My philosophy is simple: Use the best available evidence.
The world of supplements and “anti-aging” practitioners is unfortunately riddled with misleading claims, dubious advertising, and vigorously promoted treatments of no proven benefit. I find this quite frustrating for two reasons: first, because patients who spend a lot of money on ineffective treatments become discouraged and disillusioned, and we lose the opportunity to help them; and second, because it makes all of us in Age Management Medicine look bad—and most of us are trying to do the right thing for our patients.
Hippocrates is often referred to as the “Father of (Western) medicine”, and is relentlessly quoted for having said “First, do no harm.” Good advice, to be sure! But I’m drawn to a lesser-known quote of his:
There are, in effect, two things: to know, and to believe one knows. To know is science. To believe one knows is ignorance.
This quote is the underpinning of evidence-based medicine. The very nature of Age Management Medicine keeps us on the cutting edge of new therapies: everyone is looking for the Fountain of Youth. There will always be those among us willing to experiment with the unproven. That is acceptable under appropriate conditions, including well-informed and consenting patients. What should never be acceptable is the promotion of supplements and treatments as “science” when in fact they are either unknown quantities, or worse, disproven.
My grandparents died of pancreatic cancer and Alzheimer’s disease, two illnesses for which Western medicine has very little to offer. After their passing, I spent three years researching the evidence behind the myriad supplements I might have offered them, searching for clinical evidence of efficacy. As a result, I am comfortable that my Age Management regimens offer patients not just hype, but a legitimate opportunity for better health.
Prior to my joining PhysioAge, two supplement companies offered to put my logo on their products so I can sell “my own line” of (their) supplements. I turned them down, because the evidence regularly shifts as to which nutraceuticals are the most effective or have the best pharmacokinetics. Being tied to one brand would make it quite difficult to switch ingredients and suppliers when new data becomes available. (My blog posts make it pretty clear that I will seek out the company with the best evidence behind their product.) And if you have heard something that goes contrary to what I’ve recommended, let me know!
I have been very lucky to obtain training in this fairly new field of medicine under doctors who pride themselves in taking a relentlessly evidence-based approach. After getting an overview of Age Management protocols from Cenegenics (for an exorbitant fee… buyer beware), I went on to complete a four-part seminar under Dr Neal Rouzier, a well-known Age Management physician, which yielded a thorough knowledge of the relevant HRT studies of the past 30 years. (You can see much of this work evidenced in my Hormone FAQs page.) Following that, I joined PhysioAge and got further training “the old fashioned way”– I ‘apprenticed’ for five months under PhysioAge founders Joseph Raffaele, MD and Ron Livesey, MD. In so doing I was able to draw on a cumulative 30 years of Age Management experience from two passionate doctors who are dedicated leaders in this field.
There will always be some patients who want to try things that are not yet well-proven. If a treatment is legal and I cannot find evidence that it is dangerous, we may agree to tread unmarked trails together. But I promise to always let you know when we are headed off the beaten path, and to guide you back to it when appropriate.
Josh Trutt, MD