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Hormones, aging and the metabolic syndrome

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Hormones

Complex changes occur in the human endocrine system with age. First of all, aging is associated with a decrease in the level of growth (somatotropic) hormone, which is released by the pituitary gland. Of particular importance is the drop in the level of sex hormones – estrogen in women and testosterone in men. The picture of hormones involved in the aging process is completed with a decrease in the level of androgens (dehydroepiandrostenedione and its phosphate form), which are produced in the adrenal cortex.

What is the relationship between growth hormone and aging?

The level of growth hormone starts to decrease from the age of 30-40 years. and this happens gradually and slowly over the years. Currently, growth hormone is used as an antiaging drug in many countries, but the benefits and harms of its use are not sufficiently understood. In recent years, numerous studies have come out on this subject, disappointing those expecting good news for an anti-aging agent in the face of growth hormone. Indeed, the level of total cholesterol decreases significantly when growth hormone is taken by adults, but at the same time, there is an increase in blood pressure and blood sugar with a greater tendency to develop diabetes mellitus and impaired glucose tolerance.

The possibility of increasing the risk of developing tumor diseases has not yet been ruled out. Fluid retention, edema, diffuse joint pain, and gynecomastia (breast enlargement in men) are often observed. In other words, to the best of our knowledge at this point, we have no reason to recommend growth hormone as a hormonal antiaging agent.

 What is the connection between sex hormones and aging?

The male sex hormone – testosterone – is mainly produced in the testicles. Its amount in the blood begins to decrease gradually from the age of 40. age. Characteristic for older men is the loss of the circadian (day and night) rhythmicity in the secretion of testosterone typical of young men. It should be mentioned that, unlike menopause in women, hormonal changes in men that occur with age have long remained poorly studied. Therefore, WHO in 2000 devoted a considerable part of its efforts to this subject. Recently, there has been more talk about the so-called klimakteriumvirile or male climacterium.

Epidemiological studies in Europe show that every third man over the age of 55 is affected by it. Complaints are nonspecific and would rarely lead to a doctor’s visit. It refers to scattered autonomic complaints, impaired concentration ability, weakened memory, feeling of fatigue, reduced muscle strength, increased irritability, reduced load endurance, diffuse muscle and joint complaints, sweating (especially at night), sometimes insomnia, reduced libido and potency, loss of morning erection. Behavioral changes are also observed, such as a decrease in the desire to work and to undertake undertakings of a different nature, and depressive moods become more frequent.

When is replacement therapy needed?

Then, when the subjective complaints mentioned above are present and a significant drop in the testosterone level below the lower limit of the norm is proven, replacement treatment is applied. The use of testosterone among adult men increases the general sense of health, improves muscle strength and tone of the body, enhances hematopoiesis, improves mental health, libido, and potency, gives youthful freshness to the skin, and most importantly – increases the mineral density of the bones, preventing the development of osteoporosis. Men who have not only a reduced level of testosterone but also an increased level of gonadotropic hormones (LH, FSH) respond particularly well to the therapy.

It is extremely important not to practice self-medication! The level of testosterone in the blood is raised only to the lower limit of the norm, and it is not aimed to obtain in 60-year-old men values ​​that are characteristic of 20-year-olds. The presence of relevant contraindications for testosterone treatment, such as suspected prostate cancer, breast cancer, polyglossia (increased number of red blood cells), liver diseases, etc., must also be taken into account. When administering testosterone, it is necessary to periodically control both the level of this hormone in the blood and the level of PSA (prostate-specific antigen), liver parameters (transaminases), lipid profile, and blood count (hemoglobin, hematocrit, and erythrocytes).

What are the future expectations?

Recommendations for hormone replacement therapy in men in different countries are somewhat contradictory. Since the conclusion of the Health Initiative study (discussed below) in 2002, the question of the long-term effect of testosterone on life expectancy and the possible increase in cardiovascular disease, as found with HRT, has been raised. treatment in women. So at the moment, in countries like Germany, where until 2003 testosterone was relatively liberally substituted, serious prospective studies are awaited to definitively prove the absence of such risks.

Is there a link between testosterone levels and metabolic syndrome?

A characteristic of patients with metabolic syndrome is the presence of a lower level of testosterone compared to their peers. In other words, in men with obesity, diabetes, hypertension, and hyperlipidemia, premature “aging” is observed in a sexual aspect. Hormone replacement treatment in these cases improves muscle mass, reduces body fat content, reduces insulin resistance and thus favorably affects blood sugar, and lipids and, as a result, reduces cardiovascular risk.

Unlike many other parameters, the testosterone level does not show a linear relationship, as with systolic blood pressure, for example, where the higher it is, the greater the cardiovascular risk. Testosterone level is an atherogenic risk factor both at low values ​​(below the lower limit of normal) and at high values ​​(above the upper limit of normal). That is why it is dangerous to uncritically increase the level of testosterone in the form of self-medication.

Female sex hormones and aging

With the cessation of the monthly cycle in women, there is a sharp drop in the level of female sex hormones, which is referred to as menopause. The changes that occur in connection with this are relatively well-known among non-medical people. The neuropsychological balance is disturbed, there is increased irritability, as well as the presence of autonomic complaints such as palpitations, sweating (known as warm or hot flashes), etc. The appearance of the skin also changes, with the loss of its youthful freshness and the appearance of a tendency to form wrinkles. Particularly characteristic is the adverse effect of the fall of female sex hormones on bones – it reduces their mineral density, with the development of osteoporosis and increased susceptibility to fractures.

What menopause causes the most serious health problems is the unlocking of genetically coded cardiovascular and cerebrovascular diseases. In other words, after menopause, the protective function of female sex hormones is lost, which in familially predisposed individuals reduces the sensitivity of tissues to insulin, leads to an increase in body weight and blood sugar, to atherogenic changes in the lipid profile, and especially typically – until an increase in blood pressure that was normal until now.

What is the role of female hormone replacement therapy?

Numerous studies over the past 10-15 years have shown that replacing female sex hormones in postmenopausal women leads to a reduction in the level of several risk factors for atherosclerosis. Therefore, mass application of these hormones has been practiced after women’s menstrual cycle has stopped in Western European countries, the USA, etc.
However, in 2002, the data of the Women’sHealthInitiative study conducted in the USA came out, which showed that contrary to expectations, with hormone replacement therapy, significantly greater cardiovascular and cerebrovascular mortality was proven, twice as high risk of venous thrombosis and pulmonary embolism and a significant increase in the risk of breast cancer! This is the reason why hormone replacement therapy is not recommended as a mass practice.

DNEA and aging

Dehydroepiandrostenedione (DNEA) and its phosphate form (DNEA-S) are androgens that are secreted by the adrenal cortex and are precursors of sex hormones. In men, their role is almost insignificant, because their action overlaps with the much more active male sex hormone – testosterone. In women, they are important for the synthesis of proteins, regulating muscle mass, giving the skin a dense or “youthful” appearance (more collagen fibers), increasing hair growth, and raising libido.

DNEA is currently very widely used in the US and Western European countries as an anti-aging agent. Serious scientific research shows that the average postmenopausal woman does not benefit from the use of this preparation. In the cases of women with so-called dysthymia (mood disorders with a tendency to depression) in middle age, however, positive effects of DNEA as an antidepressant have been demonstrated. In this case, an improvement in mood, vitality, motivation, and desire for life is registered.
A good effect on bone mineral density is also observed. A particularly good effect is observed in women, who have proven reduced amounts of DNEA in the blood. Unfortunately, these effects are not observed if DNEA is administered to women in whom its level is not lowered, and in this aspect, the results of large epidemiological studies on DNEA as a mass antiaging preparation have given disappointing results.
In conclusion, from all the studies done so far, DNEA is the best candidate for anti-aging preparation.
However, it cannot be claimed that it can be used to prolong life or reduce cardiovascular mortality, and only a certain improvement in quality of life has been demonstrated so far. So, unfortunately, there is still a lot of work to be done in the field until finding the “eternal youth” remedy that people have been dreaming of for centuries.

I graduated in journalism at the Faculty of Journalism and Mass Communications of the Sofia University "St. Kliment Ohridski" in 1997, master's degree, where the object of study is a long series of disciplines from recruiting and working with information sources, systematic processing of information and presentation of data in a readable form of text, types of publications and media market.

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