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Q
Can You "Manage" Aging?

What do you think of age management programs like Cenegenics?

A
Answer (Published 9/8/2008)

Cenegenics is one of several "age management" systems that have sprung up in recent years as baby boomers increasingly face the fact that no one remains young forever. Cenegenics claims to provide a strategy for "managing" aging based on a battery of tests, diet, exercise and, in some cases, the use of an array of hormone treatments reportedly including human growth hormone (HGH), DHEA (dehydroepiandrosterone), and testosterone replacement. The outfit advertises that its evaluations go far beyond conventional medical assessments of how well you're aging.

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I have not reviewed the assessments in detail, but I know of no tests for biomarkers that indicate how to "manage" the aging process. Robert Butler, M.D., a gerontologist who heads the nonprofit International Longevity Center USA, has noted that although gerontologists have searched for such markers for years, none has been identified: "We simply don't have the equivalent of a blood pressure cuff for testing aging," Dr. Butler has said.

Without doubt, the Cenegenics program is pricey: reportedly an initial evaluation costs $2,495 and monthly charges for vitamins, supplements and hormone therapy can add up to $400 or more. None of this is covered by health insurance.

I would be leery about the use of any of the hormone replacements mentioned in news reports about Cenegenics, even though its practitioners are medical doctors who, I would hope, are aware of possible adverse effects. Overall, I doubt that the benefits of these treatments outweigh the risks. For example, the regular use of DHEA poses an increased risk of heart attack and breast and prostate cancer. Prolonged testosterone replacement can lead to breast enlargement, acne, decreased testicular size, and an increased risk of prostate enlargement or prostate cancer in older men. In men with heart, kidney, or liver disease, there is also a risk of fluid accumulation that may contribute to congestive heart failure.

As for HGH, while some studies show that supplements of it can increase muscle mass, there's a question of whether it significantly improves muscle strength or function. A Stanford University review of clinical studies published in 2007 concluded that the only benefit of HGH was a slight increase in muscle mass while risks included significantly more soft tissue swelling and joint pain and carpal tunnel syndrome among the approximately 500 people who participated in 31 studies the researchers analyzed. Unless you have a legitimate medical need for supplemental HGH (such as pituitary deficiency in adults), it could do you more harm than good.

If your goal is healthy aging, focus on your diet and regular physical and mental exercise. You don't need an expensive age management plan, and there is no hormonal fountain of youth.

Andrew Weil, M.D.

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