Internal Renewal:

At Integrative Family Medicine of Bend, we believe in a holistic approach to health and wellness, and that includes addressing the aging process from the inside out. While topical treatments and cosmetic procedures can do wonders for the skin, true anti-aging goes deeper, focusing on optimizing cellular function, hormone balance, and overall systemic health.

As we age, various biological processes can become less efficient, leading to a decline in energy, cognitive function, physical performance, and an increased susceptibility to age-related conditions. The exciting news is that cutting-edge research and clinical advancements are offering powerful interventions that target these internal mechanisms of aging.

Here are five of the most sought-after internal anti-aging treatments that are gaining significant attention for their potential to enhance healthspan and promote a more vibrant, youthful you:

1. NAD+/Niagen Injections and IV Therapy: Fueling Cellular Youth

What it is: Nicotinamide Adenine Dinucleotide (NAD+) is a vital coenzyme found in every cell of your body, playing a crucial role in energy production, DNA repair, and cellular communication. As we age, NAD+ levels naturally decline, contributing to various age-related issues. NAD+ therapy, often administered via intravenous (IV) infusions or intramuscular injections of NAD+ itself or its precursors like Nicotinamide Riboside (NR, sold as Niagen) and Nicotinamide Mononucleotide (NMN), aims to replenish these levels.

How it works: By boosting NAD+ levels, this therapy supports mitochondrial function (the "powerhouses" of your cells), enhances cellular repair processes, and activates sirtuins, a family of proteins associated with longevity and healthy aging.

Potential Benefits: Increased energy and metabolism, improved cognitive function (memory, focus, mood), enhanced muscle recovery and athletic performance, better sleep, and support for overall cellular health and DNA repair.

2. Sermorelin and Other Peptide-Based Therapies: Signaling for Renewal

What they are: Peptides are short chains of amino acids that act as signaling molecules in the body, instructing cells and tissues to perform specific functions. Sermorelin is a synthetic peptide that mimics Growth Hormone-Releasing Hormone (GHRH), stimulating your pituitary gland to naturally produce and release more of your own growth hormone (GH). Other peptides like BPC-157 and Thymosin Alpha-1 are gaining recognition for their regenerative and immune-modulating properties, respectively.

How it works: Sermorelin, unlike synthetic human growth hormone (HGH), encourages your body's natural GH production, leading to more physiological and sustained benefits without the potential downsides of exogenous HGH. Peptides like BPC-157 promote tissue repair and reduce inflammation, while Thymosin Alpha-1 can enhance immune function.

Potential Benefits (Sermorelin): Improved body composition (increased lean muscle, reduced fat), enhanced sleep quality, stronger bones and joints, improved energy levels, and potential benefits for skin and tissue repair.

Potential Benefits (Other Peptides): Accelerated healing from injuries, reduced inflammation, enhanced immune function, and improved gut health, depending on the specific peptide used.

3. Senolytics: Clearing Out "Zombie Cells"

What they are: Senolytics are a class of compounds that selectively target and eliminate senescent cells, often referred to as "zombie cells." These are old, dysfunctional cells that accumulate with age and contribute to chronic inflammation and tissue damage, accelerating the aging process.

How it works: Senolytics work by inducing apoptosis (programmed cell death) in senescent cells, thereby reducing their harmful effects on surrounding healthy tissues. By clearing out these problematic cells, the body can function more efficiently and potentially regenerate more effectively.

Potential Benefits: Reduction in age-related inflammation, improved tissue function, potential for preventing or mitigating age-related diseases like osteoarthritis, metabolic dysfunction, and cardiovascular issues. While research is ongoing, promising results have been seen in animal studies.

Examples of Non-Pharmaceutical Senolytics:

Quercetin: A natural flavonoid found abundantly in many fruits and vegetables, such as apples, onions, berries, and leafy greens. It is one of the most widely studied natural senolytics and has shown promise in preclinical and early human studies for its ability to selectively target and eliminate senescent cells.
Fisetin: Another powerful natural flavonoid, fisetin is found in strawberries, apples, persimmons, and onions. It has gained significant attention as a potent senolytic, demonstrating effectiveness in animal models for extending healthspan and reducing markers of aging.
Curcumin: The active compound found in turmeric, curcumin is known for its anti-inflammatory and antioxidant properties. Emerging research suggests it also possesses senolytic activity, contributing to its potential health benefits in the context of aging.
Resveratrol: A polyphenol found in the skin of red grapes, red wine, and certain berries. While primarily known for its antioxidant properties and its role in activating sirtuins (longevity-associated proteins), studies also indicate its potential senolytic effects.

4. Metformin (Off-Label for Anti-Aging): Targeting Metabolic Pathways

What it is: Metformin is a widely used prescription drug for Type 2 diabetes. However, a growing body of research is exploring its off-label potential as an anti-aging compound.

How it works: Metformin primarily works by modulating metabolic pathways, particularly by activating AMPK (AMP-activated protein kinase) and inhibiting mTOR (mammalian target of rapamycin), both of which are key regulators of cellular energy and longevity. It can also improve insulin sensitivity and reduce chronic inflammation.

Potential Benefits: Improved metabolic health, potential for reducing the risk of age-related diseases such as cardiovascular disease, certain cancers, and neurodegenerative conditions. It may also promote cellular repair and reduce oxidative stress.

5. Rapamycin (Off-Label for Anti-Aging): Inhibiting a Key Aging Pathway

What it is: Rapamycin is an immunosuppressant drug approved for use in organ transplant recipients, but it has garnered significant attention in the anti-aging field due to its ability to extend lifespan in various model organisms.

How it works: Rapamycin specifically inhibits the mTOR pathway, a central regulator of cell growth, metabolism, and aging. By dampening mTOR activity, rapamycin mimics some of the beneficial effects of caloric restriction, leading to improved cellular health, enhanced autophagy (the body's cellular cleanup process), and reduced inflammation.

Potential Benefits: Significant lifespan extension in animal models, potential for improving age-related conditions like cardiovascular disease, neurodegenerative disorders, and even some cancers. Human trials are underway to further investigate its anti-aging effects and safety.

Expanding Your Internal Renewal Journey: 5 More Integrative Therapies

Beyond the initial five, integrative clinics are increasingly incorporating a broader range of therapies to support systemic health and combat aging from within. Here are five additional approaches gaining traction:

6. Bioidentical Hormone Replacement Therapy (BHRT): Restoring Balance

What it is: As we age, hormone levels naturally decline (e.g., estrogen, progesterone, testosterone, DHEA, thyroid hormones). Bioidentical hormones are compounds that are chemically identical to the hormones naturally produced by your body. BHRT involves replenishing these hormones to optimal physiological levels.

How it works: By restoring hormonal balance, BHRT can mitigate many age-related symptoms, supporting cellular function, metabolism, bone density, cognitive sharpness, and overall vitality. It's about optimizing, not just normalizing, levels.

Potential Benefits: Improved energy, mood, sleep, libido, muscle mass, bone density, cognitive function, and reduced hot flashes or other menopausal/andropausal symptoms.

7. Ozone IV Therapy (Major Autohemotherapy): Activating Healing & Detoxification

What it is: Major Autohemotherapy (MAH) is a form of ozone therapy where a small amount of your blood is drawn, mixed with medical-grade ozone gas, and then reinfused into your bloodstream. Ozone ( $O_{3}$ ) is a highly reactive form of oxygen that acts as a powerful signaling molecule.

How it works: When ozone interacts with blood components, it creates beneficial biochemical messengers that stimulate the body's natural healing responses. This includes enhancing oxygen utilization, boosting antioxidant systems, modulating the immune system, and improving circulation. It can also have antimicrobial properties.

Potential Benefits: Enhanced immune function, increased energy production, improved circulation and oxygen delivery to tissues, reduction in oxidative stress and inflammation, and support for detoxification pathways. Often used for chronic infections, fatigue, and autoimmune conditions, its systemic benefits also contribute to anti-aging.

8. Gut Microbiome Optimization: The Foundation of Health

What it is: The gut microbiome, the vast community of microorganisms residing in your digestive tract, plays a profound role in immunity, metabolism, hormone regulation, and even brain health. Imbalances in the gut are increasingly linked to systemic inflammation and accelerated aging.

How it works: Integrative approaches focus on rebalancing the gut microbiome through personalized dietary interventions (e.g., fermented foods, prebiotics), targeted probiotics, and addressing gut permeability ("leaky gut").

Potential Benefits: Reduced systemic inflammation, improved nutrient absorption, stronger immune function, enhanced mood and cognitive clarity, better digestive health, and a positive impact on overall longevity.

9. IV Nutritional Therapy (Beyond NAD+): Targeted Micronutrient Support

What it is: While NAD+ IVs are specific, broader IV nutritional therapies deliver a concentrated blend of vitamins, minerals, amino acids, and antioxidants directly into the bloodstream, bypassing the digestive system for maximum absorption.

How it works: This ensures that cells receive the specific nutrients they need to function optimally, combat oxidative stress, support detoxification pathways, and enhance energy production, which can be crucial for aging individuals with absorption issues or higher nutrient demands.

Potential Benefits: Increased energy, improved immune function, enhanced detoxification, reduced oxidative stress, better hydration, and addressing specific nutrient deficiencies that can contribute to age-related decline. Common blends include Myers' Cocktail, high-dose Vitamin C, and Glutathione pushes.

10. Personalized Lifestyle and Nutrigenomic Interventions: Tailored Anti-Aging

What it is: This involves utilizing advanced testing, such as genetic (nutrigenomic) and comprehensive metabolic profiles, to understand an individual's unique biological predispositions and current cellular function. Based on this, highly personalized lifestyle (diet, exercise, sleep, stress management) and supplement plans are developed.

How it works: Instead of a one-size-fits-all approach, this therapy targets specific pathways identified through testing that are contributing to an individual's aging process (e.g., specific detoxification issues, nutrient deficiencies related to genetic variations, or metabolic inefficiencies).

Potential Benefits: Highly optimized health outcomes, more effective prevention of age-related diseases, tailored dietary and supplement strategies, enhanced cellular resilience, and a deeper understanding of one's unique aging blueprint.

Important Considerations:

It's crucial to remember that while these treatments show significant promise, some are used off-label for anti-aging purposes and should be approached with careful consideration. At Integrative Family Medicine of Bend, we emphasize a personalized and evidence-based approach. Any of these treatments should be considered only after a thorough consultation with a qualified healthcare professional who can assess your individual health needs, discuss potential benefits and risks, and monitor your progress. Our goal is to empower you with the knowledge and tools to optimize your health and vitality for years to come.