MEDICINE AND AGE MANAGEMENT
Dr. Pierce and Ageless Forever can work with you to develop an age management regimen that's best for you. There are many age management drug therapies available, and the following is a brief description of some of the most popular. Some of the information presented here is about drugs used internationally in antiaging programs and longevity programs but are not all allowed to be used here in the United States. The following is not a complete list, but contains the most common drugs. Dr Pierce can inform you which of these antiaging drugs can be legally used and how to implement it into your program in a safe way. No treatment should be undertaken without the guidance and care of a qualified physician.

HUMAN GROWTH HORMONE
Human Growth Hormone (hGH) is secreted by the pituitary gland. It causes growth and repair of body tissues, including the muscles, the skin, the kidneys, and more. HGH levels naturally rise sharply throughout puberty, peak at about age 20, and then slowly decrease. HGH has been used to treat children who fail to make sufficient growth hormone and to treat adults with HGH deficiency.

HGH's age management benefits may include increased vitality and energy, changes in fat levels in location, increased muscle mass, thickening of the skin, improved sleep, enhanced bone growth and maintenance and increased life span.

A 1990 study conducted by Daniel Rudman, M.D. and colleagues and published by the New England Journal of Medicine reported that HGH reversed aging in human subjects. An experiment conducted by Drs. David Khansari and Thomas Gustad of North Dakota State initially showed that mice treated with HGH outlived untreated mice, but the study ended before all mice died of natural causes. A two-year trial conducted by Drs. G. Johanson, B.A. Bengtsson and others reported in 1996 that treatment with HGH increased bone growth and maintenance.

Side Effects and Contraindications: Side effects may include bloating, carpal tunnel syndrome, gynecomastia (increase in mammary glands in men), slight decrease in response to insulin, slight increase in blood pressure, hypertension accompanied by headaches and swelling of the optic nerve and decrease in thyroid hormone production.

Distribution: HGH treatments are currently very expensive and available at clinics and through prescription for adult HGH deficiency.

ESTROGEN
Estrogen is the female sex hormone. Before menopause, the ovaries produce estrogen. Low levels of estrogen have been linked to osteoporosis, arteriosclerosis, declining cognitive function and increased risk for Alzheimer's disease. Estrogen replacement therapy has been shown to decrease incidences of osteoporosis and arteriosclerosis, improve cognitive function and increase life span.

Estrogen's age management benefits may include a decrease in osteoporosis, decrease in heart attacks and strokes, improved memory and cognitive function, reduced risk and slowing of Alzheimer's reversal of thinning of skin and drying of mucous membranes and increased life span.

A study reported in 1997 in the Journal of the American Medical Association reported that post-menopausal women using estrogen experience as much as a 50 percent reduction in osteoporosis, heart attack, stroke, reversal of thinning of the skin and mucous membrane, significant reduction and possibly reversals in Alzheimer's disease and extended life span.

Side Effects and Contraindications: Conflicting information exists as to whether estrogen replacement therapy increases the risk of breast cancer, but some researchers indicate that combined estrogen-progestin therapy may eliminate this risk.

Similarly, some studies indicate an increase in risk of developing endometrial cancer when using estrogen replacement. Again, it seems that co-administration of progestin may decrease this risk.

PROCAINE (GH3 and KH3)
The two most popular antiaging drugs in the world are Gerovital-H3 from Romania (GH3) and KH3 from Germany. The active ingredient in both these drugs is procaine, which is also the active ingredient in the numbing dental drug Novocaine. The benefits of procaine were initially touted by Romanian physician Ana Aslan, who claimed that her GH3 formula could be used in the treatment of virtually all the diseases of aging. Subsequent studies in Europe and the U.S. with both GH3 and KH3 showed that these drugs are effective antidepressants, and that they may be useful in treating arthritis. A large animal study conducted by Aslan showed that GH3 extended the lifespan of laboratory mice by 20%. A subsequent, much smaller study, using higher doses of GH3, did not show prolongation of lifespan. Initially dispensed as an injection only, some international manufacturers now produces it as an oral capsule.

VINOPOCETINE
Vinopocetine improves brain energy and blood supply and has been used as a preventative and as a treatment for stroke and other brain injury. It acts as a cerebral metabolic activator, which may improve cerebral circulation and enhance oxygen and glucose utilization in the brain. Vinopocetine may diminish, or reduce, disturbances due to hypoxia, or to deficient cerebral metabolism. It has been noted to improve oxygen and glucose utilization by brain cells and increase their resistance to damage by hypoxia.

Vinopocetine's age management benefits may include prevention and treatment of stroke and other brain injuries, improved aged conditions caused by poor brain blood circulation, particularly eyesight and hearing, improved concentration, treatment and alleviation of the problems of menopause and increased potential life span.

Side Effects and Contraindications: Side effects are rate, but may include nausea, eruption and individual hypersensitivity. Patients thought to be in complete homeostasis after cerebral hemorrhage should avoid vinopocetine. Although only applicable to high doses, if hypersensitive signs occur, discontinue use.

Distribution: Vinpocetine is available in 1mg, 5mg and 10mg tablets.

DMAE
In three experiments, the drug DMAE, sold in the U.S. and Europe under the names Deaner and Lucidril extended the lifespan of mice up to 49.5% when given in the animals' drinking water. In the early 1980s, Riker Laboratories, the manufacturer of DMAE decided to withdraw the drug from the market because of poor sales for its FDA-approved use (hyperactivity in children). Since then, a similar version, commonly sold under the name DMAE has become available as a dietary supplement. The combination of DMAE and the herb gingko has become popular as a cognitive-enhancing therapy or "smart drug". DMAE also has become a popular additive as an antioxidant in skin creams. Dr Perricone has popularized the use of DMAE as a topical agent to slow the effects of skin aging, although age management physicians have used it for a long time. Typically a compounding pharmacy will make the product for the doctor so stronger concentrations of DMAE can be achieved than are typically found in Dr Perricone's formulas.

CENTROPHENOXINE
Centrophenoxine removes lipofuscin, potassium age pigment from the brain, heart and skin. Appearances of lipofuscin in the skin are referred to as liver, or age spots. Lipofuscin occurs in much higher levels in Alzheimer's patients than in their counterparts, and some theories relate brain and memory function to the ability of potassium to enter and exit brain cells. As we age, this ability is reduced and potassium levels rise. Centrophenoxine can also increase production of brain RNA and aid in a patient's oxygen consumption and carbon dioxide production.

Centrophenoxine's possible age management benefits include protection against free radical damage in the brain, increased potential life span, reduction and prevention of age spots in skin, increased mental energy, improved memory, and prevention and treatment of stroke and brain injury.

Side Effects and Contraindications: Possible side effects may include nausea, or mild dizziness. People with severely high blood pressure, or convulsive disorders such as epilepsy, should avoid Centrophenoxine.

Notes: Because of its low toxicity and side effects and potential positive effects in age management, Centrophenoxine is considered to be an important age management supplement. In France, it is viewed as a superior DMAE product and is available over-the-counter.

VASOPRESSIN
one of the most potent nootropic drugs, vasopressin, is a hormone secreted by the posterior portion of the pituitary gland. While it may help prevent frequent urination, vasopressin's main use is to treat memory deficits due to old age, senile dementia, drug toxicity and amnesia. Whenever a memory is deposited in the brain, vasopressin regulates the process. It helps select bits of information from the stream of consciousness and forms this information into an image, or concept, which is eventually transformed from an electrochemical impulse into a chemically encoded long-term memory. Vasopressin's benefits may include enhanced clarity, increased attention to detail, improved short-term memory and improved memory imprinting (when taken before an event, one can recall the event later in much greater detail). Vasopressin is so powerful that it has been banned in some California colleges for giving students an "unfair" advantage.

Vasopressin's age management benefits may include treatment and prevention of age-related mental decline, prevention and treatment of senile dementia, improved short-term memory, attention and clarity, enhanced memory imprinting, and treatment of diabetes insidious.

Side Effects and Contraindications: Side effects include rhinorrhea and nasal itchiness, headaches, conjunctivitis, sore throat, nausea, abdominal pain and the urgent need to defecate as a result of increased peristalsis. Vasopressin is contraindicated for patients suffering from coronary insufficiency, or using halothane, or cyclopropane anesthetics. It should be administered with caution in cases of hypertension, epilepsy, advanced arteriosclerosis, or any case where increased blood pressure is to be avoided.

AMINOGUANIDINE
Glycosylation is the pathological binding of glucose to an amino acid that results in the formation of a non-functioning structure in the body. Diabetics suffer from an accelerated rate of glycosylation, and many of the premature degenerative diseases common in Type I and Type II diabetes is attributed to the glycosylation process.

As organisms age, glycosylation becomes a major factor in the development of aging-relating diseases. Some gerontologists believe that glycosylation is the most significant biologic event responsible for the degenerative diseases of arterial system, the eye and the brain. Those seeking to add healthy years to their lives have a significant interest in interfering with the glycosylation process.

Oxidative damage plays a role in the glycosylation process, which helps to explain why antioxidant supplements have shown benefit in preventing diseases associated with diabetes. It requires a lot more than antioxidants, however, to adequately block age-related glycosylation.

As more European suppliers have begun offering aminoguanidine, the cost has declined sharply, making this an inexpensive addition to one's life extension regimen.

HYDERGINE
Hydergine is another "smart drug", which has been shown to improve learning and memory in both young and old men and women. In clinical trials, Hydergine has been shown to improve blood supply to the brain, increase the amount of oxygen available to the brain, enhance metabolism in brain cells, prevent free radical damage in brain cells, increase ATP levels in the brain, and enhance the use of energy-generating glucose in the brain. An important age management and nootropic drug, hydergine may help protect the brain from free radical damage and oxygen starvation. Hydergine maintains the brain's optimal metabolism of oxygen. Oxygen is a free radical scavenger and generator. Free radicals cause age-associated damage, and at optimal levels, oxygen will neutralize more free radicals than it generates. Hydergine may also stimulate the growth of dendrite nerve fibers, which may have a possible link to intelligence. Also, recent studies suggest that hydergine may reduce Senescent Cell Antigen (SCA), a destructive autoantibody appearing more frequently in elderly cells. SCA damages cells and finally destroys them.

Hydergine's age management benefits may include protection from free radical damage, especially to the brain and the heart; protection from hypoxia and peroxidation; prevention and treatment of strokes and other brain injuries; increased potential life span; and improved and extended periods of mental workloads.
European studies on cats proved that hydergine-treated cats survived severe diminished blood and oxygen supply for much longer periods than non-hydergine-treated cats. Whereas, cats in the control group suffered brain damage within five minutes, cats treated with hydergine survived 45 minutes later with strong brain wave pattern.

Side Effects and Contraindications: Mild side effects including nausea, headache, flushing of the skin, dizziness, and more rarely, vomiting, may occur with initial use. Stomach upset may be more common with the tablet forms.

Hydergine is synergistic with other nootropics, especially Piracetam and its analogues. Overall dosage may need to be reduced. Hydergine is supplied in 1mg, l.5mg, 3mg, 4.5mg, or 5mg tablets.

PIRACETAM
Piracetam is the foremost of the so-called nootropic "smart drugs". It is a derivative of the amino acid GABA that increases the sensitivity of receptors involved in learning and memory in brain neurons. Studies in both animals and humans have shown that Piracetam can improve memory, increase attention and concentration, and improve spatial learning. Piracetam is, perhaps, the most potent of the "smart drugs", and is used commonly to increase intelligence, information processing ability and creativity. Piracetam has been shown to harmonize and synchronize the spheres of the brain by modulating electrical activity within the brain.

CHROMIUM PICOLINATE
Originally a prescription medication, now chromium piccolinate is now an over the counter supplement. This patented form of the trace mineral chromium has been shown to lower blood glucose (sugar) and is considered a potential antiglycosylation agent. In one study, supplementation with chromium piccolinate reportedly extended the lifespan of laboratory rats. After 41 months, 80% of rats receiving chromium were still alive, while all the control rats had died. There was also a reduction in AGES (Advanced Glycation End products) in the animals receiving chromium. In human studies, chromium piccolinate has been found to decrease body fat and enhance lean body mass, while lowering blood cholesterol levels. Other studies with chromium piccolinate have not produced the same kind of results.

PICAMILON
The hottest new "smart drug" is the Russian therapy Picamilon, which has been shown to be better than Hydergine and Vinpocetine in improving blood flow to the cerebral vessels in the brain, as well as reduced oxygen flow (ischemia) to the brain. Picamilon is sold as a pharmaceutical in Russia, but is really a vitamin-like compound, consisting of a niacin analog (N-Nicotinoyl) bonded to GABA. This combination creates a molecule that readily penetrates the blood- brain barrier to enhance cerebral and peripheral circulation, and improve cognitive function.

Deprenyl
Deprenyl is a drug that was discovered around 1964-65 by Dr. Joseph Knoll and colleagues. It was originally designed to integrate some amphetamine-like brain effects with antidepressant effects. Also known as L-Deprenyl, and selegiline, deprenyl has been intensively researched over the past 36 years, many research papers on deprenyl have been published. Knoll has stated that deprenyl "...is an exceptionally lucky modification of PEA [phenylethylamine], a member of the family to which also the transmitters noradrenaline and dopamine belong." Deprenyl has shown a unique and exciting pharmacologic/clinical profile. It is the only potent, selective MAO-B inhibitor in medical use. Deprenyl is a "catecholamine activity enhancer." Deprenyl has been shown to protect nerve cells against a wide number of neurotoxins. Deprenyl has also been shown to be a "neuroprotection" when nerve cells are exposed to damaging or stressful conditions. Deprenyl has become a standard treatment for Parkinson's disease. Deprenyl is also useful in treating drug-resistant depression. In aged rats, deprenyl has proven to be a highly effective "sexual rejuvenator." Deprenyl also shows promise as a cognitive enhancement agent. Deprenyl has also proven in four different rat studies and one dog study to be an effective life-extension agent.

TESTOSTERONE
Although the decline in testosterone production as men age (sometimes referred to as "andropause") is not as dramatic as the drop in women's estrogen production with the onset of menopause, testosterone decline is a serious issue for many older men. Among other problems, declining testosterone production is strongly associated with impotency and libido problems. age management benefits that have been associated with testosterone replacement therapy may include increased libido and sexual potency; improved erectile function; improved mood and increased feelings of well-being; decreased fatigue; increased red blood cell count; reduction of LDL cholesterol and overall cholesterol levels and strengthening of the bones.

Distribution: Testosterone replacement needs to be managed by a physician to ensure that a patient receives only enough of the hormone to replenish lost levels.

Many forms of administering testosterone have been developed, including intramuscular injections, suppositories, a transdermal patch attached to the scrotum, oral micronized capsules and sublingual lozenges. Oral administrations seem to be the least effective method.

Side Effects and Contraindications: If testosterone replacement is administered to men with normal, or near-normal levels, of the hormone, any number of dangerous side effects may occur. Most notably, excess doses of testosterone may inhibit the body's ability to produce testosterone.

Testosterone replacement carries with it the risk of stimulating both benign and malignant prostate tumor growth. In addition, because it can reduce HDL cholesterol levels, testosterone replacement may be associated with an increased risk of coronary artery disease.

METFORMIN
Metformin may improve insulin use and help prevent age-related onset diabetes. It may increase the sensitivity of peripheral tissues (like muscles) to the effects of insulin, restoring the effects of glucose and insulin to younger physiological levels. Metformin may also be a useful dieting aid as it acts to stabilize sugar levels, thus preventing sugar highs and lows and sugar cravings.

Metformin's age management benefits may also include decreasing risk of age-related adult-onset diabetes, prevention of sugar cravings, improved body composition with improved insulin use, stabilization of sugar levels and slowing of the effects of diabetes.

Side Effects and Contraindications: Side effects in healthy aging individuals are rare, but may include nausea, loss of appetite, and very rarely, vomiting, stomach pain and diarrhea. Patients with diabetes type I and II sometimes take doses as high as 3 grams a day, in which case side effects may include hypoglycemia, or lactic acidosis. Use of Metformin is contraindicated when combined with Thiazide, Cimetidine, diuretics, or other anti-hypertensive products, which could cause renal malfunctioning. Also contraindicated in individuals with ketonuria, serious hepatic and renal disorders, serious cardiovascular problems, serious respiratory problems, suprarenal insufficiency, chronic alcoholism, serious dystrophic illness, acute hemorrhaging, gangrene, diabetes with previous episodes of lactic acidosis, or hypersensitivity to Metformin. Note: Because metformin may cause the malabsorption of vitamin B12, patients should supplement their diets liberally with vitamin B12.

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