Frequently Asked Questions


What is Age Management Medicine?

The practice of Age Management Medicine is preventative, integrative and functional medicine all in one.  It is unique because the Provider will go beyond the typical band-aid approach of treating symptoms by drilling down to the root cause.  Treating the cause is often curative, and also stops the symptoms.  We address nutrition, exercise, stress management, and total hormonal balance.  This takes much more time than a conventional hurried 5-10 minute visit with your doctor.  And, it is far more comprehensive and educational.  Our goal is to uncover your metabolic weaknesses. We always measure your levels of inflammation, oxidation (free radical damage), glycation (too much sugar), and poor methylation (toxicity issues and more).  These are precedents to the chronic degenerative diseases of aging:  heart disease, diabetes, hypertension, cancer, dementia, and joint disease. We stabilize vulnerabilities using pharmaceutical grade supplements, and when appropriate, prescribe bioidentical hormones.  This is a new way of treating people and improving their quality of life.  It is also beginning a revolution called Personalized Lifestyle Medicine, which is at the cutting edge of medicine.
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What are bioidentical hormones?

Hormones come from many sources, and not all hormones are the same.  Bioidentical hormones have the exact same molecular structure, atom for atom, as the hormones that your own body makes. Many women use an estrogen cream derived from plants.  A plant estrogen cannot be bioidentical because plant hormones are different from human hormones.  Thankfully, bioidentical hormones can be prescribed for people in need because they are molecular twins, therefore there are no immune system conflicts.  Bioidenticals can work more efficiently in harmony with your body.
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Are Hormones Safe?

Not only are they safe, they are essential to good health. Like everything in your body, balance is the key. Specific hormones are prescribed so that all hormones are in balance and incredibly safe. Unfortunately, a 16-year old study, The Women’s Health Initiative (WHI), gave some very misleading information. It was widely publicized by the media, and is still reverberating today. The study was conducted in such a way that the data was quite misleading. An abundance of more recent studies have totally countered all the erroneous WHI conclusions. The most recent and well done studies are now telling us that women on hormones:
a. Reduce their risk of heart disease 50%. (This is huge and exciting and is far superior to outcome studies of Statin cholesterol drug studies).
b. Reduce the risk of dementia / Alzheimer’s approx 50%.
c. Reduce bone loss, or osteoporosis. (Women who do not take hormone will suffer bone loss to the extent that 30 years down the road 40% will be subject to fracture).
d. Experience relief in estrogen-sensitive tissues like those in the vagina and bladder. Without estrogen, tissues will become thin, dry and inelastic, effecting sexual relationships and bladder function.
e. Reduce colon cancer by 35%. (Colon cancer kills more women than breast cancer).
f. Enjoy thicker and less wrinkled skin while taking estrogen.
g. Reduce their risk of breast cancer by 20% — according to two large studies, though three are needed for medical validity.
Bioidentical hormones are not only safe, they restore a healthier state. There is more risk in not taking the appropriate, bioidentical hormones.
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Do Hormones cause cancer?

No. Recent studies are very reassuring! This is a common fear among many. The Women’s Health Initiative (WHI) study talked about an increase in breast cancer. Upon more studies, we now know that this information was a half-truth. In the WHI, the progestin (fake progesterone) that was prescribed to all study participants was Provera. There are now at least 12 studies on Provera showing that it, itself increases breast cancer. When bioidentical progesterone is used instead of Provera, there is no increase, and possibly a decrease in breast cancer. Estrogen alone has been shown to decrease breast cancer 23% in the same WHI. The risk of colon and uterine cancer is reduced with hormones. With men, low testosterone has been shown to increase your risk of prostate cancer.
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Do hormones cause heart disease?

On the contrary, this is one of the greatest, most significant values of hormones. From multiple studies now, we know that women on estrogen reduce their risk of heart disease by 50%. With hormones, we can cut in half the #1 killer of women (and men). This is truly phenomenal and should be front page headline news. There is nothing that comes close to this. Statin cholesterol drugs are handed out like candy, and they only reduce heart disease 14%. And statins have a long list of negative side effects. So, this is a huge benefit.
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Why should I consider taking hormones?

Hormones are essential to good health. They are great at lowering heart disease, dementia/Alzheimer’s, bone loss, colon cancer, and maintaining bladder and bowel. Hormones are also good for healthy looking skin. Of course hormones will stop all those annoying menopausal symptoms, and elevate your feeling of well-being, increase energy, and aid sleep. In some people, they rid joint aches and pains, and clear foggy brain.
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Are supplements important?

Supplements are necessary because we no longer get what we need from our food. Things like GMOs, farm raised fish, Round Up, corn-fed cattle, lack of crop rotation, using antibiotics and hormones in animals, etc., have made our food incomplete and lacking the nutrients/ingredients to which have been accustomed. These are the nutrients that we need for good health. We measure levels of supplements. We also measure important biomarkers of health like hs-CRP, HgbA1c, homocysteine, Vitamin D3, and B12. By restoring needed nutrient levels with supplements, we encourage the body’s ability to heal itself and repair normal function.
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Is exercise important?

Exercise is fundamental – foundational, even! – to good health. It is good for the heart, brain, bones, weight, energy level, sleep, and the list goes on. Exercise will only happen when you commit to it. No one has the time. It is a matter of making the time, planning it, and following through.
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What exercise is best?

The best exercise is the one that you will do! High Intensity Interval Training (HIIT) is the fastest way to improved fitness. Walking is a good way to start. Walking in a HIIT workout means running as fast as you can until you can’t. Then walk until you can run again. 15 minutes of this will yield great results. Stretching and strength training are also important to be incorporated into your workout session. This is a cornerstone to good health.
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How much exercise?

A good rule of thumb is 150 minutes per week. That can be three sessions of 50 minutes each, or five sessions of 30 minutes each.
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How can I avoid dementia/Alzheimer’s disease?

Exercise reduces dementia risk by as much as 25-50% with 150 minutes of exercise per week. Nutrition with low sugar, high fat, and high protein is helpful. There are many supplements that help as well. Some examples: Fish Oil, Vitamin D3, Curcumin, B Vitamins (B Complex) keep inflammation low, and now there are more and more brain formulations are being produced. Estrogen and testosterone are vitally important. Avoiding gluten and dairy will be good for some. What is good for the heart is also good for the brain, and vice versa.
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Can hormones help me sleep?

Absolutely. Especially progesterone, and melatonin. Sometimes the melatonin dose is way too low. You might gradually increase the dose as high as 20 mg at night. Bioidentical progesterone pills are usually very helpful for most. The balance of hormones and needed supplements can be very beneficial. Having normal cortisol (the stress hormone) is very important.
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What do hormones do for bones and avoiding osteoporosis?

Patients at Age Management M.D. are routinely gaining bone density rather than losing it, like their low-hormone friends. Woman taking estrogen, testosterone, Vitamin D3, and doing weight-bearing exercise are gaining bone density. The drugs for osteoporosis grow the wrong kind of bone. It is easy to maintain bone density by following our formula.
Still have questions? Give us a call! (303) 730-2229

Does Age Management enhance energy?

One of the most gratifying statements that I hear from returning patients is that they have so much more energy, are sleeping better, and simply feel better. Some say the “cloud has lifted” or “I feel like my brain has been windexed.” This occurs with balanced hormones, customized vitamin and mineral supplementation, and metabolic issues properly addressed.
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What is a Carotid Artery Ultrasound and why should I get one?

The Carotid Artery is a large vessel in your neck, feeding the brain. It is easy and painless to ultrasound this vessel, measuring blood flow, looking for plaque, and measuring the thickness of the vessel wall. Our vessels all thicken and become stiffer with age. The advantage of examining the carotid artery is that there is a 90% correlation between plaque in the carotid and plaque in both the coronary arteries, and the brain blood vessels – whereas traditional cholesterol and LDL tests can be very misleading. So, rather than talking about the risk of coronary disease, the non-invasive Carotid Ultrasound tells us exactly the extent of the plaque load. This can be the warning shot across the bow, or it can be very reassuring. I think everyone above the age of 40 for men, and 50 for women, should have this test done. If problems are discovered, there are many counteractive measures we can take to stop plaque formation and even reverse the plaque. These ultrasounds are rarely performed by conventional doctors and PCPs.
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What is a seca test?

The BMI is inaccurate depending on your body type and muscle to fat ratio. The seca test provides a way to measure your body composition with 99% accuracy, compared to DEXA scanning, which is the gold standard, and much more costly. You will stand on what appears to be a large scale with handle bars. A weak electrical current passes through your body – so weak you don’t even feel it. The machine calculates your percent body fat, percent lean body mass (muscle, ligament, bone), and percent water. Healthy people have adequate water and they maintain the majority of it inside the cells. It also calculates phase angle which tells us the health of your cell membrane. And it calculates the number of calories you burn at rest, and with normal exercise. This is a great tool to determine your level of general health.
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Are there new early cancer detection blood tests?

Yes. These are very new. They have found these proteins in the blood stream that only exist if you have a cancer. It allows for cancer detection before it is recognized by other means. The original test was called Oncoblot. The newer test is called CancerSEEK (“Liquid Biopsy”), done by Ivy Gene. It picks up Pancreatic and Ovarian cancer 90-100%; Liver 85-100%; Stomach 60 – 83%; Esophageal 85-80%; Colorectal 60-70%; Lung 50-70%; Breast 30-40%. It is new technology, and not yet covered by insurance. The investment is around $500.
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Does testosterone cause prostate cancer in men?

No. But, this is a long, interesting story.
The short version: Treating men who have a testosterone deficiency with testosterone will not increase prostate cancer.
The long version: In 1944, Dr. Huggins, a Harvard Urology Professor, received the Nobel Prize in Medicine for proving that Testosterone causes prostate cancer. For years, this information has been passed along to new doctors in training. It became dogma. Approximately 10 years ago, another Harvard urologist named Dr. Morgentaler, went into the Harvard Library and looked up Huggins’ original paper. Much to his surprise, he found that Huggins only had 3 study patients. He had data on two men, one of whom had been castrated (the treatment at that time for prostate cancer). So, based on the remaining man, we’ve thought that testosterone was the cause of prostate cancer. Dr. Morgentaler’s practice had evolved into many men with either infertility or erectile dysfunction. He was treating them with testosterone. Dr. Morgentaler’s previous professor was alarmed that Morgentaler was using so much testosterone and advised him that he should be doing prostate biopsies on these men. These were men with a normal PSA test, a normal exam, and low testosterone. This is a very low risk group of men. Dr. Morgentaler biopsied 34 men and found a 14% occult cancer rate. His professor stated that Morgentaler’s sample size was too small and advised that he biopsy another group of 34. He got the same result, a 14% occult cancer rate. Dr. Morgentaler wrote this up into a paper to be submitted to JAMA, the big journal of the AMA. The editor called Morgentaler and said that the study was contrary to what they all believed. Dr. Morgentaler agreed and stated that this was why he was publishing the data. The editor advised that he do another 34 biopsies so that his sample size would exceed 100. This was published in JAMA approximately 5 years ago. The conclusion: Low testosterone increased men’s risk of prostate cancer. And therefore, treating men who have a testosterone deficiency, with testosterone will not increase prostate cancer.
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What are the benefits of hormones for women?

Hormones provide many benefits for women. They lower the risk of the number one killer, heart disease, by 50% (enormous benefit), lower the risk of dementia by approximately 50%, lower the risk of colon cancer by 35%, lower the risk of bone loss substantially, decrease vaginal dryness and bladder problems, maintain vaginal elasticity, increase skin thickness, which decreases skin wrinkles, and possibly reduce the risk of breast cancer – according to two large studies, though three are needed for medical validity. Women sleep better with hormone therapy, and have more energy. The symptoms of menopause disappear. Brain fog is lifted. Sometimes muscle and joint aches and pains depart. Weight loss is possible and feels more obtainable. A general feeling of wellbeing is restored.
Still have questions? Give us a call! (303) 730-2229

What are the benefits of hormones for men?

Hormones benefit men in many ways. Men will have better cognition, focus and concentration. There will be better physical workouts, maintaining greater muscle mass. Libido is increased, as well as sexual performance, though this is multifactorial and complex. Most men have more energy and an enhanced feeling of wellbeing. Testosterone is good for the heart and dilates coronary blood vessels. It builds bone density in men just as it does in women. Testosterone increases as cortisol (the stress hormone) decreases. Lowering cortisol is good because cortisol will tear down muscle, ligament, and bone, and put on fat. Excess cortisol is not our friend. Generally there is improvement in mood and energy, with a decrease in aches, pains, and stiffness.
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What is inflammation? Is it bad?

Inflammation, when acute, is part of the body’s defense system, as it protects us from bacteria, viruses, toxins, and other infections; and seeks to rid us of abnormal cell growth, called cancer. Excessive and chronic inflammation, on the other hand, is the number one problem facing most Americans. Chronic inflammation results from obesity, lack of exercise, toxins, lack of sleep, chronic oxidation, too much sugar, and stress. Over decades, excessive inflammation can result in many adverse symptoms and illnesses, none of which we would choose. Inflammation is associated with diabetes, hypertension, cancer, joint disease, and bone loss (osteoporosis). Chronic inflammation is the number one cause of America’s number one killer, heart disease, and it is a leading cause of the most feared disease, dementia. Your level of inflammation can be measured with a common lab test, CRP. Inflammation can be effectively reduced by a good fish oil, vitamin D3 (properly dosed), and curcumin. Still have questions? Give us a call! (303) 730-2229

What is Methylation? Is it important?

One of the body’s natural detoxification processes is methylation. Methylation is a biochemical process that goes on in the body continuously. One important function is to convert the amino acid, homocysteine, into the amino acid, methionine. Excessive homocysteine is associated with a three-fold increased risk of heart disease, osteoporosis, and/or dementia. Methylation also metabolizes estrogen. Poor methylation can lead to increased amounts of toxic estrogen byproducts (metabolites), which can increase the risk of all the chronic degenerative diseases of aging: heart disease, diabetes, hypertension, cancer, dementia, and joint disease. Your level of methylation can be determined by running a lab test for homocystein. If you are a “poor methylator,” this can be normalized with a special form of Folic acid, called methyl tetrahydrofolate, and some supplements to help methylation.

Thus, methylation is of great importance and many people’s bodies struggle to do this efficiently. Up to 50% of people do not methylate effectively, but it is important to know * if you are a “poor methylator,” corrective supplements can be taken to change the trajectory of your health. Still have questions? Give us a call! (303) 730-2229

What is Glycation? How do I control that?

Sugar overload is one of the most severe health problems in America, and it is becoming a worldwide problem. Too much sugar in the blood is associated with diabetes, and sugar overload is associated with “glycation.” Glycation is the pathological process of a sugar molecule attaching to a protein. Hemoglobin is a protein. When sugar attaches to hemoglobin, it results in glycolated hemoglobin ~ which accelerates aging and can be a very serious health problem.

Even before diabetes is recognized, glycation is going on. Some glycation can be normal in the body. However, excess glycation creates problems. Proteins are meant to be slippery, to slide between cells and go into cells and organs. When a glucose molecule attaches to proteins in the body, the proteins become too large and sticky to function optimally. Excessive glycation leads to plaque, fat, and the maladies of diabetes; including blindness, peripheral neuropathy, kidney disease and failure, heart disease and dementia.

Your level of glycation can be measured by doing a HgbA1c blood test. This tells us the three-month average level of glucose in the blood stream. The best way to lower blood sugar and glycation, is to exercise. Also avoid the very sugary things like soda and fruit juice. Don’t forget that the starches, potato, pasta, bread, and rice, all turn into sugar as well. The low fat craze is finally over. Today, we want to eat low carb, high protein, and high fat. There are good fats and bad fats. Still have questions? Give us a call! (303) 730-2229

What is oxidation? Need I worry about this?

The biological process of energy production releases free radicals in the body. Free radicals cause oxidation. The clearest way to understand what this means is a statement by Ray D. Strand, MD., author of What Your Doctor Doesn’t Know About Nutritional Medicine: “The same process that turns a cut apple brown or rusts metal,” he wrote, “ is causing you to rust inside.” This why we are to take antioxidants. We don’t want to be rusting inside!

Free radicals are normal molecules in the body, which have a dangerous affinity of binding to our blood vessel walls, cell membranes, organs, brain, DNA, and mitochondrial DNA. Within the mitochondria, energy is manufactured inside our cells utilizing sugar or fat, combining with oxygen. These harmful bio-chemicals that the body manufactures day in and day out ~ all day, every day ~ * contribute to and initiate common diseases like heart disease and cancer, the number 1 & 2 killers of Americans. An overabundance of free radicals over time, results in disease, dementia, loss of energy, and ill health.

Free radicals are usually balanced by the natural processes and systems of the body. As we age, however, these protective processes can become overwhelmed and our body produces fewer antioxidants to balance out the free radicals. Menopause (women) and andropause (men) are associated with increased free radical damage, because these conditions are associated with loss of hormones, and hormones are antioxidants. There are many, many antioxidants whose manufacturer is often times presenting misleading information. Some of the least expensive antioxidants are vitamins C and E. Vitamin C goes to the water parts of the body, and vitamin E goes to the fatty parts of the body. Another possibility is to take NAC (N Acetyl Cysteine). It turns into the “master antioxidant” which is very good. Still have questions? Give us a call! (303) 730-2229

Age Management MD
7200 South Alton Way, Ste A100
Centennial, CO 80112
Phone: 303-214-1351
Fax: 303-243-3911
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