Though age often confers wisdom, we all want to feel youthful in mind and body. The quest to keep age-related physical and cognitive changes at bay has created a huge industry that includes hormone therapies that promise vigor and dewy skin, intravenous vitamin cocktails for energy, and drugs to boost cognition. ¶ While the prospect of slowing the clock is tantalizing, evidence suggests that there’s no anti-aging magic bullet yet. Consumer Reports helps you put common anti-aging practices in perspective.
Proponents say that drugs known in some circles as “smart” — some of them prescription-only, others sold over the counter or online — can improve memory, focus and attention.
One group of these drugs, collectively called nootropics, includes supplements containing such ingredients as caffeine, fish oil, herbals and piracetam, which isn’t approved in the United States but is prescribed in the United Kingdom for movement disorders.
The other main group of smart drugs includes the ADHD prescription medications methylphenidate (Ritalin and generic), and amphetamine and dexamphetamine (Adderall and generic); the narcolepsy and sleep-apnea drug modafinil (Provigil and generic); and the Alzheimer’s drug donepezil (Aricept and generic).
Reality check: There’s limited evidence that nootropics improve cognition. And some may cause side effects or interact with medicine you’re already taking. In addition, what’s on a container’s label might not reflect what’s inside unless the supplement has been verified by a group such as the U.S. Pharmacopeia.
It’s legal for doctors to prescribe smart drugs for an off-label use (one not approved by the Food and Drug Administration). But they don’t help enhance cognition in everyone and might worsen it in some, according to the American Academy of Neurology. And there are no long-term studies on how those drugs may affect healthy people, says Orly Avitzur, a neurologist and medical adviser to Consumer Reports.
Ads trumpet the lethargy and lost libido that can accompany low testosterone levels in men. A daily dose of the hormone, the ads suggest, will take care of “low T,” boosting your sex drive and helping you reclaim your more energetic self.
Reality check: Testosterone treatments are approved by the Food and Drug Administration only for men with diagnosed hypogonadism, a failure to produce enough testosterone because of disorders of the testicles, pituitary gland or brain. The American Association of Clinical Endocrinologists and the Endocrine Society advise against prescribing them without a confirmed deficiency.
That’s because the therapy has risks. The FDA recently required prescription testosterone (including AndroGel, Aveed, Axiron, Fortesta and Testim) to carry a warning about the possible higher risk of heart attack and stroke. In June 2014, the agency began to require a warning about blood-clot risks. Other research suggests that the treatment might encourage the growth of existing prostate cancer, boost the risk of sleep apnea and cause an enlarged prostate, enlarged or painful breasts, swollen feet and a lower sperm count.
HGH fuels growth in children and adolescents, and helps maintain tissue and organs. Some say that injections of it can increase muscle mass, reduce body fat, aid skin elasticity and slow bone loss.
Reality check: The FDA has approved HGH only for three adult conditions, including growth-hormone deficiency caused by pituitary damage. For anyone else, taking it is a risky proposition. HGH can cause carpal tunnel syndrome, swelling, joint pain, organ enlargement and Type 2 diabetes. It may also increase cancer risk. It’s illegal for doctors to write prescriptions for — or to distribute — HGH for anti-aging effects. Any benefits may be modest and temporary.
Prescription hormone therapy (HT) is generally considered to be a reasonable short-term solution for hot flashes and other menopause symptoms. But some people recommend long-term use of compounded bioidentical hormones to help women look and feel younger, says Margery Gass, executive director of the North American Menopause Society. (She says that bioidentical hormones are chemically the same as hormones that your body produces. Compounded drugs are mixed in certain pharmacies.) And some claim that compounded bioidenticals are superior to traditional hormone therapy because they’re customized.
Reality check: Compounded bioidentical hormones aren’t approved by the FDA (though some traditional hormone therapies have FDA-approved bioidentical hormones), so there’s no guarantee that they contain safe levels of hormones. Compounded bioidenticals carry the same risks as traditional hormone therapy: an increased likelihood of blood clots, breast cancer, heart disease and stroke. And those risks grow with long-term use. Estriol, a type of estrogen, is found in some compounded formulations, but its safety and effectiveness aren’t known.
A slew of supplements are alleged to stave off aspects of aging. Widely sold ones include DHEA, which can, in theory, modestly raise levels of testosterone and estrogen; coenzyme Q10 (CoQ10), a vitamin-like substance that helps provide energy to cells; and the sleep-regulating hormone melatonin. Proponents claim that high doses can help ease depression, enhance sexual function, and more.
Reality check: There’s little evidence in humans that supplements have anti-aging properties, and you can’t be sure that what’s listed on labels is what’s in the container. As with all supplements, the ones mentioned above can interact with drugs you take, and they haven’t gone through the FDA approval process required for prescription medications. Also, some supplements pose health hazards, especially at the high doses that proponents may recommend.
A hot trend among celebrities, these cocktails send higher-than-normal levels of nutrients directly into your bloodstream.
Reality check: Nutrient infusions won’t extend your life and may in fact harm you. And they’re pricey: Consumer Reports found practices charging $75 to about $150 for one. Instead, stick with a well-balanced diet.
For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.