|Breaking the Aging Barrier: Interview with Ward Dean, M.D.
o one has his finger on the pulse of anti-aging medicine more than Life Enhancement's Medical Director, Ward Dean, MD.
Ward has been actively engaged in gerontological research for nearly 20 years, during which time he has published many articles and reviews in professional journals. He has been on the Board of Directors of the American Aging Association and is also a member of the Gerontological Society of America, and other medical associations. A former U.S. Army flight surgeon and diving medical officer, he spent 3 years as the flight surgeon for the top secret counterterrorist unit, the Delta Force, where he participated in a number of classified missions.
In recent years he has authored or co-authored The Neuroendocrine Theory of Aging and Degenerative Disease, Biological Aging Measurement (which he is currently updating), Smart Drugs & Nutrients, and Smart Drugs II.
LEN: You just got out of the Navy after being in for 20 years. What are you thinking about? What are you planning? What's on the table for your future?
Dean: Basically, I'm going to continue in the same direction that I've been going for the last 20 years in the field of life extension and anti-aging medicines. I've been interested in the field of anti-aging medicine since I was about 12 years old. In fact, it was the impetus for me to go to medical school.
LEN: Where does this odyssey go on from "Smart Drugs I" to "Smart Drugs II?"
Dean:That was also the era during which I coauthored The Neuro-endocrine Theory of Aging and Degenerative Disease with professor Vladimir Dilman from the Soviet Union. Dilman had written a book called The Law of Deviation of Homeostasis and Diseases of Aging, which came out shortly after Durk Pearson and Sandy Shaw's book, Life Extension: A Practical Scientific Approach. The title of Dilman's book is quite a mouthful, and reading his book was very difficult. But after the second or third time through it, I realized that Professor Dilman was really onto something, and we began corresponding. Our correspondence culminated in his arriving at my doorstep in 1990.
"Dilman was the Albert Einstein of medicine.
He was absolutely brilliant. As more and more
information is developed about the neuroendocrine
system, these findings are fitting in with his theory,
just as he predicted."
We spent 3 to 4 months working together, with editorial assistance from Steve Fowkes, Executive Director of CERI and editor of Smart Drug News, revising his earlier book and bringing it up to date. These efforts resulted in the publication of our book The Neuroendocrine Theory of Aging and Degenerative Disease. Dilman, as far as I'm concerned, was the Albert Einstein of medicine. He was absolutely brilliant. He developed his concepts beginning in the mid-'50s, prior to the existence of the sophisticated diagnostic equipment we have today.
"The pineal gland is a fundamental modulator of the entire neuroendocrine system. It functions as a true "biological clock," secreting its primary neurohormone, melatonin, in a circadian fashion.
Melatonin synthesis and release is regulated mainly by the light-dark cycle, as well as adrenergic regulatory mechanisms, with peaks during the night. Research with pineal polypeptide extract supports the premise that the pineal gland controls hypothalamic sensitivity to feedback regulation, and governs the cyclic rhythmicity of the hypothalamic-pituitary system. Decreased pineal gland activity may be one of the mechanisms responsible for elevating the neuroendocrine threshold to feedback signals."
-Dilman V, Dean W.
The Neuroendocrine Theory of Aging and Degenerative Disease.
(The Center for BioGerontology, Pensacola, FL, 1992),
He based his theories almost entirely on his intellect and the results of some very crude tests. As more and more information is developed about the neuroendocrine system, these findings are fitting in with his theory, just as he predicted. His theory is called the neuroendocrine theory of aging, because it places the focus of aging on the hypothalamus and related structures in the brain. He believed that aging was caused by a progressive loss of sensitivity to negative feedback, which causes a continuing shift in homeostasis throughout the lifespan. Probably the best example of homeostasis is the thermostat that controls the temperature in your house.
Dilman believed that many physiological and biochemical parameters do not change with age. According to his theory, basically four homeostatic systems control the aging process and the diseases of aging. These are the adaptive, the energy, the immune, and the reproductive homeostats.
LEN: Could you give an example of how this system works?
Dean: Let's take the reproductive system, for example. Dilman points out that if homeostasis did not shift after birth, we would never develop into adults. Consider the male sex glands, which in children produce only very small amounts of testosterone but enough to inhibit the production of the gonadotropins from the pituitary gland, which normally stimulates the testes to produce testosterone.
Now, if the body were truly in homeostasis and never changed, we would never develop. But with increasing age, the hypothalamus becomes less sensitive to the feedback inhibition produced by these small amounts of testosterone. In response to this loss of inhibition, the hypothalamus stimulates the pituitary to produce more gonadotropins in order to stimulate the testicles, so they'll produce more testosterone. The result is the well-known rise in testosterone with development.
LEN: Does this increase in hypothalamic activity ever stop?
Dean: That's the problem. The system doesn't know when to stop, and the hypothalamus continues to become less and less sensitive to this feedback. This causes a gradual shift in homeostasis, which results in elevated blood sugar and glucose intolerance, which every physician knows occurs with age. It also amplifies the effects of cortisone, causes higher blood levels of insulin, and various other hormones and substances that may have harmful, deleterious effects, including hypertension, atherosclerosis, diabetes, the metabolic conditions that produce cancer (cancerophilia) and all the other degenerative diseases. That, in a nutshell is what Dilman believed to be the primary aging process.
"Dilman believed that there were actually four
causes of aging, which converge on the body's
vital systems: genetic, enironmental,
ontogenetic/neuroendocrine, and free-radical"
Now, the beauty of Dilman's theory is that it does not conflict with most of the other well-recognized theories of aging. It even incorporates Walford's immune theory. Dilman believed that there were actually four causes of aging, which he called his four models of medicine. For conditions such as hyperlipidemia and atherosclerosis, these four causes converge on the body's vital systems, eventually causing them to break down.
The first cause of aging is genetic. Dilman showed, for example, that certain people have genetic predispositions to develop certain degenerative diseases, such as atherosclerosis. The second cause is environmental: poor diet, inadequate exercise, too much fat, things like that. The third is what he called the ontogenetic or the neuroendocrine cause. It involves the metabolic conditions that are typically associated with the diseases of aging. The fourth goes by several names, including the cumulative, the free-radical, the membrane, or the cross-linking theory. Dilman believed that the diseases of aging and aging itself could be blamed on these four causes.
LEN: What are some practical benefits of this knowledge?
Dean: We can't do anything about our genes right now. We can do a lot about our environment, though. We're learning what to do about the neuroendocrine theory, and we're learning better ways to attack the free-radical diseases. Dilman believed that most applications of the free-radical theory to try to slow the aging process have really been a failure and that there are two reasons for this.
First, we are not able to adequately alter the intracellular levels of many antioxidants; there seems to be a homeostatic feedback mechanism that controls total antioxidants within the cell. Second, the folks that have relied solely on antioxidant therapy have not taken into consideration the neuroendocrine causes. So there is no magic bullet to slow or stop the aging process. It must be a broad treatment that uses many modalities.
LEN: Durk and Sandy said that Dilman was very intelligent, but they thought his ideas were something they had encountered in one form or another elsewhere.
Dean: I think that when Durk and Sandy were criticizing Dilman, they were really criticizing the superficial understanding of the aging process based on what many endocrinologists in the United States were saying at the time. In fact, Dilman was far ahead of his time in describing the entire integrated causes of aging.
"In the last few years, American physicians have
been describing something they call Syndrome X,
which is a combination of atherosclerosis,
hypertension, and diabetes, all related to increased
levels of insulin. This is something that Dilman
had predicted back in the '50s."
Dilman had been criticized loudly by the American gerontology community for years when, for example, he claimed that insulin levels increased with aging and were the cause of many of the diseases of aging, like atherosclerosis and depressed immunity. But, just in the last few years, American physicians have been describing something they call Syndrome X, which is a combination of atherosclerosis, hypertension, and diabetes, all related to increased levels of insulin. This is something that Dilman had predicted back in the '50s.
LEN: It seems that a lot of the work we're hearing about now seems to kind of come right out of the pages of Dilman's books.
Dean: Yes, the rationale for using acetyl L-carnitine, for one, is based directly on Dilman. The other thing that Dilman did - in fact, we did not even cover it in our book, but he had discussed it with me and he had written about it in one of his books in Russian - was to integrate the free-radical theory with the neuroendocrine theory. He believed the free-radical theory was a component of and contributed to the aging process. Unless you understood the neuroendocrine causes as well, your efforts with antioxidants and free-radical inhibitors would be wasted. But, if you could incorporate both approaches, you would get a synergistic increase in life span.
LEN: You also made the analogy between Dilman and Einstein. Einstein was smart, of course, but one of the reasons he is still recognized is because he came up with the theoretical fundamentals.
Dean: Einstein did it without the use of computers, and Dilman, likewise, did not have very sophisticated radioimmunoassays to measure hormone levels as modern physicians do. All he had was his brain.
LEN: And Dilman has developed totally new theoretical fundamentals.
Dean: Right. One of his approaches that has never been exploited, as far as I know, was his idea of using something called anahormones. These were hormone blockers that would block the adverse effects of hormones without having a hormonal effect themselves. So in cases where, for example, the prolonged effects of cortisol or the gonadotropins adversely affects the body, Dilman's plan was to devise anahormones that would actually block these hormones, but would not have hormonal effects.
LEN: I know that Professor Dilman tragically and unexpectedly passed away a few years ago. Is anyone continuing with the work that he was doing?
Dean: I am currently revising The Neuroendocrine Theory of Aging and Degenerative Disease, and I hope to enlist the assistance of Morris Silber, MD, who was one of Dilman's colleagues. Dr. Silber also personally knows a number of Dilman's former associates in Russia. So we plan to benefit by updating the neuroendocrine theory by consulting with Dr. Silber and also with Dilman's former associates in Russia.
LEN: What other spin-offs, in terms of products do you think there might be lurking? Is there a new generation of DHEAs or pregnenolones or melatonins?
Dean: I think that one thing is vanadyl sulfate, which mimics the effects of metformin. Metformin is a brand new antidiabetic drug, which is very effective in restoring muscle tissue sensitivities to glucose and insulin. Vanadyl sulfate appears to share these same properties. The downside of vanadyl is that it has a very narrow therapeutic range. Once that therapeutic range is exceeded, it can become toxic to the kidneys, so the dosing has to be watched very carefully.
LEN: How would you watch the dosing?
Dean: You would have to use minimal effective doses.
"Another interesting product that we really
need to increase in our diet, perhaps,
is alpha lipoic acid. It is an antioxidant,
a cognitive enhancer, and one of the best ways
there is to raise the HDL levels,
the good form of cholesterol"
LEN: Is that going to be effective for people who are not diabetic or are prediabetic?
Dean: Yes, it seems to, because as we become older, everyone becomes prediabetic and has a decreased glucose tolerance. So vanadyl sulfate will increase glucose tolerance in older people by restoring muscle tissue sensitivities to glucose and insulin. Another interesting product that we really need to increase in our diet, perhaps, is alpha lipoic acid. It is an antioxidant, a cognitive enhancer, and one of the best ways there is to raise the HDL levels, the good form of cholesterol. So I think that that could be easily incorporated into either a cardiovascular or a cognitive supplement.
LEN: Are you working on any other books?
Dean: Yes, I'm also preparing an update of my book Biological Aging Measurement, which was published in 1988. It was really based on technology up to about 1985. It spawned a resurgence in the scientific community in aging measurement and the development of interest in human biomarkers of aging. A great deal of work has been done since that book came out, so an update would really be a whole new book, just as the second "Smart Drugs" book was not merely an update of Smart Drugs & Nutrients, it was a totally different book.
Volume II of Biological Aging Measurements, which is now in the works, will bring us up to date with biological aging measurements and biomarkers, which is absolutely essential to monitor the success of an anti-aging, life extension program. Instead of being just an encyclopedia of aging measurement systems, which the first book was, this book will actually recommend various aging measurements, test batteries, some of which can be done at home and others which will require the assistance of a physician or a lab.
"Many life extensionists and smart drug enthusiasts
are not interested in politics but are concerned
about the restrictions by government on the
availability of cognitive enhancers and life-extending
drugs and nutrients"
Another book, which is about 60 to 80 percent completed, is a comprehensive anti-aging book. It will include not only the theories of aging and a summary of aging measurement techniques, but what we believe to be the most advanced state-of-the-art anti-aging program that has ever been presented in any book to date. I also have several books in preparation politics and government. Many life extensionists and smart drug enthusiasts are not interested in politics but are concerned about the restrictions by government on the availability of cognitive enhancers and life-extending drugs and nutrients.
These books will explain why things are the way they are and why we are losing our freedoms, not only at the national level, but down at the state, county, and city level as well. They identify the people and organizations behind the growing American police state. These organizations are like a cancer that has metastasized throughout all levels of our society and we really need to get the word out on this. I think that a book on life extension for pets is also a good possibility, too. We are finding out that as people are planning to live longer, they want to keep their pets living longer and keep them younger and healthier at the same time.
Of course, most of the smart drugs humans are taking have been first tested on a variety of animal species. So, the key is to report on which drugs seem to work best on which animal species and recommend the appropriate dose. We think this will create a whole new market for smart drugs for humans, because even people who are not aware of smart drugs for humans may be buying them for their pets, and after they see what it does for their pets, they'll start taking them themselves.
LEN: Where do you think this whole area is going? A lot of people have said that we may be moving into mechanical repair at the sub-cellular level through nanotechnology, or that we are going to end up being ultimately 100 percent cyborg.
Dean: Well, Don Kleinsek, who is probably one of the leading genetic researchers in the field of aging, believes that if he just had the funds, he could develop genetic techniques to rejuvenate the skin to much more youthful levels right now. As you know, the skin is the largest organ in the human body and is our major barrier for protecting us against disease. It is also the first thing that someone sees, and they base their opinion of your age largely on the appearance of your skin. So, even though it has been a gerontological joke that "nobody ever dies of old skin," the skin is very important.
If the skin can be rejuvenated using genetic techniques, the chances that we will be able to develop genetic techniques to rejuvenate other organs and tissues in the body is quite high as well. This is very different from what plastic surgeons do today. They simply remove wrinkles, and that makes people think they are younger. However, although the skin appears to be younger, it is not really younger. It has not regained any of its youthful elasticity. Basically, the only thing the cosmetic surgeons do is to stretch the skin, cut off a little excess, and remove the cutaneous wrinkle. With the genetic technique, however, we are talking about actually making the skin younger.
LEN: We've all been doing a lot of talking about the Life Extension Clinic. What can you tell us about that?
Dean: I had a life extension clinic when I had my office in Beverly Hills, but I think I was a few years ahead of schedule with the establishment of that clinic. Since that time we have come a long way in our development of protective, anti-aging therapies. Computer technology has also advanced to the point that biomarker testing and calculation of biological age has become an economic and technically feasible thing to do. The aging measurement system that we've developed is going to be the core of the clinic, because we will actually be able measure changes in biological age and be able to evaluate the effectiveness of our treatment.
Now, one of the other things we've talked about recently also was to develop a comprehensive supplement line that would be based on the aging measurement test. If any of the tests were abnormal in a negative way, ie, if the cholesterol was up for a person of a given age or if kidney function were down, we could then provide a supplement program designed to augment those biomarkers to restore those particular parameters to more youthful levels, and this would then result in a reduction in biological age and a healthier, younger human being.
LEN: There's still a great deal of resistance to the concept of "smart drugs." What's your experience been like in this area?
Dean: When we were writing Smart Drugs and Nutrients, we were extremely cautious and tried our best to sound pretty conservative. In fact, we were almost defensive throughout the whole book. And here's an example of why.
Recently, I was reading that book when a female internist who was sitting in the chair next to me made sort of a disparaging comment about whether I was reading that book for fun or not. After I discussed some aspects of the book, she wanted to know what I did, and I said, "Well, I'm interested in cognitive enhancement and life extension." And she said, "Oh, then you must use a lot of Cognex in your practice." And I said that, no, as a matter of fact, we specifically avoid Cognex, because it's so toxic. She said, "Oh, well, what do you use then?" I said that I use deprenyl, phosphatidylserine, acetyl L-carnitine, and hydergine. "Why, I've never heard of any of those," she said. "We only used FDA-approved drugs in our practice." We went round and round.
"The moral of this story is that there is still no
category of drugs called nootropics, as far as
the FDA is concerned, because they only approve
drugs that are used for "diseases." Premature aging
and premature memory disorders are not considered
diseases by the FDA..."
The moral of this story is that there is still no category of drugs called nootropics, as far as the FDA is concerned, because they only approve drugs that are used for "diseases." Premature aging and premature memory disorders are not considered diseases by the FDA, so they would never approve what we would call a "smart drug" unless there were evidence that it was effective in treating Alzheimer's disease or Parkinson's disease or some of the other dementing illnesses. As we mentioned in our book, although there are hundreds of antidepressants available, the FDA considers drugs that will make you feel better after a rough day at the office, even if you're not depressed, to be drugs with abuse potential, and they will continue to push to make them illegal.
LEN: Because Alzheimer's disease is the standard, other drugs that could be developed are effectively cut off at the pass.
Dean: Absolutely, and the only way Americans are going to have access to them is by using their right to order drugs that are approved in other countries and bring them in through the mail, or to link up with savvy marketing firms.
LEN: Could you explain for our readers why you think not licensing doctors would actually improve medical care in this country.
Dean: First, by requiring medical licenses, the medical profession has been able to restrict the number of physicians, nurses, and practically every aspect of health care. They should let the market determine the numbers of physicians. That's how the chiropractors do it. There is no waiting list for people to go to chiropractic college. If you can pass the entrance examination and pay for the school, you can attend chiropractic college. It's the testing system that determines who is qualified to be a chiropractor, not as in the medical field, where there are approximately 20 to 30 applicants for every vacancy, because there are so few vacancies.
If the profession would allow the medical schools to expand to meet the demand for doctors, it would be the market that would ultimately determine how many people go to medical school. Then the cost of going to a physician would go down, because competition would increase and what you would really wind up with would be a better doctor, because they wouldn't make so much money. People would be going into medicine for the right reasons, ie, to help people, not to make money.
Another factor driving up the cost of medical care is insurance. There are 37 million uninsured Americans. The tragedy is that you've got to have insurance to go to the doctor today. It's that expensive. We don't have grocery insurance; we don't buy gas with car insurance. People should not have to have medical insurance to get medical care.
So we've got to get the insurance companies out of it. In 1963 the American Medical Association said it was unethical for physicians to accept money from third parties. But about 1965 Medicare came in, and suddenly the physicians saw this big pot of gold at the end of the rainbow. They decided that they were going to cash in on that, and that was when the insurance industry just burgeoned. And, of course, that's when medical costs began to skyrocket. The other thing that drives costs up is the price of drugs.
You know in almost any other country in the world, you can walk into a pharmacy without a prescription and buy most of the drugs that you would reasonably want to buy. There's no reason to go to the physician, pay him 45 bucks to tell you that you need a prescription for some athlete's foot medicine and then go down to the drug store. Most people know what they need; they can go to the pharmacist, tell him what they need, and they should be able to get the drugs without having to go to the doctor to get a prescription. The health of the countries where prescriptions are not a requirement does not seem to suffer, because these people haven't been to the doctor first.
We also need to bring the cost of drugs down, and the way we do that is we allow people to actively promote the importation of drugs from overseas. It's legal to import drugs, but it's not legal to promote that fact or to have that as your business here, so not too many people really know about it. That would force the American drug companies to reduce their prices to something that's reasonable.
LEN: Drug prices are also determined by the rigmarole they're put through by the FDA.
Dean: Absolutely. I think we either need to get rid of the FDA or drastically curtail its powers. The FDA should be spending more time on safety and compliance with proper dosage rather than kicking in the doors of doctors that prescribe vitamins and trying to shut down the vitamin industry.
LEN: Which was their origin mission back when.
Dean: The other thing we should do to make medicine more available is to let doctors take a tremendous tax break for charity work so that 75% to 100% of their charity work could come off their income tax. You'd have doctors beating the doors down to treat these patients. Also we need to get rid of these regulatory agencies that drive people crazy; the administrative overload in hospitals is absolutely horrendous. And part of this is due again to government requirements.
LEN: I met a pediatrician recently who's 80 years old, and he was complaining about how things used to be so much better in medicine. Now doctors run their clinics like they were major corporations.
Dean: Sure, today you've got to have one person to do your insurance work, and an accountant to do your books and take care of your taxes, and, of course, you've got to have a malpractice attorney in case you get sued. These people are all on retainers if they're not full-time employees. All this helps kick up the costs. In the old days, the doctor, and probably his wife, who was probably a nurse, were the only two people in the office. The patients came in and paid cash, or chickens, or fixed his car, or whatever.
LEN: You recently attended the Eris Society conference. Could you tell us a little about that?
Dean: Eris was the Greek god of chaos who, in The Iliad was credited with starting the Trojan Wars. Doug Casey, who started these conferences, used to complain that, although he lived in two of the most desirable places to live in the United States, his neighbors were all basically functional idiots, and there wasn't really anybody that he liked to talk to that lived nearby. So, about 16 years ago, he began inviting people that he had heard about and wanted to associate with and exchange ideas with to come up to Aspen. This has grown over the years to a very eclectic, interesting, diverse group of people who meet once a year.
LEN: What were some of the presentations that you found particularly interesting?
Dean: One of the people that I found particularly interesting was Ragnar Benson, who is quite well-known among the patriot community, who is the author of a number of books on mayhem and violence, of ways of basically, defending yourself and your family from whomever may need defending; James Pate, an author for Soldier of Fortune, who has written extensively about the Ruby Ridge and Waco fiascos; Dr. Ron Paul, former congressman from Texas and former Libertarian presidential candidate. I'm giving him a few bucks to support his candidacy for Congress this year; Frances Kendall and Leon Louw were pretty interesting too, both Nobel Peace prize nominees. Their book was called South Africa, The Solution. They were a big part of writing a proposed constitution for South Africa, which is based on many Libertarian ideas, but is strikingly similar to the constitution of Switzerland.
LEN: What does smart drugs and life extension have to do with such an elite group of people?
Dean: These are people with a real zest for life; they are interested in the future, and they want to be there when it happens. This is pretty characteristic of the caliber of people that are interested in life extension, because they have such a diversity of interests, and they realize that time is a limiting factor. By optimizing their life span and their cognitive ability, they hope to be able to experience an increasingly diverse area of interests.