Blended Medical Approach to Anti-Aging


Aging is a natural consequence of successful life survivorship.  Suffering the ravages of age may be an avoidable consequence of this success.  Health is maintained and youth is prolonged when attention is paid to maintenance of hormonal, nutritional and life-style balance.  We will briefly discuss a few of the most cost-effective interventions that can prolong health, improve function and improve quality of life.

The goal to ‘anti-aging’ is to bring the body into a healthy metabolic and hormonal balance.  This balance changes with age, and with ‘anti-aging,’ the intention is to restore that balance that would emulate a more youthful condition.  In essence, you cannot get younger, but your body can be made to operate under parameters that more closely emulate youth.  When your body operates in a more youthful chemical and hormonal environment, performance increases, mental capacity improves, and many of the little annoyances of aging can be ameliorated.

The discussion below is an overview.

 Hormonal Balance

Physiological control and command mechanism include the wired, or nerve-modulated systems, and the wire-less, or hormone-modulated systems. The hormones that influence physiology are numerous, and module the form, function and health of every cell in the body.  These hormones regulate cell growth, death, and metabolism.  These hormones do not operate alone, but hormones influence cell function when present together, in appropriate levels and ratios.  Some hormones are well understood, some are less so.  What is of greatest importance is the fact that the most important hormones are the ones that are absent or ‘out of balance.’

Thyroid Hormone

Thyroid hormone is important to the regulation of metabolism in every cell in the body.  Dysfunction of thyroid hormone  balance is common.  While it occurs most frequently as a person ages, it can occur at any time in life.  Thyroid imbalance can occur as a result of inadequate production, inadequate release, but it can also occur as a result of metabolic interference from chemicals in our diet.

Adrenal Hormones

The adrenal glands secrete many hormones, including cortisol, adrenaline, DHEA, testosterone, pregnenolone, progesterone, as well as estriol, estradiol and a host of other hormones. The adrenal glands are responsible for production of a variety of hormones.  In times of health, the adrenal glands have a substantial capability to produce these hormones rapidly, known as ‘adrenal reserve capacity.’  As we age and with disease states and nutritional deficiency, this ‘adrenal reserve capacity diminishes or disappears.

When decreased adrenal reserve becomes critical, we sometimes refer to it as ‘adrenal failure’ or ‘adrenal fatigue.’  At this point, the body has a noticeable and measurable inability to cope with acute illness and stress.


Melatonin is a hormone best recognized as a modulator of sleep.  less well recognized is the effect that melatonin has on weight management and immune response.  melatonin secretion decreases with age, which may explain the sleep-difficulties that occur with age.  Melatonin secretion also decreases in patients that receive pain medicines on a chronic basis.

Melatonin dosage varies with gender and disease state.  Women tend to need higher doses than do men, and dosage requirements increase with opiate administration, gastro-intestinal disease states and in depression.


Vitamins function in the body as enzyme co-factors.  By definition, a ‘human’ vitamin is not manufactured by ‘human physiology.’ It must be obtained from external sources, usually in the form of nutritional food. To complicate matters, there are important and necessary chemicals that are produced in small quantity, and medical conditions can occur that make produced quantities inadequate.  These are sometimes known as ‘functional vitamins.’ Some vitamins, like ‘Vitamin D’, are hormones, and are not vitamins, at all. Of the many enzymes present in cellular, tissue and systemic physiology, some vitamins are present in many different enzymes, and a some may be important to but one chemical reaction.

While adequacy of vitamin balance implies a suitable source and supply of these vitamins, most vitamin deficiencies arise from problems of absorption. Some vitamins are water-soluble, and some are oil-soluble.  Oil soluble vitamins must be in an oil environment to be absorbed and water soluble vitamins must be in a water-rich environment to be absorbed.


Essential minerals function in a number of different ways.  In some enzyme systems, they function as enzyme co-factors, just like a vitamin.  Minerals may be necessary to maintain protein shape, as in hemoglobin, or bind different proteins together. A mineral is an element, but many of these minerals can take assume different ‘shapes,’ reflective of electron-orbital morphology.  The implication is that some minerals can be present in nutrition, but if the mineral is of the wrong ‘shape,’ it will not work.

Mineral deficiencies are very common in our population.  Present in trace amounts in our food, nutritional levels of these minerals is dropping,  progressively, as our fields are being cropped, year after year.  Worse yet is the fact that our gastro-intestinal tract becomes less efficient as we age, and gastro-intestinal mineral absorption drops, with each progressive year of life. That is, mineral deficiencies can occur in the young, and diagnosis is often apparent due to growth problems.  As you age, mineral deficiencies occur very commonly, but the diagnosis can be difficult.


A great deal of attention is paid to oxidative damage, sometimes known as ‘oxidative stress.’ Anti-oxidants are necessary to prevent damage to cell membranes, sensitive nerve structures, and each and every cell in the body.  Different  tissues generate different metabolic ‘toxins,’ and different anti-oxidants are needed to deal with the various and varied toxins.  For this reason, one ‘anti-oxidant’ is insufficient to maintain a healthy homeostasis.

Fats and Oils

Perhaps the most under-appreciated of all anti-aging interventions is the thoughtful use of essential oils.  It is tempting to focus on single products, like fish oil, and fall into a false sense of accomplishement.  In fact, the chemistry associated with the use of fish-oil products is quite complex.  Fish oils differ in chemistry, and they differ in therapeutic use.  Certain ratios are more ant-inflammatory in nature, some decrease blood ‘stickyness’ or viscosity, and some are most useful for nerve-related problems.  in general terms, it is a wonderful revelation that the health-conscious society is paying greater attention to the omega-3 fatty acids, few take the time or effort to study the relative effects of different EPA:DHA ratios, and oils of different ratios have different physiological effects.

largely ignored are the omega-9 fatty acids and the lesser known lipoic acid analogs.  None of these need to be expensive, but the market is flush with poor quality commodity products.  Nowhere else in health and nutrition is the consumer more likely to get poor quality for ‘bargain prices’ than in the therapeutic oils.  Simply stated, if you buy cheaply here, you would do better keeping your money in your pocket.  Either buy quality or stay on the side-lines.  Poor quality fish oil can be mercury laden.  Saving a few dollars on a bargain-store product can result in inadvertent mercury ingestion.

The difference between the best quality and safest fish oil and the poorest quality junk may be as little as $10 per month of use.


Anti-aging should not focus on the use of unhealthy injections of growth hormone and  testosterone. The human physiology does not recognize these modalities as healthy.  Focus on Botox®, collagen fillers and derm-abrasion may provide some temporary improvement, but repeated use leads to peculiar changes in appearance.

Focus and investment is better accomplished through the thoughtful use and administration of nutrients found in nature.  Recogniaing the nutritional deficiencies that accompany modern life, restoration of balance is easily accomplished with an approach that involves replacing those minerals, vitamins, and biologicals that are identical to those that are depleted or deficient.  Equally important is restoration of hormonal balance, again using bio-identical agents.

Determination of hormonal deficiency is best accomplished with time-specific blood analysis.  The use of’sputum testing, small drops of blood, and urine lead to erroneous conclusions.  As it is in most of life endeavors, attention to the basics will lead to the most satisfactory conclusion.  Diagnosis is made through the evaluation of hormonal levels, ratios and a proper diagnosis reflects accurate and reproducible data.

Blood studies, when used properly, can determine the presence of common mineral and vitamin deficiencies.  Blood levels, alone, are insufficient.  Cell culture analysis will demonstrate subtle vitamin and mineral deficiency states where routine blood analysis cannot.

About David S Klein, MD 149 Articles
David S. Klein, MD, FACA, FACPM was born in Washington, DC, and was raised in Chevy Chase, Maryland. He completed his undergraduate education at the University of Maryland with degrees in Chemistry and Psychology. Medical School was completed at the University of Maryland at Baltimore, followed by Internship in General Surgery at the University of North Carolina and Residency in Anesthesiology at the Duke University, Durham, North Carolina. Dr Klein has been practicing medicine since 1983, concentrating in Pain Medicine, Minimally Invasive Medicine and Surgery, and Neuroendocrinology. Earning Board Certification in Anesthesiology, Dr. Klein was elected Fellow in the American College of Anesthesiology, and he was elected Fellow in the American College of Pain Medicine. He is currently an adjunct Associate Professor at the University of Central Florida, School of Medicine. He has focused his private practice on treating patients with hormone imbalance issues, nutritional deficiency related medical problems as well as pain related issues and impairment. With a highly-complex, CLIA licensed laboratory in-house, he has been able to provide rapid-turn around analysis efficiently and cost-effectively. Lecturing extensively nationally as well as internationally, Dr. Klein has authored many articles on topics relating to pain, injury and nutritionally modulated illness. His radio show, “Pain Free Living,” received top ratings during the 6 years it was on the air. Currently practicing in Longwood, Florida, Dr. Klein practices entirely in the office setting.