Copyright 1991-2010 by Jerry Emanuelson

Chapter 1


One of the most important realizations in medicine in the last decade has been the widespread acceptance of the fact that important aspects of our health are directly under our personal control.  For example, physicians now understand that an individual's chances of developing heart disease and some types of cancer are strongly influenced by our diet and behavior.  Scientific developments reported in the last few years have given us methods of slowing the manifestations of the aging process and preventing many degenerative diseases.  Our future health and our personal life expectancy are potentially under our individual control to a far greater extent than is generally recognized. 

During the 20th century, life expectancy increased by more than 50 percent.  Most of this increase has been due to the discoveries of cures for previously fatal diseases and knowledge of how to prevent transmission of infectious diseases.  (Tuberculosis was the leading cause of death in the U.S. in the 19th century.)

For the most part, taking advantage of this great increase in life expectancy has not required any extraordinary action on the part of the individual.  Medical treatment has been something a person receives after the onset of illness.

The previous methods of increasing our health and lifespan are reaching their limits, though.  Most medical scientists believe that we cannot increase average life expectancy beyond about age 85 by using the present methods of "curative" medicine.  In addition, this "curative" medicine does little to prevent the increasing frailty of aging and the general deterioration of our bodies.  It is becoming clear, however, that this increasing frailty and degeneration is not inevitable.

The importance of preventive medicine is becoming increasingly apparent.  The methods that have the potential to increase health and life expectancy without limit are methods that must be put into practice by the individual.  The total body of human knowledge in medicine, especially in aging research, is expanding at an ever-increasing rate.  The remarkable discoveries of the past few years have given us the potential to be individually in control of our own health and longevity to a degree never before possible.  This manual will examine some of those discoveries.

Two things are of primary importance to anyone undertaking a serious life extension program:   self-education and medical supervision.

Each individual must take ultimate responsibility for his or her health.  The medical professionals that one consults should be considered as hired experts -- experts who should be fired if they do their job poorly.  Their opinions and judgements should always be taken seriously, but the final responsibility for actions taken with respect to an individual's health must always remain with that individual.  Whether one's physician is an expert in preventive medicine, or an authoritarian who considers life extension to be quackery, the individual is responsible for self-education on health matters and for making ultimate decisions.

This is especially true in life extension and advanced techniques of preventive medicine.  Medical professionals cannot be expected to know about these subjects.  Every week, more than 8,000 reports on medical research are published in the scientific literature.  Once these reports are published, there is no mechanism in place for getting this information into the hands of medical practitioners.  In addition, the U.S. Food and Drug Administration (FDA) actively blocks much of the flow of information from the scientific literature to physicians and the general public.  FDA obstruction of the free flow of information is a primary reason why individuals who actively educate themselves in health and medicine will be far ahead of the average person in health and longevity.

A document such as this Life Extension Manual cannot approach being a comprehensive guide to the subject.  It is intended as a guide to other information sources and as a source of information not readily available elsewhere.  It gives little coverage to basics, such as antioxidant vitamins, that have been written about extensively elsewhere.  Some important information on vitamin and mineral supplements, however, is contained in Appendix A of this manual.  If you are looking for a well-designed vitamin/mineral supplement to serve as a foundation for your life extension program, examine the Pearson-Shaw formulations sold by Life Enhancement Products, the Extend supplements sold by Vitamin Research Products and the formulations sold by Life Extension Products (The Life Extension Foundation).   (See the Resources section of this manual.)

This manual also does not cover calorie restriction, which is the most well-documented and accepted form of life extension.  Most people consider calorie restriction to be a much too difficult and demanding lifestyle.  Those interested in calorie restriction should read Roy Walford's books listed in the Resources section of this manual.  Calorie restriction (CR) is the only method currently proven to slow the aging process at its fundamental level, although it is not yet known whether this technique works in humans.  Other current methods may have some minor effects on slowing the basic aging rate, but they are mainly targeted at greatly slowing the manifestations of aging.  There is good reason to believe that, by staying alive and healthy using the non-CR methods, one can stay alive long enough to be able to use future non-CR life extension techniques that will stop the underlying processes of aging completely.

To put it another way, with our present level of knowledge, it is likely that only calorie restriction can currently push the maximum lifespan significantly beyond its current limits (about 120 years in humans).  It is likely, however, that full application of the current non-CR techniques of life extension can increase the average life expectancy well beyond the (currently-typical) late seventies by stretching the healthy middle years by about three decades.

Anyone seriously pursuing a program of life extension or advanced preventive medicine should read many of the books listed in the Recommended Books section at the back of this manual and learn how to use a medical library (or the online equivalents) to research the National Library of Medicine online.  See:

This may seem like a lot of work, but the most common mistake made in this area is to spend large sums of money on nutritional supplements while paying attention to only one or two "experts" in this field.  It is important that anyone who plans to spend the remainder of an extended lifespan on a life extension program make sure that the time and money that such an endeavor requires is spent wisely.  Self-education and reading about these subjects with a skeptical mind is the only way to do this.  No one should entrust their health to any one source of information, not even this manual.  This manual is written by a science writer, not a physician.

Anyone undertaking a serious life extension program should be under medical supervision and should have complete blood chemistry tests at least once a year.  A physician familiar with comprehensive life extension programs may be difficult to find, but your physician does not need to approve of everything you do.  You will at least need a physician who can order blood tests and monitor your general state of health.  You should obtain and keep copies of blood chemistry and other tests for your own records.

If your physician is reluctant to order the blood test that you believe are important, you can order them yourself.  As mentioned elsewhere on this site, I had a DNA test in my personal search for the cause of the male osteoporosis that existed in my family, a condition that was beginning to afflict me.  The DNA test show a defect in a the gene that produces the aromatase enzyme that converts testosterone to estradiol.  Since low estradiol levels might explain my low spinal bone density, I suspected that I might have developed low estradiol, although my estradiol levels had been normal ten years earlier.  I ordered my own estradiol test through the Life Extension Foundation, which showed that my estradiol levels were low.  I began to use a supplemental transdermal estradiol gel, which resulted in a dramatic increase of more than 20 percent in lumbar spinal bone density after just 10 months of estradiol therapy.  Although I had my doctor monitoring all of these steps, and writing the prescription for the estradiol, I am the one who discovered the abnormal gene, traced the function of the gene, read the appropriate medical journal articles, and concluded that a lifelong regular use of supplemental estradiol should correct my bone density problem (although there are some IGF-1 gene variants that are also involved in my bone density problem).

The message here is that you don't need to be a medical professional to find developing medical problems, even if they involve defective genes, and to figure out what needs to be done to make a dramatic change in your future health.

Another important reason for regular blood chemistry testing is motivation.  Some benefits of a comprehensive life extension program occur quickly, but many benefits will not become apparent for decades.  The results of your blood chemistry tests can provide motivation for continuing to do those things that will provide profound long term benefits.  Many people are surprised at the degree of control they have over the chemical composition of their blood.

Blood chemistry tests provide a good indication of your heart disease risk.  They can also detect a great many serious diseases long before they would otherwise be detected.  Regular blood chemistry testing, by itself, can significantly extend the healthy years of your lifespan.

Until recently, it was not realistic to expect to find any physician who would set you up on a life extension program or any other regime of aggressive preventive medicine.  Many such anti-aging physicians are now available in the United States.  Whether or not you enlist the services of an anti-aging physician, if one is to pursue any advanced program of preventive medicine, a physician's supervision is essential.

Self-education is extremely important.  Reading most of the books recommended in this manual, and doing your own thinking about preventive medicine, may require more effort than you would like to expend.  The penalty, though, for not doing the work is the probability of death or disability decades sooner than might otherwise be the case.

Whether you are seeking a cure for an illness or supervision of a preventive medicine program, the quality of the medical care you receive will depend heavily on your attitude and approach to a physician.

Too many people go to a doctor with an attitude that stays:  "Doctor, cure me.  I don't know anything about medicine, and I don't want to go to the trouble to learn.  Just give some medicine, and tell me what to do."  (And then they often go home and complain about doctors being closed-minded and authoritarian.)

The quality of medical care you receive will increase dramatically if you approach a physician with an attitude that says:   "I need your help in solving this problem.  Although I'm not an expert in medicine at all, I want to learn as much as I can about my condition. I need to cooperate with you in taking responsibility for my own health. Please help me to learn what I can do."   Of course, you wouldn't use those words, but rather convey that attitude through your own words and actions.

In most cases, the patient in the second example will receive a much higher quality of care that the patient in the first example.  This is true whether you are consulting the physician for supervision of a life extension program or to treat a specific illness.

There are, of course, a great many doctors who would prefer to have patients who just answer their questions and obey their orders.  If you value your life and health, do not become one of their patients.

If you are looking for a physician to supervise a life extension program, you may have more success with a D.O. (Doctor of Osteopathy) than an M.D. (Medical Doctor).  Even though their training and expertise is virtually equivalent, a D.O., in general, is more likely to be open-minded and interested in preventive medicine than an M.D.  Also, look in the Physicians classification of your local yellow pages for physicians specializing in Preventive Medicine or Nutrition. 

Even the physicians who are well versed in preventive medicine must not be expected to know about everything that is presented in this manual and in the books recommended in this manual.  If, for example, after reading the section in this manual about deprenyl, you decide you want a prescription for low-dose deprenyl, do not expect any physician to just hand you a prescription.  You are much more likely to get the desired prescription if you make copies of a few of the relevant medical journal articles cited in this manual, then read them yourself and give copies of the articles to your physician.

This allows the physician to learn of the reasoning behind low dose deprenyl, it demonstrates to the physician that you are taking some responsibility for your own education and that the ultimate source of your information is scientifically respected medical journals.  Finding the nearest medical library and learning how to use it is not only helpful for getting accurate information about life extension, it may save your life in the event of a serious illness.

If you don't know where the nearest publicly-accessible medical library is, ask a reference librarian at your nearest library.  Most colleges and universities carry at least a few of the major medical journals.  Most cities have at least one hospital with a medical library that is available to the public.  Many medical journal articles are now available on the internet.

Most medical schools and many large hospitals have free evening lectures and classes on various aspects of medicine.  These can be very useful for enhancing medical understanding and keeping up of some of the latest medical advances.

Browsing through the Medline database using PubMed can be a memorable, educational and eye-opening experience.  PubMed enables keyword searching through more than 19,000,000 medical journal reports and life sciences articles in seconds.  Access to the Medline database is available a number of ways, including Internet PubMed and Medscape.  (Medscape requires registration.)  You can also ask a reference librarian at your local public or university library if you are interested in regular access to medical databases.

It's not necessary to know how to do PubMed searches to embark on a successful life extension program; but the more self-education you pursue, the more successful your quest for a longer, healthier life is likely to be.

Finding a physician familiar with anti-aging medicine has become much easier in the last few years.  Such a physician can now be found in nearly every state in the U.S. and in most of the industrialized countries of the world.  Lists of such physicians can be found at the following web sites:

A local compounding pharmacy can often suggest a good anti-aging physician.  Ask a compounding pharmacy about nearby physicians who prescribe bio-identical hormones.

A good physician is vital because life extension and anti-aging medicine are still experimental.  If you engage yourself in the process of anti-aging medicine, you are performing a medical experiment on yourself.  Therefore, you need to be medically monitored.

If being in a medical experiment sounds scary, just remember that aging, as it has usually been experienced in the past, is also pretty scary.  I like to use an analogy to an argument originated by Dr. Ralph Merkle when he talks about cryonics.  You can choose to be either in the control group or the experimental group.

In the case of anti-aging medicine, if you choose to be in the control group (not using any kind of anti-aging medicine), then you can pretty much know what the results will be.  Visit any local nursing home for examples of what the future may be like for those in the control group.  For those of us in the experimental group in life extension and anti-aging medicine, the future is uncertain; but it is likely to be much more pleasant than what the control group will be experiencing.

The best sources of ongoing information for practical life extension are Life Extension Foundation and the American Academy of Anti-Aging Medicine.

  • An important approach to life extension is to aim directly at the prevention of the common causes of death.  It does little good, for example, to slow the general aging process if you neglect certain aspects of cardiovascular health and die prematurely of a heart attack.

  • Another important approach to life extension is to maintain the levels of hormones and other natural chemicals in the body at the level that one would expect in a healthy twenty-year-old.  There is good evidence that the decline of some of these substances is a cause, rather than just an effect, of the manifestations of the aging process.

  • Growth hormone is an important hormone that declines with aging.  It can be replaced by direct injection, but a far less expensive way that works for many people under 40, is to use growth hormone releasing agents stimulate the natural release of growth hormone.  (Unfortunately, there are a great many growth hormone releasing products on the market that are worthless.)  Replacement of growth hormone with low doses of injectable growth hormone is an important component of anti-aging medicine for many people over 40.

  • Dehydroepiandrosterone (DHEA) and pregnenolone are other very important hormones that decline markedly with aging.  DHEA and pregnenolone can be replaced by taking supplements containing these hormones.  It is important, though, not to take too much DHEA unless you are under medical supervision.

  • Levels of the important brain chemical dopamine decline with aging, while levels of type B monoamine oxidase (MAO-B) go up.  MAO-B destroys dopamine and other important brain chemicals.  Low doses of the prescription drug deprenyl will raise dopamine levels and inhibit the activity of MAO-B.  Deprenyl may protect critical brain cells from damage if it is taken along with a broad spectrum of antioxidants.

  • Loss of insulin sensitivity appears to be a major cause of aging.  Loss of insulin sensitivity results in high and unstable blood sugar levels, with resulting damage to vital proteins in the body.  There are very effective techniques for restoring insulin sensitivity.  These techniques are much more effective if they are started early.

  • Melatonin is a very important hormone that declines with aging, but can be replaced orally.  Some scientists believe that melatonin is the master hormone of aging, with the decline of melatonin signaling other hormones to accelerate the aging process.  Most of the evidence suggests that this is only partially true.

Let's look at the details of these and other approaches to life extension.

Next Chapter:   HOW WE DIE:  Preventing the Common Causes of Suffering and Death


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