Anti-Aging Medicine is a topic of great interest to many people. The effect of aging on our ability to perform our work, enjoy our leisure and avoid the disabilities of chronic disease is a source of great concern. The media devotes a great deal of attention to these issues. The Pharmaceutical and Health Supplement industries are constantly bombarding the public with promises of improved health through the use of their newest products. Some of the recommendations have validity and some are hyperbole.

I have practiced medicine for thirty years. I remember being impressed by the observation that many patients in the hospital with serious illness were there because of life-style and or environmental factors. I created the Union Memorial Hospital Fitness Center, the first preventative medicine program in the Baltimore area, in 1981. At that time I emphasized life-style change and modification of identifiable risk factors through diet, exercise, supplements and medication.

At that time, I had a simple premise. Your chronological age is your age in years. That cannot be changed. Your biological age speaks to your measure of vitality or lack of vitality. Biological age variables can be affected by life-style factors such as exercise and diet, supplements and medication. Our philosophy of life, our social engagement, our relationships are also very important factors contributing to good health and healthy longevity.

Over the years, I have been gratified to see that these ideas have been proven to have scientific validity and are increasingly embraced by mainstream medicine. Examples of this include the idea of maintaining an optimal, (not just adequate), blood pressure, blood sugar and cholesterol level throughout life.

I went to an “Anti-Aging Medicine” conference two years ago. I went out of curiosity. The presentations were interesting. They all seemed to have a product to sell. This made me suspicious about the scientific validity of their premises. I have spent the last three years studying the medical literature and attending courses on the subject. I have tried to identify the ethical practitioners in this area. I believe that I have been able to separate valid information from exaggeration.

One of the major areas of interest and debate is whether hormone replacement therapy for the aging adult will result in a slowing of the aging process and a reduction in the incidence of chronic and debilitating disease onset with aging. There are two main schools of thought. There are those that adhere to the strict principles of scientific inquiry and mainstream medical practice. This group acknowledges that the topic is worthy of discussion and inquiry. They acknowledge that there is a growing literature on the topic. However, until there are classical double-blinded, crossover studies proving the validity of intervention, (hormonal supplementation, nutritional supplementation, etc.), they will not apply these therapies to their patients. In a sense, unless a patient has an identifiable disease there is no value in treating them for a natural condition such as aging. Our medical reimbursement system as designed by insurance companies and the government supports this point of view. The other school of thought believes that strategies that maintain aging parameters in the range of a younger adult are reasonable and worth applying. Patients who are aging do not want to wait the twenty to thirty years it will take to have definitive answers; not that we ever have definitive answers.

I think that the balance in all this is to do what is prudent and safe. However, even this middle path is controversial. There is wide disagreement about what is prudent and what is safe. In the area of hormone replacement therapy, I believe that maintaining the hormone levels of a younger adult will allow the individual to age more gracefully. There is growing scientific evidence that supports this point of view. It will take another 20 years before there is broad consensus in the medical community, however. Insurance companies do not want to pay for the testing or the therapy to treat aging. Unless it is a disease or unless there is broad consensus as to the benefit they will refuse to cooperate.

This same premise holds true for each of the arms or pathways that anti-aging/healthy longevity advocates work with. Aside from the hormonal pathway we look at:

1. The effect of chronic inflammatory processes on organ reserve. Examples of this include arteriosclerosis, arthritis, Alzheimers disease and Parkinsons disease.

2. The effect of oxidative damage on the molecules, cells and organs of the body. This phenomenon goes arm in arm with inflammatory events. An example of chronic oxidative stress that leads to an unhealthy aging process is tobacco use. What about environmental pollution and its effects on our lungs, skin and eyes? Even non-smokers must deal with this chronic ongoing oxidative stress and its consequences.

3. The effect of inefficient glucose metabolism is another underlying theme. Most people understand that diabetes is associated with an increased risk to age related diseases such as heart attack, stroke and cancer. As many as 25% of the population have a predisposition to diabetes. Many have insulin resistance, a pre diabetic state that is independently associated with an acceleration of age related illness.

4. Methylation is a chemical activity that is not well known by the public. It is a very common and very important biochemical activity. A byproduct of Methylation activity is a chemical called Homocysteine. Usually, our bodies have an efficient way of metabolizing homocysteine and getting rid of it. Some younger individuals and many older individuals have elevations in homocysteine. Elevated homocysteine greatly accelerates arteriosclerosis and aging. Once elevations in homocysteine are identified, treatment with nutritional supplements is effective in lowering it to a safe level.

5. There is a decline in the function of our immune systems with aging. This results in a greater susceptibility to infectious diseases and cancer. We can identify those individuals who would benefit from specific supplements designed to enhance immune function.

6. Our digestive process is important in obtaining adequate nutrition from our diets. As we age we may develop insufficiencies of hydrochloric acid or digestive enzymes. We identify these insufficiencies and supplement appropriately. We make sure that the living organisms within our intestinal tract are in appropriate balance for optimal health. We support many other aspects of gastrointestinal tract function in order to aid the individual in attaining their optimal level of health.

7. The ability to remove unwanted chemicals from the body is very important. We refer to this process as Detoxification. As people age they may need support in optimizing the detoxification process. We can measure an individual’s detoxification ability and provide support with nutritional supplementation and dietary guidance.

8. Certain foods may cause problems for an individual. They may just be difficult to digest. They may cause classical allergy symptoms such as hives, (nuts, shellfish, citrus). Symptoms of intolerance may be secondary to a lack of specific digestive enzymes as in lactose intolerance. People may develop more obscure food sensitivities mediated by the immune system by mechanisms that are different from classical allergy. We work with the individual to identify their unique sensitivities.

9. Metabolic typing is a process of identifying the individuals unique metabolism and guiding towards an optimal diet and supplement program. This can be very important in optimizing health, controlling body weight and stabilizing mood.

10. We can’t do it all. An individual must come to us with a desire to engage in a process that will create a gradual transformation in their health and a slowing of the aging process. Pills and potions are not as important as the desire to participate in life to its fullest and the willingness to make the effort. We can help.

After the assessment process recommendations are made for health enhancement through exercise, dietary change, nutritional supplementation, herbal therapies, and hormonal therapies.

Additional therapeutic measures may be useful for specific clients. These include Acupuncture, Physical Therapy, Massage Therapy, and Yoga.

We see this as a transformational process that takes place slowly over several years. Our fee schedule supports this reality and is designed to provide the clients with maximum access to our physicians during this process. -- Dr.Warren Ross

Practitioner Profile
 Dr. Warren Ross
 

I have created an Anti-Aging Medicine program that is safe, prudent, and affordable.

Step 1: ASSESSMENT

1. Historical Parameters: Personal and family history is reviewed for relevant data that directs subsequent assessment and therapeutic recommendations.
   

2. Physical Parameters: We measure height, weight, body mass index, body composition, and chest, abdominal and hip girth. These are simple tests but are very valuable in following the aging process.

3. Physiologic Parameters: We measure Blood Pressure, Resting Heart Rate, Total Lung Capacity and Peak Flow rates. Blood pressure is also measured after doing mental exercises and after exposure to a physical stress to determine vascular hyperactivity and stress tolerance.

4. Routine Blood Measurements: CBC and Chemistries that measure blood sugar, liver function and kidney function.

5. Cardiovascular Panel:
   
   1.  Simple Panel: Total Cholesterol, HDL, LDL, and Trigycerides.
   
   2.  Advanced Panel: For individuals determined to be at increased risk by personal history, family history, physical findings or lab findings we do additional testing, which includes homocysteine, lipoprotein (a), fibrinogen and ultra sensitive CRP.

6. Endocrine Testing: Endocrine testing is individualized but may include:

1. Testing for adequacy of glucose metabolism and insulin resistance, (a pre-diabetic state)

2.  Sex Hormone Testing: This may include FSH, LH, Testosterone, DHEA-S, Progesterone, Estrogen

3. Adrenal Hormone Testing, (24 Hour Urines, ACTH Stimulation Test.

4. Growth Hormone Testing, (IGF 1)

5. Adrenal Hormone Testing, (24 Hour Urines, ACTH Stimulation Test)

6. Growth Hormone Testing, (IGF 1)

7. Functional Medicine Assessment: Functional  Medicine assessments will be suggested where appropriate in order to round out the health assessment and optimize therapeutic suggestions. These may include assessments of Gastrointestinal function, Hepatic Detoxification Function, Allergy Testing and Toxicological testing.