Anti-aging Medicine and The Doctors who Practice it.
This week, Brett Newcomb and I are discussing a couple of articles in Endocrine Today. These articles review the literature, and concepts that examine hormone replacement therapy and the claims made by proponents both for and against using HRT as a tool for improving the quality of life in those who are aging. One of the doctors in the article claims that there is no research to back up the claims that are made for the benefits of HRT. I point out that this is factually inaccurate and makes the case that we should be leery of universal or sweeping claims. When someone argues from the point of all, or none, be wary. There are exceptions to almost everything. At the very least they should modify their claim with qualifiers, such as some or many or usually or as of yet, things like that make considering their statements and claims easier.
Actually, I have issues with the idea that endocrinologists are the ones to make definitive statements in this area of medicine anyway. Generally (notice the qualifier?), endocrinologist aren’t treating patients with testosterone and estrogen. They work on diabetes, fibroid, adrenal and pituitary issues. Typically claims made by these doctors regarding hormone replacement globalize all hormones into a global cluster and infer that they are all similar. This article focuses primarily on the replacement of human growth hormone, not on the sex hormones of testosterone and estrogen, and yet the physician makes the claim that hormone replacement (globally) has not been researched enough and that the benefits claimed for HRT are bogus. He argues from one single example and concludes for multiple hormones. His information is wrong and his data are inaccurate.
One of the challenges faced by doctors who practice what is called anti-aging medicine is that the name is a horrible descriptor of what we do. It is easy to make fun of the term and state absolutely that we can’t stop the aging process and that everyone gets older and dies. Anti-aging medicine is not about stopping the aging process, it is about improving the quality of life of those who are aging so that they can be robust and active and live independently for as long as possible. We should develop a better name for what we do, but we seem to be stuck with this poorly descriptive term that is easy to make fun of. This is legitimate science based medicine it is not quackery or charlatanism.
One of the concerns that causes us to receive such negative reactions when we begin to talk about HRT is the abuse of testosterone and testosterone related “products” or herbals really, by athletes and by marketers who are attempting to sell something to the mass market. Doctors who practice HRT especially for the sex hormones, are not doing the same thing, they have medical histories and relationships with their patients. They are looking at very specific symptom-based complaints, and are developing individualized treatment protocols which they then monitor and adjust in an ongoing way with their patients. We want to track our care so that symptoms are reduced, side effects are identified and eliminated or minimized, and our patients’ quality of life is improved.
Another issue discussed in the articles we review, is the issue of prostate cancer and the replacement of testosterone. There is much misinformation and erroneous information regarding the replacement of testosterone in men. As men age their prostate becomes a concern. Claims have been made that replacing testosterone can lead to prostate cancer issues, or if someone has already developed prostate cancer, it will make it worse. We point out that these are in the nature of urban myths. They are not accurate medicine. There is research and experiential data that shows replacing testosterone does not cause cancer.
Once again, we want to make the case that you should be an informed consumer and that you should discuss your concerns with your medical provider. Ask them what they know and why they think what they think. If you don’t get answers that satisfy, keep asking until you do!
