At each stage of life, we face different health challenges. From the special care and diet for infants to staying healthy on the go for working adults, our health is always a changing landscape. But the stage of life that is becoming more and more important, health-wise? The senior years.
People are living longer than ever nowadays. Our average life expectancy in Canada is now 82.4 years, an increase of 5 years just since 1986. Advances in medicine play a big part in this improvement – however, just because we’re living longer, are we still living well?
As we enter our sixties, all the aches and pains that have been visiting once in a while suddenly seem like they’re always there. We might get tired more easily, and not recover as quickly from exertion. Our digestion rebels a bit more often than it used to. Our medicine cabinet starts to look a pharmacy; (actually, it kind of looks like our parents’ medicine cabinet).
So what is it about getting older that ages us so much? And is this process absolutely unavoidable? Let’s look at how aging affects different body systems and what we can do to diminish it.
Caution: many natural supplements can interact with prescription medications in various ways. Some supplements can reduce the effectiveness of drugs, and some can actually increase the effectiveness of a medication. Although this might sound like a positive thing, your dose has been carefully selected by your doctor to maintain a certain therapeutic level in the body – a higher level can be harmful. If you are currently taking any prescribed medications, please speak to a health care practitioner who is well-trained in the safety and use of supplements and medications before starting to take anything new.
You’re not as young as you used to be, but there’s no reason you can’t feel like you are. You all know that one woman, maybe a neighbor or relative, who always seems to have lots of energy. What’s her secret? How can you have the energy to keep up with your grandkids, or just keep up with your own busy life?
The basic formula for more energy – get more, and lose less. Getting more involves a proper diet (including sufficient water) along with good digestion, to maximize the energy received from your food. Also important is getting enough quality sleep. And how to minimize energy lost? Chronic pain, repeated minor infections, mental and emotional stress – these are all insidious drains on your energy that can leave you feeling wiped out at the end of the day. For an extra boost – Vitamin B12 (along with other B vitamins) is used to produce glucose - the main fuel for the body – from the food we eat. And CoQ10 then helps the mitochondria in your cells turn that glucose into energy.
Skin & hair
Mark Twain said “Wrinkles indicate where smiles have been”. One of the things that contribute to wrinkles are facial muscles flexing in emotional expressions – joy, sadness, anger, excitement – the colours of life that make it worth living.
However, a few other things contribute too, and these are worth controlling. If you smoke, quit! It’s the worst cause of premature aging, both skin deep and throughout the body. Skin structure depends on collagen integrity, and vitamin C and hyaluronic acid are two things that go a long way to maintaining younger looking skin. As well, make sure you get your beauty sleep – it’s not just a phrase, it’s a real thing. And there are even supplements out there that claim to reverse greying by targeting the decreasing levels of the catalase enzyme (that normally prevents the greying of your hair by getting rid of naturally-occurring hydrogen peroxide. The SOD enzyme (superoxide dismutase) also helps prevent that by decreasing oxidative damage from free radical molecules (research indicates it might also be partly responsible for hair falling out). And a bonus – controlling free radicals benefits your health in a lot of other ways.
Bones, Joints and Muscles.
In general, pain is thought of as a sign of inflammation. So it makes sense that controlling inflammation will help with many of those aches and pains. Focus on foods rich in anti-oxidants and omega-3 fatty acids. Using spices such as cinnamon and turmeric also help. Even more potent are supplements that provide a concentrated form of these foods, like fish oils (for omega-3s) and curcumin (the active component of turmeric).
Long-term suggestions would concentrate on supporting the general health of your bones and the connective tissues that hold your joints together. Having a diet high in calcium-rich fruits and vegetables is much more beneficial than getting your calcium from dairy sources, which can affect the pH level in the body in such a way that it might actually be harmful for bone health. Vitamin C is integral to the health of ligaments and tendons. And we can’t forget the role that exercise plays – regular, moderate exercise that includes a mixture of cardiovascular and weight-bearing will give you the most health benefits overall. For reducing chronic pain from conditions such as osteoarthritis, acupuncture can be very effective.
Cognition – “Use it or Lose it”
Modern medicine has made incredible breakthroughs that can keep our bodies alive longer, but it lags behind in supporting our cognitive health. And how else will you know if you’re actually enjoying your golden years or not?
Studies have shown that the idea of “use it or lose it” definitely applies to your mind, so keeping mentally active is a great idea. Puzzles such as crosswords, Sudoku, or playing challenging games like chess or bridge are a great way to stay busy and keep healthy. Nutrition is certainly important – nutrients like vitamin B12, omega-3 fatty acids (especially DHA), CoQ10 and vitamin E. High blood pressure is also a risk factor for cognitive decline. Finally, certain medications have recently been associated with a higher risk of developing dementia – for example, long-term use of proton-pump inhibitors (a common class of antacid drugs used to treat heartburn and ulcers). Finally, many other medications can cause symptoms of dementia that will often disappear when the medication is discontinued.
Quite recently there has been some extremely exciting work coming from the American functional medicine community (“functional medicine” is what medical doctors call it when they practice like medically-focused naturopathic doctors). One clinical study significantly reversed the effects of Alzheimer’s disease in multiple patients using a carefully-designed protocol that included monitoring certain lab values and optimizing health targets primarily using natural supplements and other interventions.
A common misconception is that people need less sleep as they get older. Closer to the truth would be that it’s just harder to get the same duration and quality of sleep. Melatonin production decreases with age (this is the hormone that helps us fall asleep). Joint aches and muscle pains can keep you from finding a comfortable sleeping position (as we saw earlier in this article). And many find they have to get up to urinate more often during the night. Finally, snoring is more common as people age – a variety of factors contribute to this, including increased weight and weakening of the muscles in the throat.
What can you do? A melatonin supplement is cheap, safe, and often very effective. Most come in a standard 3 mg dose; if you find you’re groggy the following morning, try a half dose. Limit your fluid intake later in the day, especially anything containing caffeine or alcohol. If you’re on a diuretic medication for high blood pressure, talk to your doctor about moving your dose earlier in the day (and keep reading to find out how to quit your medication altogether). And maintain a healthy weight – this benefits you in lots of ways other than just sleep. If it’s your partner who snores, get a good pair of earplugs, or consider sleeping in another bedroom if it’s really bad.
Let’s start at the beginning – in the mouth. A diminished sense of taste and smell is a common complaint among seniors. This can result in what is called the “tea and toast” diet – food doesn’t taste as good, making it less enjoyable to eat, and so you might be tempted to just go with what’s easy. Unfortunately, this limited diet can lead to nutritional deficiencies – one of which (zinc) might have been the cause of the loss of taste and smell in the first place. Another factor – dental work. Dentures might make it harder to enjoy some of the foods you used to love, including the fresh fruits and vegetables that are so integral to a balanced diet. A popular and easy fix? Smoothies – all your favourites blended up together in an easy-to-swallow meal. Just watch the sugar content.
Next up, we come to the esophagus and stomach, the source of heartburn. Too many people take antacids for this common problem – only thing is, most of the time heartburn isn’t caused by elevated stomach acid, but rather low stomach acid, which means the muscle at the bottom of the esophagus isn’t closing properly. This allows acid from the stomach to contact this sensitive tissue, resulting in that familiar burning sensation. Stomach acid production naturally declines with age, so give it a boost with some digestive bitters just before any larger meals – especially ones containing protein.
Finally – the intestines. Your small intestines continue the digestion process, and carry out most of the nutrient absorption. Healthy levels of beneficial bacteria are vital for this, which come from cultured foods like yogurt, sauerkraut, and more exotic drinks like kombucha and kefir. If that sounds too complicated, just pop a probiotic pill – look for a mix of bacterial strains and a number in the billions. Almost to the end is the large intestine. Problems here include gas and bloating, and the dreaded constipation. Gas usually results from food that hasn’t been properly digested and absorbed in the small intestine. Constipation can generally be fixed by drinking enough water and having plenty of fiber in your diet. If you’re concerned, take a fiber supplement. Psyllium is the fiber in brands like Metamucil, only without the artificial colours, flavours and sugars.
According to the Heart and Stroke Foundation, in 2012, one person died every 7 minutes of heart attack or stroke. And up to 80% of premature cardiovascular disease is considered to be preventable with simple lifestyle changes.
One of the most recent health myths to fall is cholesterol. For years, cholesterol was the devil, to the point where statins (the class of drugs to lower cholesterol) became the most-prescribed class of drugs in North America. And while it’s true that having elevated cholesterol can be a risk factor for cardiovascular disease – that’s only when there’s inflammation present. Without inflammation, cholesterol acts only as the precursor for making certain hormones. But if there’s inflammation in the blood vessels, your body uses cholesterol to plaster over the damage as a quick fix. The more layers that are applied, the more it blocks your arteries, eventually leading to heart attacks and angina - yet another reason to control inflammation.
High blood pressure is pretty much ubiquitous among seniors. In the 60 to 79-year-old group, 52% of people have a diagnosis of hypertension (compared to 22% in the 40 to 59-year-old group). Lifestyle changes including a healthy diet, regular exercise and meditation can be very effective at controlling blood pressure. Add to that supplements like garlic, magnesium, and CoQ10, and you can certainly reduce your blood pressure medications, or possibly even quit them altogether.
This is another system that just naturally decreases with age, for a few reasons we already talked about. That low stomach acid that gives you heartburn? It also means that your first line of defense for bacteria and parasites could be compromised. That tea and toast diet? Not the optimal nutrition that your immune system needs. And the lack of sleep only makes it worse. The last thing to consider is stress – which has a huge negative effect on the health of your immune system. It’s never too late to learn how to really deal with your stress (instead of just pushing it down and pretending it doesn’t exist - more on that below).
But general immune support involves getting your vitamin D levels checked and supplementing if necessary; using proven immune boosters such as astragalus or medicinal mushrooms; or for minor acute illnesses like a cold or the flu, herbs like Andrographis and Echinacea and minerals such as zinc and selenium can get you back on your feet sooner.
After statins, anti-depressants are the second-most prescribed class of drug in North America. And according to some experts, they’re also the drugs that are the most-often wrongly prescribed. When a neurotransmitter imbalance is at the root of those symptoms of depression, then anti-depressants can be a lifesaver.
But what about when depression is secondary to other things? Stress over health concerns or financial problems, loneliness following the death of a partner or lifelong friend, nutritional deficiencies from a poor diet, decreased activity level, or even having less sex – these are all things that can cause symptoms of depression. And in most of these cases, an anti-depressant will have a minimal effect, if any at all. But adaptogenic herbs and B-vitamins help your adrenal glands cope with chronic stress. And meditation is easily the most ignored yet most effective self-care for stress. Other things to rule out – low hormone levels such as thyroid, testosterone, estrogen or progesterone.
Two problems are just for the men who are reading – prostate issues and erectile dysfunction. First, a quick anatomy lesson - your prostate is a small gland located inside the body approximately between the testicles and anus. The urethra passes directly through it before entering the penis to carry urine out of the body. So if you’re experiencing a delay in starting urination, or stopping and starting, or dribbling, there’s a good chance (about 75% if you’re over 70) that you have an enlarged prostate. This is either BPH (benign prostatic hypertrophy) or prostate cancer. Obviously the second one is worse, but even that might not be as bad as you think. Many forms of prostate cancer are very slow-growing, so depending on your age and the severity of your symptoms, you might not need to have it treated at all. Tests for this include PSA and having a DRE done by your doctor.
On to erectile dysfunction – this could be from decreased testosterone (called andropause). More likely it’s caused by one of the conditions we already looked at: high blood pressure, atherosclerosis, or simply from being overweight (fat tissue produces estrogen, further skewing the hormone balance). Fix those things, and the problem will likely be dramatically improved. Now how to treat your wife’s chronic headaches…
After surviving menopause, all sorts of other issues come up from the sudden decrease in hormones. Osteoporosis is one of the most common health issues among older women, resulting from lower estrogen levels. This can also lead to decreased libido and vaginal dryness. Hormone replacement therapy is something that can help dramatically, but should be considered carefully on an individual basis.
A gentler solution can be herbs that contain phytoestrogens – “plant estrogens” – which act as hormone modulators. These compounds resemble hormones closely enough that they can interact with estrogen receptors and weakly stimulate them. But in cases of estrogen being too high, they can also decrease the effects of estrogen by occupying those same receptors – hence the “modulatory” effect. Soy products and flax seeds are two of the most well-known examples of phytoestrogens. Equally crucial for protecting bone density is regular, weight-bearing exercise to stimulate bone growth.
Final words: am I claiming that by using natural medicine, you can get off every one of your medications and solve all your health problems? Absolutely not. But I can guarantee that working with a properly-trained naturopathic doctor can improve your health, decrease your need for certain medications and leave you feeling better. Because what’s the point of living longer if you can’t enjoy it?
Dr. Reuben Dinsmore, ND
Reuben Dinsmore is a naturopathic physician in Vancouver, BC interested in opening up the lines of dialogue around health.