Are Supplements Worth It?
An interview with Dr. Ward Dean (September 2000)
Dr. Ward Dean graduated from the U.S. Military Academy at West Point. A former infantry officer with combat service advising Vietnamese Rangers on the Cambodian border, he taught at the U.S. Army Mountain Ranger School in north Georgia. After graduating from Han Yang University College of Medicine in Seoul, Korea, Dr. Dean spent seven years as an Army Flight Surgeon and Diving Medical Officer, including three years as a member of the Delta Force, America’s top-secret counter-terrorist unit. He practised life extension medicine privately in southern California for five years, then transferred from the National Guard into the Navy as a Flight Surgeon in Pensacola, Florida. In 1996 he retired as a Commander.
A specialist in anti-aging and life extension medicine, Dr. Dean served on the founding Board of Directors of the American Academy of Anti-Aging Medicine and as the group’s first vice-president. He has written extensively on the biology of aging and has published nearly 100 articles and reviews in professional journals. He is the author of Biological Aging Measurement—Clinical Applications, and is co-author of the best sellers, Smart Drugs & Nutrients (with John Morgenthaler), Smart Drugs II—The Next Generation (with John Morgenthaler and Steven Fowkes), GHB—The Natural Mood Enhancer (with Messrs. Morgenthaler and Fowkes), and the critically-acclaimed Neuroendocrine Theory of Aging and Degenerative Disease (with Professor Vladimir Dilman).
Dr. Dean is also founder and Medical Director of the Center for Bio-Gerontology in Pensacola, Florida. He continues to study the causes of aging, and works to develop ways to measure and retard the aging process, with the goal of restoring people to more youthful biological ages. Since 1996, Dr. Dean has also been the Director of Research and Development for Vitamin Research Products in Carson City, Nevada. Recognised as an expert witness on issues of safety, toxicology, and clinical uses of dietary supplements, he has testified for the defense in a number of dietary supplement-related criminal cases.
I met Dr. Ward Dean about six years ago at a conference in Atlanta, and was immediately fascinated. Much of his practice aims at studying the causes of aging, and attempting to slow or even reverse the effects of aging, a topic that interests every one of us.
In spite of the official propaganda that Americans now are healthier than ever, most of us remember grandparents or even grandparents who seemed to retain physical and mental vigour even into their eighties and nineties. Today, who doesn’t fear spending his last days in a diaper, staring vacantly out the window? What accounts for the difference in our resistance to the ravages of aging?
I asked Dr. Dean what role pollutants play in advancing aging. In his own locale, Pensacola, he opposed fluoridation of the water supply, on grounds of health and liberty. It amounts to forced medication of the population. In areas where drinking water contains high naturally occurring fluoride levels people suffer from accelerated aging.
Add to fluoridation our ubiquitous exposure to aluminum. We cook in it, drink from it, and slather it under our armpits (it’s in every antiperspirant). Canadian researchers in particular, Dr. Dean remarked, suspect aluminum as a chief culprit in Alzheimer’s disease.
Among pollutants Dr. Dean stressed the danger of mercury amalgam dental fillings. While many people tolerate them well, others show extreme sensitivity and react in a multitude of ways that appear as degenerative diseases. “Biological” dentists will remove and replace them with non-metallic fillings. Chelation combined with taking DMSA (dimethylsuccinic acid) is the treatment of choice to remove mercury from the body after the fillings are replaced. DMSA—which used to be available only with a prescription at a cost of 4 or 5 dollars a pill—is now available over the counter as a supplement, at a fraction of that cost.
I asked Dr. Dean about artificial sweeteners. As little as he favours feeding his children sugar, he would much prefer they drink sugared beverages than those laced with some artificial sweeteners. I had to laugh when he observed that no one had ever lost a pound drinking diet drinks. Some people are extremely sensitive to them, too, as they are to food dyes.
The way our animal foods are raised create additional nutritional problems. Crowding chickens into small cages increases their levels of cortisol, which the body produces in reaction to stress, especially the stress of overcrowding. Cortisol makes their meat softer and less palatable. Factory raised eggs, too, lack colour so the layers must be fed additives to colour the yolks. Compare yard-raised chickens or eggs to pen-raised, and you’ll see the difference immediately.
If these all contribute to feebleness in aging, what is the solution? I wanted to interview Dr. Dean because he studies and treats aging, and because he formulates supplements for Vitamin Research Products. Over the years I have read many of his articles in Vitamin Research’s outstanding newsletter, where he does an excellent job of making complex biological chemistry understandable.
Dr. Dean kindly made time for this interview on September 28, 2000. We pick up where we began discussing supplementation.
Moneychanger: I pass through cycles of ambiguity towards supplements. Many times I find myself taking handfuls (seems like bowlfuls) of supplements, and then I just drop them all. Very few of them leave me feeling any different. What do you think about supplementation?
Dean: I’m a big believer in supplements. Most of us are far removed from natural food, many soils on which the foods are grown are depleted, and our bodies have to overcome a number of toxins and additives in food. Even though we may not actually feel anything from the supplements we’re taking, we clearly know, based on scientific studies on both humans and animals, that in the long run they’re helping us. You may not feel any different today than you did yesterday or last month or last year, but when you attend a high school reunion (I just came back from my fortieth), you can see how the deficiencies and abuses to our bodies really add up over time. The difference between people who had been taking care of themselves and those who were not doing anything positive for their bodies and their health really stood out.
Take one example. Homocysteine [ho mo CIS teen] has been recognised as a cardiovascular risk factor. By taking supplemental B-6, B-12, folic acid, and trimethylglycine [tri meth ull GLY ceen], we can reverse homocystein levels and reduce cardiovascular risk.
Another substance is turmeric or curcumin, a very powerful anti-oxidant. Turmeric will also drop fibrinogen levels like a rock. Fibrinogen is another cardiovascular risk factor, and one of the most significant risk factors for atherosclerosis and strokes, but doctors don’t talk about it much. Why not? Because no known drug will lower fibrinogen levels. However, turmeric—a common herb used in Indian cooking and available as a dietary supplement—will, as I said, drop fibrinogen levels like a rock and dramatically reduce cardiovascular risk, even in the face of elevated cholesterol.
Moneychanger: This is just the common spice?
Dean: Exactly. In fact, in clinical studies, those with low cholesterol and high fibrinogen had a greater risk for heart attacks and strokes than those with low fibrinogen and high cholesterol. And it takes less than 50 milligrams [mg] daily to obtain these fibrinogen-lowering benefits.
Moneychanger: Everybody fears the Big Three: heart attack, cancer, and senile dementia (or Alzheimer’s). Aren’t all of those related somehow to lowered hormone levels in older people?
Dean: Yes, and we can now do something naturally about these adverse changes. Since the passage of the Dietary Supplement Act in 1994, substances that previously fell within the domain of the pharmaceutical companies have become available to dietary supplement companies. A number of natural hormones are now available as dietary supplements, including melatonin, pregnenolone, DHEA, progesterone creams, and some companies are even starting to offer natural thyroid. [mel uh TONE in; preg NEN alone; pro JES ter own]
The pineal [PIE nee ul] gland produces the hormone, melatonin. That is the body’s central regulator of biorhythms and also of most hormones. Melatonin levels start dropping in the late 20s and early 30s. That’s one reason for disordered sleep as we get older. Melatonin levels in older people virtually don’t exist, so a lot of older people have trouble sleeping at night, get tired during the day, and they’re forgetful and confused. Many of these symptoms can be reversed if we can just make sure to get adequate sleep at night. Melatonin is totally non-toxic, and has been used intravenously in doses as high as 200 mg.
Moneychanger: Whoa! The normal dose is one to fifteen milligrams!
Dean: Exactly, so people who are concerned that they’re taking too much can relax, because it is absolutely non-toxic in any dose. By restoring melatonin levels back to those of healthy young adults, people can sleep more soundly and stay alert during the day. In experimental animals, studies have shown that supplemental melatonin in the drinking water at night actually increases lifespan and prevents a number of degenerative diseases. So melatonin is one supplement that people actually do feel. They sleep more soundly.
I recommend starting with a dose anywhere from one to three milligrams on an empty stomach about an hour or so before bedtime. Take enough to help you go to sleep and stay asleep all night, without feeling drugged in the morning.
One caveat: a very small percentage of people have an idiosyncratic reaction to melatonin. That means, they have an unexplained adverse reaction—opposite of what should be expected. In these folks, melatonin actually makes them hyper and jittery. Those people, unfortunately, can’t take melatonin—but for most people, it’s an extremely safe, beneficial hormone.
Moneychanger: You can buy that at any drugstore or health food store?
Dean: Yes, over the counter.
The hormone cascade starts with pregnenolone. Pregnenolone was really popularized following a recent review article by Dr. Eugene Roberts with the City of Hope in Duarte, California. Dr. Roberts had actually been researching pregnenolone back in the 1950s for a pharmaceutical company. He was getting tremendous results in improving cognitive performance of experimental animals and also in treating a number of experimental inflammatory conditions. The scientists would induce arthritis, and then use pregnenolone as an anti-inflammatory substance. It’s totally non-toxic. In humans, they were using doses as high as 500 - 600 milligrams daily, and were getting some interesting results. However, the company president came through one day and asked Dr. Roberts what he was working on. When Roberts told him, the president said, “Look, this is a natural product. We’re not going to make any money on it. We’ve got prednisone and prednisilone, triamcinolone, and all these synthetics. Forget about this, and let’s get on with it.”
So he shelved his pregnenolone research. But now he’s getting up in years himself. Recently he started getting creaky joints so he dusted off his research on pregnenolone and wrote this beautiful review article about it. Now, a number of supplement companies are offering pregnenolone. I recommend dosages anywhere from 10 milligrams once daily in the morning, up to 100 milligrams. This has both anti-inflammatory and cognitive enhancing effects. In the body, pregnenolone also converts into DHEA and progesterone. It’s beneficial for both men and women.
Going a little farther down the hormone cascade, you asked about DHEA. Like melatonin and pregnenolone, DHEA drops dramatically with age. As the levels drop there also seems to be increased incidence of a number of diseases, including diabetes, atherosclerosis, and cancer. Although DHEA is not a miracle rejuvenating hormone, it does have a number of anti-aging properties, which help to prevent a number of aging-related diseases. One of DHEA’s significant properties is its ability to restore insulin sensitivity.
As we get older, we all tend to become diabetic due to “insulin resistance.” As the tissues become resistant to insulin’s effects, even more insulin is produced. Insulin, although essential for life, is also an aging accelerator.
We want to keep our insulin levels at the minimum required for health. We do that by restoring insulin receptor sensitivity. One way to do this is to restrict our carbohydrate consumption. Carbohydrate consumption just accelerates the insulin resistance.
DHEA seems to restore insulin sensitivity and helps both diabetics and non-diabetics. It also helps to stimulate immunity, and is also a cognitive enhancing hormone.
I recommend virtually everybody over the age of 30 to supplement with DHEA in doses from 10 to 50 milligrams. Women tend to convert DHEA very efficiently into testosterone. Consequently excess DHEA may cause male symptoms such as facial hair or deepening voice. They just have to reduce the dose down to five to 25 milligrams a day, but it’s very easy to adjust. If they see the adverse effect, just reduce the dose.
Men tend to be able to take a little bit more. I usually start them at 25 - 50 milligrams. In some disease conditions women can take much higher doses. For example, in lupus doses from 75 - 100 milligrams have helped women without the excess conversion to testosterone.
Now the question is, if pregnenolone converts to DHEA, then do we need to take DHEA? The ultimate steroid in the body is cholesterol. That’s where all the steroid hormones originate. If the answer to hormone supplementation were to just take the precursors, then we would only need to take more cholesterol. [laughing] That’s obviously not the answer. Why not? Because the problem lies with the enzymes in our body that convert these hormones to other hormones. So it works better to take moderate doses of a variety of these hormones.
Moneychanger: Should they all have their beneficial effects on degenerative diseases, such as arthritis, loss of mental acuity . . .
Dean: . . . immune suppression, hypertension, exactly. Many physicians have cautioned those with prostate problems (both BPH, [benign prostrate hypertrophy], or prostate cancer] against taking DHEA.
However, who has prostate problems? Is it young people with high DHEA and testosterone levels, or older men with low levels? Clearly, it’s the older men. If high levels of DHEA and testosterone were causing prostate problems, then 20 year olds would all have prostate problems. Looking at the literature critically, we find that DHEA and testosterone both actually help those with prostate problems.
Moneychanger: DHEA stands for?
Moneychanger: What about another one that sounds similar, DMAE?
Dean: DMAE is really an interesting substance that gets us into another whole area of cognitive enhancement. Dimethylaminoethanol is actually found in high concentrations in fish and sardines, so Grandma was probably right when she said that fish is a brain food.
Back in the 1970s DMAE used to be considered a drug, when it was used for a condition called “minimal brain dysfunction,” today known as “attention deficit disorder” (ADD). DMAE increases levels of acetylcholine in the brain. Acetylcholine is the neurotransmitter, the brain chemical that decreases in Alzheimer’s disease. So DMAE may have some benefit in Alzheimer’s and other cognitive impairing illnesses.
Acetylcholine is sort of a feel-good neurotransmitter that enhances our memory formation. DMAE also inhibits the accumulation of lipofuscin. Liposfuscin is a pigment that begins accumulating on the backs of the hands, of many people in their 50s and 60s. These accumulations are known as “aging spots.” But lipofuscin also accumulates in other cells in the body—the brain, heart, liver, and kidneys. DMAE can actually flush that pigment from the body, like an intracellular garbage collector. Over a period of six to eight months, many people on DMAE have watched their aging spots virtually disappear.
I usually recommend doses from 100 milligrams a day up to 500 milligrams. Too much DMAE can cause excessive muscle tension, a little bit of jaw tightness, tightness in the back of the neck, or maybe a headache. These side effects go away with a reduction in dosage. DMAE is a mild cerebral stimulant, and has been used as a cognitive enhancer for years. It’s probably one of the most beneficial and inexpensive dietary supplements that people can take.
Moneychanger: Do you find any other supplements particularly valuable?
Dean: Absolutely. One is a fairly new one, vinpocitine [vin POH suh teen], extracted from the periwinkle plant. I usually recommend it in doses of 10 milligrams three to four times a day. Vinpocitine enhances brain cell metabolism and glucose uptake. It’s one of the few things that has been used to improve vision, hearing, and a condition known as labyrinthitis. This is a disease of the inner ear that results in a sudden onset of vertigo accompanied by nausea and vomiting. There’s really no drug that effectively treats this condition. ENT doctors will prescribe antihistamines for it, but they only make people sleepy. So in addition to enhancing cognition, this is the substance of choice for anyone suffering from labyrinthitis or Mennier’s disease.
A lot of different things may cause cognitive problems. One could be impaired blood supply. That’s why we use chelation therapy, and the herb gingko biloba, which improves blood supply to the brain. We use vinpocitine to enhance brain cell metabolism. We can use DMAE to flush the lipofuscin out and increase acetylcholine levels.
There’s another substance called phosphatidylserine [phos FATE uh dill sear een], which maintains membrane fluidity and restores receptor sensitivity in the brain cells. Those who have been following the instalments on the neuro-endocrine theory of aging in our newsletter from Vitamin Research understand the importance of restoring receptor sensitivity in the brain. This may be a real key to the aging process. Phosphatidylserine has been used to treat a number of dementing illnesses, as well as to improve cognitive performance in normal adults. I usually recommend 300 milligrams a day to start, and after two to three weeks, the dosage can be reduced to 200 milligrams daily, still retaining the same benefit.
Another supplement used as a “smart substance” is acetyl-L-carnitine [uh SEAT ul ell CAR nuh teen]. This is a form of L-carnitine that has been used primarily in Italy for Alzheimer’s and other dementing illnesses. It improved cognitive performance in normal people, helps to normalise lipid [fat] metabolism and acts as a mitochondrial resuscitant. The mitochondria are the powerhouses of the cell responsible for producing all cellular energy. Acetyl-L-carnitine actually restores several biochemical parameters of old mitochondria to scores characteristics of youthful adults.
I usually recommend anywhere from 1,500 to 3,000 milligrams a day. It used to be fairly expensive, but the price is coming down so now it’s more affordable. But if price is a concern, I recommend plain old L-carnitine, which may have all the benefits of acetyl-L-carnitine at a lower cost.
There are some drugs that can be used also to improve cognitive performance. The one that I recommend the most is piracetam [purr ASS uh tam]. This is the prototype of a whole class of what we call nootropics [no oh TROPE ix]. All the nootropics are fairly similar, extremely safe, and highly beneficial. The nootropics have the unique characteristic of facilitating communication between the right and left hemispheres of the brain. We all seem to be dominated by the left or the right half of the brain, and the noötropics seem to cause the left & right sides of the brains to communicate more efficiently.
Moneychanger: Do you need a prescription for piracetam?
Dean: Actually, a prescription won’t even do you any good because it’s not available in the US. I usually recommend people go to International Anti-aging Systems (IAS) in Great Britain. You can legally order drugs from IAS even though the drugs are not approved in this country. It’s legal to import them without a prescription. Call VRP (800-877-2447) for contact information for IAS.
There’s one more substance which I think is probably the best anti-aging substance currently available. It is glucophage or metformin. Glucophage is an anti-diabetic drug that restores insulin sensitivity. As I mentioned, we all tend to become diabetic as we get older. If elderly people were judged by the same criteria for diabetes that are used for young people, a very high percentage of our older population would be diagnosed with diabetes. But since the HMOs and the insurance companies obviously don’t want to provide that much treatment, they move the goalposts and change the criteria.
Glucophage actually restores insulin sensitivity to that of a much younger person. As a result, we have less cross-linking of our tissues, which causes our tissues to lose flexibility and dry out like old windshield wiper blades. Glucophage is also one of the most effective weight-loss substances there is. Why? Because insulin drives sugar into the cells where it becomes fat. We don’t become fat because we eat fat, we become fat because we eat sugar. Sugar drives our insulin up, and the insulin drives the sugar into the cells, where it’s converted into fat. So to lose weight, we need to eat fewer carbohydrates and restore our insulin mechanism back to a more youthful level. We can do that with this drug, metformin. It’s available by prescription in this country, but is fairly expensive. Unless people have a pharmacy plan, I usually recommend that they go to IAS for it, where it costs 40-50¢ a pill.
Moneychanger: You can order it from there and import it into the country?
Dean: Or you can go to Mexico and buy it there at a fraction of the US cost.
Moneychanger: We’ve talked about supplementation. That’s sort of the easy way to fix things. What about exercise?
Dean: Exercise is the best anti-aging pill there is. I recommend that everybody should take a daily walk around the block, as a minimum. I have seen wonders in people who have done just that.
Moneychanger: Nothing more than just walking around the block?
Dean: Exactly. That dramatically reduces diabetics’ blood sugar levels and insulin requirement. It’s amazing what just a little bit of moderate exercise accomplishes. A lot of people think they don’t have time to exercise, or it takes too big a commitment. Well, everyone can walk around the block, and it’s amazing how much benefit that confers, in dropping insulin, dropping blood sugar, getting some oxygen into the system, and improving your outlook on life. It also helps to keep the cortisol down.
Moneychanger: Does it help to take the stairs instead of the elevator?
Dean: Absolutely, absolutely.
Moneychanger: That sounds almost silly, but if you do enough of that during the day it means quite a bit more exercise.
Dean: What’s one of the most popular exercise machines in the gym? The Stairmaster.
Moneychanger: What about the loss of sexual function as we grow older? Viagra® has been an incredible success, even to the extent of enticing a former presidential candidate to do a commercial for Viagra. Do any non-prescription, non-pharmaceutical supplements have similar effects?
Dean: In fact I’ve designed a formula for that. It’s a combination of arginine [ARR jin neen], one to three grams; choline [KOH leen], one to three grams; vitamin B-5 (pantothenic acid), 500 milligrams. Taken several hours in advance, this combination has almost the same nitric oxide producing effect as Viagra.
Other supplements that also work in many people, and can be taken in conjunction with the above formula, include an herb, tribulus terrestris, about 500 milligrams. The most potent versions come from Bulgaria. I believe tribulus acts to restore the brain’s hypothalamic sensitivity to testosterone. In other words, it makes the available testosterone work more efficiently. Yohimbe, also available as an herb, is the only other drug listed in the Physician’s Desk Reference as a male aphrodisiac. The dose on that is five to ten milligrams three times a day.
Another aphrodesiac herb for men is the herb muira puama, which has also been extensively studied. To sum up, that’s a combination of tribulus, yohimbe, and muira puama, arginine, choline, and vitamin B-5. This combination has reportedly worked wonders in many cases.
Moneychanger: Does that work for men only, or for women, too?
Dean: Some women have responded positively to tribulus and to yohimbe as well. However, they seem to do better with the South Sea Island herb, Kava Kava.
Moneychanger: Of the many publications I get, I really enjoy reading the newsletter from your supplement company, Vitamin Research Products, and I’ve really learned a lot from it. How could my readers subscribe?
Dean: They can call (800) 877-2447 or they can visit the web site, vrp.com. We have all of the articles from back issues of the newsletter on the website. We cover most of the things we’ve talked about today, including hypothyroidism, ADD, perimenopause, postmenopause, osteoporosis, and the importance of magnesium for a variety of conditions.
Magnesium is one of the most under-appreciated and least expensive supplements that people can take. Every TV station bombards us with exhortations to take calcium. However, our problem isn’t calcium deficiency but improper calcium utilisation.
As we get older, calcium deposits develop in our joints, called arthritis. Calcium deposited in our arteries is called atherosclerosis. In our brain, calcium deposits calcify the pineal gland, impairing production of melatonin. I think that people actually lack magnesium more than calcium. They’re putting calcium in orange juice, milk and dairy products, breakfast cereals—but we don’t see much about magnesium.
Magnesium deficiency results in hypertension and contributes to ADD in children. It may cause asthma and allergies. Many of these conditions can be reversed by adequate magnesium supplementation. Magnesium is a smooth-muscle relaxant, so it helps in hypertension and asthma. When magnesium is lacking, calcium is not adequately absorbed. Likewise, an excess of calcium impairs magnesium absorption.
One of the real keys to osteoporosis and other conditions is to take adequate magnesium. You can adjust your dose by taking it just up to “bowel tolerance.” An excess of magnesium will result in stomach upset and diarrhea, so we take the dose up to that point, and then drop it back to where we feel comfortable. That assures us we’re getting adequate magnesium to help maintain dense bones.
Moneychanger: You have a connection with Vitamin Research Products?
Dean: Right. I’m Director of Research and Development.
Moneychanger: Some people would criticise that and complain that as a doctor you shouldn’t have a commercial interest in these preparations. What do you think about that?
Dean: Why shouldn’t I have a commercial interest? As a vitamin junkie myself, I have a personal as well as a financial interest in producing quality nutritional supplements. We also put out a lot of cutting edge information in our newsletter. I assume that a lot of the readers may buy products from their local discount store based on information we provide. Our articles in our newsletter are backed up by scientific references. People can check on the accuracy of what I write. I take supplements because I believe in them. Of course, I still pull out the prescription pad occasionally. In fact I’ve talked about some drugs today that your readers can get a prescription for.
But if they don’t have a doctor, they can also go to IAS or some other overseas pharmacy. I don’t think there’s any real conflict with my recommendations.
Moneychanger: Thank you very, very much for your time and courtesy, Dr. Dean.
WARNING & DISCLAIMER: By publishing this material, neither The Moneychanger nor the author/interviewee recommends or endorses any specific treatment or therapy for any physical condition or disease. Neither The Moneychanger nor the author/interviewee guarantees or warrants any results from any treatment discussed, nor assumes any express or implied liability for any use to which the reader puts this information. By this interview, the interviewee does not prescribe any treatment whatsoever for anyone who is not his patient. All the information here is offered for information purposes only, subject to the reader’s own research, prudence, and judgment.