THE INSTITUTE

M.D. News

The Hammer Institute for Anti-Aging Medicine

TURNING BACK THE CLOCK—AND TO THE FUTURE OF MEDICINE

In 1999 Dr. Eli Hammer was a successful family physician in Scottsdale with a ten+ year family medicine practice. He was married and just beginning his family, and at 40, was entering the prime of his life. And yet he’d never felt more miserable. His practice wasn’t what he envisioned it would be; in recent years insurance companies had changed, requiring him and the rest of his profession to see more patients in less time—as many as 30-40 patients per day, for just a few minutes each. To complicate matters, his father was dying of colon cancer. He was tired, depressed, and overweight. He started antidepressants. He upped his dose. Nothing seemed able to stop his severe downward spiral.

So when he learned about a doctor from Palm Springs who was looking to open a satellite office in Scottsdale specializing in anti-aging medicine, he went to see him. He had himself evaluated and discovered that his lifestyle of poor eating habits and little exercise had taken its toll. “I was also deficient in every hormone they could measure,” says Hammer. Under the guidance of this doctor, Dr. Hammer began a new health regimen, and the results were life changing. “In two weeks, I felt like a whole new person. In six weeks, I was off my antidepressants. And in twelve weeks, I walked away from my family medicine practice. Just walked out with nothing, no income, nowhere to go. But I knew one thing: that the future of medicine was anti-aging, and I wanted in. Six months prior, I couldn’t even get out of bed. But here I was, full of energy and ready to start a whole new career.”

And that he did. Joined by his former office manager, Hammer founded the Hammer Institute for Anti-Aging Medicine, which has continued to grow steadily since it opened its doors in 2000. Hammer, who studied at University of Pennsylvania and received his medical degree from Rutgers Medical School, practices what he preaches, and credits anti-aging medicine with where he is today, both personally and professionally. “I’m 45 now, and I feel, look, and perform physically, mentally, and sexually as I did twenty years ago; in fact, I’ve surpassed that. It’s amazing.” As for his traditional family practice, he believes the current health care system kept him from delivering the best care he could. “I realized that what I was doing for myself then and my patients simply wasn’t working anymore,” he says. “This is not a health care system; it’s a sick care system. There’s little time spent preventing illnesses from occurring and a lot of time treating the resultant damage with drugs.”

What is Anti-Aging Medicine?

Contrary to what many think, says Hammer, anti-aging medicine is not some marginal form of alternative medicine. “Anti-aging medicine is a bona fide field of medicine just like internal medicine or pediatrics.” Dr. Hammer points out that the American Academy of Anti-Aging Medicine (www.worldhealth.net)  began in 1994 with just 11 physicians and now boasts of over 13,000 members.

Anti-aging Medicine has three goals for each patient, says Hammer: Improve the patient’s current health;  prevent the development of age-related disease;  and improve their quality of life. He says that what often gets missed are multiple markers and evidence of early disease—and as a result, doctors are often unable to step in and prevent it from happening. “Put it this way,” he says. “No one should be surprised by a heart attack. It evolves over decades. We have the power to help people prevent heart attacks, strokes, obesity, Alzheimer’s, but we wait for them to come in with it and then treat them with a drug. It’s backwards.”

But the third point, about improving quality of life, gets perhaps the shortest shrift in modern medicine, which tends to view the aging process as inevitable. Too often, he says, complaints about aches, pains, fatigue, weight gain, loss of libido, or other preventable and reversible conditions get chalked up to just part of getting older. “Chances are your doctor will say, ‘What do you want? You’re not 22 anymore,’” he says. Unlike traditional medicine, anti-aging medicine does not view aging as an inevitable process; it treats aging like a disease, and seeks to understand it, measure it, and help prevent it from taking its toll.

There are four parts to any anti-aging regimen, says Hammer: proper diet, proper exercise, proper supplementation, and hormone restoration therapy. Most physicians do not have adequate time to discuss the first three, he says. They will recommend that you “eat healthy, exercise, and take some vitamins,” which often leaves the patient to interpret that for themselves. Doctors are experts in drugs and illness, an obvious important part of medicine.  Unfortunately, nutrition, supplements, and exercise are seldom taught in medical schools, medical conferences, or discussed by the multiple drug reps visiting daily. “Doctors are doing the best they can, given their overloaded schedules, and many are finding useful information through journals and the Internet.”

As for the last part, hormone restoration therapy, the media and drug companies are a big part of the problem.  Take Premarin, for example—a medication prescribed for women who have undergone a hysterectomy or menopause. “Do you know what Premarin stands for?” asks Hammer. It’s a rhetorical question. “Pregnant Mare’s Urine.” In other words, freeze-dried horse urine. And for twenty years it was the number one drug prescribed in this country. It’s called ‘standard of care.’ But it’s really horse urine. That just about describes the state of medicine these days.”

Hammer calls into question one pivotal study, The World Health Initiative, which was ended prematurely in 2002. The study examined the value and effect of hormones on women—except as Hammer points out, no hormones were used in this study. “People always look at me funny when I say that,” he says, “but it’s true. Hormones are naturally occurring substances in the human body that are released from one organ affecting another organ distally. This study used oral Premarin, or horse estrogens, and Provera, which is progestin, a chemical created in a lab decades ago that has properties said to protect the uterus, but has since been shown to be a toxic chemical in women.” Another point Hammer makes is that the women used in the study were in their late sixties and seventies who already had advanced coronary artery disease. The conclusion Hammer makes, though flip, bears a seed of truth. “They called off the study because women were shown to suffer negative effects from the ‘hormone treatment.’  The media quickly interprets the results to mean that hormones are bad for women and should be discontinued immediately. But truly all we learned from this study was this: If you’re a woman in your seventies, don’t take oral horse urine and toxic chemicals… a brilliant revelation.  Of course, bioidentical estradiol, estriol, progesterone, and testosterone administered transdermally in a 50-year-old woman is a whole different ball game.”

So what about the current controversy over hormone replacement therapy? “Synthetic and natural are not always opposites,” he says. “You can make a synthetic natural hormone—bio-identical to what’s inside you—by building on an ingredient in wild yams to create progesterone, and from there, other natural hormones. But,” he warns, “wild yams on their own will never turn into progesterone, so beware of manufacturers who try to sell you a product with wild yam in it. You can eat it, drink it, bathe in it, and it’s never going to do what these lab-created hormones can do.”

Hormone “restoration” therapy, as he likes to call it, is considered by many to be safe and effective. Use of human growth hormone, a synthesized protein identical to the one produced by the body, can improve the effects of aging on the skin, the immune system, muscles, and bones, and is accomplished through painless (if pricey) daily subcutaneous injections costing between $500-$1000 per month.  He warns patients against bogus products that claim to supply HGH in any other form. “There’s nothing available to date that significantly increases the body’s release of this hormone,” he says. “It has to be injected under your skin for it to work.” How does he know it works? He uses it himself.

The Anti-Aging Evaluation

In the current in-and-out health care system, patients are used to being shuffled through with little more than a few minutes of the doctor’s attention. Not so if you’re going to see Dr. Hammer. This is not a lunch break appointment. Dr. Hammer performs a body fat analysis, vital statistics, and other tests to measure biomarkers of aging to begin the evaluation.  He then proceeds to a lengthy history and complete physical examination (minus breast/pelvic exams). It is then not uncommon for him to spend the next two hours or so sitting side by side with a patient to educate him or her on everything he or she needs to know about hormones— HGH, Estradiol, estriol, progesterone, DHEA, thyroid, testosterone, and so on— as well as the myths, benefits, and side effects of the treatments he uses.  While the benefits are abundant, true side effects are rare.

Then he moves on to diet, which he says, is actually fairly straightforward. “I ask them, ‘If someone dropped a hamster on your front step, what would you feed it? You’d probably go to a pet store and buy hamster food. If you had a fish, you’d feed it fish food. What do you feed a human? Easy. Human food.” The problem, he says, is that as easy as that sounds, we don’t always eat human food. “It’s not until the last 200 years that we introduced things into our diet that we shouldn’t be eating, such as processed flours, partially hydrogenated oils, artificial colors, preservatives, and sweeteners. Our bodies were not designed to function on these things. What we should eat are things that have been plucked from trees, pulled from the ground, and killed from the land and the sea (fruits, vegetables, fish, meat, and good oils). And because we have deviated from that, we have one of the unhealthiest populations in the world.”

Hammer is a proponent of the popular Zone diet created by Dr. Barry Sears, and he says that if you avoid pasta, rice, bread, and milk products, you’ll lose weight and improve your health. He also goes over the glycemic index, which tells you how quickly your glucose and insulin will rise in your blood after consuming a particular food. “What people don’t understand is that the reason this country has so much obesity, diabetes, heart disease, and stroke is because of a poor diet, which increases insulin, and is the primary cause behind all four of those diseases. It’s not cholesterol or fat. It’s primarily excess insulin.”

Nutraceuticals and the Truth About Supplementation

Another key part of his anti-aging plan is nutritional supplementation, which doctors and patients often know little about, says Hammer. While statin drugs fill the commercial breaks during primetime hours with information on which to take and why, there’s no one promoting healthy supplementation. Why? Because no one stands to make money off them, says Hammer. Because nutraceuticals—nutritional supplements including vitamins, minerals, antioxidants, and herbs purchased over the counter—are naturally occurring substances, they cannot be patented, and as a result, Hammer surmises, they don’t get primetime push by drug companies who might otherwise stand to profit from them. In fact, most people don’t even know about them. They take a multi-vitamin, if they think of it—many of which are almost worthless, he claims, leading consumers to falsely believe that they’re getting all they need nutritionally, making the goal of a healthy diet less important. “The words missing next to ‘recommended daily allowance’ is ‘to prevent the disease of deficiency.’ My idea of good health is more than simply not getting scurvy.”

Hammer believes that there are so many powerful and natural ways to supplement a healthy diet which not only keep you functioning at your peak, but can help prevent serious disease. “If women over 35 knew that 400 mg per day of indole-3-carbinol (found naturally in cruciferous vegetables like broccoli and brussels sprouts) could possibly prevent the majority of breast cancer cases, wouldn’t they take it? If people knew that homocysteine, an amino acid in your blood, has actually been proven to be more harmful than cholesterol, and could be lowered by taking vitamins B6, B12, folic acid, and betaine, and could save billions of dollars of medical costs along with thousands of lives each year, wouldn’t they do that?  The equation doesn’t work, maybe its because its difficult to profit significantly from these unpatentable, naturally occurring substances.

In addition to educating his patients on nutraceuticals, he provides them as well. Disappointed with the quality and types of wholesale supplements available to doctors, Hammer decided to make his own. In collaboration with a group of anti-aging physicians, Hammer helped create NutriLinksMD™ (www.NutriLinksMD.com) , a line of nutraceuticals created by physicians for physicians and their patients consisting of hand-picked formulas designed to be used in combination. “We have what I believe are the most comprehensive, highest quality, and most affordable nutraceutical products available. We make it easy for doctors to share them with their patients.  We regularly track clinical literature so we know what has been proven to work. Plus, we’ve made it easy for doctors to match the right formulas to their patients’ needs, without having to know everything about it. We’ve essentially done the legwork for them. Plus, they can use it to supplement their business income while benefiting their patients’ health.

The Future of Anti-Aging Medicine

So why are most physicians uncomfortable with practicing or condoning anti-aging medicine to their patients?  Most say it is because we don’t know what the long-term (20-30yr) consequences will be. That is true, since anti-aging programs are at most 10-15 years in progress. However, the past ten-plus years of study show that anti-aging programs have been associated with less disease, lower morbidity, and better quality of life. “There’s nothing to indicate that something terribly wrong is going to happen,” he says. “I’m willing to take the risk, personally and with my patients, that these programs will continue to yield great results. I mean, the flip side of this is simply not to do anything at all, and succumbing to heart disease, diabetes, cancer, and so on.—and that doesn’t seem to be working.”

Hammer compares critics’ fears of anti-aging medicine to the kind of fear people once had that Columbus would sail off the edge of the earth—a fear, he says, which is just as unfounded. “Everything I do, including the way I administer hormones and supplements, is based on hundreds of studies that support anti-aging medicine and its safety and efficacy.” The future, he says, is in preventing disease, which is infinitely more promising than trying to cure them. But Hammer reminds us that anti-aging is not about striving for eternal youth or immortality. “We’re not claiming longevity; we want to increase your “healthspan,” the time in which you’re well, vital, active, and enjoying life.” If he could go back in time to his former life as a family physician, he would do things a lot differently.

“As doctors, we’re simply not comfortable doing things we’re not trained to do. What I hope is that doctors will keep an open mind about this, and help and encourage patients take steps to prevent illness.  It’s a time-consuming and sometimes expensive endeavor to take the necessary steps to improve and maintain your health, and I commend anyone who chooses to do it.”

Terri Trespicio is a Boston-based writer and associate editor at a national women’s magazine. A regular contributor to M.D. News, she can be reached at ttrespicio@earthlink.net