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Can anti-aging hormones live up to their name?
Over-the-counter hormone replacement products are enjoying increasing popularity as an anti-aging agent. By supplying the hormones, their natural decline in the course of aging is to be compensated for and the aging slowed down, so the manufacturers promise. But can the preparations keep the promise? The German Society for Endocrinology has carried out an assessment.
The decrease in various endogenous hormones in the course of aging is a natural process. Many are trying to counteract this decline by taking hormone replacement products such as testosterone, growth hormones, the pineal hormone melatonin or dehydroepiandrosterone (DHEA). A large market for hormone replacement products has emerged, although there are no substantive anti-aging effects with regard to these hormone doses, reports the German Society for Endocrinology (DGE).
Hormone production declines in old age
"Aging is a biological process that begins at birth and is irreversible," emphasize the experts at the DGE. The skin becomes thinner, wrinkled and dry with increasing age, the eyes and ears lose their performance, the bones become porous and the vessels constrict more and more. Hormone production, for example of dehydroepiandrosterone (DHEA), melatonin and growth hormone (GH), is also declining. This is where the hormone replacement products come in.
Missing evidence of effectiveness
"Even if there is a large market today for hormone products and therapies that promise to delay the natural aging process, maintain performance, youthful appearance and quality of life at a high level, and even extend life overall, there is no scientific evidence for this "Urges Professor Dr. med. Matthias M. Weber, media spokesman for the DGE and head of endocrinology for university medicine at the Johannes Gutenberg University Mainz. In addition, the drop in hormones is "not the cause, but the result of the natural aging process."
How effective are dehydroepiandrosterone supplements?
According to the DGE, dehydroepiandrosterone (DHEA), an adrenal hormone, is one of the widely used, over-the-counter and non-medicinal hormone replacement products. The body's steroid and precursor hormone are biotransformed in the organism to both estrogens and androgens. However, the scientific evidence on the effects remains poor. For example, high-quality studies would not have had any significant effects on important metabolic parameters or well-being. "Long-term data on the frequency of illnesses and mortality are completely lacking, and regarding the risks and side effects, it can only be reliably said that they were not of concern in the observation period up to a maximum of two years," said Professor Dr. Sven Diederich, Vice President of the DGE.
Melatonin as an anti-aging agent?
When it comes to melatonin input, the promises made by the providers as "miracle cures" are great, according to the experts at the DGE. The over-the-counter hormone of the pineal gland is often touted as anti-aging and as an antioxidant radical scavenger, but placebo-controlled clinical studies in humans are difficult to find and positive effects in humans are documented at best for sleep behavior. The promised anti-aging effect could only be determined in animal experiments with sometimes high doses. At least there are no side effects when ingested. "The all-clear can be given with regard to possible negative effects and side effects," says Prof. Diederich.
Take special care with growth hormones
The prescription growth hormone (growth hormone, abbreviated GH) is intended for use in cases of severe deficiency, for example due to an anterior pituitary insufficiency. In this way, short stature in children can be compensated and in adults, the preparations should help against metabolic disorders, changes in body composition (fat and muscle distribution) and corresponding deteriorations in quality of life. However, placebo-controlled studies of GH administration in older people showed only a minimal beneficial effect on fat distribution, while "quite negative effects on sugar metabolism, water retention and joint pain were documented," reports Diederich. Possible effects on cancer promotion are also suspected, which is why GH administration should be completely avoided, warns the DGE expert.
Testosterone supplements for men
The hormone replacement products with testosterone are aimed specifically at men, since their testosterone level drops by around one to two percent annually from the age of 40. However, according to the experts in Germany, an actual testosterone deficiency with consequences such as a libido deficiency and other symptoms such as erectile dysfunction affects only three to five percent of men aged 60 to 79. Supplemental therapy with the male sex hormone can help you, but this is not the case for those who hope to use testosterone to counter depressive moods, weight gain, tiredness, nervousness and declining sexual potency. The research results are sobering here too.
Placebo-controlled clinical studies on testosterone administration in older men would have shown very few positive effects and these only related to libido. Since long-term safety data are also lacking and "there is evidence of a possible negative effect on the risk of heart attack, the patient should be treated very carefully and with good information," said Diederich.
Exercise and weight loss better anti-aging agents
The DGE experts come to the conclusion that anti-aging effects with regard to hormone administration are not proven in old age and that the preparations cause unnecessary costs. In addition, due to potential risks, the application should not be carried out outside of clinical studies, emphasize Prof. Diederich and colleagues. The risks and side effects of some active substances are already known, but overall there is often a lack of long-term data that demonstrate the safety and harmlessness of hormone administration, reports the DGE. In order to positively influence the aging process and maintain a high quality of life, other measures are also much more suitable. A reduction in weight in the second half of life and regular moderate exercise have been shown to have a positive effect and can sometimes also have positive effects on your own hormone production in old age, the experts emphasize. (fp)