Dr Craige Golding, a specialist physician in anti-aging medicine and medical director of Solal, admits that the term ‘anti-aging medicine’ is perhaps not the best description of his field of interest. “It tends to suggest a focus on the exterior, giving the impression that it’s all about wrinkles and Botox treatments. But the focus is much broader than that. Anti-aging medicine is really about the prevention, early detection and reversal of the chronic diseases that become more common with age, and which constitute nearly 90% of the illnesses doctors treat on an ongoing basis. It truly is the medicine of the new millennium, advocating that people actively take control of their health rather than simply waiting for diseases to develop. People want to spend a longer time living healthily and a shorter time dying.”
Golding qualified as a specialist physician in 1999 and quickly found that much of the time he was treating the symptoms of conditions like diabetes, cancer, dementia, heart disease, osteoarthritis and osteoporosis, rather than addressing the causes. “And yet many of these degenerative diseases of aging are largely preventable or reversible, if one can intervene early enough using anti-aging treatments, like vitamins, minerals, amino acids, essential fats, nutraceuticals, herbal extracts, chelation therapies, intravenous nutrients and other intravenous treatments such as glutathione, hydrogen peroxide, phospholipid exchange, and measures like lifestyle modification. Hormone balancing and neurotransmitter assessmant and normalisation are also offered in anti-aging medicine. However, conventional practice didn’t give me the tools to practice this kind of preventive medicine. Anti-aging medicine addresses the cause of the underlying problem, rather than merely treating the symptoms.”
And then Golding heard of A4M, the American Academy of Anti-Aging Medicine. It offers two board-certified courses in anti-aging medicine, requiring, inter alia, the completion of a number of modules (courses offered in the United States), oral and written examinations, participation in interactive webcasts, and case studies. Completing these courses required five trips to the USA. Golding is now the only person in Africa to hold these qualifications. The qualifications are: ABAARM (American Board Certification in Anti-aging and Regenerative Medicine) and FAAFM (Fellow in Anti-Aging and Functional Medicine.)
“The primary aim of anti-aging medicine is to prevent disease,” he says. “We’ve seen a huge explosion in ‘convenience living’, with a lot of bad nutrition as a result of high intake of fast foods. In addition we’re exposed to a high level of pollutants. In fact, just living increases one’s risk for disease, since we are living in an increasingly toxic environment and exposed to poor diets and excessive stress. But by paying attention to one’s health, detoxifying and implementing lifestyle changes such as sound nutrition, exercise, stress management and anti-aging medicine, sickness can largely be prevented.”
“We also look at the role of hormones in disease processes. The hormonal decline associated with aging predisposes people to disease, thus increasing risk. Replenishment with bio-identical/compounded hormones, which have the same structure as hormones naturally occurring in the human body, can be highly beneficial to one’s health.”
Golding is looking to establish several integrative medicine centres throughout South Africa. The first of these, in Bryanston, Johannesburg, is already up and running, and offers bio-identical hormone therapy, chelation therapies, intravenous nutrient treatments and integrative approaches to cancer including, for example, high-dose vitamin C therapy. This centre also offers anti-aging skin treatments, specialist anti-aging consultations and bio-identical compounded hormone replacement therapies.
Other future plans include the establishment of an age-diagnostic lab in South Africa. Says Golding, “In so many cases, ‘normal’ and ‘optimal’ hormone levels are not the same thing. We have aggressive reference ranges when it comes to issues like testosterone levels in men, for example. Conventional guidelines have a one-size-fits-all approach, even though one would think it obvious that what is normal or optimal in an 18-year-old would not be so in an 80-year-old. Low testosterone increases one’s risk for conditions like prostate cancer, loss of muscle mass, heart disease, vascular disease and osteoporosis. Restoring declining testosterone levels in an older man to the physiologically normal levels of a younger person can prevent a wide array of diseases.”
Golding is also planning to do a number of seminars on anti-aging medicine, starting February 2008. The topics covered will include all areas of anti-aging medicine; to give some examples:
- bio-identical hormone replenishment
- thyroid health
- adrenal fatigue
- brain health
- prevention of cancers, such as breast cancer
- integrative approach to cancer treatments
- chelation therapies
- attention deficit disorder and autism spectrum
- metabolic syndrome
- weight loss
Areas of promise
Metabolic syndrome is now a major problem worldwide. “If we can prevent it from developing – or even just retard the process of decline – we can make a huge difference to an individual’s quality of life,” says Golding, “For example, chromium and other nutraceuticals such as alpha lipoic acid and Egcg can reverse or even prevent diabetes – and our goal is to ensure a healthy life without the burden of the chronic diseases of aging.”
Chelation therapy is showing promise for the treatment of heavy metal toxicity – and treatment of this is unique to anti-aging medicine. Heavy metal toxicity can be tested for quite easily through urine tests, MELISA blood testing or hair sampling. We are all exposed to heavy metal toxicity and the consequences can be dire if not dealt with, contributing to conditions like heart disease, vascular disease, dementia and cancer.
Golding is also very enthusiastic about the nutritional treatment of cancer by means of intravenous nutrients. In 2007, Dr Shari Lieberman presented her successful case studies to the Fellowship in Anti-aging. She has seen very positive results using nutraceuticals and high doses of intravenous vitamin C. Golding hopes to introduce this to South Africa in the course of 2008.
Anti-aging medicine also extends to psychological wellness, and neurotransmitter testing. (South Africa still does not have the necessary facilities for this, however, and the evaluations have to be done overseas.) Rather than just prescribing antidepressants for depression and anxiety, amino acids, nutrients, cofactors, vitamins and minerals can be used in a more sustainable manner to restore neurotransmitter levels in the brain. Neurotransmitters are essentially molecules of behaviour within the brain and many disorders ranging from depression to anxiety to attention deficicit disorder to psychosis and other mental disorders can be addressed by optimisation of neurotransmitters.
Golding is very conscious of the mind-body link. “Conventional medicine underestimates the importance of happiness. People want to feel good and be conscious of it. That’s why anti-aging medicine puts great emphasis on a holistic approach, viewing the patient/client as a complete entity, rather than only focusing on the one area where overt disease may be present.”
The wellness revolution
Golding feels that the world is undergoing a wellness revolution, and that anti-aging medicine will have an ever-greater role to play in the future. “More and more people are embracing the wellness model, realising that lifestyle plays a key role in the development of disease – and that because lifestyle is modifiable, disease is reversible. People want to feel well and be healthy, and the fact that many anti-aging practices are constantly booked up – often months in advance – attests to this changing mindset.”
Golding became Solal’s medical director because he was very impressed with the company’s range of anti-aging products. The range comprises more than 200 types of nutraceuticals, all formulated with scientifically supported optimal doses. “It’s a very impressive range, maybe the best of its kind in the world and superior even to those available in the USA,” he says. “In addition, Solal also has ranges of cosmaceuticals and dermaceuticals, which hold a lot of promise for retarding aging of the skin.”
Golding reveals that the A4M intends bringing the qualifications in anti-aging medicine to South Africa. He says, “GPs, for example, would be able to do these courses without giving up their practices.” Golding also foresees a time in the USA in the not-too-distant future when anti-aging medicine will become a recognised sub-specialty, requiring a four-year degree course. And given that South Africa tends to track trends in the USA, this will almost certainly become the case here too. “However, those of us who already hold the current qualifications will probably be ‘grandfathered in’,” he says.
Though passionate about anti-aging medicine, wellness and the prevention of illness, Golding underscores that he is not negating the importance and value of conventional medicine, which also has its place. “After all, if you’ve actually had a myocardial infarction, you need treatment in an ICU, not a dose of vitamin C. My point is simply that for so long we’ve been over-focused on just managing diseases. But prevention, early detection and reversal of the disease process are better options. Take the analogy of a car. What makes more sense? To have the car serviced regularly or to wait for it to break down?”
“We already have the diagnostic capabilities to pick up markers of disease before it becomes clinically evident. Developments in DNA/RNA measurement and genetic testing will continue to advance this – already, genetic studies can even pick up abnormalities before these are evident on PET scanning. Genetic modification in utero will be the next big, exciting development. Stem cell therapy is also showing great promise and is already being used in anti-aging medicine for the treatment of conditions like osteo-arthritis and macular degeneration, as well as myocardial infarction and stroke. Exciting times await us with an increased life expectancy and better health.”