Anti-aging supplements: Hope or hype?

People have been searching for the fountain of youth for ages. And the lure of anti-aging products in the advertising world can be hard to resist. Who wouldn’t want to look and feel younger by simply taking a pill?

But aging is an intricate, complex process that involves practically all body systems. So, it’s not likely that one product, pill or potion could be a cure for all the ills age can bring. Yet, "anti-aging" advocates insist that there is enough proof that these supplements do prevent or delay aging. In a recent review article on the subject, Cornell University presented the opposing views of two experts on "anti-aging" remedies.

"I don’t regard these supplements as responsible agents," says Robert N. Butler, M.D., president of the International Longevity Center and professor of geriatrics at the Mount Sinai School of Medicine in New York. "There’s little long-term research to establish their efficacy and safety." For the same reason, the U.S. National Institute on Aging "doesn’t recommend any supplement as an anti-aging remedy." But Jeffrey Goodman, M.D., a New York-based naturopathic physician, prescribes a number of supplements for his patients and says he sees positive results.

Gold Standard

Popular anti-aging supplements include hormones, antioxidants, and amino acids. Hormone levels decrease as we age, and some experts believe that this decline causes many of the changes associated with aging. Proponents say that taking hormones, antioxidants and amino acids can control, prevent, or even reverse age-related problems, such as decreases in cardiovascular function, muscle mass, and strength, as well as the effects of "free radicals." Free radicals are extremely reactive atoms or molecule fragments that steal electrons from other molecules in body tissues, in a process called oxidation, which damages cells.

"We don’t have evidence that supplements retard aging," contends Dr. Butler. Aside from the anecdotal clinical experience of physicians like Dr. Goodman, most evidence for anti-aging comes from laboratory studies on how they affect isolated cells, and "lab work may not be transferable to human physiology," Butler adds. The gold standard for evidence-based medicine is still randomized, placebo-controlled clinical trials, but until recently, few have been done on anti-aging supplements.

DHEA

Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands, is converted by the body into the sex hormones estrogen and testosterone. DHEA is most abundant in your body around age 25. After that, production wanes. The idea behind the use of DHEA is that increasing blood levels should elevate estrogen and testosterone, which also decline with aging.

Dr. Goodman claims that "taking DHEA improves memory, stimulates libido, alleviates depression, boosts energy, regulates weight, and builds muscle mass, increasing strength." It also minimizes the risk of osteoporosis for women over 50 whose estrogen levels are generally lower, he says. Dr. Butler however, is not impressed by such "anecdotal clinical experience." In his view, giving women DHEA amounts to a "huge trial being carried out on the public of substances about which we know little."

DHEA is used medically to treat systemic lupus erythematosus, an autoimmune disease that often strikes women. However, DHEA is sold not as a drug, but as a dietary supplement (it’s mostly made from yams), so it’s not subject to FDA scrutiny. The FDA actually banned DHEA in 1985 but it reappeared later as an unregulated "dietary supplement."

Until more is known about its effects in healthy people, most experts advise against taking DHEA. The U.S. National Institute of Aging warns that DHEA can have serious side effects including liver damage, and can lead to high levels of estrogen and testosterone. Too much estrogen may increase the risk of breast cancer, while excess testosterone causes increased facial hair, acne, and mood swings. If you are taking DHEA, inform your doctor and have your blood level checked every six months.

hGH

Human growth hormone (hGH) is released from the pituitary gland and affects metabolism; it’s what triggers growth spurts during childhood. Production starts to decline when we reach our 30s so the theory is that restoring hGH to youthful levels will help stave off age-related diseases and strengthen the body.

Interest in hGH was triggered in 1990, when a small clinical trial was reported in the New England Journal of Medicine. The trial, among 21 men aged 61 to 81 at the Medical College of Winconsin, found that storing hGH increased their lean body mass, decreased body fat and improved the appearance of their skin. Six years later, when researchers at the University of California at San Francisco tried to replicate that study, they failed to find any effects. In 1994, a small study among post-menopausal women found that women who took hGH had an 11 percent decrease in body fat. Encouraged by this research, the U.S. National Institute on Aging is sponsoring a number of studies on hGH, but so far, none has produced any striking results.

Human growth hormone injections are approved by the FDA only for children who fail to grow normally because their bodies don’t make enough hGH, adults with a deficiency of the hormone, patients recovering from pituitary surgery, and people with AIDS-related wasting syndromes. The possible side effects can be serious – fluid retention, high blood pressure, heart failure, diabetes and joint pain. Until research proves anti-aging benefits, stay away from hGH.

coQ10

Antioxidants prevent cellular damage by neutralizing free radicals. coenzyme Q10 (ubiquinone) is an antioxidant similar to vitamin E, found in all living cells of the body and in small amounts in meat, fish and soybeans. Sold as a dietary supplement, coenzyme Q10 is said to provide anti-aging benefits for the brain and heart by bringing more oxygen into those organs.

However, most of the research into coenzyme Q10, had been in heart disease, especially congestive heart failure. This is a condition where the heart becomes so weakened it can’t pump enough blood to the body, and coQ10 is often given to heart failure patients to be used along with prescription drugs, and does seem to revitalize the heart in many patients. However, a randomized double-blind study on 55 patients with congestive heart failure, published last year in the Annals of Internal Medicine, found no benefits. Studies that have found positive effects were small and uncontrolled or had other limitations. While proponents claim it can stimulate the immune system, enhance physical performance and cognitive functioning, anti-aging claims for coQ10 have not been proven.

Should you decide to try coQ10, do so only under a doctor’s supervision. The average dose is from 100-200 mg a day, taken in water-soluble form (soft-gel capsules, wafers, pills or chewable tablets). Side effects are usually mild: heartburn, stomachache, and nausea. You can avoid most of these problems by taking coQ10 supplements with a meal.

Caution

So, should you consider taking anti-aging supplements? The jury is still out. "I’d say we’re in a land of uncertainty, but possible danger," advises Dr. Butler. Dr. Goodman, however, feels that the results of studies done to date, and his own clinical experience, support their use. "It’s not true that there’s no proof of efficacy," he argues.

If you’re considering using an anti-aging supplement, or you’re concerned that you may have a hormone deficiency, talk to your doctor. He or she can help you decide whether the potential benefits of a product outweigh any risks. But remember: Supplements should just be one part of a healthy lifestyle, which should also include low-fat vitamin-rich foods and regular exercise, which should help maintain you in an optimal level of performance as you age.