Aging Overview
Aging has been a hot topic for the past several years. Finding ways to prevent aging or defy the effects of aging have been the source of significant product development controversy. You cannot go through a day without coming across something related to “aging”, whether product advertising in magazines or on television or the countless number of “anti-aging” claims being advertised. It need not matter whether you're concerned about appearance, weight, sex drive, or chronic diseases, the key to healthy aging is a healthy lifestyle. This includes eating a healthy diet, practicing portion control and including appropriate physical activity in your daily routine. Let me make one thing very clear – there is no way to prevent aging. It will happen every day regardless of weather; we all will get one day older. Therefore, the idea of “anti-aging”, whether it is marketed in a clinic or a beauty product, is not feasible. We need to get into the mindset of “healthy” or “graceful” aging.  If these ads happen to spark interest in considering anti-aging therapies, I urge you to go about this cautiously and with an open mind. Also be prepared that most “therapies” will not be covered by most insurances.  Be cautious and ask questions, as there is no way to fix the aging process. “Anti-aging” therapies often are expensive and don't live up to their claims.

As a result of our bodies aging process, there are natural physiologic changes that occur. Specifically I am going to discuss the endocrine or hormonal changes that occur.
Age-related hormonal changes

As we age, hormonal changes occur naturally, as some organs or tissues become less sensitive to their controlling hormone and the amount of hormones produced may also change. Many of the organs that produce hormones are also controlled by other regulating hormones. Aging changes these processes. For example, an endocrine tissue may produce less of its hormone than it did at a younger age, or it may produce the same amount at a slower rate. This is most commonly seen through the menstrual changes that women go through in menopause. The body’s hormonal regulator (pituitary gland) produces fewer hormones to stimulate women’s ovaries to produce estrogen, thereby creating the state of menopause. While some hormone blood levels  decrease, some increase and some are unchanged.

Some other hormonal changes that can occur are…

The thyroid gland produces hormones that help control metabolism. With aging, the thyroid often becomes lumpy (nodular) and our metabolism gradually declines. As our metabolism declines, there is less thyroid hormone produced. Our bodies begin the aging transformation in appearance and the once, lean muscular appearance, can be replaced by higher fat due to the loss of muscle and bone tissue. It is normal to see this change in appearance without any changes in the laboratory testing for thyroid hormones.

Osteoporosis, which was discussed in a separate section, can be caused from an inappropriate amount of parathyroid hormone production from the parathyroid glands. This not only affects the strength of bones, but affects calcium and phosphate levels. As discussed above, as we age, sex hormone production declines causing menopause in women and low testosterone levels in men. The low testosterone levels can be responsible for a low sex drive and erectile dysfunction.

The adrenal glands are a complex gland that produces a variety of hormones, one of them is aldosterone. Aldosterone secretion decreases with age, which can contribute to light-headedness and a drop in blood pressure with sudden position changes (orthostatic hypotension). Cortisol secretion decreases with aging, but the blood level stays about the same. Dehydroepiandrosterone levels also drop; however, the effects of this decline on the body are not clear.
Menopause

Menopause itself is a rather complex condition as the body goes through a significant hormonal change. The body which was once (usually) precisely regulated and balanced enabling a monthly menstrual period for approximately 40 years of life, transforms to cease this cyclical regulation. These affect not only menstrual health, but are also involved in behavioral, mood, bone and cardiac health. Obtaining an optimal treatment can take a multi-pronged approach that includes diet changes, medication, and exercise.
Some of the alternative therapies that patients consider include the use of “bio-identical” hormones. I urge every one to please review:

The Position Statement on Bio Identical Hormones by the American Association of
Clinical Endocrinologists (AACE) Reproductive Medicine Committee.

To summarize, there is concern regarding “Natural” or “Bio Identical Hormones”. These terms, “bio identical,” “natural,” or “compounded” hormones gained popularity with the increase in concern about chemicals and preservatives and people eating and living more natural lifestyles. People are consuming more organic foods and are more interested in “natural” health solutions. Additionally, there has been a media frenzy - mainly due to uninformed and rather, vocal celebrities. The general public’s understanding of the term "bio identical hormones” is quite vague, and often misconstrued. Most commonly, this term denotes plant-derived hormones which are claimed to be “identical in structure” to those produced by the human body. However, this is not the case. These “bio-identical” preparations are compounded in various forms by pharmacists. Usually, patients treated with compounded preparations are by non-traditional health practitioners. It is important to note that compounded medications are not subjected to stringent FDA oversight and regulation, whereas, commercial preparations are under the purview of the FDA. Additionally, compounded products are usually not reimbursed by most insurance companies. Also there are claims about the alleged higher safety and efficacy of compounded bio identical hormones. There is already enough controversy and debate over the safety of hormone replacement therapy. Adding another safety concern about  bioidentical hormones merely complicates this equation even further. In fact, it is well known that compounded preparations have significant variability in potency, high potential for contamination and impurity of those preparations. Lastly, one of the biggest misconceptions and false claims is the “individualized” formulations based solely on unproven, invalidated testing methods such as salivary assays.

If you are interested in alternative therapy, please make an appointment to review your options prior to making a potentially costly hazardous decision.

Women may not be the only ones who suffer the effects of changing hormones. Some doctors are noticing that their male patients are reporting some of the same symptoms that women experience in perimenopause and menopause, now referred to as Male Menopause or Andropause.

While a well-defined period, similar to menopause, is not seen in males, it is well documented that as men age there is a progressive and significant decline in the testosterone levels. This decline can also be exacerbated by some chronic diseases such as diabetes. This decline in testosterone may cause or worsen symptoms such as fatigue, weakness, depression, and sexual problems.

The diagnosis of low testosterone ultimately is done through laboratory testing.  Once diagnosed with a low testosterone, male hormone replacement therapy (testosterone) may help relieve such symptoms as loss of interest in sex (decreased libido), depression, and fatigue. However, as with estrogen hormone replacement therapy in women, testosterone replacement therapy does have some potential risks and side effects. It is important to discuss symptoms and treatments with a physician, as there may be other therapies or conditions which may be causing the symptoms.

Low Testosterone
Edgewater Office
109 W. Knapp Avenue
Edgewater, FL 32132



Mon-Thur 8:30am - 5:00pm
Fri 8:30am - 2:00pm
386-427-4544
Lake Mary
925 Williston Park Point,
Suite 1003
Lake Mary, FL 32746


Mon - Thurs 8:30am - 5:00pm
407-691-3200
Deland Office
1431 Orange Camp Rd.
Suite 115
Deland, Fl. 32724

Nurse (Diabetes)
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Nurse (Endo General)
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Office Administrator
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Edgewater Office
109 W. Knapp Avenue
Edgewater, FL 32132



Mon-Thur 8:30am - 5:00pm
Fri 8:30am - 2:00pm
386-427-4544
Lake Mary
925 Williston Park Point,
Suite 1003
Lake Mary, FL 32746


Mon - Thurs 8:30am - 5:00pm
407-691-3200
Deland Office
1431 Orange Camp Rd.
Suite 115
Deland, Fl. 32724


386-427-4544

Nurse (Diabetes)
Email Me

Nurse (Endo General)
Email Me

Office Administrator
Email Me
Lake Mary
407-691-3200
Edgewater
386-427-4544
DeLand
386-427-4544