What does a specialist in Anti-Aging and Regenerative Medicine focus on?
My approach is individualized and focuses on mitigating conditions which could negatively impact health-span or lifespan. This requires understanding your health status, risk factors, relevant labs, and family history. This also involves offering hormone normalization for life in eligible patients.
This blog is meant to stimulate thought and give patients an outline that guides how longevity might best be approached and addressed.
There are clever and cutting edge treatments that we offer; however, the foundation of anti-aging and longevity is to risk mitigate the statistically likely causes of death and disability. These are infrequently optimized by primary care physicians. The “we’ll watch this,” while not optimizing, is a common approach, which is the slippery slope to poor health outcomes.
#1/#3 Cause of Death and Disability, respectively relate to vascular disease - that being Coronary Artery Disease and Stroke (peripheral arterial disease also).
So optimization of:
ApoB to 70’s if Lp(a) negative and 50’s if Lp(a) positive
HbA1C goal 5.0%
Blood Pressure Goal 110-120/70-77 mmHg is optimal
No Tobacco or smoked THC
Limit Alcohol
Reasonable exercise goals (150 min/week Zone 2 aerobic and 2-3 sessions of weight training weekly)
Diverse, mostly plant based diet with minimum 40 grams/day of dietary fiber, and at least 30 different veges/fruits/seeds/grains/nuts weekly (if not daily)
Consider genetic testing with Vibrant's CardiaX panel (available under Labs Button in the right upper margin of the home page) if you have parents who had unexpected premature coronary artery disease.
Consider assessing micronutrients with tests like Vibrant's Micronutrient Panel.
#2 Cause of Death/Disability - Infections
The message here, is to be vigilant to pay attention when you have a bacterial infection to seek help ASAP. I frequently see patients in the ER who have sat at home watching something get worse for days before seeking help. Early treatment is critical. Key areas are red-swollen areas on your skin, a cough-fever-shortness of breath without runny nose, pain with urination, flank pain or any constant and worsening abdominal pain should be investigated EARLY by a qualified healthcare professional.
Additionally, staying physically fit, and have a lot of reserve, along with staying up with recommended immunizations is critical. We can also discuss methods to optimize T cell immunity, which is critical with aging to avoid bad outcomes with virus infections.
#4 Cause of Death/Disability - Malignancy
This is individualized - but there are some general strategies. First stay up to date on all recommended cancer screenings. BUT these will miss many cancers. Most of my patients have a yearly body MRI as this will detect solid organ tumors that won't be found by screening). Additionally, we recommend an MRA Head and Neck Periodically with Neuroquant, with the frequency depending upon age and if there are abnormal findings. This is a great objective way to find things when they are easy to treat, rather than waiting for symptoms to prompt a workup. The cost is $650 for the body, and $1250 for the body and head/neck MRA. We think it is worth it, as it could save your life and also a lot of suffering.
#5 Cause of Death/Disability - Constellation of Cognitive Decline/Trauma/Sarcopenia/Osteoporosis
The last two items relate to exercise, maintaining muscle mass, and a careful mix of impact, aerobic, and weight lifting types of exercise. Creatine can be helpful, as can optimization of Vitamin D and K2 MK7, Omega 3 index, Vitamin B12,Homocysteine and diet. Getting a whole body DEXA for body composition can be a useful and cost effective way to monitor your current status, including visceral fat, which is important to optimize for one's metabolic health.
#6 Hormone Normalization for Life
We recommend normalizing sex & thyroid hormones, but also assess cortisol, dhea and in some cases growth hormone.
#7 Toxin Exposure Avoidance - or treatment if you have these
This included microplastics, BPA's/PFA's, mold, heavy metals and other industrial chemicals. If there are concerns in this area, we will order appropriate testing.
The sections below are just a tiny subset of the types of treatment, and a selected evidence base, we offer appropriate patients. The logic is fairly consistent when we deal with patients who have, or are at risk of progressive conditions. There is an assessment of the risk of treatment versus the likelihood of benefit. For many patients, we jointly make the decision to utilize treatments that have low risk of harm, and likely evidence of benefit.
Do you have one or two copies of ApoE4? This predicts high risk for early Alzheimer’s Disease. Quest also has a panel called AD Detect which is interesting as an add-on if money isn’t too tight. Agents like Rapamycin, and all the items listed below for Parkinson’s Disease can be considered.
This is an interesting space as we are seeing a range of evidence for drugs such as Rapamycin, SGLT2 Inhibitors (drugs like canaglifozin, dapagliflozin, empagliflozin), GLP-1 agonists (drugs like tirzepatide, exenatide, semaglutide), agents with mounting evidence for decreasing risk, and possibly reversing disease to some extent in some patients.
- An Overview of Top Longevity Medications:
Anti-lipid and Blood Pressure Medications, as well as rapamycin, dasatinib, and especially newer medications for Type 2 diabetes are at the forefront. I’m deliberately not including metformin (except this article: https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.718942/full ), as I’m favoring other agents over it; but it likely has substantial benefits.
- Some interesting articles on SGLT2-inhibitors:
There are a lot more … whether longevity, cerebrovascular/cardiac disease, Parkinson’s or Alzheimer’s Disease - not to mention better HbA1C.
- Some interesting articles on GLP-1 Agonists:
Some interesting articles on Acarbose:
Some interesting articles on Telmisartan (my first choice agent for hypertension in most patients):
Some interesting articles on PDE5 Inhibitors (Like Cialis/Viagra)
A recent article on Rapamycin is here:
For a deep dive into Rapamycin, consider joining (it’s free) one of the best healthcare consumer communities who are focused on longevity. There are interesting conversations and a review of lots of literature, vigorous debates and more. Visit: https://www.rapamycin.news/about
Omega 3 Fatty Acids
None of the information above is medical advice, and if you choose to act based upon this information, do so with the advice of your physician, or consult with Dr. Fraser.
