Episode 59: Optimizing Longevity

Adding years to your life is only beneficial if you have the ability to enjoy them thoroughly. In this episode, Jeannette Queen, Nurse Practitioner, shares the role our hormones and stress play in anti-aging to maximize your golden years.

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The content of this podcast has not been evaluated by Health Canada or the FDA. It is educational in nature and should not be taken as medical advice. Always consult a qualified medical professional to see if a diet, lifestyle change, or supplement is right for you. Any supplements mentioned are not intended to diagnose, treat, cure, or prevent any disease. Please note that the opinions of the guests or hosts are their own and may not reflect those of Advanced Orthomolecular Research, Inc.

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Welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. We are all about applying evidence based and effective dietary lifestyle and natural health product strategies for your optimal health. In each episode, we will feature very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.

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 [01:43] Cassy Price: Welcome to Supplementing Health. I am very excited to introduce today’s guest Jeanette Queen. She is a nurse practitioner with a masters in nutritional and metabolic medicine as well as advanced training in functional medicine. For this discussion we will exploring hormone management for healthy aging and longevity. Welcome Jeanette.

[02:00] Jeanette Queen: Thank you Cassy.

[02:02] Cassy Price: So, when we talk about aging it conjures up images of skin spots, wrinkles, grey hairs and the like but there are factors outside of just the physical appearance. What are some of those factors of aging that people should be taking into consideration?

[02:18] Jeanette Queen: You know I think you are right. When we talk about aging everybody gets these bad images in their head but there are plenty of people who age very well and are very healthy well into their 80s and 90s. They stay active and their brain is engaged, and they are happy. Your older years should be some of the best years of your life. You’re financially usually more stable. You don’t have kids at home to worry about. Often you are retired and don’t have to work all the time. We really need to focus more on positive aging and focus on muscle and hormones and aging better.

[03:02] Cassy Price: So, what is normal when it comes to aging then? I think this word normal is kind of confusing. What one person’s normal isn’t necessarily what someone else’s normal is as you kind of alluded to that lots of people can age healthily to 80 and others maybe are suffering from ailments like dementia or other classically known as aging ailments.

[03:26] Jeanette Queen: Yes. I hear this all the time from patients. We are so quick to call things normal. “That is normal.” Your achy, your tired, you are this and that. Just because it is common doesn’t mean that it is normal. Again, I have plenty of patients or we have all met people who are in their 80s and have more energy than a lot of people do in their 30s. I think we have to be very careful to stop calling things normal aging because that does mean something different to everyone else.

[04:00] Cassy Price: So, actually on that point where you were saying that some people in their 80s have more energy than those in their 30s, can the aging process be reversed to some degree then?

[04:10] Jeanette Queen: I believe it can be. Everything that we do especially lifestyle and nutrition and exercise and hormone replacement therapy because you know that is a lot of what I do but how we sleep, how is our stress, do we have a sense of community, do we have a sense of purpose and belonging in this world? All of those things have such an impact on how we age and as far as hormones go there is always the question of do we age because we lose our hormones or do we lose our hormones because we age? In that round that is why a lot of what I do, people come to me for hot flashes and night sweats and different issues but really the part that I am looking at bigger and wider with hormones and everything I do is how can I help people age better?

[05:03] Cassy Price: Speaking about the hormone declines, HGH is a hormone that we associate with kids growing up and that sort of thing, but the production declines as we age, and it has been hypothesised that the decline in the secretion creates that aging process so if we can slow the decline, we can slow the aging process. What are your thoughts on growth hormone and these theories?

[05:30] Jeanette Queen: Well, it certainly makes sense. I think some of the original research on growth hormone was blown out of proportion but definitely growth hormone can help so many things.As you said has been thought to counteract the aging process. You see people claim that they build more muscle, increase fat loss, improve mood and sleep improves. So, again with all of my patients the idea is always to increase growth hormone hopefully naturally. I have seen people use growth hormone and it be tremendously beneficial. I have seen people use growth hormone and it not be that beneficial. I think it depends on the individual. There are other ways now that we can increase growth hormone using different signalling molecules and different things but even lifestyle and other hormones will help increase the growth hormone naturally. I think that is always in the back of my mind, how do we help people increase growth hormone?

[06:37] Cassy Price: Have you ever used secretagogues in your practice to increase growth hormone?

[06:42] Jeanette Queen: I have with mixed results really. Some people can tell the difference and feel really good. Some people don’t notice that much of a difference. So, it really depends on the person but in my practice, I measure IGF-1 is kind of a marker of growth hormone and sometimes I even measure growth hormone and I do sometimes see movement in the growth hormone with secretagogues but not always. So, it is very individualised as far as that goes.

[07:16] Cassy Price: Okay. Another hormone that is thought to play a role in increasing longevity is DHEA. What is it about the role of DHEA hormonal symphony that has given it the nickname of that longevity hormone?

[07:31] Jeanette Queen: Well, DHEA is a prohormone that we make all of the hormones from although some research is mixed on DHEA, we don’t even really understand all that it does but one thing we do know is that if there is a drastic reduction in DHEA and testosterone in men it can be predictive of death so in that respect it can be a precursor to longevity if you keep it up. So, it does so many things and benefits so many things; skin benefits, increased muscle mass, increased fat burning, it is neuroprotective, it improves memory, it improves mood, it helps with blood sugar metabolism, enhanced sexuality, it improves survival in many things, it improves wound healing, it helps with the cardiovascular system, immune function. DHEA also has even shown to be anti-viral. So, they are looking at it even with Covid. For people with autoimmune disease, it just has so many implications and does so many things. I can certainly see why many people call it the longevity hormone.

[08:51] Cassy Price: That is really cool. I didn’t realise that DHEA had that immune benefit there. So, aging in general is also associated with a decline in your immunity. What, if any, is the relationship between this decline and hormone function outside of DHEA?

[09:12] Jeanette Queen: Well, really all of the hormones can affect immunity but DHEA and testosterone especially are anti-inflammatory, and they directly affect both TH1 and TH2 response within the immune system. That is very important. That is why I think mostly it comes into play. Oestrogen is anti-inflammatory as well. You change the inflammatory response you change immunity. Cortisol as we know can completely mess up everything as far as immune function because it affects all of the other hormones. Yeah, as far as hormone replacement therapy DHEA and testosterone are extremely important for immune function.

[09:58] Cassy Price: Would testosterone affect men and women in the same way, or would it be more prominent for men since it is their more dominant hormone?

[10:08] Jeanette Queen: As far as immune function it does impact both.

[10:13] Cassy Price: Then would it be the same for the aging process as well then?

[10:17] Jeanette Queen: Yes. Just more of it. It is just how much you give. As far as Oestrogen goes that is different. Women need more and it is definitely more antiaging for women, but men need it a little bit too. It is just the different hormones effect men and women differently.

[10:37] Cassy Price: So, then jumping a little bit, evidence from animal models suggest that in addition to its effects on glucose metabolism metformin may influence metabolic and cellular processes associated with development of age-related conditions. Just last week we were talking to a couple of the ladies from Conceive Health about PCOS and its commonly used to help manage PCOS which has that endocrine dominance. What are your thoughts on this substance and is it possible that it has effects on longevity?

[11:17] Jeanette Queen: Well, really this seems that it is new that metformin is this antiaging drug but really it has been touted in the antiaging world for probably well over 20 years now. We really don’t know how metformin works. It probably has lots of targets and has different mechanisms of action. We know it inhibits glucose production in the liver, so it helps with blood sugar control, helps insulin sensitivity which is why also it helps so well with PCOS and it reduced glycation because it lowers blood sugar, so it helps in so many areas and in some of the antiaging pathways anyway. I do think we have to be careful with it. Some people do not tolerate metformin. It causes in some people significant GI side effects that can sometimes be helped with the dose. Every drug has side effects, so we do have to be careful with that. You know my thoughts on this, I am not afraid to use metformin, I measure insulin, I measure insulin resistance, I use an insulin resistance calculator in my practice and if people are insulin resistant, I will definitely will use it. I also think about berberine. In a lot of studies berberine has been as effective as metformin in control blood sugar with very little side effects. It is not hard on the liver or kidney. Often times I talk to my patients and talk about the risks and benefits to both but with all of this information that we have on metformin I am not afraid to use it, if that makes sense?

[13:10] Cassy Price: Absolutely. That makes sense. Now, if insulin resistance is the big player that people look to metformin for, what kind of impact does that have on the aging process or the cells?

[13:24] Jeanette Queen: So, when you become more insulin resistant then your blood sugar goes up, as blood sugar goes up it increases inflammation and it also increases damage to cells in general so anything you can do to reduce blood sugar and reduce inflammation obviously is going to help the cells survive longer and stop so much cell destruction. So, that helps. It helps in many of the other pathways as well but in a nutshell and for ease of instruction I think that is the best way to describe that.

[14:07] Cassy Price: Okay. That makes sense for sure. Another somewhat trend that has been talked about for longevity is intermittent fasting. It’s been said to have a positive impact on the metabolic process and of course in turn linked to aging. Fasting can actually increase levels of stress hormone cortisol which as you mentioned can have negative impacts on all of your hormones and other functions within the body. So, can you speak to this relationship and how someone can go about finding a beneficial balance between intermittent fasting to get the positive impacts on their metabolic processes before doing damage?

[14:50] Jeanette Queen: You know what, I have this conversation very frequently in my practice because I see people when they are stressed and they are sick and they are tired and all these things and I have read the studies and I have listened to the conferences and I have read about the benefits of intermittent fasting but I also have patients sitting in front of me and I don’t necessarily think that it is the best thing for them when they are in this state for me to tell them “Okay, by the way you need to starve yourself.” As you say, in many people cortisol goes up and I see it. The benefit that I have is that I can measure these things and I can see cortisol goes up or changes in lipid metabolism and different markers that aren’t always beneficial. My answer to that a lot of times is why don’t we just start slowly and work backwards because do we need to eat all the time? No. Does it help not to eat all the time? Probably yes. At the same time if people are already stressed and they are not managing their blood sugar as well it causes changes in cortisol so what I suggest the number one thing to focus on is a low glycaemic index diet, so you are not getting the ups and downs in blood sugar to begin with. Also, with intermittent fasting many people are skipping breakfast which there are plenty of research to show that if you eat a good breakfast your blood sugar stays more balanced the whole day long.

[16:38] Balancing our blood sugar and keeping our blood sugar low is one of the most important things to do for healthy aging. So, if people want to do intermittent fasting or time restricted eating I have them do it the other way. I say eat breakfast, eat lunch, eat an early dinner and then fast for the evening. The other thing I will start with is to try to start with no snacks and work it that way rather than to tell people don’t eat for two to three days. I like to work it in that way because ever since all of this came out about intermittent fasting that is immediately what I thought of the cortisol response. Like I said, I see it.

[17:23] Cassy Price: I have also read in studies that it is actually more beneficial for men than for women and I assume that is due to the differences between their hormonal makeup. Would that make sense to you as well? Have you read anything on that?

[17:39] Jeanette Queen: I haven’t read anything on that but that does make sense to me. Absolutely. Still, it depends on the person and it depends on what is going on with them. What is their target and how sick are they? If they are this healthy human being who is not stressed and all these things, they would tolerate it better, but other people might not. Also, you have to take into account their activity. Some people who are saying they work out better and it improves their workout but sometimes it doesn’t. I think it is very individualised. Even looking at genetics. What is their COMT? You have to look at all of these things. How people produce cortisol. How people manage cortisol. I think take that one on an individual basis.

[18:44] Cassy Price: Okay. Now you do a lot of hormone replacement therapy in your practice, correct?

[18:51] Jeanette Queen: Yes.

[18:52] Cassy Price: So how can that hormone therapy support healthy aging and increase longevity then?

[18:58] Jeanette Queen: So, this is my favourite part of what I do. Hormones support healthy aging from head to toe literally. As far as longevity I am not so sure on the studies as far as actual living years but the quality of life, absolutely. Oestrogen as I said is anti-inflammatory. It improves skin, hair, teeth, bones, mood and sleep. It has shown to be neuroprotective. It improves memory. Progesterone helps with sleep which is one of the most important things we can do to age well is sleep well. Mood and bone. Testosterone has positive effects on muscle which is also one of the key factors for antiaging that people overlook, cardiovascular health, mood, motivation, drive, libido. DHEA again we talked about earlier but cardiovascular health, bone health, neurologic improvements, skin health. It also improves sarcopenia. One of the number one thing that we have to do is maintain our muscle mass to age healthy. Pregnenolone is something we don’t talk about a lot but it is neuroprotective and improves memory. You know there is thyroid, vitamin D, melatonin and all these things. Literally, from top to bottom and inside out and head to toe you name it hormones effect every aspect of aging.

[20:34] Cassy Price: So, you mentioned two pieces that I would like to dive into a little bit deeper. The first is the heart health piece there. It is believed that the decline in nature oestrogen levels may be a factor in heart disease increase, especially in menopausal women but birth control pills have been shown to increase blood pressure levels which is a risk factor for heart health. I realise generally it is younger women that are on birth control pills. Can you share how that shift or that hormone replacement in birth control pills can lead to an increased risk factor yet using hormone replacement therapy later in life can actually decrease that risk, like the ratios or what the shift is there?

[21:20] Jeanette Queen: Sure. So, it is a very important point that women understand especially now that more and more people, I have seen anyway, a lot of women are put on birth control pills and ‘hormone replacement therapy.’ They actually work exactly the opposite. Birth control pills are made up of a super oestrogen that really impacts the liver and the gall bladder, and it stays on the receptors. So, even though the dose might not be a lot higher, or we don’t even consider dosing, we do a little bit, but it is a super acting oestrogen that is so much harsher and stays around longer than any hormone we use in hormone replacement therapy. Again, oestrogen is one of the most important anti-inflammatory hormones, but it can also be proinflammatory particularly when taken orally which is one of the big problems. The other problem, the biggest problem in birth control pills is the progestin. Naturally occurring progesterone effects our brain, our heart, our blood vessels in positive ways where the progestin in birth control pills actually works the opposite in every place including the cardiovascular system except the uterus. It was developed to prevent the build up of the lining of the uterus, but it actually has very negative effects on the cardiovascular system. That is one of the things when people talk about “my doctor put me on progesterone” but they are actually on progestin. It actually drives me a little bit crazy because they are very different and nowhere else in medicine do we take two different molecules that are very opposite and call then the same thing. You would never give a progestin to a pregnant woman yet we use progesterone in pregnancy. One is a Class B drug, and one is a Class D drug. They are very different, but we call them the same thing. So, that is where we get the biggest difference in the cardiovascular risk. One we get a super active oral oestrogen that creates all kinds of metabolites that we don’t want on top of the progestin which is also not beneficial in the cardiovascular system.

[23:56] Many women are very surprised to know this but if I do blood work or any type of hormone testing on any woman no matter how old she is, even 19 or 20 years old, who is on birth control pills, you would not be able to tell the difference in her and an 80-year-old woman. All of the hormones are suppressed because the birth control pill suppresses hormone function whereas hormone replacement therapy gives the body hormones.

[24:27] Cassy Price: So, for girls that have been on the birth control pill and are maybe coming off because they are wanting to start their family or for other reasons, would it make sense to do hormone replacement therapy as part of coming off potentially?

[24:41] Jeanette Queen: Well, some people need that but thank goodness our body is resilient and it will come back and start functioning on its own once you take that suppression away. With some birth control methods, it takes much longer than others but usually when you stop the pill hopefully the body will kick in and start functioning properly again. You have to think about all of the hormone suppression that we are doing in particular the androgens. In the younger years which are the only years that we build bone. So, you have someone with low testosterone and low DHEA all of the years of their teens and 20s and even into their 30s and then we take them off and we wonder why we see all of this osteo-pain and osteoporosis. It is just a thought.

[25:39] Cassy Price: Yeah. It is a good thought. It was the second part that I wanted to explore with you from the oestrogen effects that you had listed there. So, my question was what exactly is the role that oestrogen plays in bone health that links it to that osteoporosis?

[25:58] Jeanette Queen: We know that oestrogen is one of the best treatments that we have for osteoporosis and for bone health. Oestrogen actually inhibits osteoclasts and increases the osteoblastic bone formation. It also directly inhibits bone reabsorption. So, oestrogen does literally help us build bone as does testosterone. Even in men we have to be careful with testosterone therapy or androgen replacement therapy because often times men are using or given, even by me, an astrosol to keep the oestrogen down but you don’t want to drive the oestrogen down too low in men either because we see bone loss. Oestrogen and testosterone and DHEA and progesterone are but mostly oestrogen and testosterone help build the bone directly through reducing osteoblasts and increasing the bone building cells.

[27:04] Cassy Price: Calcium is one of the minerals that come to mind first when you are thinking about bones and bone loss. Does oestrogen and testosterone play a role in that absorption or does taking extra calcium or other nutrients help the testosterone and oestrogen function correctly?     

[27:23] Jeanette Queen: Well, you have to have calcium present for them to work but there were some recommendations many years ago that post-menopausal women that we no longer recommend calcium supplementation to them because we see it build up in the arteries of the heart. So, again then you have to get into the whole D3K2, vitamin K2 thing, and you want to keep inflammation low and you want to keep all of the other hormones in check because you want the calcium in the bone and not in the arteries.

[28:01] Cassy Price: Okay. So, I was going to speak to cortisol and the role it plays with that as well then because if you are stressed out we know that can suppress your oestrogen levels and so that would potentially also exacerbate that issue if you are already low in oestrogen?

[28:22] Jeanette Queen: Absolutely. Even when you are not. Cortisol is a catabolic hormone. It builds and breaks things down from brain to bone to skin to whatever. That is why stress will affect every aspect of aging and also when you think about it with bone especially one of the things that when you are under a lot of stress you chew through your minerals. You have an increased mineral need which what do we see lacking in our fresh fruits and vegetables and lack of minerals and people focus on vitamins and forget about minerals. That is another way in which cortisol and high stress break down bone. Also, bone itself, I had found an article possibly last year when one of the physicians in my group shared it with us again, that bone actually secretes stress hormone when we are under stress. We think bone just kind of hangs out and supports our body, but bone is metabolically active also. So, all of these things, hormones in general and too much stress all affect bone health.

[29:39] Cassy Price: That is really cool. I didn’t know that about bone secreting stress hormone.

[29:45] Jeanette Queen: It’s fascinating. There is so much we don’t know.

[29:47] Cassy Price: Then one last piece of this bone and joint health is lean muscle mass. Our muscles actually support our joints and our bones and can be part of preventing that deterioration, correct? So, then the lean muscle mass can also impact your hormone balance can it not?

[30:08] Jeanette Queen: Yes. Hormones effect the lean muscle mass. Sarcopenia or loss of muscle mass is one of the most important aspects of aging that gets overlooked so often. It is so important because as you said when you work your muscles you put stress on the bone and that leads to healthy bones, but muscle in itself impacts our glucose metabolism, our metabolism in general and our health. Anything we can do to preserve muscle is going to help us age better. Keep moving. Keep the right hormones. Keep the right nutrients. All those things are so important to health.

[30:56] Cassy Price: If you had to pick top three tips that you would give someone to provide healthy aging what would those be?

[31:10] Jeanette Queen: Healthy aging in general?

[31:13] Cassy Price: Yeah.

[31:15] Jeanette Queen: It would be lifestyle; healthy diet and exercise, stress reduction, sense of community and connection and hormones. That is four.

[31:28] Cassy Price: That’s alright.

[31:31] Jeanette Queen: They are all important. The interesting thing is that testosterone and DHEA are truly the two key antiaging hormones as we know. Like I said, especially in men when you see a rapid drop off death is imminent. I saw a very healthy 83-year-old woman. She was still running. She did not have grey hair. She would take the old people out to lunch. She was still working on a farm. You know in her serum, her DHEA and testosterone were still high, and she was not on anything. That is where I think genetically some people age better than others but some of us probably have to work a little harder or we have to replace a little more. That was fascinating to me. This 83-year-old who literally did not look a day over 60 and didn’t act like either was strong as an ox and her hormones looked like someone much younger than her naturally even.

[32:38] Cassy Price: Do you think mindset plays a role in that as well?

[32:42] Jeanette Queen: Absolutely. You know it is not a vicious cycle, but it is a cycle because when your hormone levels are optimal you feel better and your outlook is better. You have more serotonin and you have more GABA and you have more oxytocin and all of those things. Men and women both, their mood and their outlook on life changes when their hormones are healthy and nutrition and all of these things. Whether you have to replace it to get that outlook better, or your outlook is already better. Exercise also improves hormone balance. It improves mood and all those things. Everything impacts everything. Some people, like I said, it is a little bit easier and have better genetic predisposition to all of these things. If you don’t you have to do what you can do to augment it. You have to have a little more upkeep as we get older.

[33:46] Cassy Price: At least we live in a time where we know what the upkeep is, and we have options out there to do that. Like you said 80 is the new 60 if you want it to be.

[33:57] Jeanette Queen: Yes. Very true. There are lots of substances that are coming out all of time to help us age better that we know increase longevity. So, yeah all of these things make such a difference. You know somebody came to me the other day and it was interesting. He said “You pay now, or you pay later. You pay now with exercise and eating right but then you age better. If you don’t do that now, then you don’t age as well.” I thought that was a really important insight.

[34:30] Cassy Price: Yeah. I think that is great. Honestly it is not worth living the extra years and having that longevity if you are not going to have the quality of life to enjoy those extra years, right?

[34:44] Jeanette Queen: Instead of lifespan we are looking at health span.

[34:51] Cassy Price: Exactly. So, we can actually enjoy our time with family and friends and your community in general. Awesome. Well, this has been a fantastic conversation and I have really loved chatting with you Jeanette. If our listeners want to work with you, how can they get a hold of you?

[35:05] Jeanette Queen: So, my clinic is called EvolveWell and we are located in Mission and you can contact the clinic either through our website at evolvewell.ca or call the clinic at 5877749355 either way.

[35:25] Cassy Price: Awesome. Thank you again. This has been fantastic, and I really appreciate you taking the time to chat with me.

[35:31] Jeanette Queen: Thank you Cassy.  

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Thank you for listening to Supplementing Health. For more information about our guests, past shows, and future topics, please visit AOR.ca/podcasts or AOR.us/podcasts. Do you have a topic you want us to cover? We invite you to engage with us on social media to request a future topic or email us at [email protected] We hope you tune in again next week to learn more about supplementing your health.

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