Age Reversal: Understanding the Epigenetic Clock
Can age really be reversed?
We hear about “anti-aging” therapies, “longevity medicine”, and “wellness” as opposed to traditional health care. Case study included in this story.
But can the clock be turned back? First we have to decide what clock we are talking about. Since chronological age cannot be reversed without a time machine, what clock can we use to measure biological or physiological age?
The Epigenetic Clock:
This is currently the best way to measure age (besides years). The epigenetic clock measures methylation changes that occur on our DNA as we age. This starts before we are born and the clock ticks (in terms of methylation changes of the DNA) throughout our life.
Steve Horvath first described the epigenetic clock about a decade ago, and since that time, the clock has been validated as a way to predict an individual’s internal, or genetic age.
There are other ways to measure a person’s internal age, but organ specific. For example, a CIMT (Carotid Intima Medica test) can measure a person’s cardiac age, meaning the individual’s vasculature relative to their age group. We use CIMT to predict future heart attacks and strokes, as well as to confirm that intervention to avoid heart attack and stroke are working.
An MRI can be used to exam the brain and compare it to others in the same age group. Are you younger or older (your brain) than your peers? What is your brain age? These are important data points to be aware of if you want to live a long healthy life with a healthy brain. We can intervene on early brain deterioration, but advanced Alzheimer’s is hard to manage or alter.
Back to the epigenetic clock. This requires a tissue sample (say blood or urine) and a specialized laboratory such as https://www.mydnage.com/.
If we introduce interventions that reverse the cardiac age (by a younger CIMT) or brain age (by a younger brain on MRI), can we reverse the epigenetic age?
In November 2021, Mark, a 61 year old CPA wanted to be younger. He had been doing some things to promote longevity such as not smoking and trying to eat healthy, but not much else.
His first epigenetic age test showed him at 63. Two years older than he was chronologically. This is Mark’s epigenetic clock November 2021.
Assess the cardiovascular system. He had a CIMT which showed his arteries were about average for his age. His CIMT put him at 60, or a year younger than he was. This was November 2021:
He saw Dr Joel Kahn who specializes in reversing cardiac age. Lifestyle modifications were made, supplements were added, and he intentionally worked to reverse his cardiac age.
October 2022, a year later, he repeated his CIMT and had gone backward a decade:
Mark had sleep apnea, tested in November 2021, with a moderate to almost severe level. Advanced sleep apnea shortens the lifespan about 6 years and leads to earlier onset dementia (see my book https://www.alluremedical.com/books/)
We performed NightLase® to reverse the severity of Mark’s sleep apnea, which is shown to extend healthy lifespan. In April 2022, his sleep apnea became clinically insignificant (26.7 down to 7.5):
Now, onto the epigenetic age. Mark started with an epigenetic age 2 years older than his chronological age. He did several things such as a fasting mimicking diet, hyperbaric oxygen treatments, numerous supplements.
He also went on a targeted drug approach of 3 classes of drugs that have an impact on aging. I do not want this blog to be interpreted as a cook book, but for education, so the actual drug regimen will not be disclosed. We started Mark on the following protocol (in addition to maintaining lifestyle modifications)
- Senolytic drug cocktail 3 days in a row every 3 months. Senolytic drugs kill off senile, or senescent cells.
- Gero-inhibitor once weekly for a year. These are drugs that work on a genetic pathway that accelerates aging. These drugs work by inhibiting, or blocking, aging by that pathway (mTOR)
- Growth hormone releasing hormone two months on, two months off.Dr. Greg Fahey demonstrated that he could reverse the epigenetic clock with a specific pattern of growth hormone use.
None of these drugs are FDA approved to reverse age. But they are FDA approved, so they can be used however your doctor feels appropriate.
Remember, at 61 years old, Mark’s epigenetic age was 62.6 months later his epigenetic age went backward to 60:
Mark continued his antiaging protocol and retested his epigenetic age in January 2023, 14 months after he started the program with us:
This last epigenetic test was at a different laboratory, but a similar methodology was used, that is the epigenetic clock. His epigenetic clock went from 62 down to 48. That is 15 years! (14 actual, but one more year went by so 15 years).
Mark has noticed other changes in his body as well. He has less dependence on reading glasses. He is building muscle, losing fat, running, working out, and feels a better overall quality of life. We have not re-measured his brain age, this changes slower, but will later this year.
Healthcare is focused on disease management, and to some degree, disease prevention. We are re-imaging health care to be about health, not disease.
I see this as a few categories of healthcare (which are not always covered by insurance)
1. Restore organ function:
Degenerative joint disease with cellular medicine such as platelets and stem cells.
Chronic venous insufficiency with ablation of diseased valves.
Reversing obstructive sleep apnea with non invasive NightLase®
Restoring vaginal and urinary health with IntimaLase®
Restoring hormone levels with bioidentical hormone pellets (see my books referenced above)
2. Don’t die of anything stupid:
Cardiovascular disease, get a CIMT every 5 years and intervene if needed
Cancer, get a full body MRI and a liquid biopsy (discussed in earlier blogs)
Get a quantitative image of your brain, specifically the hippocampus to predict if you are at risk for early onset dementia.
3. Slow down, stop, and reverse age (I got this quote from Richard Rossi who runs Divinci50, a mastermind group for antiaging of which I am a medical director).
Senolytic drugs on a quarterly basis to kill sick, aged cells that are trying to recruit more sick aged cells.
Geroinhibitor drugs to slow down cellular aging.
Epigenetic clock reversing drugs as described.
Dr. Charles Mok