THE YOUTH PILL
“In ten years, anti-aging medicine may become accessible to everyone,” says Elena Zigmund. Anti-aging medicine has been around for more than 20 years. Its current achievements and future were discussed by participants at a major congress in Las Vegas, which brought together around 6000 doctors and was organised by the American Academy of Anti-Aging Medicine.
To recall how it began, in 1992 around 40 forward-thinking American doctors came together to establish a new field: one concerned more with prevention than with treating diseases acquired with age. As one of the founders of anti-aging medicine, Bob (Robert) Goldman, put it: “We wanted to change the paradigm, the very approach to a person’s age. If someone is 80 but as active as they were at 50 and happy with life, what difference does the age in their passport make? People should not hypnotise themselves with their own age. So we began to distinguish between biological age—the condition of a person’s vital organs and systems, or biomarkers of age—and chronological age. By studying these biomarkers, we can suggest how to delay aging in each individual case. If someone knows their ‘risk areas’ and regularly undergoes a course of revitalisation—for example, rejuvenation using stem cells, injections containing high doses of antioxidants, detoxification or, say, support with bioidentical hormones—the body ‘remembers’ this information for a while and responds with a greater capacity for work and better concentration; in other words, with ‘younger’ responses. Unlike traditional, narrowly specialised medicine, we began to practise a holistic approach, combining the latest technologies with advances in alternative and sports medicine.”
THREE PILLARS
As the world’s population is not getting any younger, demand for anti-aging medicine is growing. Monika Golková, a participant in the congress and head of the A2C anti-aging clinic in Prague, showed Itogi magazine an interesting statistical chart presented by the US Census Bureau, illustrating life expectancy in different countries around the world based on the results for 2011. To determine ‘life expectancy’, the average lifespan of people born in the same year was used, with the assumption that mortality at the specified age would remain unchanged.
Monaco led this chart by a wide margin, with 89.73 years: men there live to an average age of 85 and women to 94. Next came Macao, an administrative region of the People’s Republic of China, with 84.41 years (81 and 87 respectively); San Marino, with 83.01 years (75 and 83); Andorra, with 82.43 years; and Japan, with 82.25 years. Italy completed the top ten with 81.77 years, while the USA was only in 50th place, with 78.37 years. Russia ranked 162nd, with 66.29 years (59.5 for men and 73.2 for women). According to American experts, average life expectancy is mainly influenced by the following factors: the standard of healthcare and medical services; economic conditions; nutrition, or the diet customary in a particular region; environmental pollution, including the condition of the air, water and soil; differences between the social status of men and women in the country concerned; natural disasters; and epidemics, such as AIDS…
Why does Monaco continue to lead, when life expectancy in this tiny principality was no different a year earlier? According to Dr Golková, its natural environment and climate, the population’s strong motivation to stay healthy, and its high standard of living—which includes the Mediterranean diet—are the ‘three pillars’ on which longevity is essentially built. “A Czech colleague of mine works at an anti-aging clinic in Monte Carlo. She says that almost everyone there can afford genetic testing to analyse genes associated with serious diseases. Thus, by the age of 30–35, Monaco’s residents learn about the problems they may face in the future and do everything they can to prevent them. Almost one in two regularly consults anti-aging specialists. Of course, the people living there are very wealthy and keep track of every medical innovation. And their way of life is distinctive too: no stress, no rushing, no poor or homeless people—social differences are evened out through taxation. In Monaco, even a taxi driver carries himself like a crown prince: he feels confident about his future,” says Dr Golková.
Unfortunately, many other countries are a long way from this: the US Census Bureau’s list covered 222 countries, with Afghanistan and Angola at the bottom. Even in relatively ‘prosperous’ countries such as the USA, the potential of preventive medicine is far from fully used. For example, American economists Kevin Murphy and Robert Topel of the business school in Chicago used 5 million dollars as the average amount spent by health insurance on treatment over a lifetime in their calculations of the losses incurred by a country paying for its citizens’ treatment. They found that a reduction of just 20 per cent in mortality from cancer and cardiovascular disease would benefit the USA by around 10 billion dollars a year. If these diseases could be defeated, the savings within this one country alone would be enormous: around 47 billion for cancer and 49 billion for cardiovascular disease. And this is just one example of a country where only 10 per cent of the population uses the possibilities offered by anti-aging medicine.
As Ronald Klatz, one of the founders of anti-aging medicine, noted at the congress: “If the twentieth century was the century of cardiovascular disease, the twenty-first century will be one in which cancer poses the most serious threat to us.” The number of free radicals attacking us from the environment and breaking through our immune defences is increasing. At the congress, the Americans presented data showing that the body of a baby born today contains more than two hundred different chemical compounds that should not be there at all, and nobody knows when or how this unnecessary ‘burden’ on the body will make itself felt.
STIMULATING TELOMERES
It is hardly surprising that the beginning of the century saw a boom in anti-aging medicine in antioxidant nutraceuticals that strengthen immune defences. More than 800 natural preparations—dietary supplements—appeared in anti-aging medicine. Doctors at anti-aging clinics stated that even the most environmentally clean diet needs to be reinforced with supplements: not just vitamins and trace elements, but also stronger antioxidants that had previously been unknown. These included, for example, curcumin, a bioflavonoid that protects skin cells from aging; pycnogenol, an extract of Mediterranean pine bark that is a more powerful antioxidant than vitamins E and C and neutralises the effects of cigarette smoke; citrinol, which lowers cholesterol without causing side effects; and glutathione, a tripeptide described as a key substance in the body’s antioxidant defences and used, for example, to treat Parkinson’s disease successfully in the USA. Resveratrol, a polyphenol obtained from red wine, is called an ‘elixir of youth’ with some justification. One tablet containing 200 milligrams of resveratrol a day—the amount found in 50 litres of red wine—improves metabolism and stimulates the body to an extent equivalent to doing about two hours of fitness training and eating nothing but environmentally clean food. As a result, the risk of diseases associated with aging, such as diabetes, cancer, cardiovascular disease and Alzheimer’s disease, is substantially reduced. Admittedly, there are as yet no long-term statistical studies confirming the effectiveness of resveratrol, because it only began to be used relatively recently. This does not, however, stop Americans from spending an average of 1300 dollars a year on resveratrol, according to calculations based on online sales of the substance.
Dietary supplements are certainly useful, but many people want to try more radical methods of rejuvenation. It was noted at the congress that stimulating telomeres—the terminal sections of a linear DNA molecule—is becoming increasingly sought after in anti-aging medicine. As the Americans say: “If you do not keep up with innovations in biotechnology and do not use them, you are falling behind.” Fundamental discoveries relating to telomeres were put to use in anti-aging medicine almost immediately. Many researchers are inclined to conclude that the aging process is linked to the shortening of telomeres, so finding a way to stimulate them means ‘preserving’ a body that is beginning to wear out.
Scientists at the biotechnology company Geron in New York developed and certified TA-65, an activator of the enzyme telomerase, without which ‘sleeping’ telomeres cannot wake up. TA-65 is considered a dietary supplement: it is a laboratory-purified extract of the Astragalus plant, which the company obtains from a particular farm in China. A year-long course of rejuvenation using TA-65 is now practised in the USA and is considered one of the most effective methods. However, this treatment is still expensive. The blood test showing the condition of telomeres in two key types of cell in our immune system—lymphocytes and phagocytes—is costly. In Europe, only the laboratory of an anti-aging clinic in Madrid performs this test. It requires certified specialists, strict adherence to the method and considerable urgency: blood taken for the test cannot be stored for more than 12 hours. This is why the test costs so much in other European countries. In America, this type of test is also performed in only a few locations, such as New York, Florida, Northern and Southern California, and Las Vegas, and costs around 2300 dollars, of which insurance companies cover about 900 dollars. Once the tests have been processed, there is a personal consultation with a doctor specialising in telomere biology, who selects an individual programme: the required concentration of TA-65, a schedule of subsequent blood tests and the use of additional preparations. One such consultation costs 500 dollars. TA-65 is taken in tablets, and a six-month course costs around 6000, though it may be cheaper—from 1200 to 4000 dollars—depending on the prescribed concentration of the preparation. Many people naively wonder why they cannot simply buy Astragalus at a pharmacy and make the extract themselves. But it is not that simple: Astragalus has to undergo special chemical purification and extraction of the active substance in a laboratory, and the finished product must contain at least 90 per cent pure, biologically active TA-65.
The problem is that insurance companies do not yet pay for treatment by anti-aging specialists in any country in the world. This package of medical services is considered to go beyond the standard covered by health insurance. However, the American doctors discussing this issue at the congress believe that anti-aging medicine will be accessible to everyone in just ten years. The more people consult anti-aging specialists, the more financially beneficial it will become for insurers. By 2030, genetic medicine will have advanced considerably, and everyone will be able to undergo basic screening to identify genes that represent risk factors. According to Professor Ronald Klatz, medical technologies change every 2–3 years, so in 15–20 years specialists will be able to slow aging at the level of DNA and RNA: “Personalised genomics lies ahead of us. For example, if genetic screening reveals a predisposition to diabetes, a doctor will be able to ‘repair’ that section of DNA so that the disease never develops at all. At present, genetic analysis in an anti-aging clinic is used to select an individual patient’s medicine from ten similar drugs. On the basis of such an analysis, performed for example at a university laboratory in Vienna, the doctor recommends a cholesterol-lowering medicine. Genetic screening currently costs around 1000 euros in Europe, but it is not yet possible to ‘restore’ genes.”
Ronald Klatz believes that by 2050 scientists will grow artificial organs identical to those in our bodies. Aubrey de Grey, a biogerontologist from Cambridge, observed: “We will be able to live much longer if we learn to restore tissues and organs; in other words, 100–120 years will become the norm.” Since artificial skin has already been produced, the optimism of some specialists may have a basis in reality. In their view, by 2050 there will be tissue banks storing samples of cells from every organ of people living on Earth. Need a new liver? Certainly—we will grow one. Some forward-thinking people in the USA are already freezing their own stem cells ‘just in case’: perhaps their heart will start playing up, or they will suffer an injury… Every day brings new discoveries that make anti-aging medicine more accessible. Recently, for example, Czech scientists announced a unique method they had developed for producing glutathione in the form of a nanofibre, which is better absorbed by the body than poorly absorbed tablets. Producing glutathione will therefore become cheaper, making it more affordable too. “Advanced technologies will be perceived as magic,” science-fiction writer Arthur Clarke once said. So when a picture was painted at the Las Vegas congress of miniature robots smaller than blood cells restoring damaged organs or cells and repairing blood vessels, those present responded with a gasp of amazement. And the wait may be no more than a decade…
A REAL-LIFE EXAMPLE
One example is the typical story of a patient at the Prague clinic. A young woman aged 35 came to the anti-aging clinic complaining of chronic fatigue. Doctors had found nothing wrong with her and said it was simply seasonal hypochondria. She looked older than her years, her skin was in poor condition, her hair was falling out, her eyes had lost their sparkle, she had no energy for anything and felt completely apathetic towards her work. As a senior manager, however, she could not afford to give in, so she decided to undergo all the necessary tests to find the cause of her condition. A blood test for heavy metals showed that she was highly allergic to them. It emerged that this patient had amalgam fillings and dental bridges made from this metal, and these turned out to be the source of the problems. Her dentist removed the metals, and she underwent a course of detoxification with anti-aging doctors, consisting of special injections under the supervision of certified specialists. After 2–3 years she had forgotten about her fatigue and successfully returned to work.