the bad fats like trans fats and omega-6 fatty acids in their system causing inflammation of the blood vessels as explained in this blog. The LDL cholesterol and triglycerides get elevated, sugar from sugary snacks oxidizes the LDL cholesterol and your coronary arteries and brain arteries get clogged up. This sets anybody on the downward pathway, and it is now only a matter of time when the chronically stressed person will develop a heart attack or stroke.

Chronic stress extremes: PTSD and burnout in soldiers

Dr. Thierry Hertoghe gave a lecture during the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec.10 to 14, 2014). The title was: “Burnout: A multiple hormone deficiency syndrome”. Burnout is the extreme of chronic stress. He said that burnout is a common condition where several hormones are affected, with the cortisol axis being the main one, but other hormone glands being stressed as well. As a result endocrine glands age prematurely. Symptoms are fatigue, exhaustion, gastrointestinal problems, anxiety, depression and aggressiveness. The underlying hormone abnormalities are a lack of cortisol, thyroid deficiency, growth hormone deficiency, testosterone and estrogen deficiency and oxytocin deficiency. Burnout is common in teachers and there is a questionnaire that has been developed for teachers (teacher’s burnout scale) to monitor them whether they are heading this way.

Burnout or PTSD

Soldiers who return from combative situations often suffer from burnout or from PTSD. The teacher’s burnout scale already mentioned can monitor their burnout severity. In suspected cases laboratory tests that measure hormone levels give concrete answers about hormone deficiencies. Treatment protocols were discussed in detail. Multiple bioidentical hormone replacements are necessary, possibly for prolonged periods, if not life long. In addition supportive counseling sessions from a counselor or psychiatrist will help to tone down increased brain activity and help regain the internal balance. Why is this important? It is important, because hormones are necessary on a cellular level and regulate the energy metabolism of every cell in the body. Also, by recognizing what is going on and helping the affected individuals, a lot of pain and suffering can be prevented.

Accelerated aging from telomere shortening

Chronic stress has been shown to cause telomere shortening. So does a lack of sleep (insomnia), smoking and alcohol overconsumption, all conditions that can be associated with chronic stress. What can we do about this? Learn what shortens telomeres and ultimately your life. Cut out what you can and take supplements that lengthen your telomeres.

Positive thinking combats stress

Negative thoughts are draining you of energy. You want to stay optimistic within what’s reasonable. Be thankful for all the good things in your life. Minimize what’s negative, but think about positive solutions to get rid of energy draining parts in your days. Do this persistently until it becomes part of your life and you will have extra energy that you didn’t waste in negative thinking or needless, anxious anxiety. Worrying does not get us anywhere, but it depletes our energy.

Relaxation methods counter stress

Self-hypnosis is a simple way to allow your whole body to relax. However, the various forms of yoga will do the same thing for you. Meditation is another way of finding peace and tranquility. Prayer is know to help people in sickness and in health. All of these methods will re-energize you. They calm your brain, help you to cope with stress and rebalance your hormones at the same time.

Building social ties and mutually supportive relationships will also build you up. It makes you feel that you belong, you have your place in society, you help others, and they support you.

Constant overdrive has physical consequences

We need some stress to get us going, but we do not need “distress”. Dr. Hans Selye, the father of the general adaptation syndrome due to stress, gave a lecture about this topic in Hamilton, Ont. in 1977, which I attended. I vividly remember how he projected a picture of his skeleton showing bilateral hip replacements. He said that chronic stress could lead to arthritis. In his case, he said, he had developed end stage arthritis in his hips requiring total hip replacements on both sides. To illustrate further that stress leads to physical consequences, he explained that one person may develop a heart attack, another a stroke, a third could get arthritis. Constant overdrive has physical consequences.

What Stress Does

What Stress Does

Conclusion

Stress can be deadly, particularly if it lingers on and becomes chronic. But we can reorganize our lives to minimize stress. Some people may decide to seek a less stressful occupation. Others may elect to stay at that job, but develop hobbies, learn how to relax and take relaxation classes to combat job stress. The key is to start thinking about what stress you may be under and then develop a plan to counter it so you can allow yourself to rebalance your life.

Apr
25
2015

Rejuvenate With Stem Cells

We all age; but can we rejuvenate with stem cells? There is a limit to detoxification, to eating organic food, to exercising, to the effects of vitamins and supplements and even to the effect of bioidentical hormone replacements. The limit comes from our telomeres and from stem cells that get depleted in our body as we age. Some researchers report that in regions where we suffer from a disease stem cells are even more depleted than in the rest of the body.

We do not have all the answers yet. We would like to know why our stem cells in the fatty tissue or in the bone marrow do not migrate on their own into an aching back or a sore shoulder. There are all the aches and pains associated with old age. So, why do our own stem cells not help us? They seem to be locked away in fatty tissue and in bone marrow.

At the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec. 10-14, 2014) I learnt that there is a group of stem cell experts in California with affiliates all over the US. They simply take stem cells from the fatty tissue and sometimes also from the bone marrow, isolate the stem cells through a stem cell separator and infuse the stem cell rich fraction (minus fatty and connective tissue) in a bit of saline solution back into the vein of the patient. When the stem cells are in the blood stream, they get activated by the growth factors that are present in blood and can now find where they are needed and start the healing process.

Studies have shown that when stem cells are in circulation in the blood, they are very sensitive to signals from tissues that indicate that there is an inflammatory process. This is why stem cells will repair arthritic changes. The can repair a torn meniscus, a rotator cuff tear in the shoulder or repair a weak immune system. The interesting observation is that stem cells from fatty tissue, also termed mesenchymal stem cells, are pluripotent. This means they can develop into cartilage building cells (chondrocytes) and build up cartilage; this is badly needed in a person with severe osteoarthritis. But stem cells are flexible: they can turn into meniscus cells in a knee with a torn meniscus. They also can repair the damage and relief the patient of the chronic pain. In a shoulder with a rotator cuff tear they can turn into a tough ligamentous material mending the tear.

Some data even indicates that circulating stem cells can repair vital organs like the brain, heart, liver, kidneys and bone marrow; these latter observations were mostly done in animal experiments, but human data is starting to be published in the medical literature.

So, let’s examine what has been found useful with regard to stem cells that are taken from your fatty tissue or your bone marrow and injected into one of your veins.

Here is a website from Arizona that I am only showing as a typical example (I have no conflict of interest and no commercial connections to this group) of what I described above.

With websites like this it is also important to read the disclaimer: “Even though our treatments are done using autologous cells, our Stem Cell Therapies are not approved by the FDA. Stem Cell Treatments are not a cure for any condition, disease or injury, nor a substitute for proper medical diagnosis and care…” Another website from La Quinta, CA describes the use of mesenchymal stem cells for regenerative therapies.

Stem cell treatments are in flux. There is a large body of knowledge that has accumulated showing that with proper technique and aseptic conditions it is a safe procedure. The FBA has been watching this. There are publications regarding the safety of procedures with adipose mesenchymal stem cells; here is one example.

The next step is to show in clinical trials that a certain procedure with stem cells is effective in treating a certain condition.

Below I did a literature review, which are only a few examples, but does not claim to be complete; it highlights some of the problems with stem cell treatments.

Stroke treatment with intravenous administration of bone marrow mononuclear stem cells

This study from India showed no statistical difference of stroke patients treated intravenously with bone marrow derived mononuclear stem cells (the experimental group) and the control group that did not receive such treatment. The investigators examined both groups with functional brain tests and performed PET scans to look at the healing of the brain lesions. Unfortunately the tests showed no statistical difference, but did show that the stem cell procedures were safe. It may be that the wrong stem cells were used (mononuclear bone marrow stem cells) when adipose derived mesenchymal stem cells may have done better. In stark contrast to the study from India is the stem cell treatment for a severe stroke in the former hockey player, Gordie Howe that has gone through the media recently. His procedure was done in Mexico. The stem cells were administered via a lumbar puncture approach as well as intravenously. As you can see from this case, stem cell treatment is even possible in patients who are in their mid 80’s with impressive results.

Parkinson’s disease

Here is a feasibility study from March 2014. A 71-year-old Asian man with progressive supranuclear palsy, an aggressive form of Parkinson’s disease was treated with adipose tissue-derived mesenchymal stem cells that were administered intravenously and intrathecally (to get stem cells into the cerebrospinal fluid that bathes the brain). A remarkable functional recovery took place.

Possible side-effects

This is a report of pulmonary embolism after administering intravenous adipose tissue-derived stem cell therapy. The blood clots in the lungs were treated with anticoagulant therapy. Repeat CT scans of his lungs showed later that the emboli were dissolved spontaneously. It is not clear whether this was a case where familial clotting problems pre-existed as a relative of this patient experienced a similar occurrence after stem cell therapy as well.

A case of chronic autoimmune thrombocytopenic purpura

A rare form of autoimmune disease exists where the body forms antibodies against platelets that help your blood to clot. Here is a paper from June 2009 that describes how a man with this disease was cured using adipose tissue-derived mesenchymal stem cells that were injected intravenously.

Renal transplant survival in type 1 diabetes patient

This case report from India shows that adipose tissue derived mesenchymal stem cells that were given at the time of a kidney transplant to treat end stage kidney disease. The treatment stabilized the condition of this patient after a kidney transplant. At the same time some of the mesenchymal stem cells differentiated into insulin producing cells, which made it much easier to control this patient’s diabetes. In this case stem cells were providing stability following an organ transplant (kidney) and some stem cells turned into insulin producing pancreatic cells.

Osteonecrosis of hip treated with adipose tissue derived MSC

In this study from South Korea dated January 2012 two cases of osteonecrosis of the hip, where the hipbone died (osteonecrosis) are described. The following stem cell protocol helped: The fraction that contained the stem cells (called stromal vascular fraction) was mixed with platelet rich plasma and hyaluronic acid. Using a long needle this mixture was injected into the affected hip joint. Conventional medicine has nothing to offer except a total hip replacement. But here are two cases that showed complete resolution of their pain, regained hip function completely, and healing could be documented with the help of MRI scans.

Treating heart attack patients with stem cells

Here is a paper from The Netherlands, published in June 2014 that describes the problems with stem cell treatment in humans. It points out that much has been learnt from animal experiments. The problem following a heart attack is that there is a massive inflammatory response in the infarcted heart muscle, which makes it difficult for stem cells to establish themselves in the injured heart muscle. However, stem cells have been shown to prevent the development of cardiomyopathy that follows a massive heart attack and often is the cause of death. More refinements are needed for successful treatments, such as the ideal timing of stem cell injections in relationship to the time of the heart attack, the best treatment approach and what number of stem cells to inject are all questions that still need to be answered.

MS model in mice shows promise with adipose mesenchymal stem cells

Experimental encephalitis in mice is used as a model for MS in humans. It helps to preselect potentially effective treatments for MS in humans. In this 2013 paper from Australia researchers used mesenchymal stem cells from adipose tissue and injected them intravenously. To their surprise the mesenchymal stem cells were able to penetrate the blood/brain barrier and end up in the myelin lesions inside the brain. In contrast, bone marrow derived stem cells were unable to do that. The researchers stated that adipose mesenchymal stem cells should be considered “as a cell therapeutic that may be used to treat MS patients”.

A group from Iran published this paper in February 2015 further emphasizes that mesenchymal stem cells would be a logical way to treat MS in humans.

Immunosenescence

As we get older the immune systems weakens because of a process called immunosenescence.

A research group from Austria published a paper in December 2011 that is typical for the thinking that mesenchymal stem cells from fatty tissue have properties that help the immune system to get stimulated. Based on this human data it should be possible to stimulate the immune system by giving stem cells from the fatty tissue to the same person intravenously. This publication shows that this process, which would benefit people above the age of 50 or 60 when the immune system gets weaker, will indeed stimulate the immune system. However, at this point we do not have the data of large clinical trials where this would have been done with measurements of the immune function before and on several occasions after stem cell injection to get a feeling for how long the effect would last. We also do not know whether this procedure is associated with longevity.

Rejuvenate With Stem Cells

Rejuvenate With Stem Cells

Conclusion

Stem cell therapy is definitely coming and many applications are already established as I discussed in a prior blog. It is only recently that physicians are no longer worried about creating tumors with stem cell transfer. Now we are in a phase where various stem cell transfer methods (intravenous, intrathecal, interstitial) are being tested as a treatment for various illnesses. It looks like stem cells from fatty tissue may soon be used intravenously, but I have not seen any such trials when checked on PubMed. The activation of stem cells by laser light has only been mentioned sparingly in the literature. This combination (laser activated, intravenous mesenchymal injection) has the potential for being useful for a multitude of chronic illnesses like fibromyalgia, MS, generalized arthritis, just to mention a few. Mesenchymal stem cells are anti-inflammatory, and they can mend defects without leaving scars.

Mar
21
2015

What Alcohol Does To You

The media has praised alcohol  for preventing heart attacks, but let us examine what alcohol does to you. There are other articles in which we hear about alcoholic hepatitis and liver cirrhosis, both of which can be killer diseases. To get some clarification, let us discuss the various facts.

Dr. Finnel points out that 7.9% of all emergency room visits in the US are due to alcohol related conditions (Ref.1). When the causes of deaths that are a consequence to alcohol are listed, the top 8 causes are: cancer of the mouth and pharynx, alcohol abuse disorders, coronary heart disease causing heart attacks, cirrhosis of the liver, traffic accidents, poisonings, falls and intentional injuries. This is not what you read in the news. What you do read about is that one glass of red wine per day would be good for women and up to two glasses of red wine would be good for men to prevent heart attacks and strokes.

Bioflavonoids

It is the bioflavonoids , and among those in particular resveratrol, that are the active ingredients responsible for heart health. Resveratrol is a powerful antioxidant that protects against ischemia-reperfusion injuries. It is responsible for the cardio protective properties of red wine known as the “French paradox” (Ref.2). According to this reference resveratrol contributes to at least 3 processes that stabilize the metabolism.

Toxicity of alcohol

Alcohol toxicity is a complex problem. According to the WHO 5.3% of all deaths worldwide are a consequence  to alcohol. In 2012 the WHO recorded that 7.6% of deaths in males were due to alcohol. In comparison, 4% of female deaths were due to alcohol. Toxicity comes from the breakdown product acetaldehyde, which all cells can convert from alcohol, but liver cells are especially able to do this. According to Ref. 3 alcohol diffuses easily through all of the cell membranes and reaches every organ in the body. The toxicity of acetaldehyde is the reason  for shutting down the mitochondria which affect the energy metabolism and causing cell death. The immune system reacts with inflammation, when it attempts to repair the damage.

So, what are the major problems what alcohol does to you? These are the processes: First fat accumulation (steatosis), next chronic inflammation followed by necrosis (dying of cells) and fibrosis. An example of fibrosis is liver cirrhosis, where non-functioning connective tissue replaces liver cells.

Different tissue sensitivity to alcohol

Certain tissues are more susceptible to alcohol toxicity than others. As the concentration of alcohol is highest in tissues that are in direct contact with alcoholic drinks, cancers related to alcohol consumption develop in the oral cavity, pharynx, larynx, esophagus, and in the colon and rectum. The pancreas is particularly vulnerable to inflammation and fibrotic changes with subsequent degeneration into cancer of the pancreas. The heart tissue and the arteries are very sensitive to alcohol; hypertension, heart attacks, stroke, cardiomyopathy and myocarditis as well as irregular heart beats (arrhythmias) can develop. The brain is very sensitive to toxic effects of alcohol as well. This causes major depression, personality changes with violent behavior, car accidents and injuries.

Other toxic effects of alcohol on organs

Kidney disease (alcoholic nephropathy) is another alcohol caused illness. 5% of breast cancers in northern Europe and North America are directly related to the toxic effects of alcohol (Ref.3). Finally, the liver being so active in detoxifying alcohol is affected by developing liver cirrhosis, which accounts for a lot of premature deaths at a relatively young age (typically in the mid to late 50’s).

Ref. 3 goes on to say that literature exists which claims that 1 to 2 drinks per day would be useful for prevention of heart disease. But the observation of the authors is that people will not discipline themselves to stick to these limits and very quickly enter into the zone of alcohol toxicity. The authors further noted that with regard to causing any kind of cancer there is no safe lower limit; the risk is directly proportional to the amount of alcohol consumed and the risk starts right above the zero point.

The pathologist has the last word

When I studied medicine at the University of Tübingen, Germany I attended lectures in the pathology department where Professor A. Bohle, M.D. demonstrated pathology findings of deceased patients. Dr. Bohle had a special interest in Mallory bodies. These are alcohol inclusion cysts within liver cells that can be stained with a bright red dye.

Histological documentation of toxic effects in livers of corpses

I will never forget when Prof. Bohle pointed out that the livers of this most diverse population whose bodies we had the privilege as medical students to study had a rate of 25% positive Mallory bodies. He wanted to impress on us as medical students to watch out for the alcoholics that are usually missed in general practice. Obviously 25% of the pathology population was affected by the consumption of alcohol. It was Prof. Bohle’s hope that we could perhaps interfere on the primary care level before things went out of control. Many of these corpses belonged to traffic accidents that could have been prevented (now seat belts and alcohol limits are standard, in 1968 they were not).

Alcohol as an aging substance

Consistent use of alcohol on a regular basis will slow down cell metabolism and hormone production significantly. The major effect of alcohol leads to poisoning of the mitochondria in multiple organs, which translates into faster aging and a shortened life expectancy. This in turn results in a change of appearance. An older person who has abused alcohol for a number of years may look 5 to 10 years older than their chronological age.

50% of people above the age of 65 drink daily (Ref.4). Some more statistics: alcohol abuse in elderly men is 4-times higher than in elderly women. 5% to 10% of all dementia cases are related to alcohol abuse. About 15% of older adults are experiencing health risks from abusing alcohol. And about 90% of older adults are using medications and close to 100% of medications can adversely interact with alcohol (Ref.4).

Social pressure

These are the scientific facts , and then there is social pressure when you are invited to a party.

When you are young and invincible, do you care what the science says? You want to have a “good time” and not worry about consequences. The data about long-term exposure and a slowly increasing cancer risk is there. The wine industry will remind you that 1 drink for women and two drinks for men will protect you from heart attacks. They will withhold the cancer information from you, as they don’t really want to hear about that (yes, it’s bad for their business!).

Resisting social pressure and doing what is good for you

Can you have a good time at a party without drinking alcohol? Yes, you can. You can talk and you can listen; you are probably more with it than those who had too much to drink. I like mineral water and hold on to a glass of that.

I explained in a blog before how I was convinced by three speakers at an A4M conference to join those who abstain from alcohol.

Socializing without alcohol is doable. You may at times miss it, but you can warm up even to a crowd that had a few drinks too much. It is about choice: we can choose what we want out of life.

What Alcohol Does To You

What Alcohol Does To You

Conclusion

I have attempted to show you the toxic effects of alcohol. Although alcohol has played an important role in the social lives of millions over the centuries, it is becoming more apparent that alcohol is a cell poison and shortens our lives. The beneficial effect of the 1 or 2 drinks marketed by the beer and wine industry and some cardiologists does nothing to counter the threat in terms of a whole array of cancers at much smaller amounts of alcohol. Fortunately, resveratrol and omega-3 fatty acids as supplements as well as exercise will more than make up for the 1 or 2 drinks that you do not really need. And neither exercise, omega-3 fatty acids, or resveratrol are cell poisons. The choice is yours!

References

Ref. 1: John T. Finnell: “: Alcohol-Related Disease“ Rosen’s Emergency Medicine, Chapter 185, 2378-2394. Saunders 2014.

Ref. 2: “Hurst’s The Heart”, 13th edition, The McGraw-Hill Companies, Inc., 2011. Chapter 54. Coronary Blood Flow and Myocardial Ischemia.

Ref. 3: Ivan Rusyn and Ramon Bataller: “Alcohol and toxicity”, 2013-08-01Z, Volume 59, Issue 2, Pages 387-388; copyright 2013 European Association for the Study of the Liver.

Ref. 4: Tom J. Wachtel and Marsha D. Fretwell: Practical Guide to the Care of the Geriatric Patient, Third Edition, Copyright 2007 by Mosby.

Jan
16
2015

Telomere Length A Telltale Sign Of Aging

Dr. Sandy Chang gave a talk at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014 entitled “Telomere measurement as a diagnostic Test in cardiovascular and Age-related disease”, but a shorter title would be “telomere length a telltale sign of aging” (my choosing).

Dr. Chang pointed out that it is now well established that telomere length is directly related to health. The shorter the telomeres are the higher the probability to get the following: early menopause, infertility, diabetes, wrinkles, arthritis, osteoporosis, cardiovascular disease, Alzheimer’s, Parkinson’s, dementia, cancer, stress and a lack of stem cells. In this BMJ study from 2014 it was shown on a large population basis that shorter white blood cell telomeres lead to a higher risk of coronary heart disease causing heart attacks. Decreased telomere length is also associated with the development of breast cancer, cancer of the ovary and uterus, cancer of the prostate and skin cancer.

Because of these connections it makes sense to determine a person’s telomere length. If it is short, do check-ups more often to detect any cancer early when it can still be treated.

Telomere length measurements are now done in many infertility clinics as short telomeres both in the male and female is associated with infertility.

The newest finding and perhaps the most important is that a healthy lifestyle, vitamins and supplements can elongate telomeres while a poor lifestyle leads to shortening of telomeres.

Here are the factors that lead to shortening of telomeres:

– Chronic stress

– Poor diet and nutritional habits

– Chronic inflammatory diseases

– Metabolic disorders

– Lack of consistent exercise/sedentary lifestyle

– Obesity, high BMI and body fat

– Smoking

– Over consumption of alcohol

– Lack of sleep / insomnia

When short telomeres are detected, it is important for the physician to look at lifestyle changes to protect telomeres from decreasing their length even further. This has the potential of preventing dementia and Alzheimer’s when it comes to brain health. It can prevent osteoporosis and metabolic diseases (diabetes, metabolic syndrome). Telomerase is the buzzword today, which is an enzyme that all of our cells have. The purpose why we have telomerase in our cells seems to be helping us build up and repair telomeres. Any substance that preserves telomerase or prevents the breakdown of telomerase will prevent shortening of telomeres and will also prevent the above-mentioned diseases.

These supplements lead to lengthening of telomeres:

-Vitamin C and E

-Omega-3 and polyphenols

-Vitamin A and D3

-All of these help controlling oxidative stress, reduce DNA damage, reduce inflammation and build up telomere length.

-A good diet and nutrition (Mediterranean type diet) will prevent telomere shortening as well and also lead to telomere lengthening.

-T-65, an extract from astragalus has been shown in vitro to lengthen telomeres, but there is no publication yet about in vivo effects in humans.

-Resveratrol is useful to prevent shortening of telomeres as well.

-Exercise also is a simple means to prevent telomere shortening.

Telomere Length A Telltale Sign Of Aging

Telomere Length A Telltale Sign Of Aging

Another talk on telomeres was given by Dr. Harvey Bartnof with the title “Telomere Shortening and Modulation: Case Studies From The Clinic”.

This talk was a comprehensive review of what is known about telomeres, about the fact that many diseases are due to telomere shortening, about animal experiments, ways of how to lengthen telomeres and finally some data on human studies with regard to telomere lengthening.

In the following I will briefly review all of these areas that were discussed. Some of this material overlaps with Dr. Chang’s lecture.

What produces telomere shortening? Dr. Bartnof showed 4 slides that listed all of the conditions and diseases that are associated with telomere shortening. Telomere shortening is associated with twice the risk to die from a heart attack when compared to people with normal telomeres.

a) Known genetic conditions in humans associated with telomere shortening

There are three known genetic conditions due to telomere shortening: A premature aging syndrome, called dyskeratosis congenitalis; patients with this condition die prematurely from cancer, or from bone marrow failure.

People with Werner syndrome who have a genetic telomere loss have a mean life expectancy of only 54 years.

Idiopathic pulmonary fibrosis is another genetic condition with shortened telomeres due to mutations.

b) Telomere shortening associated with these health conditions

Professor Elizabeth Blackburn, PhD who is one of the three researchers who won the Nobel Prize in Physiology and Medicine for their work on telomeres in 2009 stated the following: “Telomere shortness is associated with just about all the major diseases of aging… from cardiovascular disease, death from cardiovascular disease, risks of cardiovascular disease, diabetes, diabetes risks such as insulin resistance, vascular dementia, to osteoarthritis.”

An enormous amount of clinical investigations have been done since in cohort groups like people with diabetes, high blood pressure, obesity and cancer.

There is natural shortening of telomeres due to the aging process. When we compare telomere length of body cells of a 20-year old and call this 100%, the telomeres of a 100-year old person are on average only 40%. A study from the Karolinska Institute found in a group of matching twins where one twin had shortened telomeres, this twin had a 2.8 times greater risk of death than the twin with normal telomere length.

However, as already mentioned a number of other factors can lead to shorter telomeres like chronic stress in workers who look after Alzheimer patients, being of the Caucasian race (compared to African-American), having had less education, chronic unemployment, depression, pessimism, single people versus married people, phobic anxiety in women and hostility in men, poor sleep and too little sleep, migraine headaches in women, low physical activity, smoking cigarettes and alcohol consumption. The list does not stop here. Other conditions are associated with telomere shortening like heroin abuse, exposure to smog, polycyclic aromatic hydrocarbons and lead, cardiovascular disease, diabetes, cancers, osteoporosis, osteoarthritis, rheumatoid arthritis, cirrhosis of the liver, inflammatory bowel disease, chronic obstructive lung disease, Alzheimer’s disease, Parkinson’s disease, chronic kidney disease and disability in the elderly.

c) Effects of medications on telomere length

Antidepressants used against depression have a telomere lengthening effect, but NSAID’s, aspirin and interferon-alpha shorten telomeres. Other telomere shortening effects come from cancer chemotherapy.

d) Telomerase activation elongates telomeres

Successful experiments in various mouse strains showed that special strains that were telomerase deficient, could be reconstituted to normal by reinserting telomerase: atrophied organs regrew back to normal size and function. In humans it was shown that increased physical activity elongated telomeres, so did vitamin C, E and vitamin D3 supplementation, resveratrol, a Mediterranean diet, marine omega-3 fatty acid supplementation, higher fiber intake, bioidentical estrogen in women and testosterone in men, relaxation techniques like yoga and meditation. The Astragalus-derived telomerase activator TA-65 has been shown in animal experiments to elongate telomeres. The human data about TA-65 is still spotty or not available (it is also very expensive and may be unnecessary given the fact that so many other agents are known to lengthen telomeres).

e) Human data on telomere lengthening

Much can be achieved by changing one’s lifestyle: cut out toxins like cigarette smoking and alcohol abuse. Get involved in a regular exercise program, which has been shown to increase HDL cholesterol and to elongate telomeres. Adopt a Mediterranean type diet including olive oil; take vitamin E, D, C and supplements with resveratrol and murine omega-3 fatty acids, all of which elongate telomeres. Get enough sleep (7 to 8 hours per night) and do yoga and meditation. Avoid distress and tone down your stress level to eustress (normal stress level associated with every day living). An older person should use bioidentical hormones to replace missing hormones. All of this taken together will create a milieu in your body where telomeres get elongated and you live longer without disease. Several clinical conditions were mentioned where baseline telomere length was assessed initially and was found to be too short; simple lifestyle changes were then initiated, which were able to improve telomere length and treat these diseases successfully. In addition TA-65 (also termed T-65) was given in some of these cases, but in a subsequent discussion Dr. Bartnof admitted that he could not comment on how effective TA-65 by itself was as it was only one component of many other effective telomerase stimulators given. Till further research is out on this substance, it may be just very costly without spectacular benefits on its own.

Conclusion

I gave a summary of the talks by Dr. Chang and Dr. Bartnof regarding telomeres, but these were not the only talks about telomeres, although quite representative for the others. Both speakers pointed out how powerful lifestyle is for our body functions as this is what lengthens our telomeres and allows us to live longer, disease-free lives. Stem cells also have telomeres, but they are on average longer than the rest of the body cells (called somatic dells). An improved lifestyle will keep our stem cells in good shape, so they are there when needed to replace aging somatic cells.

The new logic of a healthy lifestyle is:

A healthy lifestyle causes healthy telomeres of somatic cells and of stem cells; this causes health until a ripe old age. In the next few weeks I will blog about more topics from the 22nd Anti-Aging Conference in Las Vegas. Stay tuned.

Dec
27
2014

Stem Cells, Telomeres, Hormones And Lifestyle

I recently attended the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas (Dec.10 to 14, 2014) and stem cells, telomeres, hormones and lifestyle were the highlights this year. Every year there seems to be something new to learn. Truly, there were a lot of talks about stem cell treatments, about how lifestyle changes can be healing and how telomeres are in the center of epigenetics. It is important to realize that epigenetics is anything a person can do with lifestyle to help the body work better. In the center of many talks were telomeres, the small caps at the end of the DNA. Indeed, with all cell divisions telomeres get shortened a bit until at the end of our lives our telomeres are significantly shorter.

Shortened telomeres means shortened life

In one talk a slide was shown where the measurements of white blood cell telomeres from blood tests of a population from 20 to 100 years were shown. At the age of 100 the average telomere length was only 40% of the average length of telomeres of the group at the age of 20.

In the past it was thought that our genes and how they function was something constant. Well, we have to rethink this both in positive ways as well as negatively. Using telomere blood tests, it has been shown that certain diseases are associated with shorter telomeres. But on the other hand, positive lifestyle changes and certain supplements can elongate telomeres by stimulating an enzyme called telomerase.

Positive changes of our epigenetics can elongate telomeres

Drinking excessively, doing drugs, smoking and even using non-steroidal anti-inflammatory drugs (NSAIDs) shorten your telomeres. This is what epigenetics is all about. It is true that you cannot change your genetics, but you can change the epigenetics (meaning the length of telomeres).

As this topic is so large, I have decided to give an overview about the conference in this blog and in future blogs provide more details about some of the key talks.

A review like this is always personal. Other people probably would find other talks more illuminating. So here are my personal impressions about the topics that I found most fascinating.

Stem cells

There were several talks about stem cells. Dr. Joseph Purita talked about the rejuvenating effects of PRP (platelet rich plasma) on stem cells that he injected into patients. This was a fairly technical talk, but pointed out how important it is to provide the appropriate growth factors to nurture transplanted stem cells for a long-term success. The sources of stem cells can be from fatty tissue around the “love handles” or the abdominal fat. A stem cell separator is used to separate stem cells from the rest of the tissue. This is combined with PRP coming from centrifuged blood and is combined with the stem cells and injected.

Soft lasers can activate stem cells

The newest insight is that short-term exposure to red, green and blue soft lasers further activates stem cells. Another source for stem cells is the bone marrow, usually from the pelvic bone, particularly for orthopedic surgical problems like non-healing fractures or torn ligaments. Slides were shown of completely healed avascular necrosis following stem cell treatment. At other lectures on prolotherapy combined with stem cell therapy completely torn anterior cruciate ligaments in the knee and a complete rotator cuff tear in the shoulder in another patient were healed (MRI scan shown before and after treatment).

Lifestyle

Dr. David Katz gave a presentation about “Integrative Medicine: A Bridge Over Healthcare’s Troubled Waters”. He pointed out that the first three things on the actual causes of deaths in the US in 1993 were tobacco use, poor diet and lack of exercise. In 2004 the revised list no longer contained tobacco as the number one killer. All of the public campaigns had changed the culture of smoking so that the average American has changed the lifestyle. Stopping smoking has become desirable, and people know the devastating consequences of smoking. Dr. Katz stated that there is no magic pill to reduce mortality. However, if a healthy lifestyle were a pill, this is exactly what would reduce mortality by 80%. If you exercise on a regular basis, eat a Mediterranean type diet, and avoid sugary drinks you will prevent 80% of heart attacks, strokes and many cancers.

Telomeres

Dr. Sandy Chang gave a talk about “Telomere measurement as a diagnostic test in cardiovascular and age-related disease”. He pointed out that there is a large body of literature showing that telomere length is directly related to health. The shorter the telomeres are, the higher is the probability to experience problems: early menopause, infertility, diabetes, wrinkles, arthritis, osteoporosis, cardiovascular disease, Alzheimer’s, Parkinson’s, dementia, cancer, stress, a lack of stem cells. These are a number of factors that shorten telomeres: stress, poor diets, smoking, obesity, chronic inflammatory diseases, metabolic disorders like diabetes, over consumption of alcohol and lack of sleep.

Telomere elongation leading to longer life

Dr. Chang mentioned that there is a whole host of factors that can elongate telomeres by stimulating telomerase. His research group showed in humans that increased physical activity elongates telomeres. So did vitamin C, E and vitamin D3 supplementation, resveratrol, a Mediterranean diet and marine omega-3 fatty acid supplementation. In addition, higher fiber intake, bioidentical estrogen in women and testosterone in men, relaxation techniques like yoga and meditation are also elongating telomeres.

Stimulation of telomerase can elongate telomeres

Other speakers also talked about telomeres: Dr. Al Sears’ talk was entitled: “Telo-Nutritioneering: The latest generation of telomere modulators”. He mentioned that in his research he has identified at least 123 nutrients, vitamins and natural compounds that will elongate telomeres, often by stimulating telomerase. Vitamin C will significantly delay shortening of telomeres, which translates into delayed aging. In addition, researchers recently showed that vitamin C stimulates telomerase activity in certain stem cells. Also, there is an herb, called Silymarin extract. Researchers found that this increases telomerase activity threefold. N-acetyl cysteine is a building block for glutathione, a powerful antioxidant. In addition, research showed how to turn on the human telomerase gene. Other telomerase stimulators are green tea extract, ginkgo biloba, gamma tocotrienol (one of the components of the vitamin E group), vitamin D3 and folic acid.

Methylation defects

Dr. George Rozakis gave a talk entitled “Nutrigenomics” where he mentioned that many diseases are due to methylation defects, a cellular pathway that required vitamin B2, B6 and B12. People with this defect have minor genetic variations that lead to elevated homocysteine in the blood. For instance, migraine sufferers often have methylation pathway problems, which involves histamine overproduction and 92% of them can be helped with a histamine-restricted diet. Correcting a methylation pathway defect with the help of L-methylfolate can cure other diseases like depressive illness that does not respond to conventional antidepressant medication.

 

Stem Cells, Telomeres, Hormones And Lifestyle

Stem Cells, Telomeres, Hormones And Lifestyle

Hormone changes with stress

Dr. Thierry Hertoghe gave a lecture on “Burnout: A multiple hormone deficiency syndrome”. He said that burnout is a common condition where several hormones are affected, with the cortisol axis being the main one, but other hormone glands being stressed as well. As a result, endocrine glands age prematurely. Symptoms are fatigue, exhaustion, gastrointestinal problems, anxiety, depression and aggressiveness. The underlying hormone abnormalities are a lack of cortisol, thyroid deficiency, growth hormone deficiency, testosterone and estrogen deficiency and oxytocin deficiency. Burnout is common in teachers and there is a questionnaire that has been developed for teachers. It has the name  “teacher’s burnout scale” and monitors them whether they are heading this way.

Burnout and PTSD

Soldiers who return from combative situations often suffer from burnout or from PTSD. In suspected cases laboratory tests that measure hormone levels give concrete answers about deficiencies. There was a discussion of treatment protocols in detail. Multiple bioidentical hormone replacements are necessary, possibly for prolonged periods, if not lifelong. In addition, supportive counseling sessions from a counselor or psychiatrist will help to tone down increased brain activity and help regain the internal balance. Why is this important? Because hormones are necessary on a cellular level and regulate the energy metabolism of every cell in the body.

Conclusion

This year’s conference was a very interesting combination of new information on stem cell therapy, telomeres and lifestyle intervention. As we age we lose hormones, which makes us age faster as the telomeres shorten faster. Shorter telomeres lead to inflammation in the body, which cause a myriad of disease processes. Patients can counter this aging process by adopting a healthier lifestyle with regular exercising, a Mediterranean diet and abandoning unhealthy habits like smoking, excessive drinking or taking illicit drugs. Vitamins and supplements, particularly resveratrol, CoQ-10 and omega-3 fatty acids will help to elongate and stabilize our telomeres. As Dr. Katz said: “A healthy lifestyle will reduce your mortality rate by 80%”.