SEATTLE - Henk Kunnen noticed the skin on the back of his hands was getting paper thin. If the Seattle veterinarian banged against an animal cage, it cut right through. A dog bite took too long to heal. And his grip was growing weaker.
He could barely unscrew the lid of his favorite pickled herring. "If you can't get into your pickled herring," that's real cause for alarm, he jokes.
Nearly two years ago, after much thought, Kunnen, now 64, walked into Nonage Longevity Medical Clinic in Kirkland, Wash., hoping to slow the clock. He began a regimen of hormone replacement and medical monitoring designed to give him the energy and strength of a much younger man. The cost? About $5,000 a year.
With the age boom upon us, the ages-old search for a fountain of youth has shifted into high gear.
Research on slowing or arresting aging - once considered near quackery - has achieved mainstream legitimacy. Scientists backed by government funding are racing to unlock the secrets of what makes us grow old and to find ways to keep people youthful and functional longer.
But just as the quest for youth has pitted modern medicine against time, it has pitted doctor against doctor.
Many researchers, health providers and the National Institute on Aging advise consumers to be wary. The risks of many anti-aging treatments are unknown and the benefits unproven, they say.
"Wait for research that demonstrates this is safe and effective. This is a situation where you don't know exactly what you're getting yourself into," advises Stanley Slater, deputy associate director for geriatrics at the National Institute on Aging, part of the National Institutes of Health.
Tens of thousands of older adults aren't in a waiting mood. They're battling old age with everything at hand.
And a growing number of practitioners are hanging out anti-aging shingles. The American Academy of Anti-Aging Medicine reports its member practitioners - most of them medical doctors - have gone from 12 in 1993 to about 12,000 worldwide, including 8,000 to 10,000 in the U.S.
Demand for anti-aging products and services fuels a multibillion-dollar business. Ads for ginkgo biloba, hormones, memory enhancers and such proliferate on the Internet and fill drug and health-food store shelves.
Anti-aging medicine is so popular, it has provoked a backlash from mainstream biogerontologists and other experts on aging.
"The public is being bamboozled by an industry that wants to separate them from their money - an industry that's been around for 3,000 years," says S. Jay Olshansky, a national expert on anti-aging products at the University of Illinois.
Olshansky is among 51 researchers in the field who signed a position paper, published in Scientific American magazine last year, that warned about false claims that anti-aging medicine can slow, stop or reverse aging.
Proponents of anti-aging medicine are equally outspoken.
"The flak is about politics, about who will control and whose opinions will be heard with regard to the future of aging in the Western world," says Dr. Ronald Klatz, president of the American Academy of Anti-Aging Medicine.
In February, The Gerontologist, a journal, weighed in.
This new "war on anti-aging medicine" has two aims, according to author Robert Binstock, professor of aging, health and society at Case Western Reserve University in Cleveland.
On one level, the war aims to warn about harmful and ineffective products and services and educate people about what's really possible, he says.
But it also aims "to discredit and distinguish" practitioners and entrepreneurs who offer anti-aging products from legitimate biologists who've fought hard for their turf in the field of aging, he says.
Anti-aging medicine is a lay phrase for a broad area not recognized by the American Medical Association. Insurance usually doesn't cover it. Some practitioners "are trying to make their patients healthy. Some are trying to make money. And some are doing both," Binstock says.
Practitioners may prescribe forms of hormones that decline with age: human growth hormone, estrogen and testosterone and DHEA, or dehydroepiandrosterone. DHEA, produced in the adrenal glands, can be converted by the body to make other hormones.
The typical strategy is to boost fading hormone levels to levels of a younger age.
Research shows benefits and risks to each of these drugs.
For example, DHEA supplements taken even briefly may cause liver damage, according to the National Institute on Aging. Testosterone, credited with maintaining muscles and sex drive, may increase prostate-cancer risk, the institute says.
One of the most talked-about treatments is human growth hormone. Klatz calls it "one of the great success stories in all of medicine, comparable to cortisone, penicillin and Botox."
The Food and Drug Administration (FDA) approves use of growth hormone only to treat children with growth-hormone deficiency or other growth disorders and adults with deficiency or AIDS wasting.
However, doctors legally can prescribe it for "off-label" uses.
Kunnen, the Seattle veterinarian, injects human growth hormone every night. First thing out of the shower in the morning, he rubs a dollop of testosterone cream on the inside of his thighs. He takes an estrogen blocker to prevent breast development; DHEA, and vitamins.
"I feel infinitely better," he says. "A lot of people put me at least 10 years younger." Kunnen still wears bifocals and takes blood-pressure medication but says his wounds heal in half the time, his hands are strong again, his endurance is up and he needs less sleep.
Studies show growth hormone appears to build muscle and bone density in adults. But a study published last fall tied it to fluid retention, carpal tunnel syndrome and diabetes. Klatz and some anti-aging practitioners argue that doses used in the study were too high.
Calvin Wilkinson, 66, is pretty sure his use of human growth hormone endangered his health. Normally, the retired Boeing engineer is a conservative guy. But the pitch at a Nonage seminar made sense to him.
Wilkinson started taking hormone supplements, including growth hormone, with regular monitoring.
"It cost like hell," he says. But his strength and libido improved.
Then, on a cruise last year to Australia, he started feeling weak, urinated constantly and was thirsty all the time. A blood-sugar test landed him in intensive care for two days with a diagnosis of diabetes. The doctor who treated him cited studies linking the illness with human growth hormone.
Dr. Jerry Mixon, owner of the Nonage Clinic, explains that adult-onset diabetes is epidemic.
"By the law of averages, a certain number of people put on growth hormone are also going to get diabetes," he says. More typically, "if we're successful in reducing fat, increasing muscle and exercise levels, the blood-sugar level will actually go down."
With diet, exercise and medication, Wilkinson got his blood sugar down and is no longer diabetic. He quit anti-aging treatments.
"I wouldn't inject that crap in myself again," says Wilkinson, a mission pilot and director of aircraft maintenance for the Civil Air Patrol in Washington. Instead, he has decided to accept this stage in life.
"Yeah. I am just going to grow old. What the hell."
Other Mixon clients couldn't be happier with their treatment.
"I want to stay at the level I'm at. I'm very healthy and active. When I get to be 80, I'd like to be more like 70," says Dolores Smith, 65, a fit great-grandmother.
"We want to feel as good and look as good as we can," adds her husband, Alan Mendelssohn.
Soon after marrying two years ago, the retired surgeon and his wife began therapy at the Nonage Clinic. The couple now injects growth hormone and applies hormone creams every day. Mendelssohn takes a cholesterol-lowering drug - not because he needs it, but because he wants to be on the cutting edge of healthy.
Their annual bill for the medication is about $6,400.
No longer a clinic patient, but still on the program, Mendelssohn says he has a sharper mind, more stamina, energy and defined muscle. His wife doesn't see much change, but she has always been fit and reasons that's better than going downhill.
Mendelssohn has researched the products, and the couple are sure they would recognize negative side effects and fix them by cutting doses.
The Puget Sound area is considered a Mecca for alternative, or naturopathic, medicine. Some practitioners use what are considered anti-aging approaches but prefer to simply call them good medicine.
Typically, they first help the patient identify lifestyle issues that interfere with healthy aging: diet, exercise, sleep, stress and alcohol. They may also evaluate exposure to toxins and nutrient absorption.
"I don't like the term anti-aging. It implies we can stop the aging process. We are all aging according to our genes," says Dr. Ralph Golan, who has a Seattle preventive-and-wellness practice.
But there are "factors we can influence to slow the aging process, which also often improves how one feels and functions."
When he thinks it's appropriate, Golan prescribes hormones identical to what's in the body - testosterone, progesterone, estrogen and DHEA - in amounts calibrated to minimize risk. He prescribes growth hormone only rarely and with careful monitoring.
"That's the very last hormone I'll give somebody. There are dangers to its use. It's extremely expensive," he says.
At the Paracelsus Clinic in Federal Way, Dr. Thomas Dorman won't call himself an anti-aging doctor because, he believes, it emphasizes what shouldn't be emphasized. He believes in treating the whole person.
Dorman's primary services are chelation and prolotherapy.
Chelation uses intravenous injections of EDTA (ethylene diamine tetra-acetic acid). The FDA approves use of this synthetic amino acid to remove heavy metals and minerals from the blood. It is being tested as a treatment for coronary artery disease.
Prolotherapy uses injections of a sugar-water solution to treat ligament sprains and strains.
Dorman is enthusiastic. Hundreds of times after receiving his treatment, patients report "my vitality is back," he says.
He is conservative about prescribing growth hormone. Lots of people ask for it, but only a small percentage end up using it because he shows them other things that give "more benefit for the buck."
One of Dorman's patients is Marilyn Wilfong, director of employee benefits at Weyerhaeuser.
Wilfong, 54, gets a weekly vitamin B shot and other vitamin supplements, including one called "brain storm." Dorman helped her stop synthetic hormone replacements with plant-based hormone creams.
The rest of her anti-aging regimen is eclectic. She's a vegetarian, cardio kick-boxer and black belt in martial arts. She has had plastic surgeries on eyes, breasts and tummy and expects to have a face lift.
"When you look good, you feel good," she says. "I don't know that I'm doing anything that I would say is extending my life, but, hopefully, the quality of my life will be good to the end."
Ideally, "when my number gets called by the big guy in the sky, I'll just go to sleep."
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