S2 E4 How to Start Changing Your Biological Age: Telomere Medicine 2.0

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Welcome to the Dr.
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50 Something Podcast.
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I'm your host, Dr.
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Nicole Norris.
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Whether you are in the midst of midlife or you want to prevent the physical and mental signs of aging that occur in midlife, this is the podcast for you.
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This is a show where I share my knowledge, gleaned in family practice, preventative medicine, and aesthetic medicine to shed light on aging, or better yet, how not to feel or look like you are aging.
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We should be taking an active role in how we age from an early age.
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We should not settle with growing old gracefully or letting nature take its course.
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How we age directly affects our confidence, which impacts all of our relationships with those around us.
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The length of time in our lives that we feel really good in terms of energy, aches and pains, and thought clarity has a definite impact on the mark we can leave on this world.
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My wish for my listeners is to always be mistaken for being 50 something or less in mind, action, and appearance.
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Let's go.
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You have to grasp the concepts from Telomere Medicine 1.0 before we can delve into 2.0.
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But first, a brief recap.
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Our telomeres, which are the caps at the end of our DNA strands present in every cell of our body, can be measured.
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Their length is a direct reflection of our cellular health and therefore our biological age.
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Biological age is a measure of how healthy our lifestyle has been, which includes the foundations of diet, movement, sleep, and hormone optimization.
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I did not elaborate on this in Telomere Medicine 1.0, but our reaction to stress also plays a huge role in our telomere length.
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Some longevity medicine physicians also believe meditation and journaling about the things we are grateful for every day are key to keeping our telomeres from shortening quicker than they should.
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This is a very difficult study to do because everyone has different amounts of emotional stress, so it's hard to quantify, but it definitely makes sense.
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I figure it can't hurt.
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So add that to the list of things to do for a long, productive life.
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I like the Heart Math app for meditation and journaling daily, three things, big or small, that I'm grateful for.
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I'll put a link in the show notes for Heart Math.
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At the Longevity Medicine Conference that I attended in Vegas in December, I also learned about the first ever dietary supplement isolated from a plant called Astragalus root that has been shown to lengthen our telomeres just by ingesting it.
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Thank goodness, something to counteract my occasional bad lifestyle choices and falling asleep before I journal.
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Yes, lifestyle choices and protecting our mitochondria can help us to minimize telomere length shortening, but this supplement has actually been shown to lengthen our telomeres.
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The compound is referred to as TA65.
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TA65 is what is termed a telomerase activator and can lengthen the telomere by as many as 530 base pairs if taken daily for 6 to 12 months.
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In comparison, the average person over age 30 loses at least 50 base pairs of their telomere per year.
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So, how does TA65 work, you ask?
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TA stands for telemerase activator.
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A telemerase activator like TA65 activates an enzyme called telemerase, which turns on one of our master methylator genes.
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This gene turns on the expression of many genes at one time to improve our T cell function.
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So think of the electrical box for your house and just flipping on the master switch.
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That is essentially what a master methylator gene does.
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And T cells, which I'm sure you remember from biology in high school, are extremely important to our immune system.
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And the more we have, the less likely we are to get viruses and cancer.
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Telomerase activators also decrease the number of senescent T cells that we have, which senescent T cells are essentially dying T cells that build up and create chronic inflammation in the body and in the brain.
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So TA65 really does two things.
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Specifically, it has been shown to decrease the senescent old dyeing T cell load by 20% in our bodies and increase our active T cells that make our immune system strong by at least 10% compared to placebo.
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Okay, so that's all great.
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Now you know what TA65 does at the cellular level, but let's talk about some studies on what that actually looks like for your overall health.
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In the first documented age reversal in a mammal, researchers at Harvard University showed that telomerase enzyme activation could reverse the signs of aging in mice.
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This study was published in 2011 in the scientific journal Nature.
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Researchers used mice that were artificially aged by switching off their telomerase enzyme gene through a process of gene manipulation, and then they switched the telomerase enzyme back on.
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Researchers saw a dramatic reversal of the signs and symptoms of aging with telomerase activation.
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Benefits included increased brain size, improved cognition, restoration of the color of their hair, improved reproductive health, and better major organ health.
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In the next study, mice were given TA65 in a randomized controlled study.
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And besides lengthening their telomeres, it also made older mice at the end of life able to complete very complex mazes that they had not been able to complete prior to be given TA65.
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In yet another randomized controlled trial in 2011, old mice were given TA65, and it again showed that by lengthening their telomeres, their health span improved.
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And this happened without increasing any increased risk of cancer.
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In 2016, TA65 was given to humans in the first randomized double-blind placebo-controlled study.
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The group taking 250 units of TA65 daily for one year showed increased median telomere length by 533 base pairs compared to placebo.
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Yet another 500-person double-blind placebo controlled study put patients on 100 to 500 units of TA65 per day for nine months.
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In this study, senescent T cells, these are the inflammatory bad ones that promote aging, were significantly lowered at all doses, and there were no product-related toxicity or adverse events.
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Besides its profound effects on the immune system in the human studies today, TA65 has also been shown to reduce complication in patients who have had a heart attack.
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It's been shown to improve HDL cholesterol, lower LDL cholesterol, improve mitochondrial health, improve brain health by decreasing inflammation in the brain, improve blood flow in the brain, and even improve memory and cognition.
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TA65 does cross from the blood into the brain, so the brain is a key beneficiary.
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That is pretty impressive evidence for a 700-year-old plant extract initially used in Chinese medicine.
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To this day, human clinical randomized double-blinded placebo-controlled studies have been done on over 7,000 patients taking the TA65 compound for at least a year, with no reported adverse events attributed to it.
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It is considered safe for medical food use and thus far is classified as a supplement and not a prescription.
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Because of this, it has not been regulated by the FDA, but it does have a designation by the FDA as GRASS, which stands for generally recognized as safe.
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So what I'm telling you is that despite all this great research, this product is not intended to diagnose, treat, cure, or prevent any disease, and you should talk to your personal healthcare provider before you take it.
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Now, if I am your longevity medicine provider already, I will likely not let you leave my office without it.
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Of course, right after you have had your baseline telomere length test.
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TA65 is a great tool for longevity medicine physicians since it is well tolerated and easy to take.
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But let's talk about some other medications with promising studies on telomere length.
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Hormones, I've mentioned this before, such as testosterone and estradiol, can activate telomerase activity, thereby positively affecting the length of a telomere.
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In contrast, cortisol, the hormone in the body that rises with stress, decreases telomerase activity.
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Here is where the meditation and journaling come in, guys.
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Also, vitamin D is actually an important hormone for aging and has been shown to slow telomere shortening over four years.
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And the study participants gained an average of three years of telomere health when their vitamin D level was optimized to 100 nanograms per milliliter.
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Growth hormone can also increase telomerase activity.
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As we age, our natural growth hormone decreases.
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In my practice, we use growth hormone analogs, which are peptides like sermorellin and epimerelin that work at the same receptor site as growth hormone to improve growth hormone levels.
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These are typically injected at home in cycles.
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But before starting these peptides to improve growth hormone levels, we require lab work and we suggest cancer screening before you start them.
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I definitely will have to do a podcast soon about these growth hormone peptides, as well as our cancer screening test, which is a simple blood test that actually can screen for 40 different types of cancer and pick it up at its earliest stages.
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Very interesting.
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Sorry, I get really sidetracked when I talk about peptides because they are just so cool and integral to my longevity medicine practice.
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However, you know what I'm going to say next.
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You have to get the foundational components down first before you start peptides.
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Hormone balance, exercise, nutrition, sleep, stress management.
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My team at my office knows I love a good mnemonic.
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So let's remember this as hens.
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Hens with two S's: hormone balance, exercise, nutrition, sleep, and stress management.
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Okay, back to medication that can affect telomerase activity.
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There was one study that showed low-dose crestor or rosuvastatin could have a positive effect on telomerase activity.
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GLP1s such as semaglutide and trzepatide have shown a positive impact on telomerase activity, as well as ACE inhibitors such as Lacinopril, which are common blood pressure medications.
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Getting adequate amounts of vitamin C and zinc, as mentioned in my last podcast, polyphenols have also been shown to increase telomerase activity.
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So let's switch gears to which medications can adversely affect telomerase enzyme activity.
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These things can potentially shorten your telomeres.
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Probably the most surprising are NSAIDs.
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Aspirin, endomethicin, ibuprofen, neproxin, maloxicam, the whole kit and caboodle of them are not kind to your telomeres.
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So if you have a headache, it might be a better choice to take Tylenol.
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The last concept that I want to introduce is the relationship between telomerase enzyme and our mitochondria.
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This would be much easier with a dry erase board, but I will do my best.
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Okay, so imagine I am drawing a big circle on the board.
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This is a single cell of the human body.
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Inside the circle is the center, which is the nucleus where the DNA are stored.
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Now I'm drawing a small circle in the middle of the big circle with squiggly lines of DNA in it.
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This is also where the telomerase enzyme is activated to lengthen the telomeres on the DNA strands.
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Also in the big circle, besides the nucleus of the cell, are little grains of rice, now that I am drawing.
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These little grains of rice are the mitochondria.
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They are the powerhouses of the cell.
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The better your mitochondria work to produce energy, the better off you are in terms of your cell's aging.
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Mitochondria are extremely sensitive to something called oxidative stress.
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This comes mostly from the environment.
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Think toxins and not enough antioxidants in our diets.
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The active protein of telomerase enzyme that actually builds the end of the telomere in the nucleus of our cell is called TERT, which stands for telomerase reverse transcriptase.
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I am going to draw TERT in the nucleus of the cell.
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TERT is a crazy little protein that always wants to be building the end of the telomere to make it longer.
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But he often gets sidetracked.
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When he sees the little mitochondria outside of the nucleus are being stressed by oxidative stress, TERT will actually jump out of the cell nucleus and go to help the mitochondria when they are being attacked by oxidative stress.
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So if you think about this, if TERT isn't in the nucleus of the cell and it's outside of the nucleus helping the mitochondria, then TERT can't do its job.
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Tert is not lengthening our telomeres and our telomeres start getting shorter.
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So this is a key point.
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If you can protect your mitochondria from oxidative stress with good lifestyle choices, hence, hormone optimization, exercise, nutrition, sleep, and sleep management, your TERT will stay in the nucleus and your telomeres will maintain their length or even get longer.
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So, in a nutshell, anything that supports our mitochondrial health by reducing oxidative stress will also contribute to our telomere health and promote longevity and health as we age.
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Okay, so now I'm drawing a big heart around the mitochondria in the cell and lots of TERT in the nucleus of the cell building longer telomeres.
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In future podcasts, we will explore other ways to reduce oxidative stress in our mitochondria.
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Some of the most notable are glutathione, NAD, and hyperbaric oxygen therapy.
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So you may need to listen to the last two minutes again when you have gotten some good sleep, ate some blueberries, and had a 30-minute brisk walk.
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Understanding your aging process at a cellular level is the key to understanding how you age.
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And therefore, how aging is a modifiable process and not a destiny.
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Thank you for joining this episode of the Dr.
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50 Something Show.
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The content of this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
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Always seek the advice of your physician or other qualified healthcare provider to answer any questions you may have about your personal medical conditions.
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Until next time, get fit, get fabulous, get firm, and take care of yourself.