There’s a lot of confusion right now about immunity, especially in light of the COVID-19 pandemic. We’ve seen this across-the-board fear that people who are older are going to get COVID and die. But the increased risk is not about being older, it’s about having a dysfunctional immune system.
The reason everyone talks about protecting older people is that many older people are metabolically unhealthy—they have high blood sugar, diabetes, and/or hypertension and are overweight—which leads to immune dysfunction. It’s not about age, though. People of any age who are metabolically unhealthy are at greater risk. It’s not a given that if you’re older, you’re going to have a poor immune response.
But it’s true that as you age, your immune system, like all systems, needs more help to stay strong. Younger bodies are inherently stronger. Lifestyle choices have a tremendous effect. There’s a lot you can do to keep your immune system strong and to perpetually rejuvenate it. It’s everything we teach in this book.
There will be more viruses and pathogens to deal with—destruction of the natural world, climate change, and CAFOs (concentrated animal feeding operations), means we can expect more pandemics. You want your body to be prepared with a healthy immune system.
To be clear, a healthy immune system is one that’s well- calibrated. One that doesn’t overreact or underreact to pathogens. What we’ve seen with COVID-19 is that the illness can be deadly with some people when it stimulates something called a cytokine storm—an overreaction of the immune response, with an uncontrolled release of inflammatory particles. This can result in severe—sometimes irreversible—damage to the lungs. So while our culture tends to push the idea that more is better, a too-vigorous immune reaction can be just as dangerous as a too-weak reaction. That’s just semantics, though. The point is, a healthy immune system—one that’s well- calibrated—is not something that exists separately from the other systems in the body. The immune system is intimately connected to the gut, the lungs, the skin. If you’re in a good place on blood sugar, blood pressure, and weight, that will help optimize the function of the immune system.
Everything recommended in this book helps you build immune resilience, including calorie reduction, lots of physical activity, fasting, high-quality sleep, stress reduction, socializing—and particularly the points below.
• A strong gut microbiome. As we’ve said, 70 percent of the immune cells in the body live in and around the gut. Actively tending the gut with prebiotics, probiotics, and bone broth cultivates a healthy microbiome teeming with good bacteria, which helps maintain a strong, protective gut wall. This is absolutely key to supporting your immune system and your whole body.
• A diet high in phytochemicals and low in sugar and processed foods. Plants generate natural chemicals to protect themselves from predators. These chemicals—phytochemicals—are also immune protective for humans. Different plants offer different phytochemicals, so eat a range. The advice comes back to something we say over and over: A variety of organic vegetables should be the biggest part of your diet. That’s the best way to get lots of phytochemicals (not to mention provide the gut with prebiotics and crowd out processed foods). Organic is important; you want your phytochemicals and other nutrients intact and strong, not pesticide laden.
• Certain targeted supplements. Vitamin D, curcumin, quercetin, and resveratrol (all explained in detail on the following pages) help build immune resilience and may help reduce the severity or duration of symptoms or complications. These supplements do different things, so they combine well for a synergistic effect. Together they work to inhibit viral replication, regulate the inflammatory response, stabilize the immune response, and regulate cellular defenses.
Most of the supplements I recommend support the immune system, improve the function of the mitochondria (the energy powerhouses of your cells) and/or affect your longevity gene pathways.
Of course, supplements aren’t a replacement for healthy habits. You can (and should) be bolstering function by removing sugar and refined carbs from your diet, getting some sunshine every day, and living a physically active life. Supplements are a boost.
When shopping for supplements, get the best-quality versions you can—without sugar, lactose, or artificial colors. Some brands we recommend are Thorne, The Well, Designs for Health, Allergy Research Group, and Activated You.
Lots of people do well without ever taking supplements. My experience is that supplements don’t hurt, and that targeted supplementation is usually helpful, especially for building immune resilience. Although the science may not be quite there yet, I strongly believe that the supplements listed here are beneficial.
Vitamin D (which is actually a hormone, not a vitamin) is critical for bone health and many metabolic processes. It also enhances immune function. I recommend it despite the fact that there’s some controversy about its importance these days. Deficiency of vitamin D is associated with certain types of cancer. Have your doctor check your level, and take a supplement if you’re low (most of us are).
dosage: If your level is under 30, take 10,000 IU a day; if it’s between 30 and 50 (or if you don’t know your level), take 5,000 IU a day; if it’s over 50, take 2,000 IU a day. Vitamin D is fat soluble, so take it with fat (avocado, fatty meat or fish, nut butter, full-fat yogurt). To boost the effects and minimize the potential risk of toxicity, choose a D supplement that contains some vitamin K (many do), which is good for heart health and bone health. Recheck your level of D after three months; though it’s very rare, blood levels of D that are too high can be dangerous.
Curcumin is an extract of turmeric root. It helps combat inflammation, which reduces pain and fatigue, improves mood, boosts cognitive function, and stimulates longevity gene pathways. Curcumin is also found in traditional anti-cancer herbal formulas because it interrupts the normal progression of cancer cells.
dosage: 500 to 1,000 milligrams twice a day. Take it with fat (eggs, avocado—any of the good fats we talk about) so it can be properly absorbed. Add turmeric to your cooking too. It’s the number one spice for overall health.
Quercetin is a plant pigment (a colored substance produced by plants) that occurs in small amounts in foods like grapes, berries, cherries, apples, onions, broccoli, kale, tomatoes, and tea. It’s an anti-inflammatory and antioxidant that helps to lower blood pressure, protect the body from age-related diseases, reduce the risk of cancer, decrease viral growth, and support the heart. You can’t get very much from food, so it’s a good idea to supplement. On its own, quercetin is not easily absorbed by the body. I recommend supplements that pair it with vitamin C or digestive enzymes like bromelain to aid absorption.
dosage: 500 to 1,000 milligrams per day
Alpha-lipoic acid is a potent antioxidant that naturally occurs in every one of your cells, but the body doesn’t make enough of it. ALA helps fight inflammation, balance blood sugar, modulate the immune system, protect skin collagen, support the health of your nervous system, and boost the effectiveness of other antioxidants. You can get some ALA in grass-fed red meat—especially organ meats—and vegetables like broccoli and spinach. But most of us need more.
dosage: 300 to 600 milligrams per day (non-meat-eaters should aim for the higher end).
Resveratrol is a polyphenol with powerful antioxidant properties. It’s anti-inflammatory, it may prevent cancer, and it’s neuroprotective, meaning it’s good for the brain. Its effects seem to mimic the beneficial effects of calorie restriction. Resveratrol affects the activity of enzymes in the body called sirtuins (one of the so-called longevity genes). Sirtuins control certain biological pathways and are known to be involved in the aging process. Resveratrol gives them a boost. You may have heard that red wine contains resveratrol. This is true, but you’d need to down 150 glasses a day to get the recommended amount. Foodwise, it’s in grape skins, pomegranates, and raw cacao, but you can really get the recommended dosage only from a supplement.
dosage: 200 to 300 milligrams per day.
Fish oil is rich in omega-3 fatty acids, which are crucial to health, particularly metabolic health. They reduce inflammation and lower your risk of heart disease, diabetes, and arthritis. Most people don’t get enough omega-3s in their diet (one of the blood tests we recommend in Blood tests for longevity measures this level). Buy good fish oil that’s been tested for mercury.
dosage: 1 to 3 grams per day.
Nicotinamide riboside (NR) supports many aspects of healthy aging. It’s an alternative form of vitamin B3 that’s converted by your body into a coenzyme called nicotinamide adenine dinucleotide (NAD+), which exists inside every cell. The amount of NAD+ in your cells naturally decreases as you age; this decrease has been linked to illnesses including diabetes, heart disease, and Alzheimer’s. NR keeps that NAD+ up, and it also supports healthy brain function and cognition. It works best when combined with resveratrol and quercetin. A similar supplement, nicotinamide mononucleotide (NMN), which leads to an increase in NAD+ levels, has recently entered the market. NR and NMN both do basically the same thing.
dosage for NR: 500 to 1,000 milligrams per day.
dosage for NMN: 250 to 500 milligrams per day.
CoQ10 is an enzyme that generates energy for every cell, tissue, and organ in the body, boosting the cardiovascular system and cellular health. It’s an antioxidant that your body produces continuously but that we tend to produce less and less of as we age. Supplementing helps keep cells resilient and less susceptible to damage (when cells become damaged, organs can become impaired). If you’re on statins, then CoQ10 is pretty critical. Statins can rob your body of its natural CoQ10 store by as much as 40 percent. This shows up in a number of ways but especially as muscle pain. The best food sources are organ meats (twice a week will do the trick), mackerel, and herring. You’ll also get CoQ10—though not as much—from peanuts, sesame seeds, walnuts, adzuki beans, and vegetables like spinach, broccoli, sweet potatoes, sweet peppers, garlic, parsley, avocados, and cauliflower.
dosage: 200 to 400 milligrams daily for the first four weeks, then 200 milligrams a day to maintain healthy levels. Look for the ubiquinol form of CoQ10.
Myth: Cholesterol is bad.
Truth: Cholesterol is good, and essential to the body. It helps produce cell membranes, hormones, fat. Your brain needs it to function well. It’s a vital component of every one of your cell membranes. If your cholesterol is too low, you won’t be able to convert the sun’s rays into sufficient vitamin D. You can’t make estrogen or testosterone without it.
Myth: The most important factor in treating heart disease is to lower high cholesterol.
Truth: What’s actually more important in treating heart disease is to lower triglycerides. High triglycerides are usually the result of eating more calories than you burn, particularly from high-carbohydrate foods. Focusing on cholesterol is ignoring the root cause. It’s like bringing down a fever with Advil. A fever is your body’s defense mechanism, its response to something going on. And when you bring down the fever, that’s not really helping your body. That heat might be cooking something away. It’s a way our bodies have evolved to fight viruses. Along the same lines, there’s some evidence that your body makes more cholesterol as a defense against inflammation. This is only now being studied, so we don’t have a definitive answer yet. But the question becomes: Is higher cholesterol the body’s compensation for inflammation? And in medicating that away, are you tamping down the body’s compensatory mechanism rather than listening to it and treating the inflammation? We need to look at why cholesterol might be high and not go crazy trying to lower it without learning what it’s telling us. In treating a number that’s a result of a complex underlying process, we could be missing the really important information.
Myth: Low cholesterol means you’re healthy.
Truth: Our obsession with low cholesterol is confused and misguided. Studies show that people with higher overall cholesterol live longer. In fact, the blood test typically done—the one that measures LDL (low-density lipoprotein) and HDL (high-density lipoprotein) levels—is actually useless. The more important number is your ratio of triglycerides to HDL—that should be as low as possible. Ask your doctor to tell you this ratio.
Myth: LDL cholesterol is bad. HDL cholesterol is good.
Truth: LDL and HDL are not even cholesterol. They’re proteins that carry cholesterol (and other fatty substances) through the bloodstream. Fat doesn’t mix well with water, so it needs carriers to get where it’s needed. What matters is not total LDL versus HDL. What matters is the particle size. Small LDL particles can be a problem, whereas large LDL particles are not. The small particles squeeze through the lining of the arteries and can oxidize and cause damage, whereas the larger particles are actually good. The traditional test is pointless. The better test is an advanced lipid evaluation (see Blood tests for longevity), which measures a number of important risk factors for heart disease, including the quantity and size of LDL and HDL particles. But even if your LDL particles are too small or there are too many of them, the first line of treatment should be diet and exercise. You can also add supplements like fish oil (1 to 3 grams per day), berberine (500 milligrams three times a day), and niacin (1.5 to 3 grams per day—start low, and check with your doctor first). New evidence also shows that fasting (see 16-hour overnight fasting) can be extremely beneficial too.
We’re not against medications, but we’re against the overuse of medications. Taking a pill is not harmless. Many people have the notion that “it doesn’t do any harm and it could do some good.” That’s just not accurate. This thinking might apply to many supplements, but it doesn’t apply to drugs.
Most medications work by inhibiting certain natural functions of the body (functions that are usually positive), so over time, they’re bound to have unintended effects. And generally speaking, drugs treat the symptom, not the underlying cause. If you’re driving your car and the oil light goes on, you don’t just put a piece of tape over it. You find out why the light went on—what’s wrong—and you fix that. Similarly with the body, when you have a symptom, you need to try to ascertain what’s causing the symptom. Taking a pill usually doesn’t help get to the root cause.
The surprising news is that many common meds are not all that effective. So you’re shutting down natural systems and piling up side effects and may not even be improving the situation that led you to take the drug in the first place.
There is a place for medication. But when possible, we urge you to first treat your body with diet, exercise, quality sleep, and stress reduction instead. Following is some information on commonly overprescribed meds, and how to get off them.
common types: Xanax, Klonopin, Ambien, and Ativan
efficacy: Benefits are modest at best. Though these meds may help you fall asleep, most increase total sleep time by only 20 to 30 minutes.
side effects: Risk of dependency, increased risk of dementia, memory loss, mood changes, erratic behavior, confusion, drowsiness, loss of coordination, sleepwalking, sleep-eating, and even sleep-driving.
getting off them: This can be difficult as they cause addiction. Taper off slowly under a doctor’s supervision.
instead: Start with magnesium (see here), move on to glycine and L-theanine, then try CBD. For women, the next course of action would be to work with a doctor on checking levels for the hormones pregnenolone and progesterone. If levels are low, supplementing these hormones can often help with sleep. Sleep is very complicated, and what works for one person may not work for another.
common types: Proton pump inhibitors (PPIs), such as Nexium, Prevacid, Prilosec, Protonix, and Aciphex, and H2 antagonists, such as Zantac, Pepcid, and Tagamet
efficacy: These meds are effective at treating symptoms but don’t address the underlying cause of the problem.
side effects: Prolonged use can cause microbiome imbalances and pneumonia; malabsorption of nutrients like magnesium, calcium, and B12, leading to vitamin deficiencies; increased risk of bone fractures; and kidney and liver problems.
getting off them: Most people develop a dependency and find it hard to stop taking these meds, because when they do, they experience a rebound effect: The body creates more acid (hypersecretion), which can cause reflux. So taper off slowly.
instead: Prevent reflux in the first place by avoiding alcohol, caffeine, and foods that irritate your system. Take the supplements DGL (deglycyrrhizinated licorice) and mastic gum, and drink aloe vera juice. Some people find relief in actually ingesting acid in the form of HCL tablets.
common types: Statins like Lipitor, Mevacor, Pravachol, Crestor, and Zocor
efficacy: They do lower cholesterol, but there are questions as to whether low cholesterol is truly a relevant goal. Look at the website TheNNT.com (NNT stands for “number needed to treat”). This site, started by a group of physicians, reveals the efficacy of a bunch of meds, including statins. Its work is based on high-quality, evidence-based studies, and the site accepts no outside funding. You can search different medications and you’ll see how few people are really helped by standard meds. Statins offer no statistically significant increase in life span, and only one in 217 people taking them avoids a nonfatal heart attack—whereas everyone taking them runs the risk of serious side effects.
side effects: Muscle pain, headaches, increased risk of developing diabetes, potential memory loss.
getting off them: Speak to your doctor before stopping.
instead: Reduce sugar and junk food; increase exercise.
common types: Advil, Motrin, Aleve, Celebrex, Naprosyn
efficacy: These drugs are effective for pain relief and acute inflammation but are meant for short-term use only. Many people use them for long stretches, with alarming frequency.
side effects: Long-term use can increase the risk of heart attack or stroke; may cause all sorts of gastrointestinal problems, including ulcers, leaky gut, and a microbiome imbalance; and may also cause kidney trouble, liver inflammation, anemia, rashes, and allergic reactions.
getting off them: Can safely stop them anytime.
instead: CBD, curcumin, fish oil, bodywork, acupuncture, physical therapy, exercise.
When it comes to severe depression, antidepressants can be effective and are likely necessary. But for mild depression, studies show that these drugs are not better than a placebo. For moderate depression, they’re somewhat effective, but research proves that exercise is even more effective. If you’re in the latter two groups (mild or moderate) and you want to take yourself off depression meds, please do so under the supervision of a doctor and taper slowly. Many people experience a dramatic rebound effect coming off SSRI antidepressants (Prozac, Lexapro, Paxil, and others); in other words, they stop taking the meds and feel really terrible, then think they must have been more depressed than they realized, so they go back on. But that effect is just temporary. The body needs time to level off. This is why it’s important to have the help of a doctor.
Obviously, antibiotics can be life-saving, but they’re also massively overused. Antibiotics work only against bacteria. Most sore throats and sinus infections are viral in origin. Please don’t rush to take antibiotics unless they’re necessary—they kill many types of good bacteria too, including critical bacteria in your gut. This can wreak havoc on your microbiome, sometimes with long-term consequences.
Western medicine tends to look at testing differently than integrative medicine does; there are blood tests for longevity I recommend that regular doctors don’t necessarily do. One day these tests will be standard, but at the moment, you have to ask your doctor to prescribe some of them. Another difference in integrative medicine is that the blood levels we consider ideal are often beyond what’s standard in mainstream medicine. It comes down to a simple question: Do you want “normal” numbers or do you want numbers for optimal function? We want you to be better than normal. We want optimal function for you.
Many of the tests we recommend on the following pages look at aging biomarkers, which are not necessarily markers for disease, but markers for the possibility of disease. They’re smoke detectors for trouble. Sort of like a mammogram, they pick up predispositions and warning signs. When you catch a problem early, it’s easier to address through diet, exercise, supplements, and other habits. These blood tests are recommended in addition to (not instead of) the typical bloodwork recommended by your physician. And whether or not you choose to test, the lifestyle and diet recommendations in this book should positively affect all the biomarkers below.
Hormone levels. Most hormones will decrease as you age. These are target levels.
Vitamin levels. Ask the doctor to check vitamin D, vitamin B12, RBC (red blood cell) magnesium, folate, and RBC zinc. These are the levels you want to see, or eventually get to with supplements.
Advanced lipid evaluation. The most extensive lipid evaluation and barometer of cardiac function is the Boston Heart Test. It measures inflammatory markers and cholesterol particle size. It also determines if your body is making too much cholesterol or you’re absorbing too much cholesterol—crucial data. It provides much more information than the standard cholesterol test, measuring important heart risk factors like Apolipoprotein A-1, Apolipoprotein B, and Lipoprotein (a).
Inflammatory markers. These pick up nonspecific inflammation in the body and can be an early sign that something is not right. You want all inflammatory markers to be low.
Ratio of omega-3s to omega-6s. You want your omega-3-to-omega-6 ratio to be at least 3 to 1. This is important, and if your levels are not where they should be, it’s an easy fix: Just take fish oil, cook with olive oil rather than vegetable oils, don’t eat junk food, and don’t eat fried foods in restaurants (where the cooking oil is likely an unhealthy oil).
Homocysteine. This measures methylation, an important biochemical process happening thousands of times a day. If you’re not methylating properly, among other things, you’re not breaking down toxins well. You want a level less than 8.
Insulin-like growth factor 1. You’re looking for a number that’s less than 200. As we get older, our IGF-1 should not be high—you don’t want to “grow” more. If something is growing at that point, it could be cancer.
Fasting insulin. The sweet spot is around 5 microIU/mL. If your number is high, you’ve really got to watch your sugar. It might be an early sign of carbohydrate intolerance and diabetes. Most doctors say under 18 is good, but you want it much lower, closer to 5.
APO-E4 gene variant. The “Alzheimer’s gene.” If this shows up in your testing, it doesn’t mean you’re going to get the disease, but you’re more prone to it. Lifestyle habits have a big impact; follow the advice in this book.
MTHFR gene variant. If you have certain forms of this gene mutation, it indicates that your MTHFR gene may not be functioning optimally. Among other things, this may result in a buildup of homocysteine in your blood, leading to all sorts of health problems. Research around MTHFR and its effects is still evolving, but I have seen significant improvements in myriad health problems when addressing this mutation with the supplements: methylated B12 and methylated folic acid.
Testing for these two gene variants is available through 23andMe; this is a much less expensive route to the info than going through a doctor, so we recommend it.
Devices like the Fitbit or the Oura Ring make it easy to collect data about yourself. They’re useful for counting steps (aim for 7,500 a day, the equivalent of three or four miles), tracking heart rate, indicating body temperature, and measuring heart rate variability (the higher your HRV, the more resilient your nervous system). It’s still unclear whether these tools are accurate at measuring deep sleep and REM sleep, but they can tell you how quickly you fall asleep and how long you stay asleep. And they can offer some insight into sleep patterns. As technology advances, there’ll be better tracking of deep sleep and REM sleep, which will be valuable. If you’re drawn to tracking technology, we’re in favor. It can provide useful guidelines, and a lot of people find it motivating: You see where you are, challenge yourself to improve, then retest. There’s no telling what’s next, but some folks are already going further with tracking tech, wearing continuous blood-glucose monitors that allow them to see changes in blood sugar in real time. This may sound extreme, but once these devices are more affordable, they may become common.
That said, for some people, collecting data is more stressful than it is useful. If you have a history of obsessive thinking, anxiety, or disordered eating, tracking tech is probably not for you. Even if you don’t, if the concept of tracking yourself makes you tense, don’t do it. It’s not for everyone.
You can’t change your genes, but you can change how they’re expressed, through diet, exercise, sleep, and other lifestyle choices. One way to think of it is that genome testing + lifestyle choices = aging well. We’re using data to try to upregulate longevity genes.
As with checking biomarkers, testing your genome offers more information, which can lead to more targeted recommendations for taking care of yourself. There are a number of options; one we recommend is the health test from 23andMe. You’ll need to run your report through a separate service for analysis—we like Dr. Rhonda Patrick’s site FoundMyFitness, which charges only a small fee. The kinds of things you learn include how to optimize the function of certain genes to boost daily energy levels and whether you have a greater need for certain vitamins.
If you want more in-depth information on the best foods for your metabolism and the best supplements for your body, we recommend a test from 3x4 Genetics or Nutrition Genome, which is more expensive.
The data you gather through genome testing is just one part of your health picture. How you age is going to be affected by the environment with which you surround those genes—stressors mitigated by all the good things you do for your body.
Sex issues are common with aging, but they’re fixable. As hormones change, you might need some intervention, and that’s fine. Simultaneously, though, look at lifestyle choices. It’s the same principle as applies to general health—you can’t get away with the same stuff you did when you were younger and expect everything to function well.
Hormones are like a symphony: When they’re all working together, things run smoothly. But when one is out of tune, another may have to work harder to cover for it. For example, food affects the hormone insulin. Too many carbs will stimulate an insulin response. Lack of rest affects your cortisol (the stress hormone). And both insulin and cortisol will impact your sex hormones.
Guys run for the erectile-dysfunction meds, but the first line of defense if you’re experiencing changes in sexual function is paying attention to your diet, exercise, sleep patterns, and stress load. ED is usually a systemic circulation issue. It’s not isolated. If it’s happening down there, it’s also happening in the heart and brain. I’m not against ED drugs, but I would rather a guy look for and treat the underlying cause.
For women after menopause, one of the biggest issues is dryness. For this, I never recommend regular hormones, but I do recommend bioidenticals, and my patients love them. Bioidenticals are hormones derived from plants and chemically identical to those in the human body. Estrogen, progesterone, and testosterone are the bioidenticals I’m talking about here (but there are others). They come in gels, creams, pills, or patches made up by compounding pharmacists. The doctor will measure your hormone levels and prescribe a compound that’s just right for you. You’ll have the prescription filled at a compounding pharmacy. The hitch is that most doctors and the FDA are not there yet on bioidenticals, so you may need to find a holistic gynecologist or functional medicine doctor to prescribe them. In my practice, I’ve seen excellent results with bioidenticals, and very few side effects. I believe it’s a much safer and more effective way of replacing hormones than traditional hormone replacement therapy when levels are low.
Obviously, there’s also a significant psychological component to sex. When you’re well-rested, when your body is active and healthy, when your gut is in good condition and you’re managing life well, when you feel fit and healthy, when you’re with someone you want to be with, you tend to feel more sexual. All the advice in this book on diet, stress, exercise, and cultivating a happy life will help support sexual health as you age. And if you’re experiencing problems, you might find that something as simple as dropping alcohol will make a big difference.
Intimacy matters. No matter what’s happening, don’t write it off. If you need some intervention, get it. Don’t let a problem worsen, because the quicker you deal with it, the less stress it will cause you and your relationship and, therefore, your health. And in fact, some of these problems require less intervention when dealt with earlier.
Many studies confirm that you can enjoy sex for as long as you want, no matter what your age. As with almost everything regarding aging, it’s about taking the best possible care of your body, mind, and spirit—and bumping that up with a little help when needed.
Brain-derived neurotrophic factor (BDNF) is a relatively new discovery that we now know improves brain function and lowers your risk of mental disease. It’s a naturally occurring protein in the brain that’s stimulated by many of the lifestyle changes recommended in this book (see the following page). We have billions of brain cells, and BDNF keeps them thriving and healthy. It helps grow new brain cells and pathways and strengthens the brain cells and nerve cells you already have, protecting them from damage caused by stress. It also protects you from depression and from Alzheimer’s (and other types of dementia). BDNF can even improve sleep.
What increases BDNF? Exercise, meditation, quality rest, intermittent fasting, sunshine, green tea, and certain supplements. One is coffee fruit extract, which is made from the berry of the coffee plant; it delivers not only polyphenols (antioxidant-rich micronutrients) but also a brain-supporting chemical called procyanidin. Other supplements mentioned earlier, such as curcumin, omega-3 fatty acids (which you can get by taking fish oil), resveratrol, and magnesium, also boost BDNF. What robs your body of BDNF? You guessed it: stress, exhaustion, loneliness, sugar, and processed foods.
The following all lower the risk of developing Alzheimer’s:
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High-quality sleep Stress reduction A low-carb diet Cutting out sugar Socializing Meditating Regular exercise Passion/curiosity Having things to look forward to |
Cross-generational interaction Lifelong learning Coffee fruit extract Curcumin Magnesium Mushrooms Resveratrol Fish oil Pretty much everything we talk about in this book |
We’re not endorsing the treatments below. Although some are promising, they’re not without risk. But it’s good to know what’s on the anti-aging horizon. Consider these items potential add-ons to the larger principles of aging well: eating less, moving more, getting better sleep, developing a meditation practice, socializing a lot, and seeking out joy.
Metformin, which lowers blood sugar, is the most-prescribed medication in the world for people with type 2 diabetes. Many animal studies suggest that the drug also reduces inflammation and produces other cellular effects that alter aging. It mimics some of the positive effects of eating less, in terms of the way it affects your longevity gene pathways. The FDA has approved a study that will evaluate metformin’s ability to slow aging in humans.
precautions: Although it seems like the most promising possible anti-aging drug so far, a recent study showed that it may blunt the health benefits of exercise. Other studies have shown it to inhibit mitochondrial function. It also interferes with the absorption of vitamin B12, increasing the risk of B12 deficiency, and can reduce levels of testosterone in men.
Berberine is an herbal supplement that is, in a way, a natural form of metformin (safer but also less effective). It lowers blood sugar and may have anti-aging benefits. The benefits are milder, but there are also no significant side effects. It won’t hurt, and it might help.
Hormone therapy is not new, but it’s a category that’s evolving. Since hormones naturally drop as you get older, the thinking here is that raising levels can have anti-aging benefits. Commonly used hormones for anti-aging are estrogen, progesterone, and testosterone. There are other hormones being used for anti-aging as well. The most famous is human growth hormone (hGH), which is administered by injection. Others include pregnenolone, DHEA, and melatonin.
Rapamycin is a drug that tricks the body into thinking it’s in a state of calorie restriction, triggering the longevity gene pathways and autophagy. So theoretically, it can give you the benefits of fasting without fasting. In animal studies, it has been found to increase life span and reduce chronic inflammation. It also has been shown to stave off age-related diseases: cancer, cardiovascular diseases, cognitive diseases. Like metformin, it positively affects the longevity gene pathways.
precautions: Long-term regular use increases insulin resistance, glucose intolerance, and hyperlipidemia (high fats in your blood). In high doses, rapamycin suppresses the immune system, increasing the risk of infection, pneumonia, and cancer.
Stem cell therapy is a good example of regenerative medicine—treatments that help our natural healing processes work more effectively. Stem cell therapy can theoretically enable regeneration of damaged tissue. The research is in its infancy, but a few studies have shown that introducing fresh stem cells, or replenishing the molecules they produce, can slow down aspects of the aging process.
Peptide therapy is not yet FDA approved; research is ongoing. Peptides are basically short chains of amino acids that naturally occur in the body or can be created in a lab. They play a significant role in a number of aging mechanisms (you’ve probably heard about skin-care products that contain peptides). The most interesting currently is a synthetic peptide called Epitalon. It’s a powerful antioxidant that appears to induce the elongation of telomeres.
Cryotherapy is one of many treatments that fall under the heading “cold thermogenesis,” which is any treatment that involves the use of extremely cold temperatures for short periods of time. It’s usually done in a special chamber or booth for three to five minutes. This exposure to near-freezing temperatures induces a hormetic response (remember hormesis? Small beneficial stressors), stimulates your longevity gene pathways, increases the production of mitochondria, and helps with inflammation. Pro athletes use this routinely now, and cryotherapy spas are opening up all over. Ice baths and cold showers can be just as effective. Some experts say that ice-cold baths are better for the body than cryotherapy.
Case Study
Sick with stress, cured by a job change
Carla, 47, works in corporate law. She’s spent two decades in a job with very demanding hours and intense stress. She comes to my office and tells me she’s getting sick all the time, she’s always tired, she’s depressed and overwhelmed. Even though she’s exhausted, she can’t sleep. She doesn’t have time to see her friends or get to the gym. She talks about how much she’d like to quit her job and work for an NGO, helping people.
I do everything I can for her symptoms: I help her clean up her diet; I give her adaptogens, herbal supplements that support the adrenals (since the adrenal system regulates the body’s response to stress). I encourage her to introduce practices to help with stress, to make time for meditation and yoga. I take her off caffeine and other stimulants. Nothing helps. She’s still exhausted all the time. Finally, in frustration, I say, ‘Why don’t you leave your job and go work for a nonprofit in Africa?’ She doesn’t come to see me again.
Months later I get an email from her. It says, ‘Thank you for your advice. I’m working for a nonprofit in Uganda. I love what I do. Two months into my new life, my symptoms were gone. I feel so good.’ She talks in the email about how appreciated she feels in her new role. She still works around the clock—that has not changed—but she’s valued and respected. She’s surrounded by positivity. It’s clear from her email that she’s in love with her new situation. Leaving a toxic workplace for a nourishing situation had an almost instant impact on Carla’s health, and the effects have endured.”