Longevity Therapy

Written by:  Alan Koslow, M.D.

Longevity therapy is entering a new age. There is now scientific evidence for modalities that can truly add years to our lives. Why is a vascular surgeon getting into longevity therapy? Vascular diseases are some of the main mechanisms robbing people of those extra years of life they may potentially have. As a vascular disease specialist, 90% of my patients are either obese, have diabetes, smoke or have two or three of these risk factors. In my study of methodologies for addressing these issues, I learned that a large amount of scientific knowledge is accumulating on how to decrease the risks of these and other risk factors, extending life by many years.

A common question I get from my patients is: “Why would I want to live longer to be old and suffering?” This is a valid question. Patients see family members, parents, aunts, uncles and grandparents who suffered in last years of life. The hope of longevity therapy is to not only extend life, but to increase the quality of that extended life.

When people hear that I'm practicing longevity therapy medicine, they immediately assume that I am using several alternative medicine modalities. These include: chelation therapy; human growth hormone therapy; detoxification techniques; and mega-vitamin therapy. I feel that an integrative modality combining CAM (Complementary Alternative Modalities) is central to my methodologies. I would love to have evidence for these other modalities that they are effective and can treat diseases. However, there are very few evidence-based studies demonstrating the effectiveness of these modalities. Some may even be harmful to both the patients’ health and pocket book. It is hard for me to justify to my patients expensive treatment modality with no proven benefit. There are modalities proven by large multicenter randomized double-blind clinical trials, which are both safe and effective. 

In a recent grand Rounds at Mercy Hospital in Des Moines, Dr. Jennifer Robinson, Director of the Lipid Research Clinic of the University of Iowa College of Public Health, said that by simply following the recommendations of the NCEP (National Cholesterol Education Program) report, the average life expectancy in the United States would be increased by 11 years. The problem occurs in applying the findings in clinical practice.

My hypothesis is that if you aggressively look for risk factors in the typical 40, 50 or 60 year-old who appears perfectly healthy and disease-free, the unwell healthy, you will be able to find things you can modify, things you can add, and medications you can prescribe, to allow this person to live 10 to 15 quality years longer than they might otherwise without each intervention. There are several challenges to this hypothesis, first and foremost is getting that 40 or 50 something person to acknowledge that they can benefit from a complete analysis. Second, most medical insurance companies do not compensate for the type or preventive services that longevity therapy entails.  This means that the patient needs to pay for the service themselves. Third, to really do a complete and thorough job requires between two and three hours over three to four sessions of meeting with the physician or physician extender. That can be expensive, but the average Iowan spends between 800 and $1200 per year on routine maintenance on their automobile and the body is obviously a much more complex machine, than a car. Patients need to understand how important it is to do routine maintenance on a system that is irreplaceable, their body.

From a physical and laboratory point of view, we are looking for signs of early atherosclerosis, metabolic syndrome, glucose intolerance and hypertension. I think you can see where this is going, and unfortunately for the economics of the medical system you're right, this will mean that many apparently healthy patients coming in for longevity screening will walk out with upwards of four medications. However, combining medications with alternative medical therapies such as stress reduction, hypnosis, rational vitamin/supplement therapy, the results can be amplified greatly. A very serious question is the public health impact of this from both cost and health perspective. The basis of the hypothesis for performing this service is that the lifelong savings on medical care, particularly at the end of life will be great. Because chronic illnesses will be decreased, lowering those medical costs and increasing quality of life, the cost benefit ratio leans heavily towards aggressive medical treatment to obtain maximum longevity and quality of life. While I’m still actively practicing vascular surgery, I am also for all these reasons, devoting half of my practice to Longevity Therapy.