Despite what most guys would think, there is growing evidence in the medical literature (and foreign affairs) that more testosterone is not the answer to every problem. In particular, it appears progressively clear that the big nail of aging is not going to be pounded down by the hammer of more testosterone, or by any of the alphabet of anti-aging hormones now flooding the American diet supplement market.
While aging Ponce de Leons are paying many millions for Andro, DHEA, GH, testosterone and other such products hoping each is a sip from the fountain of youth, none of those products has yet turned out to be much more than a drink of expensive hormonal hype.
The latest “anti-aging” hormonal victim of good science may be the adrenal sex steroid DHEA (DeHydroEpiAndrosterone). It is a hormone we all make that declines with age and seems to be found at higher levels in people who live longer. Those two properties among others (studies showing anti-aging benefits in rats given DHEA) have hundreds of online and other vitamin retailers happily and breathlessly selling DHEA-containing dietary supplements for their purported “rejuvenating, life-extending” benefits.
While anything that is an “adrenal sex steroid” sounds as though more of it would always be better, a recent study in the New England Journal of Medicine (NEJM) found otherwise; administering DHEA or testosterone supplements to elderly men who had low levels of these hormones, or DHEA to women who had low levels of DHEA, did not significantly improve muscle mass, bone mass or quality of life. In other words, supplements containing the two hormones did not do much to retard the effects of aging. The NEJM study joins others casting doubts on DHEA supplement benefits, and ran contrary to the DHEA rat studies, proving once again that results from rat studies only apply to some of us.
(An accompanying NEJM editorial suggested the federal Food and Drug Administration adopt measures to stop manufacturers of DHEA-containing diet supplements from claiming DHEA has any anti-aging benefit. That seems unlikely, given the FDA seems to be the most testosterone-deficient safety agency in the U.S. government, and DHEA cannot be regulated as a drug because it is listed in federal regulations as a food supplement.)
Of all the anti-aging hormones out there, testosterone supplements have been the one many guys hoped would be the answer to the dwindling of their sexual and physiological vitality as they age (other guys, not me). It just made sense; testosterone helps makes us guys, has something to do with sex, and has a role in muscle mass maintenance. If the level goes down as we age, a testosterone pill that brings the level back up should help us stay youthful, right? It is widely prescribed by physicians to aging men who believe their get up and go that got up and went can be brought back by testosterone supplements.
The NEJM study was just the latest to suggest that giving testosterone supplements to aging men may raise their testosterone levels but does not seem to reverse the effects of aging. Individual men may take it and feel like teenagers, some may get a little more sex drive, but once the placebo effect is removed from the equation, and once these assumptions and anecdotal experience are tested in good medical studies of larger populations of men, the evidence of real benefit over the long term does not seem to hold up.
Growth hormone (GH) is also being hyped and sold as a way to slow aging, with entire “anti-aging clinics” set up to dispense GH shots and “anti-aging” dietary supplements. There is no good scientific study, however, that has proven GH to be both effective in really slowing the effects of aging, and safe for long- term use in the general aging population. Its potential to cause accelerated growth of undiagnosed tumors, for example, is unknown. Many of those who take GH to help them walk up the down escalator of aging are doing so as part of a program that includes eating better and exercising regularly, making it difficult to determine which benefits accrue from living smarter and which accrue from GH. In addition, when you spend thousands of dollars on a drug to retard the effects of aging, the placebo effect can be substantial, suggesting perhaps that hope springs eternal, not GH.
Behind our search for a pill to perpetuate pep is not simply the fact that many of us hate getting older. We are also hoping for easy answers in the war on aging, because if we cannot find one in a diet supplement we are stuck with this lousy pill to swallow; the real fountain of youth is the sweaty, grinding work of daily exercise and the obligation to eat a good diet.
No testosterone ever tested, no hormone ever hyped, comes anywhere close to the effectiveness of daily exercise and good diet in making Father Time drag his feet on his walk by your side. Study after study has proven this true; in fact, if you only exercised each time a new study came out proving again the effectiveness of these twin pillars of “youthful” aging you would be in great shape. A guy who exercises daily will be much more of an aging bull than a couch potato eating Growth Hormone chips laden with testosterone dip, and a woman who wants to be sleek and sexy at 70 can get there through the gym but not through oodles of estrogen or dollops of DHEA.
The siren songs of silver-bullet diet supplements may seduce our spending for them but they apparently will not slow our senescence in return for our investment. Good diet and regular exercise, on the other hand, have some of the “age-defying” properties many of us want desperately to find in the magical promises of anti-aging pills, potions, lotions and practitioners.
The bottom line? There may be a magic potion to help slow your aging but it will work only if you jog to the store and back to get it.
Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region.
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