Ageless: The Naked Truth About Bioidentical Hormones (33 page)

I can then explain to them that they really need testosterone to drive their libido and increase their desire so that Viagra can be more effective. In time, when I get their hormones in complete balance, Viagra isn’t as necessary as it was in the beginning.

SS:
That’s interesting. If you are balancing testosterone, you
do
need Viagra to jump-start things?

JF:
For some men, yes. Other men are deficient in growth hormone, which has amazing results when replaced. I have worked out all my life, but I could never do anything about my belly. I could never get to a six-pack. But when I first tried growth hormone, suddenly my rectus abdominis starting coming into view. Talk about a motivator. I was back into the gym before you knew it. It wasn’t until I became more sophisticated about hormone replacement that I began to see the changes. But I had a hard time talking my buddies into taking it.

SS:
Because hormone replacement is all tied up with menopause in women?

JF:
To an extent, but it has more to do with psychological issues. People start to rationalize if their sexual behavior becomes a problem. I’ve had women say to me, “Please don’t give me testosterone because I don’t want my sex life to come back. John and I have reached a point where we are happy with the fact that we don’t have sex anymore.” But you see, it is a part of your life that is missing.

SS:
But also it means that you are imbalanced and then subject to the diseases of aging.

JF:
Absolutely. My goal is to enrich and extend the quality of a patient’s life. If you are willing to work with me, watch your diet, exercise, take supplements, replace lost hormones, add to your regimen growth hormone, then I can help you reinstate a lifestyle that makes every day worth getting up for.

SS:
What can a man or woman who decides to take you on expect for the rest of their lives?

JF:
Men on testosterone can expect the following advantages. First, they will now be able to sustain muscle mass, whereas men who aren’t on testosterone will lose muscle. I see these men in the gym every day—men in their thirties and forties who are round little guys with very pale color; being on testosterone corrects this pale, pasty look. Second, testosterone increases red cell count, which is absolutely critical for delivering oxygen to the tissue. My patients who are on testosterone are well oxygenated, and they are able to sustain muscle mass, whereas before, without testosterone, they were replacing muscle with fat. So I see a leaner, healthier, better-oxygenated individual at this stage.

Third, a man can regain his bone health. Men lose estrogen in the aging process. When estrogen is lost, bone density declines. This process can be rectified by getting the right ratio of testosterone to estrogen. This will rebuild his bones and restore the integrity of his bone density. Without the correct ratio, that won’t happen; a man needs testosterone and estrogen in balance.

SS:
Because testosterone is an anabolic steroid?

JF:
In a sense, bioidentical testosterone is both anabolic, meaning dedicated to building muscle, and androgenic, meaning promoting the development of secondary sex characteristics such as sperm production. The anabolic benefit leads to a more muscular physique; the androgenic benefit leads to more virility and an improved sex life. In short, we increase his testosterone, we build his muscle mass, we restore the integrity of his bone density, and we reinstate his sex drive.

SS:
If men only knew this kind of treatment was available, they would be running to your office. Every aging man would like to get back his energy, muscle, and sexuality. What is the first thing you do when a man comes into your office?

JF:
I check his hormone levels first, then his PSA so that we know that this man’s prostate is okay. A male’s estrogen level should be around 50, ideally, and if this man’s levels are around 32, we’ve got room to play. If his PSA is .2 or .5, that is great. Anything below 4 is great. Now we can add some testosterone, and we can add it to the point that his performance begins to increase and the safety factors are not violated. On the next series of tests, we look at his estrogen again. Has it gone up? No. Has his PSA gone up? No. Such results tell me that he is responding very favorably to treatment. We need to establish those values for every single one of the hormones that we are trying to administer, and that is a long, hard process for traditional medicine. However, in my kind of practice, we can do it because we have time, and we can do it repeatedly.

SS:
As women get older, reaching orgasm gets more and more difficult. No one seems to know why. Is the same phenomenon true for men?

JF:
It is exactly the same. Not only do men find that it takes longer to reach orgasm, but they are very concerned about the volume of their ejaculations—not as much of it, or the force of it. We get into delicate issues here because how the sexual act is performed can be so emotionally charged.

SS:
This approach to treatment is catchy. You see someone in their forties, fifties, sixties, or seventies who is hormonally balanced, and their youthful way of being in the world is very appealing. You say to yourself, I’d like to feel like that, too.

JF:
I am in this practice because my mother had Alzheimer’s disease, and all of my aunts and uncles had it. Mental attitude is a critical issue. All of the things we do tend to reinforce our neurochemistry to the point where we can accept the idea that there is a brighter future. It is possible to optimize our health; we do not have to accept the degeneration of previous generations.

SS:
In recent years, there has been lot of talk about perimenopause in women. But what about men? Do they go through a “periandropause”?

JF:
Yes, they do, but the difference is much more subtle, and it is usually much lower in onset. When a young man comes to me with
low libido and low energy, I check him to see if he has primary or secondary hypogonadism.

SS:
Please explain.

JF:
Primary hypogonadism means that the testicles are not producing enough testosterone. Secondary hypogonadism is the result of problems with the pituitary gland or the hypothalamus, meaning that his testicles are not stimulated enough to produce testosterone. In either case, normal performance of the testicles is compromised.

This is a fascinating aspect of medicine. If you took my growth hormone cells (somatocytes) out of my pituitary and stuck them in a petri dish, they would produce growth hormone like there was no tomorrow, like I was fifteen years old. But if you take them out of the petri dish and stick them back in my pituitary, they wouldn’t produce 10 percent of what they produced when I was a young man. It’s as though there is some kind of genetic faucet gradually cranking down. We don’t yet know what it is. We can rectify this with testosterone replacement and growth hormone injections.

This is incredibly rewarding work. I’ve now got patients in their eighties who sit there and smile as a couple. They both look at me and say, “Yeah, Doc, we’re doing it maybe once or twice a week.”

SS:
How great … and they have the time!

JF:
Absolutely. They also have the energy and the desire. This line of medicine doesn’t pay a tenth of what I was making as an anesthesiologist, but the personal rewards are huge.

I put my aunt with Alzheimer’s disease in a convalescent home. Once, I looked down the hall, and there were about thirty people sitting there in wheelchairs. One yells and then they all start screaming. If anybody walks into my office and says, “I want to stay healthy,” I will bend over backwards to help them because I don’t want to see anybody end up like that, least of all me.

SS:
What do you want people to know so they won’t be terrified of stepping into this new realm of medicine, into this new approach to living your life?

JF:
Life itself is an experiment. We weren’t asked to be born, yet we were thrown on this planet and now we are experimenting with opportunities placed before us. Up until now, we have accepted that
the second half of our lives would be one of degeneration and disease. Now we need to turn our attention to the fact that the opportunity exists to be able to use medications that were previously reserved for disease to produce a kind of optimum health that becomes the first line of defense against degeneration and disease, and that those medications are available and they are natural (bioidentical). Everyone should have the opportunity to experiment with those to make sure (within the safe parameters) that they can enrich their lives much beyond what they ever thought possible.

When I was a little boy on the farm, somebody said something to me about the year 2000. I remember thinking to myself that I would never live to see that time. Yet here I am, and I see no end in sight. This is an incredible change in my life, and I love sharing it with people and living it by example. It gets me out of bed in the morning and keeps me in my office until late at night in order to continue setting a positive example for others.

SS:
As a father of four, do you find that your children are following suit?

JF:
Absolutely. They are wonderful people and very, very hip on all kinds of nutritional things. They all exercise, and they all believe in what I am doing, and they follow my example.

SS:
Thank you so much. You are inspiring.

DR. FILBECK’S TOP FIVE ANTIAGING RECOMMENDATIONS

1. Testosterone replacement is important for sustaining and building muscle mass, delivering oxygen to the tissues, regaining bone health, and reinstating sex drive.

2. Testosterone replacement can be accompanied by an erectile dysfunction (ED) drug such as Viagra, although in time the ED drug won’t be as necessary as it was in the beginning.

3. If you’re a young man experiencing low libido and low energy, have your doctor check you for primary or secondary hypogonadism. Primary hypogonadism means that the testicles are not
producing enough testosterone. Secondary hypogonadism is the result of problems with the pituitary gland or the hypothalamus, meaning that the testicles are not stimulated enough to produce testosterone. In either case, normal performance of the testicles is compromised.

4. Definitely consider growth hormone replacement if you are deficient.

5. Bioidentical hormone replacement is for men, too—it can enrich their lives much beyond what was ever thought possible.

PART THREE
T
HE
T
HREE
S
’S:
S
EX
, S
LEEP,
AND
S
TRESS

Every stress leaves an indelible scar, and
the organism pays for its survival after a
stressful situation by becoming a little older.

—Hans Selye

CHAPTER 16
S
EX
, S
LEEP, AND
S
TRESS

A ninety-seven-year-old man goes into his doctor’s office and says, “Doc, I want my sex drive lowered.”

“Sir,” replied the doctor, “you’re ninety-seven. Don’t you think your sex drive is all in your head?”

“You’re darned right,” replied the old man. “That’s why I want it lowered!”

S
EX

Hmm … wasn’t sex just a given? Didn’t you think that this one life pleasure was just something you never even had to think about? You want it … you have a partner … bingo. There it is.

I think the one subject that comes up more often than any other when I am speaking to a group is sex, or I might say the absence of sex. “The feeling is just gone,” I hear from so many women. “It’s not that I don’t want to ‘do’ it, it’s just that I can’t feel anything.”

And what about men? How many times a day do you see commercials on television for Viagra or the blue pill? Or the one that really cracks me up, which warns, “If your erection lasts more than four hours, call your physician”? What a sales pitch. I can feel men
running to the phones to get that one. Four hours! But what has happened to both sexes that suddenly nature’s most primal urge has become problematic?

Well, let’s first look at stress. Stress is the biggest romance killer that exists. But the other reason is hormones. Remember, stress blunts hormone production. Both women and men will lose their sex hormones in the aging process, and the negative effects are more prevalent today than at any other time in the history of mankind. Why? We are living longer, and we are living more stressful lives.

For women, loss of hormones takes away their feeling. It’s not just that their testosterone is low; it’s that everything is low, and the ratio is off. Without hormones you have no feeling. The sex hormones are your minor hormones: estrogen, progesterone, testosterone, DHEA, pregnenolone. When you are low or missing your sex hormones … guess what? No sex! No feeling! Research shows that testosterone levels in women in their forties are half the levels of women in their twenties. A similar decline is seen in the levels of DHEA, the primary precursor to testosterone. DHEA peaks at age twenty-five, slips to half that level by age fifty, and may be totally absent in the elderly. Since DHEA is a precursor to testosterone, any reduction in DHEA results in lower testosterone levels. Testosterone increases genital blood flow, which increases sensitivity and responsiveness of the clitoris. Hormonal balance, including testosterone replacement, will reawaken a sleeping clitoris. This is a good thing. This is quite a simple problem to fix if you have a doctor who gets it. I know this from experience. I lost my sex hormones, and I experienced this awful dead feeling (my sleeping clitoris). I love my husband deeply, and we have always enjoyed each other sexually very much, then all of a sudden … nothing. I could “do” it, but I would rather be reading a magazine. In fact, the best sex for me during this time was when the TV was on because then I could still watch the program and “get it over with.” But this is not the way I wanted it.